More women than previously thought may be willing to delay taking antibiotics to treat a urinary tract infection in order to reduce the potentially unneeded use of antibiotics, a new Dutch study shows.
More than one-third of women in the study with UTI symptoms said they were willing to wait a week to see if the infection would improve on its own before starting antibiotics. And more than 70 percent of the women who didn’t use antibiotics for a week showed improvements or had their symptoms disappear completely, according to the study published Thursday (May 30) in the journal BMC Family Practice.
UTIs are more common in women than men, and are caused by E. coli bacteria in 80 to 90 percent of cases. The standard treatment for UTIs is a few days of antibiotic treatment, but the increasing emergence of antibiotic-resistant bacteria has become a serious concern, experts say. “To counteract this increasing resistance, the use of antibiotics should be limited in healthy patients who can also be cured without them,” study researcher Dr. Bart Knottnerus, from the University of Amsterdam told LiveScience in an email.
Studies show that when patients have UTI symptoms, most often, antibiotic treatment is started before the results of urine cultures, which look for the presence of bacteria, are known.
“In fact, a culture is seldom done. Instead, the probability of a positive culture is estimated by asking questions and performing urine investigations,” Knottnerus said. “Since no test is perfect, some patients without UTI will get antibiotics, and some patients with UTI will not.”
In the study, 137 patients were asked by their doctor to delay antibiotic treatment for one week. Fifty-one women were willing to wait. After one week, 28 of those women had still not used antibiotics and 20 of them reported clinical improvement.
None of the participating women developed kidney infection, according to the study. Kidney infection is a serious condition that can occur if a UTI is left untreated, and needs a more aggressive antibiotic treatment.
The researchers say that bladder infections seldom progress to the kidneys. “If a kidney infection occurs in a healthy woman, she can be cured by antibiotics,” Knottnerus said. “But to make sure that these antibiotics will still be effective in the future, it is important to limit their use in mild infections (like bladder infections).”
It is important that women with UTI symptoms be monitored by a doctor if they choose to delay antibiotics. “If a woman gets ill (fever, shivering, flank pain), the infection may be progressing to the kidney,” Knottnerus said.
Previous studies have shown that in somecases, patients recover from UTIs within a week without taking antibiotics. Knottnerus said the reason is that they either didn’t have a UTI, or didn’t need antibiotics to cure it. The body’s defense mechanisms are often strong enough to fend off infections without any help from antibiotics, he said.
Dr. Timothy Jenkins, assistant professor at the Division of Infectious Diseases, University of Colorado, said about the new study: “Progressive antibiotic resistance in bacteria is a major problem in the United States and worldwide, so it is very important that we develop novel strategies to reduce antibiotic use, such as the one proposed in this study.”
Jenkins noted that antibiotic use in the Netherlands is extremely low, whereas antibiotic use in the United States is quite high. “Therefore, whether this study is applicable to women in the U.S. where the societal expectation for antibiotics is greater is not known,” he said.
New guidelines published last week, from the Dutch College of General Practitioners, support the advice to delay antibiotic treatment for uncomplicated urinary tract infections, the researchers said.
Follow MyHealthNewsDaily @MyHealth_MHND,Facebook& Google+. Originally published on LiveScience.
- Bladder Infection (Cystitis)
- What Is It?
- Abdominal pain and painful urination causes
- General UTI Symptoms
- Kidney Infection Symptoms
- UTI Treatments
- Urinary Tract Infection (Homeopathy)
Bladder Infection (Cystitis)
What Is It?
Published: February, 2019
A bladder infection, also called cystitis, is caused by an abnormal growth of bacteria inside the bladder, the balloon-like organ that stores urine. Bladder infections are one of the most common bacterial infections to affect humans, with up to one-third of all females having at least one infection at some point in their lives.
Bladder infections are classified as either simple or complicated. Simple bladder infections affect only healthy women with normal urinary systems. Bladder infections are rare in men who are otherwise healthy, so men are included in the complicated category with members of both sexes who have abnormal urinary systems.
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Abdominal pain and painful urination causes
Potential causes in both males and females include:
Urinary tract infection (UTI)
UTIs affect males and females, though they are more common in females.
These infections most frequently arise in the bladder, but they can occur in any part of the urinary tract, including the:
Females often experience pain in the pelvis, while males typically experience pain in the rectum. Other symptoms may include a more intense urge to urinate and changes in the look or smell of the urine.
