A urinary tract infection can occur at any age and is often manifested by unpleasant symptoms. Usually, urinary tract infection is not a worrisome diagnosis and can be treated well. The only problem is when a urinary tract infection is left unattended for a longer period of time and complications arise in the course of the disease. A urinary tract infection should be differentiated from cystitis.
What is a urinary tract infection?
Schematic diagram showing the anatomy and structure of the urinary bladder. Click to enlarge. Urinary tract infection is a disease of the organs that produce and drain urine – that is, it affects the kidneys, ureters, bladder and urethra. Pathogenic microorganisms settle there and cause inflammation. In many cases these are bacteria, more rarely fungi, viruses or parasites. The infection is often limited to the urethra and bladder; if it rises to the kidneys, rapid and targeted treatment is particularly important. In rare, severe cases, urinary tract infection leads to the spread of pathogens through the bloodstream.
Causes
The most common cause of urinary tract infections is intestinal bacteria that enter the urinary tract through the urethra. Weaknesses in the body’s defenses or pre-existing conditions may favor infection or be the reason why the urinary tract infection is more difficult to treat. Urinary tract infections occur more easily in cases of narrowing of the urinary tract due to anatomical anomalies, prostate enlargement, kidney stones, catheterization or inflammatory processes. Diabetics, pregnant women, very young or elderly people, patients after surgical interventions in the urinary tract, but also people who drink very little are considered risk groups. Sexual activity can sometimes cause the spread of infectious agents to the urinary tract. Not all causes of urinary tract infections are known today, so some women have repeated infections whose triggers remain unclear.
Symptoms, complaints, and signs
Characteristic signs of a urinary tract infection include burning pain when urinating or an increased urge to urinate. The urinary stream is usually weakened or breaks off suddenly during urination. In addition, most sufferers find it difficult to hold their urine for long periods. An infection is always associated with pain in the lower abdomen. A typical symptom is also blood in the urine. The intense red coloration of the urine occurs particularly in the acute phase of the disease, but is relatively harmless. Serious symptoms may occur if the urinary tract infection is particularly severe. Then general symptoms such as fever and chills may be added to the problems with urination. There is usually severe pain localized in the lower abdomen, but it may also radiate to the lateral abdominal area and to the perineal and genital areas. Occasionally, symptoms resembling the flu occur – such as fatigue and tiredness, difficulty concentrating, and cardiovascular complaints. A urinary tract infection usually occurs suddenly and becomes more severe as the disease progresses. Provided that it is treated quickly, the symptoms subside after one to two weeks. Rarely, the infection spreads, during the course of which chronic urinary tract symptoms may occur.
Diagnosis and course
At the beginning of the diagnosis of a urinary tract infection is the perception of the patient. Typical symptoms include a constant urge to urinate, pain and burning when urinating, and cloudy, possibly bloody, and foul-smelling urine. Abdominal pain and fever are common, and nausea and vomiting are possible accompanying symptoms. Such symptoms should in any case lead the affected person to the doctor. After a general examination, the physician will require a urine sample from the patient. Using test strips and possibly microscopic evaluation, a urinary tract infection can often be diagnosed or ruled out right away in the office. If the doctor needs a detailed diagnosis, the sample is sent to a laboratory. For the patient, this usually settles the matter. More specialized tests are needed only if the urinary tract infection is unusual or severe.
Complications
If a urinary tract infection is not recognized or adequately treated, bacteria can ascend through the ureters to the kidneys, where they can cause renal pelvic inflammation. This usually manifests as blood in the urine, a general feeling of illness, pain in the kidney area, and fever.If bacteria penetrate the bloodstream via the renal tissue, which is well supplied with blood, this can result in life-threatening blood poisoning (urosepsis) – the timely administration of a suitable antibiotic and sufficient fluid intake prevents this serious complication. If at the same time there is a drainage disorder of the kidneys, the acute renal pelvic inflammation sometimes changes into a chronic form, which in the long term leads to a restriction of the kidney function. In rare cases, the pathogens introduced via the bladder can cause a kidney abscess. In pregnancy, a urinary tract infection can trigger premature birth under unfavorable circumstances: pregnant women should therefore consult a doctor at the first signs. In men, germs from the bladder can reach the epididymis via the vas deferens and cause epididymitis – a serious complication that can result in loss of fertility. If a urinary tract infection is treated with an antibiotic, the therapy must not be discontinued prematurely: The causative bacteria will otherwise develop resistance to the active substance, which can lead to recurrent occurrence of the urinary tract infection.
When should you go to the doctor?
If stabbing or burning pain is noticed when urinating, it is possibly a urinary tract infection. Medical advice is needed if the symptoms do not subside on their own within a few days or if other symptoms develop. If the pain radiates into the lower abdomen or if there is an increased urge to urinate, but only a small amount of urine escapes, a doctor must be consulted. With fever symptoms should immediately go to the hospital. There may be underlying renal colic or renal pelvic inflammation, which can cause serious complications if left untreated. Blood in the urine is also a warning sign of a serious illness that requires medical clarification. If the symptoms do not subside despite treatment with medication, a specialist should be consulted. A more extensive diagnosis is necessary, as there may be another underlying condition. People who repeatedly suffer from a urinary tract infection should also have this investigated. In addition to the family doctor, the urologist or a specialist in internal medicine can be consulted.
