Healthy Plumbing

Infections of the urinary tract are among the most common diagnoses seen in the primary care physician’s office.  It is the fourth most common diagnosis treated by your Family Doctor.  The overall chance of getting a urinary tract infection (UTI) in one’s lifetime is about 20 percent in women and about 0.5 percent in men.  

The urinary system is responsible for maintaining the fluid and electrolyte balance of the body.  The kidneys also filter the blood to remove unwanted waste materials.  The resulting fluid, urine, then drains through the ureters to the urinary bladder, then out the body through the urethra.  In a UTI, any part of the system can be infected, but most commonly it is the urinary bladder.

Bacteria can enter the urinary system via the urethra, the tube that empties from the bladder to the outside.  In women, the urethra is much shorter than in men.  This is why bladder infections are seen more commonly in women.  The most common infectious agent is the bacteria called E. coli.  These bacteria are normal inhabitants of the intestines so their close proximity to the urinary system makes them likely culprits.

When bacteria gain entrance into the urinary system, they can grow in numbers and cause inflammation of the urinary tract lining.  Symptoms of a bladder infection (or cystitis) include burning on urination; frequent and urgent urination; the urge to go, but can’t; bloody, cloudy, dark or foul smelling urine; and lower back or abdominal discomfort.  If the kidneys are infected, the individual may have fever, nausea and vomiting, and more severe pain in the mid or lower back.  

Some individuals may have anatomical alterations in their urinary tract that make them prone to getting bladder or kidney infections.  These people usually begin with UTI’s early in childhood and keep getting them over and over again.  Sexual activity, pregnancy and an enlarged prostate in men are a few of the other risk factors for developing a UTI.  

Bacteria in the urinary system can be identified by examining a urine specimen in your doctor’s office.  Laboratory tests include looking for bacteria under a microscope or using special test strips that change color in the presence of bacteria.  X-rays may be employed to rule out kidney stones, growths or other anatomical abnormalities.

Treatment of simple UTI’s or bladder infections includes antibiotics.  Since the majority of infections are caused by E. coli, the antibiotics are aimed particularly at these bacteria.  At times, however, other agents may be responsible for the infection and alternative antibiotics and treatments may be necessary.

Both treatment and prevention of UTI’s includes drinking plenty of fluids daily.  Water is adequate.  Some recent studies have refuted the benefits of cranberry juice and cranberry pills in fighting infections in the bladder.  Check with your doctor before using cranberry products if you are on other medications such as Coumadin (warfarin).

Other preventative tips, particularly for women, include: urinate when you feel the urge to go; wipe front to back after a bowel movement; take showers rather than tub baths; and avoid using harsh soaps or deodorants that can be irritating to the urethra.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


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