Bacteria are typically responsible for the infection, and treatment generally involves antibiotics.
Sexually active people may be at risk of contracting infections such as gonorrhea and chlamydia. These can cause a burning sensation while urinating and pain in the lower abdomen, among other symptoms.
Some people also experience discharge from the urethra, though STIs often cause few visible symptoms.
This STI also causes painful blisters that ooze fluid then scab over. Many people feel the associated pain even before the blisters appear.
There is no cure for herpes, so treatment focuses on reducing outbreaks.
Stones made up of excess minerals can cause pain as the body tries to pass them through the urinary tract.
The pain may be intense, especially while urinating. In some cases, a stone can block off the urine stream completely.
Treatment depends on the size and mineral content of the stones. Some medications can help break them up, making them easier to pass, while others can relieve the pain.
A urethral stricture occurs when the opening of the urethra narrows and restricts the flow of urine. It can cause pain in the abdomen and pain during urination.
The narrowing usually results from inflammation or scar tissue in the area. This scar tissue may form after injury, surgery, or using medical devices such as catheters.
A doctor may try to dilate the urethra as an initial treatment. Some cases of stricture require surgery to widen the urethra.
Though not as likely as many other causes, bladder cancer can result in abdominal pain and pain during urination.
Bladder cancer can develop in males and females, but it is much more common in males.
The American Cancer Society estimate that in 2018 there were 81,190 new bladder cancer cases in the U.S. Approximately 62,380 of these cases occurred in males.
Other symptoms include:
- lower back pain
- a frequent need to urinate
- difficulty urinating or maintaining a steady stream
- blood in the urine
Treatment varies, but it typically involves removing the cancerous cells and managing symptoms.
A Urinary Tract Infection (UTI) can be a pain. Several pains, in fact. You may feel UTI pain when you urinate, in your urethra and in your back. Pain has a very basic role–it’s your body’s way of telling you, “Hey! I need a little help here!” Unfortunately, that may be about all the pain can tell you. It’s your job to look at the rest of your symptoms to see just what help is actually needed.
General UTI Symptoms
One of the most obvious symptoms of a UTI is pain during urination. Other UTI symptoms may include pain in your lower abdomen, or the need for frequent urination, even when you don’t have to go, or only have a little urine to pass. Urine that is consistently cloudy or strong smelling is another common UTI symptom. Blood in the urine can be a symptom of a UTI as well. All of these are important in recognizing a problem in your urinary tract.1
The urinary tract starts with the urethra. It continues to your bladder, and from there it passes along each ureter (the tube connecting your bladder to your kidney) all the way up to the kidneys themselves. A UTI can occur anywhere along this urinary tract. The symptoms of a UTI may vary, depending on where exactly the infection has begun, or to where it has spread. Most often a UTI begins as a bladder infection. Bladder infections are not generally considered medical emergencies; although, some people may be at higher risk for complications, including pregnant women, the elderly, and people with diabetes, kidney problems, or a compromised immune system. People who use catheters are especially at risk for urinary tract infections.2That is why it is important to seek the advice of a medical professional.
Kidney Infection Symptoms
A kidney infection is more serious than a urinary tract infection. Symptoms for kidney infections include fever, chills, nausea, vomiting, and pain in your lower back–where your kidneys actually are. The main danger of any UTI is that it may spread to the kidneys. From there, bacteria can cause damage to the kidneys, resulting in reduced kidney function. Also, because the kidneys are a primary part of the body—filtering out waste products from the bloodstream—infections can spread back through the bloodstream to other organs.
The first step to diagnose a UTI is a urinalysis. This is a test that is meant to detect bacteria and abnormal counts of white blood cells. At home urinalysis tests can be useful to aid in detection, but if you have reason to believe you have a UTI, it’s important to seek the advice of a medical professional. Oral antibiotics can be very effective in fighting a urinary tract infection and can only be prescribed by a doctor, physician’s assistant, or nurse practitioner.
There are also steps you can take on your own to help relieve UTI symptoms including, increased hydration (to encourage increased purging of bacteria). In the case of a kidney infection, one common home remedy is applying a hot water compress to the location of the pain. This will help lower pressure affecting the bladder, relieving pain. The heat helps to both decrease the inflammation while also aiding in reducing the bacteria growth causing the infection.3 However, remember these steps are methods of relieving the symptoms only–not a means of treating the infection itself.
