USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
What
is a urinary tract infection ?
A UTI is an infection of any part of
the urinary tract, which consists of the kidneys, ureters, bladder,
and urethra. Urine is made in the kidneys, which filter blood, then
passes down the ureters, to be stored in the bladder, and then excreted
through the urethra. If the infection is only in the urethra
it is called urethritis, if it moves to the bladder, you have a bladder
infection (cystitis), and if it makes it up to infect the kidneys,
it is called pyelonephritis.
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What causes
it ?
Urine is normally sterile. An
infection occurs when microbes, usually from the digestive tract,
find their way into the urethra and multiply. The most common cause
of a UTI is E.coli, which normally live in the colon. The urinary
tract is built to ward off infection. The bladder and ureters normally
prevent urine from backing up in the kidney and getting infected.
In men, the prostate gland produces secretions that slow bacterial
growth. However, bacteria still find their way up the urinary
tract to cause infection.
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Who is at risk
for a UTI ?
-
UTI’s cause about 8 million doctor visits
a year
-
Women get more UTI’s than men.
This may be due to a shorter urethra, or that it is closer
to the opening of the vagina and anus. For many
women, sexual intercourse can trigger an infection
-
People with urinary tract abnormalities
which prevent normal urine flow
-
People in with tubes (catheters) in
the bladder for long periods
-
People with diabetes or with immune
system problems have a higher risk
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What kind
of symptoms can you get ?
-
Burning or pain on urination
-
Frequent urge to urinate
-
Cloudy, milky colored urine
-
Uncomfortable pressure over the pelvic
bone in bladder infections
-
A fever may mean the infection has reached
the kidneys
-
Other symptoms of a kidney infection
include pain in the back below the ribs, nausea, or vomiting
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How is
it diagnosed ?
-
Your doctor will test a sample of urine
for pus or bacteria. This can often be done in the office, but is
sometimes sent off to a lab depending on your symptoms.
-
The lab can grow a culture of the bacteria
and test which antibiotics can work against them.
-
If the infection does not clear up with
treatment, the doctor can order and intravenous pyelogram (IVP) which is
an X-ray picture of the urinary tract that can find structural problems.
-
If you have recurrent infections, your
doctor may recommend an ultrasound exam, which can show images of your
kidneys and find any abscess.
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How is
it treated ?
UTI’s are treated with antibacterial
drugs. The choice of drug depends on the patient’s
history and urine tests. Common drugs used to treat UTI’S are trimethoprim/
sulfamethoxazole (Septra, Bactrim, Cotrim),amoxicillin
(Amoxil,Trimox,Wymox), nitrofurantoin (Macrodantin),
and ciprofloxacin (Cipro).
-
Treatment can range from 3 days to 2
weeks for uncomplicated cases.
-
Drink plenty of fluids (2 quarts per
day)so you have a good urine output to flush out the bacteria.
-
Empty your bladder as soon as you feel
the urge. Don’t wait
-
Avoid spicy foods, alcohol, caffeine-
they may irritate the bladder.
-
If you still have symptoms after 3 days,
call your doctor
-
Some patients with kidney infections
may need to be hospitalized for a few days to be given IV fluids, and then
treated with several weeks of antibiotics.
-
Any pregnant woman with a UTI should
be treated immediately, and hospitalized if she has a kidney infection,
because it can cause premature delivery.
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What are the side
effects of treatment ?
-
some of the drugs may cause an allergic
reaction in patients that are allergic to sulfa drugs or penicillins, so
you should let your doctor know if you are allergic to anything.
-
Patients that are pregnant should avoid
some of the antibiotics, because they may cause birth defects.
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What can happen
if you do not get treated ?
The biggest problem with a UTI is if
it progresses to pyelonephritis, which can cause scarring and damage
to the kidneys. This can lead to other problems, such as too
high or too low blood pressure, and inability to secrete wastes.
In more severe cases, dialysis or kidney transplants have been necessary.
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How can you help to
prevent a UTI ?
-
Drink plenty of water every day.
Some say drinking cranberry juice may decrease the growth of bacteria by
making the urine acidic. Vitamin C would have the same effect as
cranberry juice.
-
Urinate when you feel the need-Don’t
resist the urge.
-
Wipe from front to back to prevent bacteria
from the anus from entering the urethra or vagina.
-
Cleanse the genital area before sexual
intercourse, and void before and after sexual intercourse to flush out
any bacteria that may have been pushed up the urethra.
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Websites for
more information on UTI's