Mita Venkatraman* is an IAS officer, who works mainly in the rural areas of Maharashtra. She is currently bedridden with a urinary tract infection. She is taking a high dosage of antibiotics and is suffering severe pain. "I mostly work with men in rural areas and since there were no proper bathrooms, I would often not use the bathroom whenever I felt the urge," she says. Like Mita, many working women today could contract this infection due to such habits and more.

What is a urinary tract infection?

It is a bacterial infection of the urinary tract. An infection occurs when microorganisms, usually bacteria, cling to the opening of the urethra and begin to multiply, she adds. Though UTIs are usually not life threatening, they are extremely painful. Women are especially susceptible to bacteria which may invade the urinary tract and multiply resulting in infection, due to their physical anatomy.

It happens in two ways: either the bacteria in the kidney travels down to the vagina or the bacteria enters the urethra (a tube which connects the urinary bladder to the outside of the body) and travels upward to the vagina, explains Dr Darshana Apte, a gynecologist based in New York.

Causes of UTI

When women tend to have long intervals between urination, this weakens the bladder muscles and some urine is left in the bladder. This can be a source of infection. 

"Another cause of UTIs is low water intake," says Dr Apte. She explains that if the water intake is low, urination will be less and the bacteria that might have entered the bladder will have more time to multiply and grow leading to infections.

Infants who use diapers, which are not changed regularly, are also susceptible to the infection. Also, wiping the stool from back to front can lead to transfer of bacteria, add doctors.

Adds Shilpa Joshi,  gynecologist who practices in Pune, "Any abnormality of the urinary tract, which obstructs the flow of urine, like a kidney stone can result in an infection." 

A common source of infection is catheters, or tubes, placed in the bladder. Bacteria on the catheter can infect the bladder, so make sure that the catheter sterile and remove it as soon as possible.

Sexual intercourse is a common cause of urinary tract infections. Dr Apte explains that in women who are sexually active bacteria may be transferred from the anal and vaginal area to the urethra and then the bladder.

Symptoms of UTI

UTI has acute symptoms and can be easily identified. There is a frequent urge to urinate immediately and this is is followed by a sharp pain or burning sensation in the urethra when the urine is released. Most often very little urine is released and it looks cloudy and may be tinged with blood. The urine also smells strongly, informs Dr Joshi.

The urge to urinate recurs quickly and soreness may occur in the lower abdomen, back, or sides. "The infected person is also likely to feel tired, drained out and feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone," she adds. When bacteria enter the uterus and spread to the kidneys, symptoms such as back pain, chills, fever, nausea, and vomiting may occur, says Dr Apte.

How is UTI diagnosed?

A urine test for bacteria can diagnose a UTI and it is mostly is treated with antibacterial drugs. Only in extreme cases severely ill patients with kidney infections may be hospitalised. Similarly in rare cases, if the root cause goes untreated, the patient is at risk of kidney damage.

How can UTI be prevented?

i. The most important method of preventing such infections is to practice good personal hygiene.

ii. Drinking plenty of fluids each day also helps in flushing the bacteria out of the urinary system, says Dr Apte.

iii. She adds that it is vital to empty the bladder as soon as the urge to urinate occurs. Postponing could lead to UTI.

iv. The other preventive measures include wiping from front to back to prevent bacteria around the anus from entering the vagina or urethra, avoid using unhygienic toilets, take showers instead of tub baths and avoid using deodorants/sprays on the thigh area and scented douches (jets of water that are scented), which may irritate the urethra.

v. Consuming foods rich in vitamin C such as amla, citrus fruits and juices helps to reduce the number of bacteria that might be harmful to the urinary tract.

Infections during pregnancy

Pregnant women seem more prone to UTIs than other women. Experts believe that that hormonal changes and shifts in the position of the urinary tract during pregnancy make it easier for bacteria to travel up the uterus to the kidneys. For this reason, many doctors recommend periodic testing of urine during pregnancy.

* Name changed to protect identity