Diagnosis

Sometimes the diseases are detected by a urine examination, which can be done as part of a routine examination. However, much more often patients already complain of pain and other symptoms. Then a urine sample is examined.

A normal urine test usually only detects bacteria. However, there is no indication of what kind they are or how many of them are in the urine. So if you want more detailed information, even if you want to make sure that you are taking the right antibiotic, you can do a urine culture.

Normally the urinary tract is completely free of germs and bacteria right up to the bladder, so this is a good way of diagnosing a urinary tract infection. For the examination of the urine a detailed anamnesis and examination is important. Often, the patient’s stories alone provide an accurate picture of the disease.

In addition, the blood count shows that the number of white blood cells is elevated, i.e. the inflammation values are increased, as the body is struggling with an infection. In the course of the examination, an ultrasound is usually also performed to rule out other causes. If there is blood in the urine, for example, further imaging procedures must be used.

Test strips for urine are widely used and very inexpensive. They are dipped into the urine and change colour on contact with various substances. In this way it can be assessed whether there is sugar, protein, blood, leucocytes or nitrite in the urine.

Bacteria can also be detected in this way, albeit indirectly. This is usually done via the nitrite. It is produced by the bacterial metabolism in the urine. However, not all bacteria form nitrite. Therefore, a lack of nitrite does not exclude a urinary tract infection.

Therapy

The most important in the treatment of urinary tract infections is undoubtedly the antibiotic. It is almost always bacteria that have caused the disease. It is then possible to switch to another antibiotic that will eliminate the bacteria better.

A cold in the genital area is more likely to promote the spread of other bacteria than recovery, so caution is advised, especially in colder temperatures. Cranberry juice (also in tablet form) is also said to have a positive effect on recovery, as it acidifies the urine and creates an inhospitable environment for the bacteria. You can find bladder tea and ready-made mixtures for this purpose, in pharmacies and health food shops.

You should also drink a lot, because the more often you go to the toilet, the more bacteria are flushed out. If you have inflammation of the renal pelvis, you should pay particular attention to strict bed rest. If the disease is caused by bladder or urinary stones or other constrictions, surgery is of course also helpful.

If the pathogens in question are other than bacteria, other appropriate therapies must of course be used. The attending physician will provide the necessary information here. Sexual intercourse should be avoided at all costs if you suffer from a urinary tract infection, as the genital area becomes additionally irritated and unprotected bacteria can be transmitted to the sexual partner.

In the case of a urinary tract infection, so-called empirical antibiotic therapies are often used. This means that the exact nature of the pathogen and whether it is resistant to certain antibiotics is not tested. Instead, a substance is used that is effective against a large number of the most common pathogens.

It is usually desired that the antibiotic used is still effective in over 80% of urinary tract infections. The problem is that very effective antibiotics with a broad spectrum of activity should usually be retained as reserve antibiotics. Mostly cotrimoxazole, nitrofurantoin, quinolones or various beta-lactams are used.

Due to the rapid development of resistance, quinolones should no longer be used to treat uncomplicated urinary tract infections. are the first choice: Fosfomycin, Nitrofurantoin and Pivmecillinam. Pivmecillinam is similar to penicillin as beta-lactam and is still rarely used.

Fosfomycin is a very well tolerated antibiotic with a strong effect. However, it is mostly used clinically as a reserve antibiotic. Therefore, many advise against its widespread use.

Nitrofurantoin is an antibiotic that can only be used for urinary tract infections. The reason for this is that it is excreted with the urine and collects in the urinary tract. However, it can often cause side effects like nausea or vomiting.

An uncomplicated urinary tract infection does not normally require antibiotic treatment, as it heals on its own. The same applies to bacteria in the urine that do not cause symptoms. If treatment is necessary, antibiotic-resistant bacteria can cause problems.

Sometimes it is sufficient to change the antibiotic used. In particular, newly developed agents can still be effective. In rare individual cases, however, pathogens that were resistant to all approved antibiotics have already been discovered.

In this case, doctors have only supportive treatment. Especially in women, antibiotic therapy is not necessarily necessary for a simple urinary tract infection. In most cases, household remedies are sufficient to combat the disease.

Experience shows that the intake of sufficient fluid helps. Drinking a lot of water stimulates urine production. Every time you urinate, bacteria are flushed from the urinary tract.

The bladder should always be emptied completely. Sufficient rest and warming of the lower abdomen can alleviate the symptoms. In addition, this will probably stimulate the blood circulation.

This helps with the defence against germs. In addition to these simple means of combating a urinary tract infection, there are a number of freely available substances that promise to improve the condition. For most of them, however, no efficacy has yet been proven.

For example, the effectiveness of cranberry juice has become highly controversial. An exception to this is, for example, mustard oils from horseradish or watercress. Studies have shown efficacy for both.

No serious side effects were found. Even bacteria that are resistant to certain antibiotics can still react to mustard oils. In most cases, household remedies are sufficient to treat an uncomplicated urinary tract infection.

However, if there is severe pain, especially in the area of the flanks, fever or blood in the urine, a doctor should definitely be consulted. Homeopathy is often described as a gentle alternative to conventional medicine. However, it should be noted that the effectiveness of homeopathic remedies is controversial at best.

In most cases, no significant differences between a homeopathic remedy and a placebo can be proven in high-quality studies. However, since a homeopathic treatment does not seem to have any negative effects either, there is no need to advise against it strictly. Nevertheless, a doctor should be consulted if the inflammation of the urinary tract lasts longer or if more severe symptoms such as fever reoccur.