How daily hygiene can prevent urinary tract infections

Forum 7 years ago

How daily hygiene can prevent urinary tract infections

A 28 year old female starts complaining of severe lower back pain that started a day before. She’s also complaining of abdominal pain, nausea and vomiting, and has a high fever. She has been urinating about 15 times a day but there is no pain while urinating. However, she was experiencing excruciating pain while urinating several times about 2 weeks ago but she took some Ibuprofen and that seemed to help alleviate the pain.
At first glance, from this lady’s symptoms, it almost seems as if this lady is having abdominal issues since she’s having abdominal pain along with nausea and vomiting. However, what stands out with her is that she has been urinating about 15 times daily. This is known as Urinary frequency. A Urinary Tract Infection (UTI) is a common cause of frequent urination. Another finding that is worth mentioning is that she was experiencing excruciating pain while urinating about 2 weeks ago, so she took Ibuprofen to help with the pain. The painkillers just masked the underlying problem; it did not cure it.

Now, she is complaining of urinary frequency, severe abdominal pain and lower back pain, she can hardly move, looks very ill, having nausea and vomiting and has a high fever. These symptoms are a classical presentation of ACUTE PYELONEPHRITIS. This person is most likely suffering from Acute pyelonephritis (infection of the kidney) which is causing her severe lower back pain and the abdominal pain. This acute pyelonephritis is most likely due to untreated Urinary Tract Infection of which she showed symptoms of 2 weeks prior.

Urinary tract infections are usually ascending infections from bacteria that colonize the vaginal wall and these bacteria eventually get into the urethra. It travels upwards to infect the bladder; this is known as cystitis. If left untreated, the bacterial infection can go higher up the tract to infect the kidneys (pyelonephritis). Patients with Urinary Tract Infection usually present with urinary frequency, urinary urgency, pain on urination(dysuria). Though it can affect men and women, it more commonly affects young women.

Most UTIs are caused by E. coli. E. coli is a bacteria that is normally found in the intestines and it leaves the body through the anus during bowel movements. The distance between the urethra (urinary opening) and anus is very short in women so this makes it very easy for the bacteria to get in and once the E. coli gets into the urethra, it can cause an infection. Other less common causes of UTIS include anatomical defects of the urinary system. Pregnant women and people with diabetes are also at an increased risk of contracting UTIs due to suppressed immune function.

People that present with UTIs usually have classic symptoms; hence it is most times a clinical diagnosis made by the doctor. That is to say, that majority of people that present with such symptoms such as dysuria(painful urination), urinary frequency, urinary urgency most likely have a urinary tract infection. Your doctor might choose to do a Urine culture and/or Urinalysis just to make sure.
Since it is bacterial infection, antibiotics such as FLUROQUINOLONES taken for about 3-7 days are the drug of choice depending on the severity. Sometimes your doctor would go ahead and start treating even before Urine culture and Urinalysis test results are out. This is because we do not want the bacterial infection to progress to even more severe condition, so we start treatment immediately.

If the patient has symptoms such as abdominal pain, back pain (due to inflamed and infected kidneys) in addition to above symptoms, then the UTI has most likely progressed to pyelonephritis. In such scenarios, the patient would have to be admitted and given IV antibiotics till the patient starts feeling better then you can discharge and continue oral antibiotics for 2 weeks.