Urinary tract infections, or UTIs, occur when bacteria or other bugs invade your body’s drainage system. Normally, your immune defenses banish these bugs before they can grow and multiply.
A urinary tract infection is a bacterial infection that grows within the urinary tract – anywhere from the kidneys, the ureters, the bladder and through to the urethra.
The kidneys are a pair of small organs that lie on either side of the spine at about waist level.
They have several important functions in the body, including removing waste and excess water from the blood and eliminating them as urine.
These functions make them important in the regulation of blood pressure.
Kidneys are also very sensitive to changes in blood sugar levels and blood pressure and electrolyte balance.
Both diabetes and hypertension can cause damage to these organs.
Two ureters, narrow tubes about 10 inches long, drain urine from each kidney into the bladder.
The bladder is a small saclike organ that collects and stores urine.
When the urine reaches a certain level in the bladder, we experience the sensation that we have to void, then the muscle lining the bladder can be voluntarily contracted to expel the urine.
The urethra is a small tube connecting the bladder with the outside of the body.
A muscle called the urinary sphincter, located at the junction of the bladder and the urethra, must relax at the same time the bladder contracts to expel urine.
Any part of this system can become infected. As a rule, the farther up in the urinary tract the infection is located, the more serious it is.
The upper urinary tract is composed of the kidneys and ureters.
Infection in the upper urinary tract generally affects the kidneys (pyelonephritis), which can cause fever, chills,nausea, vomiting, and other severe symptoms.
Unfortunately, if you have diabetes, you are up to twice as likely as those without the disease to develop these often painful infections. They’re especially common among women.
Women with diabetes are about two to three times more likely to have bacteria in their bladders than women without diabetes (interestingly, the same does not appear to be true for men).
There also seems to be an increased risk of the infection spreading upwards into the kidneys in diabetic patients, and diabetic women with urinary tract infections are also more likely to require hospitalization than non-diabetic women.
Why Are People With Diabetes More Prone To UTI?
There are likely several reasons.
First, people with diabetes may have poor circulation, which reduces the ability of white blood cells to travel in the body and fight off any kind of infection.
Diabetes impairs some parts of your immune response. You have fewer white blood cells and T cells to fight off invading bacteria, viruses, and fungi.
For the same reason, diabetics often develop UTIs caused by less commonly encountered germs. Routine antibiotics may be ineffective.
Symptoms,Signs And Treatment of UTI
Symptoms of urinary tract infections often include, pain while voiding, blood in the urine, and increased urgency and frequency of urination.
Other symptoms may include nausea, vomiting, and pain in the back and rib region.
Urinary tract infections may be diagnosed from symptoms alone or in conjunction with laboratory analysis of a urine sample.
You should see your doctor if you have any of these signs or symptoms:
1.Burning feeling when you urinate
2.Frequent or intense urges to urinate, even when you have little urine to pass
3.Pain in your back or lower abdomen
4.Cloudy, dark, bloody, or unusual-smelling urine
5.Fever or chills
Women are more likely to get UTIs than men are. When men get UTIs, however, they’re often serious and hard to treat.
UTIs can be especially dangerous for older people and pregnant women, as well as for those with diabetes and those who have difficulty urinating.
The doctor may ask you how much fluid you drink, and if you have pain or a burning feeling when you urinate, or if you have difficulty urinating.
Women may be asked about the type of birth control they use.
You’ll need to urinate into a cup so the urine can be tested.
In addition, your doctor may need to take pictures of your kidneys with an x ray or ultrasound and look into your bladder with an instrument called a cystoscope.
If you have a UTI, your doctor can look through a microscope and find bacteria in a sample of your urine.
If the bacteria are hard to see, the doctor may let them grow for a day or two in a culture. Then the doctor can see exactly which kind of bacteria you have and choose an antibiotic that kills them.
The doctor may use either x rays, sound waves (ultrasound), or CT scan to view your bladder or kidneys. These pictures can show stones, blockage, or swelling.
The urethra and bladder can be seen from the inside with a cystoscope, which is a thin tube with lenses like a microscope.
The tube is inserted into the urinary tract through the urethra.
Once it is determined that your symptoms have been caused by an infection, your doctor will prescribe an antibiotic.
Antibiotics can kill the bacteria causing the infection. The antibiotic prescribed will depend on the type of bacteria found.
For simple infections, you’ll be given 3 days of therapy.
For more serious infections, you’ll be given a prescription for 7 days or longer.
Be sure to follow your instructions carefully and completely. If you have any allergies to drugs, be sure your doctor knows what they are.
Will UTIs Come Back?
Sometimes. Most healthy women don’t have repeat infections. However, about one out of every five women who get a UTI will get another one. Some women get three or more UTIs a year.
Men frequently get repeat infections. Anyone who has diabetes or a problem that makes it difficult to urinate may get repeat infections.
