How To Prevent UTI

Have you been experiencing burning sensation when you pee? or had frequent urination, foul smelling cloudy urine? If yes, then you may want to find out whether or not you have a Urinary Tract Infection (UTI). UTIs are infections that occur in any part of the urinary system like the kidneys, ureters, urinary bladder, urethra. It most commonly affects the lower urinary tract like the bladder or urethra, but may sometimes reach the kidneys & be a cause of serious complications.

UTI is one of the commonest causes of hospital visits in women. It is estimated that about 150 million people suffer from UTI worldwide and every woman has a 60% chance of developing UTI at least once in her lifetime. Hence, it becomes important for us to understand how to prevent or deal with UTI.

Is UTI more common in women than in men?

The incidence of UTI is much higher in women as compared to men due to various reasons which include

• The female anatomy – Every person has two kidneys which filter & drain urine through thin pipe like tubes called ureters into the urinary bladder. Urine is stored in urinary bladder and then periodically passed out voluntarily through another tubular structure called the urethra. In women, the urethral opening is situated quite close to the vagina & anus, and the length of urethra is quite short ( ~ 4 cm ) so that any bacteria or pathogens present in the vulval or perineal region can easily pass through the urethra & reach the urinary bladder to cause infection.
• Sexual activity – An act of intercourse can introduce bacteria from the vagina to the urethra & cause UTI.
• Pregnancy- Pregnancy hormones can alter the structure of the lining of the genitals & urinary tract, making them softer, congested & more susceptible to infections. Besides, the pregnant uterus presses over the urinary bladder & may prevent the urinary bladder from emptying completely. Consequently, the stagnant urine may harbour bacteria or pathogens & give rise to UTI.
• Menopause- Menopause marks the decline in the secretion of female hormones that keep the skin & lining of vagina and urinary tract, healthy & moist. After menopause, these linings become thin & fragile, hence it becomes easier for bacteria & other pathogens to grow & cause an infection in these parts of the body.
• Certain types of contraception- Use of spermicidal jelly, diaphragm also increase the chances of UTI in women as these jellies kill the good bacteria in the vagina alongwith the sperms and as a result, there is an imbalance in the bacterial environment of the vaginal/perineal region that promotes UTIs.

What happens when you get a UTI?

So a UTI can present itself in a variety of ways. You may feel a pain or burning while urinating or the frequency of urination may increase making you rush to the washroom every few minutes. Sounds familiar? There may be other symptoms of UTI that you might have:

• Burning sensation or pain during urination.
• Continuous urge to pass urine.
• Feeling of incomplete emptying of urinary bladder even after you have passed urine.
• Cloudy, foul-smelling urine.
• Frequently passing very little urine.
• Women experience pelvic pain or a low backache.
• Fever.
• Chills, rigor & shivering.
• Sometimes nausea & vomiting

Sometimes these symptoms may be accompanied by a foul-smelling vaginal discharge or itching in the vaginal region, but very often, a woman may experience only urinary symptoms and no other complaints. In either case, it is important to identify the problem in early stages & treat it so as to prevent further complications.

• When the kidneys are affected, it is called acute pyelonephritis. The symptoms include back pain or pain on the sides of the body between your hips and ribs (flank pain), nausea, vomiting, fever with chills.
• When the urinary bladder is affected, it is called cystitis. It includes frequent urination, blood in urine (haematuria), lower abdomen pain, incomplete emptying of the bladder.
• Infection in the urethra is called urethritis. Symptoms include burning urination, discharge or pain while urinating.

What are the risk factors of UTI?

UTI is a common infection & anybody can get it. However, there are certain factors that increase your chances of getting a UTI and it is helpful to know about them so that you can take adequate precautions.

Unfortunately, women are at an increased risk of developing UTI as compared to men, as we discussed. Well, of course we can’t change the gender and anatomy to prevent UTI, but there are other risk factors which can be addressed to minimise your chances of getting the infection.

