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Urinary tract infections are very common; Especially in women, infants and the elderly. The U.S. Centers for Disease Control and Prevention (CDC) reports that about one in two women and one in 20 men will develop a urinary tract infection during their lifetime.
kidney and bladder
The kidneys control the amount of water in the blood and filter waste products to form urine. Each kidney contains a tube called the ureter that connects the kidney to the bladder. Urine leaves the kidneys via the ureters and enters the bladder. The bladder is the organ that signals the need to urinate, and urine leaves the body through a tube called the urethra.
The urinary system is a sophisticated system that reduces the risk of serious kidney infections by preventing urine from the bladder from flowing back into the kidneys. Most cases of urinary tract infections are limited to the bladder and cause symptoms but are not serious or life-threatening.
The urinary bladder is normally a sterile environment that cleans itself regularly when we urinate. This mechanism helps prevent bacteria from causing infection and inflammation, just as the immune system in our body prevents germs and bacteria from spreading throughout the body.
Urine infections occur when bacteria enter the bladder from the outside via the urethra and begin to multiply in the urine. Urinary tract infections (UTIs) affect any part of the urinary system, including the bladder (cystitis), urethra (urethritis), or kidneys (kidney infection). Urinary tract infections are treated with antibiotics, but they are not always necessary.
Urinary tract infections
There are two types of infections that affect the urinary tract. The first of these is lower urinary tract infection or cystitis, which occurs when the infection affects the bladder and urethra. The second is an upper urinary tract infection or pelvic nephritis. It occurs when the infection spreads upward and reaches one or both kidneys. Pelvic nephritis is more serious. Because it can cause kidney damage.
How do you check whether it is actually a “urinary tract infection”?
First, a few questions about the medical history are asked, then a urinalysis is performed, a urine culture is done in the laboratory to determine the bacteria present in the urine, and then the treatment is directed more precisely. However, it takes a while If an infection is suspected, it may take a few days for urine culture results to be available. Ultrasound or ultrasound examinations are performed in the upper urinary tract
According to the British National Health Service (NHS), a urinary tract infection can be recognized by the following symptoms:
• First – among young people:
– Pain or burning when urinating (dysuria).
– The urge to urinate more than usual, especially at night.
– The need to urinate suddenly or more urgently than usual.
– The urine appears cloudy or has blood in it.
– Pain in the lower abdomen or back, just under the ribs.
– High temperature, feeling hot and chilly or temperature drop below 36 degrees Celsius.
– The urine may be dark or have a foul smell. If this is the only symptom, it may be because you are not drinking enough water.
• Second – in children:
– There is a high temperature; The child feels hotter than usual in the neck, back or stomach.
– Looks generally ill. Infants and young children may be irritable, not drinking, or not eating properly.
– He wets the bed or wets himself.
• Third: In the elderly, weak or people with a urinary catheter:
In older and frail people with memory, learning and concentration problems (e.g. dementia), and in people with a urinary catheter, symptoms of a urinary tract infection may also include:
– Behavioral changes, such as agitated or confused behavior (delirium).
Wetting (urinary incontinence), which is worse than usual.
– New tremors or tremors in the body.
Causes of infections
Urinary tract infections (UTIs) are usually caused by bacteria in stool entering the urinary tract and carrying bacteria through the tube that carries urine out of the body (urethra).
The most common type of bacteria that causes urinary tract infections is Escherichia coli, an organism that normally lives in the intestines without causing harm. However, these bacteria often remain around the anus after a bowel movement and can migrate into the bladder.
Urinary tract infections occur less frequently in men than in women; Because the urethra in men is longer than the urethra in women; This makes it more difficult for bacteria to penetrate the bladder and is rare in men under 50.
In women, the urethra is shorter than in men, meaning bacteria are more likely to enter the bladder or kidneys and cause an infection.
The risk of bacteria entering the bladder increases with sex, pregnancy, diseases that block the urinary tract, such as: B. Kidney stones, diseases that make it difficult to completely empty the bladder, such as: E.g. enlarged prostate in men, constipation in children, etc. Urinary catheter (a tube in the bladder used to drain urine).
