• The urinary system is composed
of as following
1. Kidneys الكلى
2. Ureters الحالب
3. Bladder المثانة
4. Urethra. القناة البولية
• This system plays an important
role in removing wastes from
• The kidneys are a pair of beanshaped organs that lie in the
middle of the back, just below
the rib cage.
• One of their functions is to
filter waste from blood.
• Tubes called ureters carry these
wastes or urine from kidneys to
bladder, where it is stored until
it exits the body through the
• All of these components can
become infected, but most
infections involve the lower
tract — the urethra and the
• What is unary tract infection?
• A urinary tract infection, also known as
UTI, is usually a bacterial infection that
affects the urinary system.
• The urinary system produces, stores and
eliminates urine and consists of two
kidneys, two ureters, the bladder, the
urethra and two sphincter muscles.
• A urinary tract infection can affect any part
of the urinary tract.
• UTI is nearly always caused
• The urinary tract is also known as the
by bacteria, specifically
Escherichia coli (E. coli).
• UTI is nearly always caused by bacteria,
specifically Escherichia coli (E. coli).
• Urine contains a range of salts, fluids and waste products, but is
• When bacteria enter the urinary tract, e.g. the bladder or kidney,
they can reproduce rapidly in the urine, causing urinary tract
• Adult women are most commonly affected as their urethra is
shorter than men and opens nearer to the anus.
• This means it is easier for bacteria to enter the urinary system
and cause an infection.
• About 40% of women get at least one attack of cystitis in their
• It is more common in sexually active women, during pregnancy,
after surgery and menopause.
• Bladder infections are common and usually not serious if
• But if the infection spreads to the kidneys, it can cause more
• There are usually no germs (bacteria) in normal urine.
• However, sometimes bacteria from outside or inside the
body can get into the urinary system and cause inflammation
• Any part of the urinary tract may be infected:
• Urethritis is infection of the urethra.
• Urethritis is infection of a ureter.
• Pyelonephritis is infection of the kidneys.
• Cystitis is infection of the bladder.
• Cystitis, often referred to as a bladder infection, is the most
common type of UTI.
• A kidney infection is potentially more serious.
• Infections of the bladder and/or urethra are known as
lower urinary tract infections; if it occurs in the kidneys or
ureters they are known as upper urinary tract infections.
• Urinary tract infections are generally easily and effectively
treated with a short course of antibiotics.
• However, infection can cause discomfort, with the patient
experiencing pain during urination, a frequent urge to
urinate, and cloudy urine.
• What are the signs and symptoms of urinary tract infection?
• Signs and symptoms of a urinary tract infection depend on whether the lower
or upper urinary tract is affected.
• Lower urinary tract infection (affects bladder and/or urethra):
The urine may have an unpleasant smell
Hematuria - blood in urine
Frequent need to urinate - this may occur during the waking hours,
sleeping hours, or both
5. Holding the urine in may become harder to do
6. Discomfort and sometimes pain when urinating
7. Abdominal pain
8. Back pain
9. General malaise; generally feeling unwell
10. Tenderness around the pelvic area
• Upper urinary tract infection (affects kidneys and/or
Fever, usually high (at least 38C or 100.4F)
Pain on the side (flank), upper back or groin - this may become
more uncomfortable when urinating
7. Lower UTI symptoms - if the infection spreads to the lower
urinary tract, the patient may also have those symptoms.
• Older patients are more likely to have urinary tract infection with no
• How does doctor know, someone has urinary tract
1.Testing of the urine may reveal pus cells or red blood cells.
2. A urine culture (clean catch) or catheterized urine specimen
may be performed to determine the type of bacteria in the
urine and the appropriate antibiotic for treatment.
3.The specimen must be fresh.
4. It is also important that the woman has separated her labia
(lips) during urination, to avoid bacteria from the skin and
vagina contaminating the specimen.
5. Further investigations may be required to check the
urinary system including the kidneys
6. Suffering from recurrent urinary infection or if urine
shows more than 30 blood cells, may be advised to have a
cystoscopy in which the inside bladder is examined using
7. Need to an ultrasound scan to check kidneys, ureters and
8. Urinary tract infections in children are unusual and most
doctors would recommend careful investigation in this
• Diagnosing UTIs
• The first step in diagnosing a UTI is
usually a simple urine test called a
• It looks for bacteria, as well as
abnormal counts of white and red
• The dipstick test provides quick
• Doctor may also send the urine to a
lab for culture to confirm the type of
• At-home test kits can help detect a
UTI, but are not 100% accurate.
• Be sure to go over the results and
symptoms with your doctor.
