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Cd mannose which u can get here in Collins pharmacy in Ballina is amazing for Uti's
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Urinary Tract Infection
By Charles Patrick Davis, MD, PhD & Jerry R. Balentine, DO, FACEP
Urinary tract infection (UTI) Fast Facts:
Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract.
E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs.
Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.
Symptoms and signs of UTI vary somewhat depending on sex, age, and the area of the urinary tract that is infected; some unique symptoms develop depending on the infecting agent.
UTIs are diagnosed usually by isolating and identifying the urinary pathogen from the patient; there are some home tests available for presumptive diagnosis.
There can be many complications of urinary tract infections, including dehydration, sepsis, kidney failure, and death.
If treated early and adequately, the prognosis is good for most patients with a UTI.
Although there is no vaccine available for UTIs, there are many ways a person may reduce the chance of getting a UTI.
What is a urinary tract infection (UTI)?
The urinary tract is comprised of the kidneys, ureters, bladder, and urethra (see Figure 1). A urinary tract infection (UTI) is an infection caused by pathogenic organisms (for example, bacteria, fungi, or parasites) in any of the structures that comprise the urinary tract. However, this is the broad definition of urinary tract infections; many authors prefer to use more specific terms that localize the urinary tract infection to the major structural segment involved such as urethritis (urethral infection), cystitis (bladder infection), ureter infection, and pyelonephritis (kidney infection). Other structures that eventually connect to or share close anatomic proximity to the urinary tract (for example, prostate, epididymis, and vagina) are sometimes included in the discussion of UTIs because they may either cause or be caused by UTIs. Technically, they are not UTIs and will be only be briefly mentioned in this article.
UTIs are common, leading to between seven and 10 million doctor visits per year. Although some infections go unnoticed, UTIs can cause problems that range from dysuria (pain and/or burning when urinating) to organ damage and even death. The kidneys are the active organs that produce about 1.5 quarts of urine per day. They help keep electrolytes and fluids (for example, potassium, sodium and water) in balance, assist in the removal of waste products (urea), and produce a hormone that aids in the formation of red blood cells. If kidneys are injured or destroyed by infection, these vital functions can be damaged or lost.
While most investigators state that UTIs are not transmitted from person to person, other investigators dispute this and say UTIs may be contagious and recommend that sex partners avoid relations until the UTI has cleared. There is general agreement that sexual intercourse can cause a UTI. This is mostly thought to be a mechanical process whereby bacteria are introduced into the urinary tracts during the sexual act. There is no dispute about the transmission of UTIs caused by sexually transmitted disease (STD) organisms; these infections (for example, gonorrhea and chlamydia) are easily transmitted between sex partners and are very contagious. Some of the symptoms of UTIs and sexually transmitted diseases can be similar (pain and foul smell).
What causes a urinary tract infection (UTI)?
The most common causes of UTI infections (about 80%) are E. coli bacterial strains that usually inhabit the colon. However, many other bacteria can occasionally cause an infection (for example, Klebsiella, Pseudomonas, Enterobacter, Proteus, Staphylococcus, Mycoplasma, Chlamydia, Serratia and Neisseria spp.), but are far less frequent causes than E. coli. In addition, fungi (Candida and Cryptococcus spp.) and some parasites (Trichomonas and Schistosoma) also may cause UTIs; Schistosoma causes other problems, with bladder infections as only a part of its complicated infectious process. In the U.S., most infections are due to Gram-negative bacteria with E. coli causing the majority of infections.
What are urinary tract infection (UTI) risk factors?
There are many risk factors for UTIs. In general, any interruption or impedance of the usual flow of urine (about 50 cc per hour in normal adults) is a risk factor for a UTI. For example, kidney stones, urethral strictures, an enlarged prostate, or any anatomical abnormalities in the urinary tract increases infection risk. This is due in part to the flushing or washout effect of flowing urine; in effect, the pathogens have to "go against flow" because the majority of pathogens enter through the urethra and have to go retrograde (against a barrier of urine flow in the urinary tract) to reach the bladder, ureters, and eventually the kidneys. Many investigators suggest that women are far more susceptible than men to UTIs because their urethra is short and its exit (or entry for pathogens) is close to the anus and vagina, which can be sources of pathogens.
People who require catheters have an increased risk (about 30% of patients with indwelling catheters get UTIs) as the catheter has none of the protective immune systems to eliminate bacteria and offers a direct connection to the bladder. Catheters that are designed to reduce the incidence of catheter-related infections are available (they incorporate antibacterial substances into the catheter that suppress bacterial growth), but are not used by many clinicians because of short-termed effectiveness, cost, and concern about antibiotic resistance development in bacteria.
There are reports that suggest that women who use a diaphragm or who have partners that use condoms with spermicidal foam are at increased risk for UTIs. In addition, females who become sexually active seem to have a higher risk of UTI. The term, “honeymoon cystitis,” is sometimes applied to a UTI acquired either during the first sexual encounter or a UTI after a short interval of frequent sexual activity.
Men over the age of 60 have a higher risk for UTIs because many men at or above that age develop enlarged prostates that may cause slow and incomplete bladder emptying. In addition, older males and female populations have seen recent rises in STDs; this increase is thought to be due to this group not using condoms as frequently as younger age groups.
Occasionally, people with bacteremia (bacteria in the bloodstream) have the infecting bacteria lodge in the kidney; this is termed hematogenous spread. Similarly, people with infected areas that are connected to the urinary tract (for example, prostate, epididymis, or fistulas) are more likely to get a UTI. Additionally, patients who undergo urologic surgery also have an increased risk of UTIs. Pregnancy does not apparently increase the risk of UTIs according to some clinicians; others think there is an increased risk between weeks six through 26 of the pregnancy. However, most agree that if UTIs occur in pregnancy, the risk of the UTI progressing in seriousness to pyelonephritis is increased, according to several investigators. In addition, their baby may be premature and have a low birth weight. Patients with chronic diseases such as diabetics or those who are immunosuppressed (HIV or cancer patients) also are at higher risk for UTIs.
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