If you get repeat infections, talk with your doctor about special treatment plans. Your doctor may refer you to a urologist, a doctor who specializes in urinary problems.
Your doctor may have you take antibiotics over a longer period to help prevent repeat infections.
Some doctors give patients who get frequent UTIs a supply of antibiotics to be taken at the first sign of infection. Make sure you understand what your doctor tells you about taking the antibiotic and do exactly that.
Men may need to take antibiotics for a longer time. Bacteria can hide deep in prostate tissue. Men shouldn’t take their spouse’s pills and think they will cure the infection.
See a doctor for treatment that fits your needs.
Urologic Complications In Diabetics
Urologic complications, including bladder dysfunction, sexual and erectile dysfunction, as well as urinary tract infections (UTIs) have a profound effect on the quality of life of men and women with diabetes.
Prevention Of UTI
Changing some of your daily habits may help you avoid UTIs.
1.Drink lots of fluid to flush the bacteria from your system. Water is best. Try for 6 to 8 glasses a day.
2.Drink cranberry juice or take vitamin C. Both increase the acid in your urine so bacteria can’t grow easily. Cranberry juice also makes your bladder wall slippery, so bacteria can’t stick to it.
3.Urinate frequently and go when you first feel the urge. Bacteria can grow when urine stays in the bladder too long.
4.Urinate shortly after sex. This can flush away bacteria that might have entered your urethra during sex.
5.After using the toilet, always wipe from front to back, especially after a bowel movement.
6.Wear cotton underwear and loose-fitting clothes so that air can keep the area dry. Avoid tight-fitting jeans and nylon underwear, which trap moisture and can help bacteria grow.
7.For women, using a diaphragm or spermicide for birth control can lead to UTIs by increasing bacteria growth.
If you have trouble with UTIs, consider modifying your birth control method.
Unlubricated condoms or spermicidal condoms increase irritation and help bacteria cause symptoms.
Consider switching to lubricated condoms without spermicide or using a nonspermicidal lubricant.
8.If you have diabetes, be aware of changes in the frequency and/or urgency of your impulses to urinate, as well as for incontinence, infections, or other symptoms that might indicate a problem.
9.A voiding diary is a simple tool that anyone can use to keep track of these signs. Write down the date, time, and estimated amount of urine you pass.
Also included in the diary should be any additional voiding symptoms that occur, such as episodes of incontinence or needing to rush to the bathroom with little warning.
If you find that you’re voiding less often than every three or four hours, see your health-care provider, armed with the information in your voiding diary.
10. Your urine can change color for a variety of reasons, including from the medications you take, so pay close attention to it to monitor your overall health. One key thing to note is that if your urine is typically a darker yellow, your body is dehydrated, so you need to step up your water intake.
11.Urinate before sex and promptly after: Also, drink a full glass of water to help flush bacteria. This can help minimize bacteria buildup and reduce your risk of getting a UTI.
12.Don’t use douches or feminine hygiene sprays or powders: As a general rule, do not use any product containing perfumes in the genital area.
13.Shower instead of a bath: Take showers and avoid prolonged baths. Bath water may fairly quickly become contaminated by the bather’s own skin florae. Sitting in a tub allows bacteria to reach the bladder opening area.
14.Use tampons for your period: Tampons are advised during the menstrual period rather than sanitary napkins or pads because they keep the bladder opening area drier than a sanitary pad, thereby limiting bacterial overgrowth.
15.Sugary foods and beverages. Biscuits,sweets , soda, and other foods and drinks made with refined sugar or high-fructose corn syrup create an environment in which bacteria thrive and multiply, making infection more likely. Try to stick to natural sources of sugar like fresh fruits.
16.Coffee, tea, cola, and alcohol. All of these beverages can irritate the bladder and make a UTI more likely.
17.When engaging in physical activity and exercise, make sure to empty the bladder frequently and drink plenty of water and other fluids.
18.An estrogen vaginal cream may help increase resistance to bladder infections.
An estrogen cream for the vagina may be suggested for women after menopause even if an oral estrogen supplement or patch has already been prescribed. The cream helps keep the tissues around the bladder healthy and more resistant to infection.
19.Don’t hang around in a wet bathing suit or on a damp towel. Get into dry stuff as soon as you can.
20.Antibiotics: Our preoccupation with a quick fix is partially to blame.
Although sometimes necessary, antibiotics are often over-prescribed for conditions they cannot help with.
Antibiotics wipe out bacteria, both bad (pathogenic) and beneficial, protective ones (probiotics). When the urinary tract and gastrointestinal systems have no probiotics in them, they are left unprotected against invading pathogenic bacteria .
With diligence and careful self-monitoring, someone with diabetes may be able to delay or completely avoid having diabetes-related bladder problems that require catheterization or other medical attention.
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