• Infections during Pregnancy
• Pregnant women seem no more prone to UTIs than other
• However, when a UTI does occur in a pregnant woman, it is
more likely to travel to the kidneys.
• According to some reports, about 4 to 5 percent of pregnant
women develop a UTI.
Scientists think that hormonal changes and shifts in the
position of the urinary tract during pregnancy make it easier
for bacteria to travel up the ureters to the kidneys and cause
• For this reason, health care providers routinely screen
pregnant women for bacteria in the urine during the first 3
months of pregnancy.
• UTIs and Menopause
• Estrogen has a protective effect in the urinary tract, but levels
of this hormone drop off significantly during menopause. Low
estrogen levels can make it easier for bacteria to thrive in the
vagina or urethra.
• For this reason, women may be more susceptible to UTIs after
• The menopause is associated with a dramatic fall in the
production of oestrogens, which causes a rise in vaginal pH
from a reduction in lactobacilli.
• This makes the lower genitourinary tract more susceptible to
infection with pathogenic organisms.
• Colonization of the vaginal introitus with pathogenic bacteria is more
common and heavier in women who are susceptible to recurrent
urinary tract infection (UTI).
• The epithelium of the bladder and urethra also undergo atrophic
changes and this can lead to atrophic cystitis and the formation of a
• The lower part of the urethra is sensitive to oestrogens.
• In some cases the cause of symptoms is interstitial cystitis.
• Postmenopausal women are therefore at increased risk not only of
recurrent urinary tract infections, but also of dyspareunia, vaginal
irritation, pruritus, pain and also symptoms of urgency, frequency,
dysuria and urinary incontinence.
• UTIs and Diabetes
• People with diabetes are more vulnerable to UTIs for several
• First, their immune systems tend to be weaker.
• Second, high blood sugar can spill into the urine and
encourage the growth of bacteria.
• Also, nerve damage related to diabetes can prevent the
bladder from fully emptying.
• People with diabetes should talk with their doctor at the first
sign of a UTI
• Why Elders Are More Likely to Get UTIs
• The population most likely to experience UTIs is the elderly.
• Elderly people are more vulnerable to UTIs related to a
suppressed immune system that comes with age and certain agerelated conditions
• Unlike younger persons who empty the bladder completely upon
urination, elderly men and women experience a weakening of the
muscles of the bladder.
• Urine can be retained in the bladder resulting in accumulating
bacteria and subsequent.
• Elderly people with serious urinary tract infection don't exhibit the
hallmark sign of fever because their immune system does not
mount a typical response to infection due to the effects of aging.
• In fact, elders typically don't exhibit any of the common symptoms
nor do they express symptoms their caregivers.
• The major symptoms of UTIs in the elderly are behavioral changes
that resemble the early stages of dementia or Alzheimer's because
symptoms may include:
1. Confusion, or hallucination -like state
4. Other behavioral changes such as social inappropriateness
• Other distinctive symptoms involve poor motor skills or dizziness
and falling, frequently touching themselves, or a new onset of
• UTIs in Infants
• Babies occasionally develop UTIs, but they can’t tell you what they
• Here are some signs to watch for:
1. An unexplained fever
2. Strange-smelling urine
3. Poor appetite or vomiting
4. Fussy behavior
• It’s vital to treat a baby’s UTI quickly to prevent kidney damage.
• Promptly changing a dirty diaper can help prevent bladder
• And of course, wipe from front to back whenever changing a
• UTIs in Children
• About 1% of boys and 3% of girls develop UTIs by age 11.
• This includes some children who repeatedly delay a
• Their muscles may not relax enough later to fully empty the
bladder and flush away any bacteria.
• More regular bathroom trips and drinking plenty of liquids
• A small number of children have a structural problem that
obstructs urine flow or lets urine flow back from the
bladder to the kidneys, triggering chronic kidney infections.
• This can lead to kidney damage.
• Symptoms and signs
• Infants and children presenting with unexplained
fever of 38°C or higher should have a urine sample
tested after 24 hours at the latest.
• Infants and children with symptoms and signs
suggestive of urinary tract infection (UTI)
• should have a urine sample tested for infection.
• Table 1 is a guide to the symptoms and signs that
infants and children present with.
• Table 1 Presenting symptoms and signs in infants and children with UTI
Symptoms and signs
Most common ------------------> Least common
Infants younger than 3
Fever, Malaise , Vomiting
Haematuria, Offensive urine
Infants and children, 3
months or older
• What boosts UTIs risk?
• UTIs are most common in sexually active women.
