Why Do People Get Bladder Infections

Causes Of Chronic Utis

A whole slew of things can cause chronic UTIs, but these are some of the biggest causes.

Basic anatomy in itself may be the single biggest risk factor for UTIs, urologist Elodi Dielubanza, M.D., assistant professor of surgery at Harvard Medical School and associate surgeon at Brigham and Womens Hospital, tells SELF.

The reason is simple: The bacteria E. coli, which causes the majority of UTIs, is naturally present in your GI tract , but it can cause an infection if it gets to your urinary tract. The genital anatomy of someone with a vagina is conveniently set up in a way that makes this trip very quick and easy for that bacteria. Basically, the distance between the anus and the urethra is extremely short , as is the length of the urethra, which basically acts as a ladder that E. coli can climb up into the bladder, Dr. Dielubanza says. In comparison, people with penises tend to have a greater distance between their anus and their urethra, which makes these infections less likely .

Being sexually active is a UTI risk factor, the Mayo Clinic explains.

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While there are a variety of anatomic and functional scenarios that put you at risk, for UTIs, the most common ones involve urinary retention, meaning you have an impaired ability to empty your bladder fully and frequently, Dr. Vasavada says. This results in stagnant urine, which can let infection-causing bacteria linger.

Why Do Utis Return Despite Treatment

There are about a half-dozen oral antibiotics that treat UTIs. Sometimes a doctor will prescribe one drug, then switch to another after a urine culture identifies which bacteria is at work. Adjusting the medication can take time, and recurrent infections may occur in the meantime.

Sometimes a person starts to feel better and decides to stops taking the antibiotic contrary to the doctors instructions and another infection soon follows. Its never a good idea to stop taking antibiotics before your dosage is complete.

But even people who take medication as the doctor prescribes may get recurrent infections, Dr. Vasavada says.

If youre a younger woman who is sexually active, your doctor may prescribe an antibiotic to take before and after sexual activity. For post-menopausal women, a vaginal estrogen cream may help reduce infections.

If infections persist, your doctor may test for other health problems in the kidney, bladder or other parts of the urinary system.

And It Wont Hurt To Try These

Like many women, you may have memorized the following age-old advice for preventing UTIs:

• Wipe from front to back.

• Urinate before and after sex.

• Drink lots of water.

• Avoid tight underpants and jeans.

These suggestions are directed at flushing the bladder and keeping E. coli from spreading into the urinary tract. Although studies have failed to show that they prevent either primary or recurrent UTIs, theres no harm in trying them, Dr. Gupta says. They cant hurt, and if they help, youre ahead of the game.

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Common Questions & Answers

UTI symptoms can be uncomfortable or painful. They include the following:

• A strong urge to urinate
• Pain or burning during urination
• Passing small amounts of urine
• Cloudy, strong-smelling, red or pink urine
• Mucus or discharge
• Incontinence
• Fever, shaking, chills, or pain in the upper back, side, or groin

E. coli

What Is A Bladder Infection

A bladder infection is a common condition with upwards of 30% of women experiencing it at least once throughout in their life.

The medical name for bladder infection is Cystitis and it appears when Escherichia coli bacteria enter and travel up the urethra, infect the urine and inflame the internal bladder lining. E. coli is found primarily in the bowel, and lesser so, in the vagina and on the skin between the anus and the vagina . Although fairly sedate in its natural environment of the bowel, E. coli bacteria thrives in urines acidic state.

Bladder infections almost always present after a bacterial infection in the urine. It is the most common type of urinary tract infection , with women being much more prone than men. The onset age is around 40 years, although many women are diagnosed in their 30s.

A womans shorter urethra allows the bacteria to reach the bladder quickly. Additionally, the close proximity of the urethral, vaginal and anal openings make it easy for bacteria to be transferred.

Most women will experience a bladder infection at least once in their lives. While it is painful and annoying, its not dangerous or contagious, and cant be passed on to your partner during sex.

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Tips For Preventing Utis In The Elderly

The following lifestyle and personal hygiene changes can significantly reduce a seniors risk of developing a urinary tract infection.

• Drink plenty of fluids.
• Drink cranberry juice or use cranberry tablets, but NOT if the elder has a personal or family history of kidney stones.
• Avoid or limit caffeine and alcohol, which irritate the bladder.
• Do not douche or use other feminine hygiene products.
• After toileting, always wipe from front to back .
• If incontinence is not an issue, wear breathable cotton underwear and change them at least once a day.
• Change soiled incontinence briefs promptly and frequently.
• Keep the genital area clean and dry.
• Set reminders/timers for seniors who are memory impaired to try to use the bathroom instead of an adult brief.

