Bacterial infections
of the female urinary tract are a frequent clinical problem. In general, women experience urinary tract
infections (UTI) much more than males due to their shorter urethra, which
drastically reduces the distance bacteria must travel to access the
bladder. Though teenagers and young
adults are often the population associated with such infections due to the
onset of sexual activity, increasing age is actually one of the more important
risk factors for the onset of UTI, since incontinence, or a lack of bowel or
bladder control, and a decline in kidney function are diseases more associated
with adulthood. Fall and winter also
seem to be the months where most UTI’s are reported; therefore, it’s important
to highlight just what a UTI is, what the risk factors are, and how they can be
managed in order to prevent their occurrence.
What is a Urinary
Tract Infection (UTI)? UTI’s are an
infection in any part of the urinary system—the kidneys, ureters, bladder, and
urethra. Most infections involve the
lower urinary tract, including the bladder and urethra.
What causes a
UTI? UTI’s often occur when bacteria
enter the urinary tract through the urethra and begin multiplying in the
bladder. Normal urine is sterile and
contains fluid (mostly water), salts, and waste products, and is free of
bacteria, viruses, or fungi. Infections
occur when microorganisms, usually bacteria from the gastrointestinal tract,
enter via the opening of the urethra, the hollow tube that carries urine from
the bladder to exit the body. There are
2 main types of UTI:
1.
Infection of the bladder, or cystitis: The type of UTI is usually
secondary to E. coli, a type of bacteria found in the gastrointestinal (GI)
tract of normal, healthy people. The
seeding of E coli into the urethra is often due to sexual intercourse, but
patients do not need to be sexually active to develop this type of
infection.
2.
Infection of the urethra, or urethritis: This type of UTI occurs
when GI bacteria spread from the anus to the urethra. This is another example of why women are
victims of UTI more commonly than men—the close proximity of the female urethra
to the anus makes this type of infection much more likely.
Risk
|
Description
|
Being female
|
Shorter urethra means easier access for bacteria
|
Sexual activity
|
Accidental seeding of E coli into the urinary tract
|
Certain types of birth control
|
Women who use diaphragms carry a higher risk
|
Completing menopause
|
Lack of estrogen can cause changes to the urinary tract
that make it more vulnerable to infection
|
Any blockages to the urinary system
|
Kidney stones or enlarged prostate can trap the urine in
the bladder and increase infection risk
|
Antibiotic Use
|
This could kill off the beneficial microorganisms of the
urinary system that could predispose a patient to colonization from a harmful
strain
|
How do I know if I
have a UTI? UTI’s do not always
carry signs and symptoms, but if you are symptomatic, the most common
complaints include: a strong, persistent urge to urinate (urinary urgency), a
burning sensation when urinating, passing frequent, small amounts of urine
(urinary frequency), cloudy urine, strong-smelling urine, pelvic pain in women
or rectal pain in men, and urine that may appear red, bright pink, or “cola
colored”—a sign of blood in the urine.
If someone has a UTI that goes undiagnosed for an extended period of
time, the infection can spread to the kidney and cause a kidney infection, or pyelonephritis. Pyelonephritis is a much more serious
infection that carries more broad signs and symptoms, including a high fever,
shaking and chills, nausea, vomiting, and upper back or side (flank) pain.
Part of the urinary tract affected
|
Signs and Symptoms
|
Kidney
(acute pyelonephritis)
|
Upper back or side (flank) pain
High fever Nausea or vomiting Shaking or chills |
Bladder
(cystitis)
|
Pelvic pressure
Lower abdomen pain Frequent urination Blood in urine |
Urethra
(urethritis)
|
Burning with urination
|
How is a UTI
treated? Uncomplicated UTI’s are
usually easily treated with antibiotics, as they are mostly bacterial in
origin. The type of antibiotic
prescribed varies depending on the type of infection, but, usually, some
commonly prescribed treatments include: Trimethoprim-sulfamethoxazole (Bactrim,
Septra), Amoxicillin, Nitrofurantoin (often indicated in pregnant patients),
and Ampicillin, among others. In
addition, proper hydration is often required to help clear the bacteria from
the urinary tract. In general, symptoms
clear within a few days of treatment.
