A 28 year old female starts complaining of severe lower back pain that started a day before. She’s also complaining of abdominal pain, nausea and vomiting, and has a high fever. She has been urinating about 15 times a day but there is no pain while urinating. However, she was experiencing excruciating pain while urinating several times about 2 weeks ago but she took some Ibuprofen and that seemed to help alleviate the pain.
At first glance, from this lady’s symptoms, it almost seems as if this lady is having abdominal issues since she’s having abdominal pain along with nausea and vomiting. However, what stands out with her is that she has been urinating about 15 times daily. This is known as Urinary frequency. A Urinary Tract Infection (UTI) is a common cause of frequent urination. Another finding that is worth mentioning is that she was experiencing excruciating pain while urinating about 2 weeks ago, so she took Ibuprofen to help with the pain. The painkillers just masked the underlying problem; it did not cure it.
Now, she is complaining of urinary frequency, severe abdominal pain and lower back pain, she can hardly move, looks very ill, having nausea and vomiting and has a high fever. These symptoms are a classical presentation of ACUTE PYELONEPHRITIS. This person is most likely suffering from Acute pyelonephritis (infection of the kidney) which is causing her severe lower back pain and the abdominal pain. This acute pyelonephritis is most likely due to untreated Urinary Tract Infection of which she showed symptoms of 2 weeks prior.
Urinary tract infections are usually ascending infections from bacteria that colonize the vaginal wall and these bacteria eventually get into the urethra. It travels upwards to infect the bladder; this is known as cystitis. If left untreated, the bacterial infection can go higher up the tract to infect the kidneys (pyelonephritis). Patients with Urinary Tract Infection usually present with urinary frequency, urinary urgency, pain on urination(dysuria). Though it can affect men and women, it more commonly affects young women.
Most UTIs are caused by E. coli. E. coli is a bacteria that is normally found in the intestines and it leaves the body through the anus during bowel movements. The distance between the urethra (urinary opening) and anus is very short in women so this makes it very easy for the bacteria to get in and once the E. coli gets into the urethra, it can cause an infection. Other less common causes of UTIS include anatomical defects of the urinary system. Pregnant women and people with diabetes are also at an increased risk of contracting UTIs due to suppressed immune function.
People that present with UTIs usually have classic symptoms; hence it is most times a clinical diagnosis made by the doctor. That is to say, that majority of people that present with such symptoms such as dysuria(painful urination), urinary frequency, urinary urgency most likely have a urinary tract infection. Your doctor might choose to do a Urine culture and/or Urinalysis just to make sure.
Since it is bacterial infection, antibiotics such as FLUROQUINOLONES taken for about 3-7 days are the drug of choice depending on the severity. Sometimes your doctor would go ahead and start treating even before Urine culture and Urinalysis test results are out. This is because we do not want the bacterial infection to progress to even more severe condition, so we start treatment immediately.
If the patient has symptoms such as abdominal pain, back pain (due to inflamed and infected kidneys) in addition to above symptoms, then the UTI has most likely progressed to pyelonephritis. In such scenarios, the patient would have to be admitted and given IV antibiotics till the patient starts feeling better then you can discharge and continue oral antibiotics for 2 weeks.
UTIs are very common infections and are easily treated with antibiotics. In fact, approximately, 60 % of people will experience a UTI at least once in their lifetime. It is very important to quickly identify and treat UTIs in order to avoid a more severe condition known as pyelonephritis which is when your kidneys are infected and inflamed. 20-30% of patients with untreated UTI will develop pyelonephritis so if you are experiencing such symptoms, please visit your nearest medical centre or talk to your doctor.HYGIENE also plays a major role in preventing UTIs. Here are some tips on how to remain UTI free.
-ALWAYS wipe from front to back after urinating. This will prevent germs from being transferred from anus to urinary opening. This is the #1 Rule. Please Don’t joke with it!
-AVOID taking prolonged bubble baths, because the water maybe contaminated and therefore, prolonged stay may allow the bacteria to reach urinary opening. So Please, Ladies, think twice before running yourself a hot bubble bath…. Please take a warm shower instead! Better safe than sorry.
-PLEASE don’t hold your urine for long periods at a time, if you have to urinate, please do so. Holding your urine will only give the bacteria a chance to multiply!
– DRINK plenty of fluids; and by fluids, I mean water…. Not soft drinks or juice concentrates! The only juice you are allowed to drink is Cranberry Juice. Water and cranberry help to flush out bacteria from the urinary tract.
-AVOID using scented vaginal products such as scented douches and sprays because they can cause UTIs and a host of other infections. Stay away from all these perfumed products designed for your intimate area. They cause more harm than good. Period!
-DIET: Avoid too much sugary foods as too much sugar decreases your body’s ability to fight infections.
Disclaimer: The medical information provided on here by Dr. Nini Iyizoba is provided as an information resource only. This information does not create any patient-physician relationship and should not be used as a substitute for professional diagnosis and treatment.