UTIs are a pain. Literally. But pain can be a good thing, if it gets you to take notice. Even better, if it gets you to take action.
The term dysuria is used to describe painful urination, which often signifies an infection of the lower urinary tract. The discomfort is usually described by the patient as burning, stinging, or itching. Pain occurring at the beginning of or during urination suggests a urethral site of disease, whereas pain after voiding implies pathology within the bladder or prostate area. Sometimes a patient will relate a history of pain in the suprapubic area.
In men, pain on urination is often referred most intensely to the glans penis regardless of whether the location of the disorder is in the urethra or in the bladder; the pain may persist between voiding. Specific questioning about a discharge from the penis should be undertaken, especially in younger men. Inquiries as to the character and volume of discharge are important. Gonococcal urethritis usually presents with a copious purulent discharge, whereas nongonococcal urethritis commonly is mucoid and of small quantity. In older men, specific questions should be asked about associated hesitancy, intermittency, or straining. Ask the patient about standing closer to the toilet or taking longer to start than previously. These symptoms suggest obstruction, a common harbinger of infection, usually occurring either from prostatic enlargement or a urethral stricture.
In women with dysuria, the first question should be whether the discomfort is internal or external; in addition to urinary tract inflammation or infection, vaginal inflammation can cause dysuria as urine passes by the inflamed labia. If the sensation is internal or suprapubic, a urinary tract source is more likely; questions about associated fever, chills, back pain, nausea, vomiting, and prior urinary tract infections should be asked in an attempt to differentiate upper from lower urinary tract infection. If the sensation is “outside,” then a vaginal etiology should be suspected. Questions about a vaginal discharge or itching should always be asked. Vaginitis and a urinary tract infection often coexist, and vaginal infections in some populations are seen almost six times more frequently than urinary tract infections. Remember that women often do not spontaneously volunteer information about a vaginal discharge or vaginal itching. To help delineate the etiology of dysuria in the individual patient, both a urinalysis and a pelvic examination will often be necessary.
Ascertain the acuteness of onset of symptoms as well as whether there is associated hematuria or suprapubic pain. Coliform or staphylococcal urinary tract infections are typically more acute in onset (less than 4 days) and more often associated with suprapubic pain and hematuria than are chlamydial infections. Women with chlamydial infections are more likely to use oral contraceptives and less likely to have a history of a urinary tract infection within the preceding 2 years. One should also inquire about the sexual history because chlamydial infections are more likely in women with a new sex partner. In addition, a history of a sex partner with recent urethritis or discharge might direct attention toward chlamydia or gonorrhea, which tends to be less symptomatic in the early stages of infection in women.
Historic information such as immunosuppression (diabetes mellitus, sickle cell disease, steroids, etc.), childhood infections, previous acute pyelonephritis, prior relapses or recurrences of urinary tract infections (especially if greater than three), underlying urinary tract disease (stones, prior instrumentation, congenital anomalies), or presence of symptoms for greater than 7 days define a population of women at risk for subclinical pyelonephritis. This clinical entity of an upper tract infection without the usual accompanying symptoms or signs of fever, chills, back pain, nausea, and vomiting is less amenable to short courses of therapy and more likely to relapse. Subclinical pyelonephritis occurs in up to 30% of women in typical primary care settings and in up to 80% of indigent women presenting with dysuria.
Urinary frequency should be differentiated from polyuria, which specifically relates to the passage of an abnormally large volume of urine in a relatively short period of time. Frequency of normal urination may vary considerably from individual to individual depending on personality traits, bladder capacity, or drinking habits. Because of this fact, a history of frequency is sometimes difficult to obtain. Changes in the pattern of frequency or a history of voiding more than once at night after retiring, however, are clues to urinary pathology. Ask about volume and voiding times, since a large bladder capacity may conceal an increase in urine production. Frequency commonly accompanies the dysuria associated with urinary tract infections but less commonly with vaginitis. Ask also about periodicity of symptoms because day frequency without nocturia, or frequency lasting only a few hours at a time, suggests nervous tension or a psychiatric cause.