Doctors may also prescribe a pain medication (analgesic) to help numb
the bladder to relive symptoms of burning with urination. It should also be noted that a common side
effect of urinary tract analgesics is discolored urine, often turning urine
orange or red.
What if my symptoms get
worse? Often, women who have had a
UTI before can self diagnose their subsequent infections based on similarity of
symptoms and expect equal bacterial clearance and symptoms resolution with
similar treatments. However, if not
promptly treated, UTI can have serious consequences, which may include:
recurrent infections, permanent kidney damage from acute or chronic kidney
infection, increased risk of women delivering low birth weight or premature
infants. It is important that if you
feel as though you have an infection, please seek medical help as soon as you
can.
What can I expect
when I see my doctor? Your doctor
will likely inquire about the frequency of the infection and what has worked in
the past and any side effects experienced from certain medications. They will also need a urine sample in order
to examine for typical infection markers of UTI.
Connect with your Urinary System
What is the urinary
system? As stated before, the
urinary system is the system where urine is made and evacuated in the
body—urine is initially produced in the kidneys, flows out from the kidneys in
the ureters and into the bladder, before being expelled from the body through
the urethra.
How does E coli cause
UTI? E coli are a normal inhabitant
of the human gastrointestinal tract.
Following accidental colonization into the urethra, small appendages on
the bacteria called fimbria allow for the organism to attach to the bladder
surface. Once attached, the bacteria
secrete chemicals to allow for penetration into the cells of the bladder. Inside these cells, the bacteria continue to
replicate. Once a sufficient bacterial
colonization occurs and if no treatment has been administered, the bacteria can
ascend the ureter towards the kidney.
Urine tests showing + nitrites or
leukocyte esterase are highly suggestive of UTI. Nitrites are positive due to bacterial
reduction of endogenous human substances called nitrates into nitrites. Leukocyte esterase is an enzyme secreted
from the natural human immune system white blood cells that aids in
inflammation and migration of our body’s immune cells toward the site of
infection to help clear the unwanted bacteria.
How does the body
work as a unit? The urinary system
is responsible for clearing the normal waste products produced by the human
body. If, for any reason, this system is
blocked or cannot function properly, these wastes build up and can have drastic
effects on every organ system.
Harmonize with Body
What is some
lifestyle advice? First and
foremost, proper hydration is key. It is
always important to drink enough fluids, especially water, to help dilute urine
and flush out any bacteria that may be present incidentally. Additionally, all patients, especially women,
must implement proper wiping techniques after using the restroom—wiping front
to back helps prevent bacteria from the anal region from being accidentally
implanted at the urethra. Additionally,
emptying your bladder soon after intercourse can also help prevent this improper
seeding. Finally, avoiding potentially
irritating feminine products like deodorant sprays or douching can help prevent
undue irritation to the urethra.
What is some
nutritional advice? Although not
scientifically proven, cranberry juice may have infection-fighting properties
and drinking it daily may help prevent UTI.
Some studies have shown that the greatest effect of cranberry juice
seems to be in women who have frequent UTI’s.
There are no known studies that show how much or how often cranberry
juice should be consumed.
Integrate Complimentary Alternative Medicine
What can be expected during an osteopathic manipulative treatment? Your osteopathic physician will release strain patterns preventing proper urinary elimination by allowing the nerve and blood supply to the bladder, kidneys and ureter to be unrestrained. The lumbar, sacrum, pelvis and abdomen will be restored to its proper alignment without restriction. During an infection, lymphatic drainage of the pelvic region can be employed as needed. Ganglion contractions blocking lymphatic drainage called "Chapman points" can be treated during an infection using firm pressure in a circular fashion until the tender mass disappears.
What are some homeopathic advice? Depending on the presentation of the infection, certain homeopathic medications are typically useful in decreasing the duration and intensity of the infection. If you are experiencing sharp burning before, during, and after urination with frequent but scant urination, take five pellets of Cantharis alternating with Mercurius Corrosivus between meals.