UTI, the cause and effect

Dr Sadhna Sharma

Urinary Tract Infection (UTI) is one of the most common bacterial infections infecting women. Of late, though, children, as young as five year old, are also contracting the infection, largely due to unhygienic toilet practices. UTI is caused by bacteria that enter the urinary tract through the skin around the anus and the vagina. The most common cause of UTI is E. coli bacteria, which originates in the intestines. Most UTIs are caused when this or other bacteria spread from the anus to the urethra. 

Girls more prone 

UTIs occur more often in girls, especially when toilet training begins, because their urethra is shorter and closer to the anus. This makes it easier for the bacteria to enter the urethra. Most of the cases are caused due to lack of sufficient toilet hygiene practices. Parents should watch out for symptoms such as fever, poor appetite, vomiting, diarrhoea, and irritability in children. Blood in urine, cloudy or foul-smelling urine, pain, stinging, or burning with urination, pressure or pain in the lower pelvis or lower back, below the navel or frequent urination are some other symptoms parents should be careful about. These infections among children generally happen due to unhygienic public toilets in schools. Also, children are not aware of the hygienic toilet practices, thus parents should make their children aware about good toilet practices to avoid such infections.

Types of UTI and symptoms

The initial signs of a UTI in children can get overlooked as younger children may not be able to describe the source of their distress. Parents should not delay consulting a doctor if the child looks sick and has high fever without runny nose, earache, or other obvious reasons for illness. A child can develop a UTI when bacteria enter the urinary tract and travel up the urethra, into the body. 

The two types of UTIs most likely to affect children are bladder infections and kidney infections. When a UTI affects the bladder, it becomes cystitis. When the infection travels from the bladder to the kidneys, it is known as pyelonephritis. Both can be treated with antibiotics, but a kidney infection can lead to more serious health complications if left untreated. 

A structural deformity or blockage in one of the organs of the urinary tract, abnormal function of the urinary tract, vesicoureteral reflux, a birth defect that results in the abnormal backward flow of urine, the use of bubbles in baths or tight-fitting clothes in girls, wiping from back to front after a bowel movement, poor toilet and hygiene habits, and infrequent urination or delaying urination for long periods of time are some of the common risk factors for children developing UTI. Getting the right treatment is important as an untreated UTI may cause kidney abscess, reduced kidney function or kidney failure, or the swelling of the kidneys, or sepsis leading to organ failure and death.

Dos and don’ts of preventing UTI

Once someone develops UTI, there are high chances that it may strike again. Therefore, one should take the following steps to prevent UTI in children:

• Parents should teach their children that if the toilets in school or even at home are not clean, they must not use it. At the same time, they should not withhold the urge to urinate for a long time. Some children do not empty their bladder completely after peeing and release just enough to make the sensation go away. Holding on to their urine makes their body tighten the bladder muscles — make them practice ‘double peeing’ which effectively sends them back to the washroom immediately after they just peed, to promote better bladder emptying.
• Adequate hydration is key in all seasons, and urine should be of a very light colour, almost like water. Dark urine is more likely to cause a burning sensation and make a child want to hold the urine inside. Constipation too is harmful and may cause UTI as those who hold their poop often hold back urine as well. 
• Wearing fresh and clean undergarments and clean wiping from front to the back after a bowel movement can also prevent the infection. In smaller children and infants, changing diapers frequently can prevent both UTI and unwanted rashes. 
• Children should stay away from bubble baths because it can lead to skin irritation on and around the genitalia. 

— The writer is senior consultant, Miracles Mediclinic and Apollo Cradle Hospital, Gurugram