Urgency may occur with or without voiding and frequently culminates in incontinence. With severe lower urinary tract inflammation, the desire to urinate may be constant with only a few milliliters of urine eliminated with each voiding. Urge incontinence must be differentiated from the other types of incontinence, especially stress incontinence. Urgency also more commonly accompanies the dysuria associated with urinary tract infections than that associated with vaginitis.
Urinary Tract Infection (Homeopathy)
Strong urging to urinate—with cutting pains that are felt before the urine passes, as well as during and after—may indicate a need for this remedy. Only several drops pass at a time, with a scalding sensation. The person may feel as if the bladder has not been emptied, still feeling a constant urge to urinate.
Irritable bladder with a constant need to urinate, passing only small amounts, suggests a need for this remedy. Burning or cramping pain may be felt in the bladder area, with an itching sensation in the urethra while the urine passes. The person may feel very irritable, impatient, and chilly. Symptoms may be relieved by hot baths or other forms of warmth.
This remedy is often useful in cystitis and often helps when symptoms are unclear, or if other remedies have not been effective. Frequent urging is felt, with burning pain at the end of urination. Urine passes when the person is standing up, but only dribbling occurs while sitting. Flakes or sediment are sometimes seen in the urine. (Sarsaparilla is sometimes helpful when stones are forming or the kidneys are involved; however, these conditions need a doctor’s care.)
This remedy is often useful when a person feels anxious both before and during urination, with hot, scanty urine, and a burning or spasmodic feeling in the outlet of the bladder. It can also be helpful if retention of urine occurs after a person has been very cold and chilled, or after a shaking experience.
This remedy is indicated when the person frequently needs to urinate, but only small quantities are passed. Stinging and burning sensations are felt (especially with the last few drops) and the person may also experience soreness in the abdomen. Heat and touch make the symptoms worse, and cold applications, cool bathing, and open air bring relief. A lack of thirst is another indication that Apis may be needed.
This remedy may be beneficial if urging to urinate is frequent and intense, and the bladder feels very sensitive. A cramping or writhing sensation may be felt in the bladder area. Small amounts of highly-colored urine pass. (This remedy is sometimes helpful if a person passes small amounts of blood and no serious cause can be found on medical examination.)
Cystitis with twinges of cutting pain, or a burning feeling that extends to the urethra and its opening, may indicate a need for this remedy. The passage may also burn at times when no attempt at urination is being made. After emptying the bladder, the person feels as if some urine still remains inside. Urging and discomfort are often worse from walking.
This remedy can be helpful for cystitis with smarting pain in the urinary opening and aching in the bladder, with a feeling that the urine is retained. Children may cry or shriek, afraid to urinate because they know the pain is coming. Borax is often indicated for people who are sensitive to noise and inclined toward motion sickness.
If a person has a troublesome urge to urinate but has to strain (or even stand up and lean forward) to make it pass, this remedy may be useful. A scalding sensation may be felt while the urine flows, with a feeling of straining afterward.
This remedy may be indicated if a person has to urinate frequently with only a small amount being passed. A feeling of constriction is felt in the urinary passage, and the flow may be interrupted, or there may be dribbling afterward. A tingling sensation may occur, lasting long after urination is finished.
If cystitis is accompanied by dull but distressing pain and a feeling of fullness in the bladder, even after urinating, this remedy may be helpful. Urging and discomfort are more intense when the bladder has recently been emptied, improving over time as the bladder become more full.
This remedy may be helpful if a person has to urinate frequently during the night and passes large amounts of urine. Or the person may feel a painful urge, but has to strain to make the urine flow. Pain may be felt in the back before the urine passes. (If fever is present, the urine has a reddish color, or discomfort is felt in the kidney region, the person should see a doctor.)
This remedy may be helpful if a person has to urinate frequently, with sudden urging, a sense that urine will leak if urination is delayed, and small amounts of involuntary urine loss. The person may experience a bearing-down feeling in the bladder region, or pressure above the pubic bone. A person who needs this remedy often feels worn-out and irritable, with cold extremities, and a lax or sagging feeling in the pelvic area.
This remedy is often indicated for cystitis that develops in a woman after sexual intercourse, especially if sexual activity is new to her, or if cystitis occurs after every occasion of having sex. Pressure may be felt in the bladder after urinating, as if it is still not empty. A sensation that a drop of urine is rolling through the urethra, or a constant burning feeling, are other indications. Staphysagria is also useful for cystitis that develops after illnesses with extended bed rest, or after the use of catheters.