• Other factors that may increase UTIs risk include:
1. Not drinking enough fluids
2. Taking frequent baths
3. Holding your urine
4. Kidney stones.
Other risk factors include:
1. One study found an increased risk of UTIs in postmenopausal women with sexual
activity, previous history of UTI, treated diabetes and incontinence.
2. Other risk factors associated with recurrent UTI in postmenopausal women are vesical
prolapse, cystocele and post- voidal residue.
3. Diabetes and cerebrovascular event (as well as other neurological conditions) can lead
to incomplete emptying of the bladder with a predisposition to recurrent UTI.
4. Poor mobility and being confined to bed also increases the risk.
• UTI or Something Else?
• Although burning during urination is a telltale sign of a
UTI, it can also be a symptom of certain sexually
transmitted diseases (STDs.) These include chlamydia,
gonorrhea, and trichomoniasis.
• Simple lab tests are available to distinguish a UTI from
• UTI vs. STD
• A UTI infection has many of the same symptoms as
common STDs chlamydia and gonorrhea. And
interestingly, both UTI infections and STDs can be
triggered by sex, especially in younger women.
• While only STD and chlamydia testing will let you know
for sure which one you have, it’s a good idea to know as
much as you can about the differences between the two.
• How Does Sex Affect UTI Infections?
• It’s no secret that sex can lead to chlamydia and other STDs, but many
people don’t realize that sex can trigger UTI infections. Here’s why:
• Female anatomy. Women have shorter urethras compared to men.
• This anatomical difference makes it easier for the bacteria to travel to the
bladder and cause an infection.
• Movement. UTI infections happen when bacteria get in the urinary tract.
• The more foreign objects and substances come in contact with the urethra,
the more opportunities bacteria have to spread.
• That’s why sex and use of spermicides can lead to UTI infections in women.
• Certain birth control methods. The use of diaphragms or spermicidal agents
can increase the likelihood of contracting a UTI.
• Keep in mind that these methods don't protect against common STDs like
• Chlamydia Symptoms vs. UTI Symptoms
• Common chlamydia symptoms in women include:
• Painful urination
• Lower abdominal or pelvic pain
• Abnormal vaginal discharge
• Pain during sex
• Low-grade fever
• UTI symptoms may include:
• Painful urination
• A strong, persistant need to urinate
• Pelvic pain in women
• Low-grade fever
• Based on the symptoms, it can be difficult it differentiate between these two
ailments, especially if you have never experienced a UTI before.
• Should someone Get STD Testing or UTI Infection Testing?
• STD symptoms and chlamydia symptoms can look a lot like UTI
• Both conditions can cause abdominal or stomach pain, along with
• When experiencing possible chlamydia or STD symptoms, it's critical
to get tested for STDs, since untreated chlamydia and gonorrhea can
cause infertility in women.
• The tricky thing is that chlamydia symptoms (which also include
vaginal discharge, nausea, fever, and spotting) often don’t show up.
• At all. That means that a lot of people with chlamydia never get the
STD testing they need. And to make things even more confusing,
chlamydia symptoms often mimic symptoms of gonorrhea, another
common and potentially harmful STD.
• Whether you have symptoms of an STD or a UTI infection, it’s
important to seek medical care.
• Untreated chlamydia and gonorrhea can lead to long-term
complications like infertility or ectopic pregnancies.
• Untreated UTI infections can become painful and lead to kidney
complications. Luckily, both are fairly common conditions and can
be cured with antibiotics, but a proper diagnosis is the first step to
• Urinary Tract Infection (UTI) and Nutrition Therapy
• Recommended Foods
1. Fruit juices, such as cranberry juice
2. Yogurts made with “live active cultures” (this term will be listed on the
3. package or ingredient list)
4. Lots of water
• Meal Planning Tips
• In general, you can eat the same foods you usually eat.
• Have cranberry juice and other berry juices instead of the drinks you
• Have yogurt with live cultures in place of milk or other milk products.
• Eat it with fruit or cereal.
• Try fruit smoothies made with yogurt.
• Choose fresh fruit drinks that list fruit juice first on the ingredient list.
• Try to drink 8cups of water daily.
• Sample 1-Day Menu in the following table
½ cup fruit juice
1 cup corn flakes
½ cup yogurt (with live cultures)
1 slice whole wheat toast
½ cup milk
1 cup coffee
At least 1 cup water
100 grams sliced turkey
2 slices whole wheat bread
Lettuce and tomato
½ cup cucumber salad with oil and vinegar
1 medium orange
At least 1 cup water
½ cup fruit juice
100 gm baked fish
1 cup rice
1 cup carrots
21 cup salad with oil and vinegar
At least 1 cup water
½ cup yogurt (with live cultures)
Small size fruit like orange or peach or half banana.
At least 1 cup water