Dr Natalie Caristo MBBS, BSc(Hons), FRACGP
Without doubt the illness that causes my female patients the most grief (albeit temporarily) is when they contract a urinary tract infection. With cries like, “Doctor, it really, really hurts!”, “It’s really stinging when I pee”, or “I have the urge to ‘go’ 20 times a day!” – it really is the infection that women hate the most.
Urinary tract infections (or UTIs) are one of the commonest infections of the body. Although they are far more common in women than men, UTIs can affect women, men, children and the elderly. The most notable symptom can be the burning sensation while peeing, which is painful and sometimes alarming if the patient is unaware of the condition.
Why women get UTIs
Urinary tract infections are so called because the infection can affect any of the parts of the urinary tract, from the urethra to the bladder, and up the ureters to the kidneys. Your urinary tract is normally a completely sterile environment, but this is disrupted if bacteria (such as E. coli) enters the urethra and sets up camp. This often happens in women because the urethra is in close proximity to the anus, so it’s easy for bacteria (from faeces for example) to enter the urethra. From there it is a short journey to the bladder, where the bacteria cause an infection called cystitis. This is what causes the burning pain and irritation, among other symptoms.
Cystitis is sometimes called ‘honeymoon cystitis’ because it can be brought on by sexual activity. It can also be caused by ‘holding on’ for too long and ignoring the urge to urinate. If left untreated, the infection can continue up the urinary tract and affect the kidneys. It’s important to seek medical advice as soon as possible, because the sooner you start treatment the better.
Relief from the burning and painful urination can be had by drinking plenty of fluids, and drinking a urinary alkaliser (such as ‘Ural’) which helps reduce the acidity in your urine and relieves discomfort. (If you can’t get to the pharmacy, a teaspoon of bicarbonate of soda (baking soda) dissolved in a glass of water will have the same effect.) One in every two women is likely to have at least one UTI before they are 24. It is far less common in men, but approximately 5% of the male population may present with UTIs - usually a sign of problems with the prostate.
UTIs in the young child
UTIs are also very common in babies and young children – many of whom are unable to describe their symptoms to a doctor, thus making it much more difficult to diagnose. Signs of a UTI in a young child include high temperature, irritability, lethargy and loss of appetite. Their wee may be cloudy or smelly, there could be signs of blood in the urine, and they may have pains in the tummy and lower back. Consult your Doctor immediately if you are concerned, as a UTI can make your child seriously ill. If your GP is closed, you can contact 13SICK and request an after hours doctor home visit.
UTIs in the elderly
Many people don’t realise that UTIs are extremely common among elderly men and women. This is primarily due to the elderly’s lowered resistance to infection, along with age-related weakening of the muscles of the bladder. If the elderly person is not emptying their bladder fully, or suffering from incontinence, or has a catheter, then UTIs can develop.
Serious UTIs in seniors can be difficult to diagnose because the symptoms are quite different to the usual UTI symptoms of pain while urinating, urgent need to urinate, smelly urine, or fever. In fact, the elderly with a UTI can often not display any of those symptoms, or tell their carers about them. Instead, the symptoms can be delirium or confusion, agitation, dizziness or falling, or other behavioural changes. Sometimes the symptoms can be mistaken for early stages of dementia or Alzheimer’s.
UTIs can cause serious health problems if left untreated. The infection can spread to the kidneys, causing organ damage and even failure. The infection can also cause sepsis (blood poisoning) in severe cases. So if you have the symptoms of a UTI, or you are concerned about someone in your care, be sure to consult your Doctor, who will advise you on the best treatment.
Dr Natalie Caristo MBBS, BSc(Hons), FRACGP, is a Medical Director with 13SICK, National Home Doctor Service. She has worked as an emergency Doctor in the hospital system, and in General Practice, and has a special interest in women’s health, paediatrics and aged care.
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