Urinary Tract Infections: Causes, Treatment, and Prevention
If you’ve ever had a urinary tract infection (UTI), you are familiar with the unpleasant symptoms: an urgent, frequent need to urinate and a painful, burning sensation during urination. UTIs are the second most common infection in the U.S., accounting for more than 8 million doctor visits each year, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Women are more likely to get UTIs than men due to anatomical differences, and women are at an even higher risk of UTIs once they have gone through menopause.
Why Women Get More UTIs
Many factors contribute to a higher incidence of UTIs among postmenopausal women.
“The primary factor is the reduced production of estrogen,” explains Tirsit Asfaw, MD, assistant professor of obstetrics and gynecology at Weill Cornell Medicine. “The presence of ‘good’ bacteria, lactobacilli, in the urinary tract (the kidneys, ureters, bladder, and urethra) help maintain a healthy environment that resists infection. Estrogen is required in order for lactobacilli to grow; when estrogen levels drop after menopause, lactobacilli levels also drop, leaving the urinary tract more susceptible to infection.”
WHAT YOU SHOULD KNOW
The Downside of Antibiotics
Taking antibiotics can cause a vaginal yeast infection. Yeast, a fungus that is a natural part of the vaginal environment, is kept in balance by “good” bacteria, but when these bacteria are killed off by antibiotics, an overgrowth of yeast may occur and produce symptoms that include itching, burning, irritation, and a white discharge. To prevent a yeast infection, wear cotton underwear or underwear with a cotton panel in the crotch. Change out of swimwear or damp clothing as soon as possible, and avoid tight-fitting pants or shorts and nylon pantyhose. Don’t use feminine deodorants, powders, or washes; chemicals in these products can disrupt the balance of bacteria in your vagina. However, it is important to keep the area clean and dry. A yeast infection can be treated with oral or vaginal anti-fungal medications, some of which are available without a prescription.
Another factor is anatomical: Women have shorter urethras than men, which makes it easier for ‘bad’ bacteria that can cause infections to migrate up through the urethra and into the bladder. (The urethra is the tube that carries urine from the bladder to the outside of the body.) In women, the urethral opening is close to the anus (the opening through which feces is eliminated), which increases the likelihood of fecal bacteria reaching the urethra. In fact, Dr. Asfaw says that E. coli, bacteria commonly found in fecal matter, is responsible for 70 percent of UTIs.
“Women who wear pads to cope with urine leakage due to urinary incontinence also may be at higher risk of UTIs, since the pads may attract bacteria. And, women who have a prolapsed bladder are at higher risk, because they are unable to empty their bladder completely, which increases the chances of harmful bacteria remaining in the bladder,” says Dr. Asfaw.
About Antibiotics
A UTI requires treatment with antibiotics.
“If a UTI is not treated, it can lead to a kidney infection, which can produce symptoms including back pain, nausea, vomiting, and fever. The most common antibiotics used to treat UTIs are Bactrim and Macrobid, which are usually taken for three to seven days,” says Dr. Asfaw.
If you experience the classic symptoms of a UTI, especially if you have previously had a UTI, you may be given a prescription without having a urine culture. However, if you have recurrent UTIs, Dr. Asfaw recommends having a urine culture so your doctor can identify the type of bacteria causing the infection and target it with a specific antibiotic.
She also notes that, although the antibiotic Cipro is sometimes prescribed for simple UTIs, it should not be used as a first-line treatment, especially for elderly patients who have an increased risk of tendon rupture while taking Cipro. Taking Cipro can also lead to increased antibiotic resistance.
Your primary care physician can treat a UTI, but if you have three or more UTIs in one year, it’s advisable to see a specialist, such as a urologist or a uro-gynecologist, who can pinpoint the cause and determine what factors are contributing to the recurrence.
Preventive Strategies
For most women who experience recurrent UTIs, Dr. Asfaw says the only reliable prevention method is vaginal estrogen supplementation. Dr. Asfaw emphasizes that vaginal estrogen is not the same thing as hormone replacement therapy, and studies have revealed no increased health risks in women using these products.
“When the estrogen level in the pelvic area rises, it helps increase the lactobacilli population in the urinary tract and becomes less vulnerable to infection,” she says.
Vaginal estrogen supplementation comes in three forms: creams, pills, and a vaginal ring. The ring, which is flexible, is placed in the vagina and remains there for 90 days, slowly releasing a low dose of estrogen. Dr. Asfaw notes that the ring may be a good option for women who have difficulty remembering to use cream or pills, or who find these options inconvenient. However, each woman needs to discuss the pros and cons of the various forms with her doctor to determine what is best suited for her.
It’s also important to practice good pelvic hygiene. Wash your genital and anal areas regularly, and keep the area dry; a moist environment makes it easier for bacteria to live and multiply.
“If you use pads for urinary leakage, change them when they get soiled, and be sure to use pads meant for incontinence, not pads for menstruation; the pads are constructed differently, and infection is more likely if you wear a menstruation pad when you’re not menstruating,” advises Dr. Asfaw.
Although cranberry juice and supplements have been touted as preventatives, clinical studies have revealed that they are ineffective.
The post Urinary Tract Infections: Causes, Treatment, and Prevention appeared first on University Health News.
Read Original Article: Urinary Tract Infections: Causes, Treatment, and Prevention »
Powered by WPeMatico