It also occurs when the immune system is weakened; For example, in people with diabetes or people undergoing chemotherapy. It also occurs when not drinking enough fluids and not keeping the genital area clean and dry.
medical advice
You should see a doctor if:
– Symptoms of a urinary tract infection appear for the first time.
– suffer from severe symptoms; Whether it is a child or an adolescent, whether the patient is pregnant or whether she is elderly and physically weak.
– Symptoms occur after surgery.
– Symptoms worsen or do not improve within two days.
– Recurrence of symptoms after treatment.
The condition can be considered emergency and urgent and may represent a serious kidney infection that can lead to sepsis in the following cases:
– Severe fever or feeling hot and chilly.
– A sharp drop in temperature to below 36 degrees Celsius.
– Confusion or sleepiness.
– Pain in the lower abdomen, back or directly under the ribs.
– See blood in urine.
Chronic urinary tract infection
In some people, the symptoms of a urinary tract infection may not go away, short-term antibiotics do not work for them, and urine tests do not show the presence of an infection, and here the most likely diagnosis is a urinary tract infection ( chronic, long-term) and is caused by the penetration of bacteria into the bladder mucosa . Chronic urinary tract infections significantly affect the quality of life and require the intervention of a specialist.
Because urine tests don’t always detect infection and symptoms can be similar to other illnesses, it can be difficult to diagnose chronic UTIs. Here the disease can be treated with antibiotics over a longer period of time.
Treatment
• Firstly – If a urinary tract infection is expected, treatment is as follows:
– Advice on self-care and recommendation of painkillers.
– Writing a prescription for a short course of antibiotics.
– It is important to take all prescribed medications, even if you feel better.
• Second: Treatment of recurrent urinary tract infections:
By this we mean the recurrence of a urinary tract infection after treatment or the occurrence of this infection twice within 6 months, so the procedure is as follows:
– Prescription of another antibiotic or prescription of a low-dose antibiotic for up to 6 months.
– Women in menopause are prescribed a vaginal cream containing estrogen.
– Further examinations and treatments will be carried out by a specialist.
• Third, measures to relieve the symptoms of a urinary tract infection:
– Take paracetamol tablets 4 times a day to relieve pain and high temperature.
– Children can be given liquid paracetamol.
– Rest and drink enough fluids until light-colored urine occurs regularly throughout the day.
– Avoid sex.
Some people drink cranberry drinks and products daily to prevent urinary tract infections, which can be helpful. However, there is no evidence that they help relieve symptoms or treat a urinary tract infection if the infection has already started.
– A clinical pharmacist can advise the patient on things that can help him get better, suggest the best painkiller and check whether the patient’s condition really warrants a visit to the doctor.
The most common causes are familial, social, environmental, behavioral and poor public hygiene
Protection
How do you protect yourself from urinary tract infections?
• First – There are a few things that can be tried to prevent a urinary tract infection (UTI) or prevent it from coming back, including:
– When exiting the toilet, wipe from front to back.
– Keep the genital area clean and dry.
– Drink plenty of fluids, especially water, so that you urinate regularly throughout the day and do not feel thirsty.
– For women, wash the skin around the vagina with water before and after sex.
-For both spouses, urinate as soon as possible after sex.
– Change diapers or incontinence pads immediately if they are soiled.
– Do not use perfumed soap.
– Do not hold back urine if you feel the urge to urinate.
– When urinating, do not rush and try to empty the bladder completely.
It is recommended not to wear tight synthetic underwear such as nylon.
– Do not drink alcoholic beverages; Because it can irritate the bladder.
– Don’t eat a lot of sugary foods or drinks; Because it can promote the growth of bacteria.
– Do not use condoms, vaginal diaphragms or caps that contain semen-killing lubricants. We recommend the opposite, that is, using non-spermicidal lubricants or using another type of contraception.
• Second – There are other ways to prevent urinary tract infections from coming back, including:
Use mannose sugar (D-mannose), which comes in the form of powder or tablets to be taken daily, and cranberry products, which come in the form of juice, tablets or capsules to be taken daily.
A pregnant woman should consult her doctor before consuming mannose sugar or cranberries during pregnancy as they contain high amounts of sugar.
If you are taking warfarin, you should avoid cranberry products.
* Community Medicine Consultant
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