URINARY TRACT INFECTIONS
uRINARY TRACT INFeCTIONs ARe COMMON OCCuRReNCes – PARTICuLARLY IN WOMeN – BuT THeY CAN ALsO AFFeCT MeN AND CHILDReN….
The ABC of UTIs u
rinary tract infections (uTIs) are a common occurrence – mainly in
women – and affect the bladder and urethra. They can, however, also occur in men and young children – even babies.
UTIs in women Infection of the bladder – known as cystitis – is usually caused by the bacterium escherichia coli (e. coli), which is a type of bacteria that is commonly found in the gastrointestinal tract. Other bacteria can, however, be responsible. All women are at risk of cystitis because of their anatomy – particularly because of the short distance from the urethra – the tube that drains urine from the bladder – to the anus.
Infection of the urethra – which is known as urethritis – occurs when gastrointestinal bacteria spread from the anus to the urethra. The fact that the female urethra is close to the vagina means that sexually- transmitted infections, such as herpes, gonorrhoea, chlamydia and mycoplasma, can cause urethritis.
Symptoms In most women, symptoms of a uTI include: • needing to pee suddenly or more often than usual
• pain or a burning sensation when peeing
• smelly or cloudy urine • blood in the urine • pain in the lower abdomen • fatigue • general feeling of being unwell
Women, who are experiencing such symptoms will be asked by the doctor to provide a urine sample to confirm that it is
indeed a uTI. The urine test will also help to rule out other conditions that might be causing the symptoms.
UTIs in men The symptoms of a uTI are similar to those experienced by women, but bladder infections are less common in men than in women because men have a longer urethra, which makes it harder for bacteria to get into the bladder. uTIs in men are, however, more common with older age.
One reason for this is that older men are more likely to develop non-cancerous enlargement of their prostate gland. This occurs when the prostate wraps itself around the neck of the bladder, where the urethra connects to the bladder.
This chokes off the bladder neck, making it harder for urine to flow freely. If the bladder doesn’t empty completely, bacteria that are normally flushed out with the urine can gain a foothold.
While men will also be asked by the doctor to provide a urine sample, if they suspect an enlarged prostate gland, they may also do a digital rectal exam. This involves the doctor using a gloved finger to feel the prostate gland through the wall of the rectum.
A uTI in the urethra (called urethritis) is almost always related to a sexually-transmitted infection, such as chlamydia or gonorrhea.
Other types of bacteria usually don't cause urethritis because urine washes away bacteria before it can infect the urethra's lining.
UTIs and children urinary tract infections (uTIs) are common in children.
In children, cystitis is the most common form of uTI. Common symptoms include: • pain, burning, or a stinging sensation when urinating
• an increased urge or more frequent need to urinate (although only a very small amount of urine may actually be passed)
• have a high temperature of 37.5°C
• waking up at night a lot to go to the bathroom
• bedwetting even though the child is potty trained
• pain in the lower abdomen (ie, in the area of the bladder)
• foul-smelling urine that may also look cloudy or may contain blood
In very young infants and babies, frequent nappy changes can help to prevent the spread of the bacteria that cause uTIs.
Also, as soon as children are potty trained, good hygiene can also help to stave off uTIs. Teaching girls to wipe from front to rear, for example, can prevent germs from spreading from the rectum to the urethra.
Girls of school age should be advised to avoid bubble baths and strong soaps that might cause irritation, and should wear cotton underwear instead of nylon since it is less likely to encourage bacterial growth.
Treatment of UTIs The main treatment for uTIs in men, women and children is antibiotic medication. In most cases, the medication needs to be taken once or twice a day for five to seven days. This depends on the type of antibiotic that is prescribed.
Once the treatment is started, the symptoms should start to clear up within five days in adults and two days in children, It is vitally important that the whole course of antibiotics is finished, even if the patient begins to feel better. In the case of a severe uTI – usually in men and children – hospital treatment may be required.
In addition to the antibiotics, it is important for the patient to drink adequate fluids. Many patients – children in particular – are often tempted to reduce their fluid intake to decrease the need to urinate. urination can, however, help to flush the bacteria out of the system and so the patient should be advised to stay hydrated and urinate often.
Many patients drink cranberry juice during uTIs as this is often cited as a ‘cure’ for the infection. While laboratory experiments with mice have shown that some substances in cranberry juice did lower the bacteria count in the bladder, there is no definitive proof that drinking cranberry juice either eliminates the infection or speeds up recovery.
Patients should seek immediate medical attention if they have:
• pain in the sides or lower back
• a very high temperature or feeling hot and shivery
• felt sick or been sick • diarrhoea
These symptoms suggest a kidney infection, which can be serious if it's not treated.
PHARMACY IN FOCus - 39
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