Other risk factors in women include

• Increased sexual activity.
• Inadequate water intake.
• Kidney stones.
• High blood sugar levels.
• Weakened immune system.
• Neurological problems like stroke, multiple sclerosis. The reason is that urine is retained in the bladder for a long time which increases the risk of UTI.
• Catheter use for prolonged duration.
• Recent urinary surgery.
• Use of certain types of birth control like diaphragms, spermicides.
• Pregnancy.
• Menopause.

So how do you prevent a UTI?

A knowledge of predisposing & risk factors for UTI helps us prevent the infection to a large extent. Although some factors cannot be changed, there are ways to prevent and reduce the risk of UTI.

• Diet:
  Drinking plenty of fluids, especially water, can prevent UTI.
  
  You can begin with drinking one extra glass with every meal. Or else, you can carry a 1 litre water bottle with you & make sure that you finish at least 1 such bottle within every 4-5 hours during the day.
  
  By drinking more water, the urine gets diluted, you’ll pass more urine which will help to remove & flush out the bacteria.

• Hygiene:
  Hygiene plays a very important role in prevention of UTI as most of the urinary infections in women are caused due to contamination by bacteria from the vagina or anus, which are anatomically located behind the urethral opening. So the logical solution is to modify your practices in a manner that minimise the transfer of the pathogens from the vagina/anus towards the urethra.
  • So make it a rule to always wipe from front to back, ie moving the tissue paper or water jet from the urethral region towards the anal region ( and NOT from back to front) after you have passed urine or stools. This will prevent the bacteria from the anal area entering the urethra.
  • Empty your bladder whenever it feels full, holding your pee back increases the risk of infection. It is said that you should empty your bladder every 4 hours while awake even when you don’t feel the urge to pee.
  • Do not use scented vaginal washes, sprays, deodorants in the genital area as it irritates the urethra and allows the growth of bacteria.
  • To reduce the risk of infections pee before and after sexual intercourse to wash the bacteria out.

• Clothing:
  • Always wear cotton undergarments that absorb excess sweat or moisture and allow your skin to breathe. If required, change your undergarments twice a day or whenever they feel wet.
  • Avoid wearing synthetic undergarments which do not absorb moisture & may irritate the skin in genital area.
  • Avoid wearing tight fitting clothes because it leads to accumulation of moisture which further promotes bacterial growth.

• Birth control options:
  As discussed, certain contraceptive options can predispose to UTI. While condoms are known to prevent cross transmission of genital infections between sexual partners, certain other methods like the spermicidal jelly or diaphragms coated with such jellies can actually increase the risk of UTI.
  • Always use lubricated condoms. Avoid using unlubricated condoms as they may increase the friction & increase the chances of infections.
  • Avoid using spermicidal jelly- Spermicides disrupts the normal vaginal florae which are otherwise important to defend against the pathogens.
  • Avoid having sexual intercourse without a barrier /protection unless you are trying for pregnancy. Birth control pills & injections provide adequate contraception & protection against pregnancy but they do not protect you from sexually transmitted infections.

• Use probiotics: Probiotics helps increase the good gut bacteria and may help in increasing the good bacteria in the urinary tract. You can consume probiotics in the form of supplements or through diet like yoghurt.

What is the Treatment of UTI?

• The first line of treatment for UTI is antibiotics. The type of antibiotics and the duration of their use will depend on the severity of the infection and the type of bacteria found in your urine culture.
• It helps to increase your oral fluid intake to ease the symptoms as well as to flush out the infectious bacteria/pathogens from your system.

Make sure to never self-treat your UTI or depend on general prescriptions available online. Use antibiotics only under the guidance of the doctor and always complete the course of the antibiotic as prescribed. Even when you feel that your symptoms are getting better do not discontinue taking the antibiotics without consulting your doctor. UTI’s can be serious and if not treated correctly can lead to recurrent UTI that have the potential to spread to the kidneys and cause chronic kidney damage.

To sum it all up, UTIs are treatable infections provided you take medical help at the right time. Remember to never undertreat your UTI as recurrent UTI has the potential to cause chronic kidney damage. In case of any doubts or queries, you can contact our experts at Maitri, where we discuss anything and everything about woman’s health.