Urinary Tract Infections (UTIs)

Reducing Urinary Tract Infections

Appeared in the August, 2013 issue of Quality Care®

How do People get UTIs: Most UTIs arise from bacteria that normally live in the colon and rectum and are present in bowel movements. These bacteria cling to the opening of the urethra, begin to multiply, & travel up to the bladder. Urine flow from the bladder usually washes bacteria out of the body. However, because women have a shorter urethra than men, bacteria can reach the bladder more easily and settle into the bladder wall.

Prevalence: More than 4 million doctor office visits per year in the United States are for urinary tract infections (UTI). About 12% of men and 50% of women will have a UTI during his or her lifetime.

Symptoms:

  • Painful urination
  • Frequency
  • Urgency
  • Lower abdominal or pelvic pain or pressure
  • Blood in the urine
  • Milky, cloudy, or pink/red urine
  • Fever
  • Strong smelling urine

In the elderly population, symptoms of a urinary tract infection can be easily overlooked, causing a delay in diagnosis. Elderly people with a UTI are more likely than younger people not to be diagnosed until the complication of sepsis occurs. The elderly often do not experience or report obvious symptoms that younger people have, such as difficult urination, or frequent urination. Instead they may exhibit far more vague symptoms that are similar to many other diseases or may be assumed to be due to the aging process. These symptoms include: confusion, feelings of general discomfort, disorientation, fatigue, weakness, behavior changes, falling, and/or a new, acute incontinence. In addition, because incontinence is common in the elderly, they may not be aware of the symptom of frequency. If you experience any of these symptoms, see your healthcare professional.

Prevention of UTIs: There are several ways to prevent bladder infections:

  • Bathroom Behavior: Emptying the bladder by trying to urinate every two to three hours.
  • Diet: The use of cranberry products in research has been shown to decrease the ability of bacteria to adhere to the lining of the urethra and bladder.
  • Hygiene: Using soap & water or commercially available cleansing wipes several times per day & frequent changing of incontinence pads as they become wet can minimize the amount of bacteria in the urethral area. Women should always wipe from the front of the vagina to the back of the anus after urination or a bowel movement and wear cotton underwear. It is also reported that wearing thong undergarments may increase ones risk of developing an infection.
  • Sexual Activity: Can be the source of UTIs in women. Insuring proper lubrication to the vagina and voiding before and after intercourse are tactics to help prevent infection. Some physicians encourage women who have a history of recurrent infections to take a prophylactic antibiotic after intercourse, as it reduces risk of recurrent UTI by about 85%. At a minimum, restrict your number of sexual partners and urinate immediately after sexual intimacy to lower the risk of recurrent UTIs.
  • Vaginal Estrogen: reduces risk of recurrent UTI by repopulating the normal vaginal lactobacilli that keep bacteria from the rectum from multiplying and causing a bladder infection. Forms of vaginal estrogen are available at very low dosages that have minimal systemic absorption.
  • Catheter Use: proper cleansing and storage of catheters is important in one who intermittently catheterizes, as the catheter can be a vehicle to introduce infection if the technique is incorrect or if the catheters are not properly cleaned between each use. A “closed system” catheter provides a reliable means of sterile IC because the introducer tip is surrounded by a urine collection bag and never exposed to bacteria typically found at the urethral opening.

NOTE: Vaginal estrogens and antibiotics are medications that need to be prescribed by your healthcare provider.

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