That Burning Sensation
Do you feel burning sensation when you micturate? Does it hurt? Do you feel an urgency to go to the toilet? Do you feel weak and feverish? You may be suffering from UTI (Urinary Tract Infection). Acute UTI occurs in many women each year, and it rate is very high in Bangladesh. Studies reveal that approximately, 60 percent of all women experience at least one UTI within their lifetime and roughly 20–30 percent women suffer from repeated infections. It is commonly noticed in hot and humid weather.
Urinary Tract Infection can be classified into two categories, depending on the site of infection-
Upper- Infection in the upper urinary tract generally affects the kidneys (pyelonephritis) which can cause fever, chills, nausea, vomiting, and other severe symptoms.
Lower- Infection in the lower urinary tract can affect the urethra (urethritis) or the bladder (cystitits)
Any part of this system can become infected. As a rule, the further up in the urinary tract the infection is located, the more serious it is.
Symptoms
Lower urinary tract infection
Dysuria- Pain or burning during urination
Urgency- Sensation of having to urinate urgently
Frequency- more frequent urination
Nocturia- waking up at night to urinate, often with only a small amount of urine
Foul-smelling urine
Cloudy urine
Low abdominal pain
Mild fever (<101°F), feeling of unwell
Upper urinary tract infection
Pain in the back or side, usually on only one side at about waist level
High fever (>101°F)
Chills or tremors (Shaking during fever)
Nausea
Vomiting
±symptoms of lower urinary tract infection
Causes
The urine is normally sterile. An infection occurs when bacteria get into the urine and begin to grow. The infection usually starts at the opening of the urethra where the urine leaves the body and moves upward into the urinary tract. Large numbers of bacteria live in the rectal area and also on the skin. Bacteria may get into the urine from the urethra and travel into the bladder. It may then travel further upwards to the kidney. But no matter how far it goes, it can cause trouble anywhere in the tract.
The most common bacteria (90 percent cases) that cause UTI are E.coli. You may have heard its name (famous for normally living in the bowel and around anus).Hence, you can say poor hygiene and sexual intercourse are few causes of UTI
Women are more prone to UTI's because they have shorter urethras than man, so bacteria have a shorter distance to travel to reach the bladder.
Diabetes also put people at higher risk for UTIs because of the decreased immune function and thus reduced ability to fight of infections
Some UTIs are hospital-acquired, as placing a catheter for a long time in the urinary tract, increases the risk of infection.
HIV, cancer, drugs, medications or any other cause that compromises ones immunity can cause UTI.
Conditions that obstruct normal urinary flow (kidney stones) also cause UTI. Even enlarged prostate aggravates UTI in males.
Preventing UTI
Maintaining hygiene after defecating, helps preventing bacteria from the anus entering the urethra, women and girls should practice wiping from front to back (not back to front)
Drinking plenty of fluids, juices, plain water, etc, will help, regular urination and flushing of the whole urinary tract on a continuous basis will also be needed.
Empty your bladder regularly, especially after sexual intercourse.
When to Visit Doctor
It is always advised to seek medical attention if you are experiencing the above mentioned symptoms. The doctor will take advice urinalysis (urine test) to see for pus cells in the urine. The diagnosis is simple, and rarely missed. Depending on your prognosis, the doctor may perform urine culture, to change antibiotics.
Treatment of UTI
A simple UTI can be treated with a short course of oral antibiotics. The symptoms may subside by a three day course if it's a simple uncomplicated UTI. But in some cases treatment may go on for several weeks. Unless UTIs are fully treated, they can frequently return. Hence full course completion is necessary. Most people make this mistake; they stop the medications, as soon as the symptom, such as pain and fever perishes.
If it's a complicated UTI, then longer periods of antibiotics with hospital stay may be needed. Intravenous doses should be given instead of oral ones.
Prognosis of UTI
Complete resolution of the disease with proper treatment is usually the common scenario. But if not treated properly, scarring of urinary tract is possible, which may later cause obstruction, and may require surgical handling. Infection may sometimes travel to blood stream, causing long/short time kidney damage.
Recurring UTIs
In some cases UTIs may recur, which is an alarming issue. If you are having three or more UTIs per year, you may need an ultrasound or CT scan to look for abnormalities in the urinary tract. Contact an urologist for further management.
Pregnancy
If you are pregnant and have symptoms of a UTI, then you should contact your doctor immediately. UTIs during pregnancy can put both mother and baby at risk if not addressed quickly and properly.
UTI Facts
Urinary tract infections are much more common in adults than in children, but about 1%-2 percent children do get urinary tract infections.
Urinary tract infection is second only to respiratory infection as the most common type of infection.
These infections are much more common in girls and women than in boys and men younger than 50 years of age. The reason for this is not well understood, but anatomic differences between the genders (a shorter urethra in women) might be partially responsible.
UTI causes Septicemia, which is one of the major causes of death in ICU.
Pregnant women are immune-compromised; hence they may develop UTI, which ultimately may cause complications, even miscarriages.
The writer is a Research Physician at Centre for Child & Adolescent Health (CCAH), ICDDR,B
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