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Savitha Shama M.D. is board certified in Internal Medicine. She completed her residency training at the Grady Memorial Hospital under the Morehouse Internal medicine residency program. She is a graduate of Govt. Medical College, Mysore, India. Dr Shama practices at the Georgia Clinic in Norcross, GA. She can be reached at 770-449-0990 or at  docshama@yahoo.com.
Take the Sting Out of UTI

Urinary Tract Infection is one of the most common reasons why young healthy adults, especially women visit a doctor’s office. Check out the symptoms of this stinging infection, and find out the treatment and prevention tips.

Have you ever had stinging pain with urination? If you did, you know how miserable Urinary Tract Infection (UTI) feels.

Urinary tract infection is one of the most common diagnosis for which young healthy adults, especially women, are seen at the doctor’s office. Often, patients get surprised when I tell them that they have urinary tract infection. Their first question to me is, “How did I get this infection???”

Well, first of all lets look at what a urinary tract is.
The urinary tract consists of organs that make and store urine. These include kidneys (that make urine), ureters (that flow the urine from kidneys to the bladder), bladder (that stores urine), and finally the urethra (the passageway through which the urine flows out of bladder when you are urinating. In women this urethra is short in comparison to men. Infection results when bacteria ascend up this tract through the urethra and multiply. A vast majority of UTI’s, especially in young healthy adults, is caused by a bacteria commonly found in our digestive tract called Ecoli. This bacteria also has the property to stick to the lining of the urinary tract which can help it stay (localize) and multiply, causing infection. The most common of the urinary tract infections is the occurrence of simple, uncomplicated bladder infections (cystitis) and occasionally the infection may ascend up to kidneys and cause more severe, complicated infection (pyelonephritis).

Now, why do people get this infection?
You can see how this infection is more common among women due to the following facts- (a) Short urethra in females (Ecoli from fecal contamination can easily ascend through the short urethra of females) and (b) proximity of the urethra to anal opening.

Some of the risk factors that may facilitate urinary tract infection are:
· Wiping from back to front after a bowel movement (BM).
· Having sexual intercourse. Germs can be pushed into the urethra. 
· Waiting too long to pass urine. When urine stays in the bladder for a long time, more germs are made and may facilitate UTI.
· Using a diaphragm for birth control, or spermicides with a diaphragm or on a condom.
· Loss of estrogen and changes in the vagina after menopause. Menopause is when you stop getting your period.
· Certain medical conditions like having diabetes, indwelling catheters, procedures on the urinary tract, anatomical abnormalities of the urinary tract, anything that blocks the urinary tract like stones or tumors, or being pregnant can predispose a patient for more severe and complicated urinary tract infection.

A small number of otherwise healthy young men may contract UTI. In this group, men who engage in insertive anal intercourse are more likely to become infected. Also men who are uncircumcised or who have had vaginal intercourse with an infected partner may also be at increased risk of contracting UTI.

Symptoms:
A person may experience the following symptoms with the simple bladder infection,
·*Stinging pain when you pass urine. 
* An urge to pass urine a lot. 
·*Pressure in your lower belly. 
* Urine that smells bad or looks cloudy or reddish in color. 
* Feeling tired or shaky or having a fever. 
Other symptoms like fever like nausea, vomiting, low back pains etc are associated with more severe, complicated upper urinary tract infections.

Diagnosis is mostly made by clinical symptoms and urine may be checked for the presence of white blood cells or blood. Urinary cultures are generally unnecessary with simple cystitis. The reason being that most infections are mainly caused by Ecoli as discussed above and for which, the antibiotic sensitivity is fairly predictable. Urinary cultures may be obtained if associated with other medical conditions and in severe complicated urinary tract infections.

Treatment varies with the severity of infections. The common cystitis may be treated with a fairly short course of antibiotics for a duration of one to three days. A bladder anesthetic may also be used to help relieve the stinging pain with urination. The course of antibiotics will be much longer for complicated infections and may vary for men and women and for people with specific medical conditions.

Can UTI Be Prevented? — Questions regarding prevention of UTIs often occur in young women with recurrent infections.
*Urinate when you need to. Don't hold it. Pass urine before and after sex. After you pass urine or have a bowel movement (BM), wipe from front to back. 
·*Increase fluid intake. 
* Don't use douches or feminine hygiene sprays. 
·*If you get frequent UTI and use spermicidals (creams that kill sperm) talk to your doctor about using other forms of birth control. 
*Consumption of cranberry juice may maybe of some benefit. Cranberry juice appears to decrease the ability of Ecoli to stick to the urinary tract lining.

Hope this information will help you to understand Urinary Tract Infection, so you can take measures to reduce its occurrence and consult your physician when needed.

*Disclaimer: The contents are meant for informative, educational purposes only. Formal recommendations can only be made by physicians involved in your care. Please check with your physician before acting on any part of this article.

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