Treatment and therapy
The goal of treating a urinary tract infection is to quickly relieve symptoms and remove harmful microorganisms. Once the diagnosis is established and there are no contraindications, the physician usually prescribes an antibiotic. For the treatment of uncomplicated urinary tract infections, there are proven preparations that are taken orally and are well tolerated. It is important that the patient does not discontinue the treatment prematurely, even if the symptoms have subsided. The doctor will often recommend accompanying measures. These include drinking plenty of fluids (about two liters a day) and frequent bladder emptying. Diuretic teas help flush the urinary tract, and keeping the affected area warm calms the inflammation. If the urinary tract infection is very painful, you can ask the doctor for a suitable painkiller, but usually the symptoms subside soon after taking the antibiotic. If it turns out that the infection is more persistent, a laboratory examination of the urine is ordered at this point at the latest and the choice of antibiotic is changed if necessary. Only in exceptional cases is outpatient treatment for a urinary tract infection not sufficient and the patient must be cared for in the hospital.
Outlook and prognosis
Urinary tract infection has a good prognosis. The disease can be treated well and usually heals completely within a few weeks. There is a marked regression of symptoms after only a few days. Medical care is not always necessary for the patient. In the case of a mild urinary tract infection, the patient can already achieve relief from the symptoms and subsequent freedom from symptoms with bladder teas and natural herbs. Important for a quick recovery are the supply of sufficient fluids and a good heat protection. In many cases, this prevents the spread of pathogens and helps to remove already dead bacteria from the organism. With a healthy immune system, sufficient defenses are often mobilized so that no further measures need to be taken.In case of a severe urinary tract infection and in people who have a weakened immune system or an enlarged prostate, the use of drug treatment is important for a good prognosis. The administration of the medicines lead to the killing of the pathogens and stabilize the patient’s health. If no further complications occur, freedom from symptoms occurs within two weeks. In the course of life, a new urinary tract infection can occur at any time. The prognosis remains favorable if symptoms recur.
Prevention
Those who have had a urinary tract infection may be more susceptible to a recurrence in the future. So prevention is a good idea. Drinking enough fluids, emptying the bladder completely on a regular basis, and avoiding cold in the bladder and kidney region all support urinary tract health. The effectiveness of various home remedies against urinary tract infections has not been proven in studies and in no way do they replace antibiotic therapy. For prevention, however, everyone can try what works for him, only it should be clarified by consulting with the doctor whether the application fits the individual health situation.
Aftercare
Follow-up care for cystitis is exceedingly important. Bladder infections that have not completely healed can spread to the upper urinary tract and lead to serious problems. Possible consequences of cystitis include inflammation of the renal pelvis. To rule out recurrence and/or spread of the bacteria, the patient should attend a follow-up appointment after treatment. The follow-up can take place with the treating family doctor or a urologist. For this purpose, the physician will conduct a medical history interview and physically examine the patient. As a rule, a rapid test of the urine is also carried out in the practice to clarify whether there is blood and/or bacteria in the urine. If this is the case, the therapy may need to be prolonged. The patient himself should take it easy after a urinary tract infection and protect the kidney area from traction. Swimming in very cold waters should therefore be avoided for the first two weeks. Hypothermia in the feet should also be counteracted by wearing thick socks. In addition, it is important for the patient to drink plenty of fluids after a urinary tract infection. An adequate supply of fluid is essential for the kidneys to eliminate harmful substances and bacteria with the urine. Urinary tract infections often have to be treated with antibiotics. This usually kills not only the bacteria responsible for the UTI, but also positive-minded intestinal inhabitants that are essential for the immune system. Some patients complain of diarrhea and stomach cramps after antibiotic therapy. In this case, a colon cleanse can provide relief.
What you can do yourself
In the case of a urinary tract infection, the doctor usually prescribes an antibiotic and recommends accompanying measures. The most effective means of self-help is to drink plenty of fluids (at least two to three liters daily) and to empty the bladder regularly. Diuretic teas help to flush the urinary tract and remove the pathogens from the body. In addition, the herbs they contain have antispasmodic and anti-inflammatory effects. Things to avoid: coffee, alcohol and other irritating drinks and foods that could irritate the urinary tract. This also includes sugary foods and sodas. Cranberry juice is considered a miracle cure, which can prevent the infection from spreading and reliably prevent the recurrence of cystitis. Acute relief is achieved by applying a hot water bottle or warm compresses. Foot baths can also help. At the same time, those affected should take it easy and avoid cool sitting surfaces. Increased personal and intimate hygiene is also recommended to prevent the infection from spreading. In severe cases – for example, when blood is noticed in the urine or the symptoms last longer than three days – a doctor should be consulted again with the urinary tract infection.
