How bad can UTIs get?

By Flavia Nassaka

Doctors give tips on handling infection By Flavia Nassaka

One in two women and one in 20 men will experience a Urinary Tract Infection (UTI)  at some point, with varying degrees of severity according to how far the infection spreads, says Dr. EvaristeBaruga,a urologist based at the Mulago National Referral Hospital in Kampala. For 30% of the women the problem will be recurrent.

A UTI is a general term for infections of the bladder, kidneys, the urethra and the ureters (the tubes that connect the kidney and the bladder).  Caused by Escherichia coli (E. coli) bacteria that normally live in the bowel, manyUTIs appear within 24 hours after sex.  Recent sexual activity is the single most important risk factor for UTIs in young women. Nearly 80% of all UTIs in these women occur within 24 hours of intercourse. However, UTIs are not sexually transmitted infections.

They occur when fecal bacteria from the anus makes its way into the urethra, the bacteria can multiply and travel upward to the bladder and kidneys. This condition can be common in people whose urine flow is obstructed by kidney stones or an enlarged prostate where buildup of urine creates a sort of warm, damp environment that bacteria thrive in, and the decrease in urination prevents the urethra from flushing out bacteria as it normally might.

Dr. Baruga explains women are more prone to the infection because thefemale urethra is short at 1.5 inches compared to 8 inches in men. That makes it a bit hard for bacteria to penetrate men but when it does; the infection can cause more serious problems than they do in women. Men with UTIs are far more likely to be hospitalised than women.   Experts say men become more susceptible to UTIs above 40 years of age, when they begin to develop prostate problems. Enlargement of the prostate gland, can produce obstruction in the urinary tract and increase the risk for infection. In men, recurrent UTIs are also associated with prostatitis, an infection of the prostate gland.

Because the urinary tract is situated near sexual organs, it can often be grouped together with infections of the vagina or the penis. The infections are not the same although they can sometimes be caused by the same pathogens.

Certain diseases and disorders of the urinary tract may mimic the symptoms of a UTI, for instance, certain types of kidney disease,says Dr. Robert Kalyesubula a nephrologist. They are also not treated in the same way and do not have the same underlying causes.  “But attimes a UTI may be a symptom of another underlying medical condition whereby it may not heal until the condition is treated”. Bacteria can get into the urinary tract through sharing a bathroom with an infected person, anal sex, or swimming in unsanitary water. UTI can also occur when the bladder does not empty completely due to problems such as a urinary tract blockage, or nerve-related problems. Doctors say one is more likely to get UTI if they are diabetic, have prostate problems, or have had prior UTI incidences.

Most common symptoms according to experts are a strong urge to urinate; frequent urination, and pain or burning that accompanies urination. You may feel soreness in the lower abdomen or the back. The urine is likely to have a strong odor, cloudy color and blood substances in it.  Fever, back pain, chills, nausea and vomiting are likely if bacteria have spread into the kidneys.

UTIs and Diabetes

Predisposition to UTIs in diabetes results from several factors where by susceptibility increases with longer duration and greater severity of diabetes.

Over time Dr. Kalyesubula explains, patients with diabetes because of the high glucose content may develop kidney disease (Diabetic nephropathy)and renal papillary necrosis, a condition that causes parts of the kidney to die. These complications predispose one to recurrent UTIs even when they are very keen on their hygiene.  In addition, as many as 30% of women with diabetes have some degree of cystocele, a condition that does not allow complete emptying of the bladder during urination, a thing that  may contribute to the frequency and severity of UTIs in female diabetics.

Treatment

Severe infections can cause kidney damage and compromise other organ systems. Although some mild UTIs can be treated with over-the-counter remedies for both sexes, antibiotics are used to reverse the infection but for those who have two or more UTIs within 6 months or 3 months within a year may need preventive antibiotics in addition to lifestyle changes to address recurrences.

“As soon as the patient develops symptoms, she takes the antibiotic. Infections that occur less than twice a year are usually treated as if they were an initial attack, with single-dose or 3-day antibiotic regimens”, says Dr.Baruga.

He adds, there are natural ways through which one can deal with the infection by  avoiding refined sugar, wearing cotton underwear and drinking plenty of water to help flush out the bacteria. Garlic can also provide relief since it’s a natural antibiotic.

However, doctors particularly encourage one to seek doctor’s advice if she’s pregnant and has had more than four infections a year or when after treatment, the symptoms do not go away within 48 hours.

Though treated with antibiotics, they warn their overuse may eliminate lactobacilli, the protective bacteria, along with harmful bacteria. This can cause an overgrowth of E. coli leading to re-infection.