Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Urine, similar to other fluids in the body, is normally
sterile without significant bacterial infection. Therefore, the presence of
bacteria in the urine is considered abnormal and may lead to urinary tract
infection. Typically, bacteria gain access to
the urinary system from outside through the urethra (the drainage tube for urine
from the bladder). The bacteria may then ascend in the urinary system and cause
kidney infections. Kidney infection (upper UTI) is typically more severe than
lower UTI because bacteria may infect the blood stream (bacteremia) from the
kidneys.
Bacteria may travel from the rectum or the vagina towards the urethra to gain
entry into the urinary system. Other bacteria may enter from the skin. Women are
more susceptible to urinary tract infections due to the shorter length of urethra.
What are risk factors for kidney and urinary tract infection?
There are many factors that may increase the chances for infection of kidney
and urinary tract.
Sexual intercourse (in women) may increase the risk of
urinary tract infection because of possible introduction of the bacteria around
the urethra into the urinary system (a condition sometimes referred to as "honeymoon cystitis").
Pregnancy may also increase the incidence of UTI and
kidney infection in women, in fact, 2% to 8% of pregnant women may have urinary infections
during their pregnancy. This may occur because of slower transit of urine in the
ureters during pregnancy from the pressure applied by the uterus.
Urinary catheters (Foley catheters) also increase the risk of developing
urinary and kidney infections. These catheters are used in settings where an
individual may not be able to urinate due to paralysis, severe illness, bed
bound state, incontinence of urine
(inability to hold their urine), or bladder dysfunction. Urinary catheters simply provide a physical vehicle for the
bacteria from outside to be directly transported into the bladder and the
urinary system.
Kidney stones and other structural abnormalities of the
urinary system may also cause kidney infection. Impaired draining and
blockage of urine may cause bacteria to ascend to the kidney without being
washed back down with the urine. Any obstruction to the flow of urine can serve as a focus of
infection that can spread to other parts of the urinary tract.
In children, risk factors for kidney infection include female gender,
uncircumcised male, structural abnormalities of the urinary tract, and Caucasian
race (four times higher than African American).
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Prostatitis is a painful condition of the prostate gland. There are four types of prostatitis, acute bacterial, chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Diagnosis is made with a digital rectal exam, urinalysis, ultrasound, MRI, biopsy, or blood test. Treatment depends upon the type of prostatitis.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis include nausea, vomiting, urinary tract infection, fever, painful urination, increased urinary frequency and urgency, flank pain, and swelling of the abdomen. Treatment of hydronephrosis depends on the cause.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Urinary tract infections (UTIs) are very common in children. Symptoms and signs include fever and abdominal pain. Associated symptoms and signs include flank pain, vomiting, and blood in the urine. Treatment for a UTI involves antibiotic therapy.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
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