Urinary tract infection

Urinary tract infection

1. Symptoms

   • Frequency of urination increase
   • burning sensation on urination
   • cloudy or pink coloured urine
   • feeling tired or shaky
   • fever or chills
   • pain in side or lower back
   • strong smelling urine

2. Causes

   • microorganisms in the bladder (e.coli) from the bowels
   • faeces bacteria
   • sexual intercourse & new sexual partner
   • female anatomy - female shorter urether
   • perimenopuase/menopause - more prone to. infection due to reduced oestrogen
   • diaphragms & spermicide
   • urinary tract abnormalities
   • blockages in the urinary tract
     • kidney stones
     • enlarged prostate
   • suppressed immune system,
   • catheter use
   • diabetes
   • pregnancy
   • incomplete bladder emptying
   • frequent sexual intercourse

3. Differentials

   • cystitis (bladder infection)
   • bacterial vaginosis
   • urethral syndrome
   • gardnerella
   • STD
     • chlamydia
     • gonorrhoea
     • trichomoniasis
     • genital herpes
   • lithium & heavy metal toxicity

4. Nutrition

   • Vitamin C - free radical scavenger, immune boosting
   • Drink plenty of water
   • drink berry juices such as cranberry juice
   • probiotics to restore gut flora
   • lactobacillus ramnosus
   • lactobacillus Reuteri
   • diuretic herbs like taraxacum officinalis (Danelion)
   • reduced refined sugar and alcohol intake
   • beta--carotene, zinc
   • vitamin A

5. Investigations

   • Leukocyte esterase test
   • Urinalysis
   • renal tract ultrasound
   • mid stream urine specimen
   • FBE
   • urine pH
   • food allergens, IgG, IgM

6. Physical assessments

   • vital signs
     • tachycardia
   • check temperature
   • suprapubic tenderness
   • flank pain

7. questioning

   • Female repro review
     • DO you have or know of any allergies you may have?
     • Any recent procedures? ie Pap smear
     • Any thrush?
     • contraception - what kind
     • How often does it happen?
   • Lifestyle review
     • current stress levels
     • current energy levels
     • how much sleep do you get?
   • LODC
     • Duration: how long has it been going for?
     • location - referred pain or location of pain
     • When did it start?
     • PHx - how often do you get these kind of infections?
     • FHx of UTI
     • presenting symptoms
   • Immune
     • how often do you get a UTI?
     • Does it take you long to heal normally?
     • what common types of infection do you get?
   • Dietary:
     • Any known food allergies?
     • Do you follow any type of diet?
     • How much water would you drink per day?
     • Are there any barriers to some dietary changes I might suggest?
     • Any foods you hate?
     • Normal eating habits
     • 24hr diet recall
     • do you take a calcium supplement ?

8. Types of UTI

   • Lower urinary tract
     • bladder
     • urethra
   • upper Urinary tract
     • kidneys (pyelonephritis)
     • ureters

9. complications

   • recurrent infection
   • permanent kidney damage or chronic kidney infection
     • untreated UTI
   • pregnant women
     • low birth weight
     • premature baby
   • urethral narrowing (stricture) males
   • sepsis - esp if works it way up to kidneys