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Urinary Tract Infection and Kidney Stones
Urinary Tract Infection (UTI) and Kidney Stones
The urinary tract is divided into the upper tract – kidneys and the ureters – and the lower tract – bladder and urethra. Treating lower tract infections is typically uncomplicated, while upper tract infections can be serious and require hospitalization.
Urine is normally sterile (free of bacteria) unless the bacteria are introduced (via catheters or during intercourse) or unless the body’s normal mechanisms for eliminating bacteria are blocked or dysfunctional. For example, some long-term diabetics are at an increased risk of contracting UTIs, because nerve damage to the bladder does not allow it to contract and empty properly with urination. Also, people with suppressed immunity, as in HIV, cancer, and long-term diabetes, have trouble fighting many bacterial infections including those of the urinary system.
Due to several anatomic factors, urinary tract infections are more common in women and rare in men. Women have a shorter urethra than men and thus it is much easier for bacteria to enter the bladder and cause infection. Many women complain of recurrent UTIs after intercourse. This is especially seen in women who use diaphragms for contraception. Post-menopausal women are also at an increased risk of developing UTIs, thought to be due to a loss of the protective effect that estrogen has on preventing bacterial growth around the urethra.
When a man gets a UTI it is usually the result of obstruction (enlarged prostate, cancer, or kidney stone). Because of this, all men with symptoms should seek medical evaluation.
Symptoms: Distinguishing lower tract and upper tract infections
Symptoms of a urinary tract infection may include lower abdominal pain, burning with urination (dysuria), increased frequency of urination (polyuria), and a feeling of urgency prior to urination. If the symptoms stop there then you likely have a lower tract infection. Upper tract infections (Pyelonephritis), in addition to dysuria and polyuria, frequently cause bodily symptoms (fever, nausea, chills, and vomiting) and/or flank pain over the affected kidney. Anyone with symptoms of an upper tract infection should seek immediate medical attention. Anyone with a medical problem that interferes with the body’s normal ability to clear urinary infections should seek medical attention for either lower or upper tract infections. This includes people with chronic urinary tract problems as seen in prostate enlargement or bladder dysfunction.
Treatment of simple, lower tract UTIS (bladder infections) in women
Many women can avoid bladder infections or treat them non-medically by drinking lots of water or fluids that contain citric acid such as cranberry juice. Drinking cranberry juice every day or taking cranberry pills help many women. It is also important to practice good genital hygiene, and some women benefit from urinating after intercourse. If you are otherwise healthy and have no signs of an upper tract infection, you can easily self-treat with a three-day course of oral antibiotics. If you experience minor but recurrent bladder infections you might obtain these antibiotics from your doctor prior to departure. If you choose to self-treat, make sure you have no prior history of allergic reaction to the medicine. If you have any doubt, consult with your primary care doctor at home or seek the advice of a designated MedToGo physician.
Note: If you are still experiencing symptoms after therapy, consult with a doctor. You may have an unrecognized upper tract infection, a sexually transmitted disease, a drug-resistant bacterial infection, or inflammation of the urethra.
Kidney stones (Nephrolithiasis) are mineral deposits that form in the renal system.
A stone localized to the kidney is usually asymptomatic, but when it breaks off and travels down the ureter it can cause pain. The pain is often severe, intermittent, and cramping. Stones that are high up in the ureter typically cause flank and back pain. As the stone descends the pain can wrap around the front of the body towards the groin. Accompanying symptoms may include nausea and vomiting. Kidney stones usually cause microscopic bleeding undetectable to the human eye. Rarely, infection may ensue and cause Pyelonephritis.
Always seek medical care if a urinary tract infection accompanies a kidney stone. In fact, if you suspect a kidney stone, consult with physician who can confirm the diagnosis with X-rays, an intravenous pyelogram (IVP), or a special CT scan. Stones that are 5 mm or less will usually pass without intervention. Drink plenty of fluids to help wash out the stone and use sedatives, anti-nausea medicines, and pain killers to get you through. Stones that are larger than 5 mm, especially if there is any enlargement of the kidney, may require additional intervention such as lithotripsy (ultrasound that breaks up the stone) or manual removal via a scope that is introduced through the urethra and bladder.