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What Can You Do If You Keep Getting Utis

If you keep getting UTIs, you must talk to your doctor. After talking with you, your doctor will either recommend treatments for recurring urinary infections or send you to a special doctor called a urologist. A urologist focuses on diseases and problems of the entire urinary system, so he may be able to better pinpoint what is causing your infections and how to treat and prevent them.In addition to the tips mentioned above, you can also take some other simple steps to help prevent UTIs, such as:

• Drink plenty of water.

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Reasons Why You Might Get Recurring Utis

Many women who get a urinary tract infection may get one again at some point in their lives. In fact, one in five women experience recurrent UTIsan infection that occurs two times or more within six months or at least three times in a year. Men can get recurrent UTIs too, but it is not as common and is often due to some type of urinary tract blockage.

What Is The Prognosis For A Person With A Urinary Tract Infection

Urinary tract infections typically respond very well to treatment. A UTI can be uncomfortable before you start treatment, but once your healthcare provider identifies the type of bacteria and prescribes the right antibiotic medication, your symptoms should improve quickly. Its important to keep taking your medication for the entire amount of time your healthcare provider prescribed. If you have frequent UTIs or if your symptoms arent improving, your provider may test to see if its an antibiotic-resistant infection. These are more complicated infections to treat and may require intravenous antibiotics or alternative treatments.

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How Is A Uti Diagnosed

To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.

If you have had a UTI before, your doctor may order more tests to rule out other problems. These tests may include:

• A cystogram. This is a special type of x-ray of your urinary tract. These x-rays can show any problems, including swelling or kidney stones.
• A cystoscopic exam. The cystoscope is a small tube the doctor puts into the urethra to see inside of the urethra and bladder for any problems.

Role Of Urinary Testing In Diagnosing Symptomatic Utis In Older Adults

The utility of urinary dipstick testing, urinalysis, and urine culture is challenging in the older adult because of the high prevalence of bacteriuria and pyuria that may not be clinically important. As in the case of Mrs M, all urinary studies to evaluate for leukocyte esterase, nitrites, pyuria, and bacteriuria over a 2-year period were positive.

The urinary dipstick, although easy and convenient, has variable test characteristics. Sensitivity and specificity for urinary dipstick testing to evaluate for leukocyte esterase, nitrites, or both vary in older adults by the age of study participants, clinical suspicion of UTI, and laboratory definition for UTI used . The sensitivity and specificity for a positive dipstick test in older patients with was 82% and 71% , respectively. Other studies of elderly patients showed the negative predictive value for dipstick testing ranges from 92% to 100%., Urinary dipstick analysis should be performed in the out-patient setting primarily to rule out and not to establish a diagnosis of UTI. In a patient with a low pretest probability of UTI, if the dipstick is negative for leukocyte esterase and nitrites, it excludes the presence of infection and mitigates the need to obtain urinalysis and urine culture . High false-positive rates limit dipstick testing effectiveness. Further urinary studies are warranted for patients with a high pretest probability of UTI.

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What Is The Treatment For A Urine Infection In Older People

• A course of anantibiotic medicine will usually clear the infection quickly. You should see a doctor if your symptoms are not gone, or nearly gone, after a few days.
• Paracetamol or ibuprofen will usually ease any pain, discomfort, or high temperature .
• An underlying cause such as an enlarged prostate gland or constipation may be found and need treatment.

Note: if you have an infection of your bladder then having plenty to drink is traditional advice to flush out the bladder. However, there is no proof that this is helpful when you have cystitis. Some doctors feel that it does not help and that drinking lots may just cause more toilet trips, giving you more unnecessary pain. Therefore, it is difficult to give confident advice on whether to drink lots or just to drink normally when you have mild symptoms of cystitis. However, if you have a high temperature and/or feel unwell, having plenty to drink helps to prevent having a lack of fluid in your body .

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Does Cranberry Juice Prevent A Urinary Tract Infection

Many people say that cranberry juice can help treat, or even prevent, a UTI. Researchers are currently looking into the topic, but havent found a definitive answer yet. Healthcare providers recommend drinking lots of fluids if you have, or have a history of getting, a UTI. Adding a glass of unsweetened cranberry juice to your diet isnt a proven way to prevent a UTI, but it typically wont hurt you either.

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Institutionalized Older Adults & Catheterized Patients

Similar to other populations, the diagnosis of symptomatic UTI in nursing home residents requires the presence of genitourinary symptoms in the setting of a positive urine culture. In older adults who are cognitively intact, the diagnosis of symptomatic UTI is relatively straightforward. However, nursing home residents often suffer from significant cognitive deficits, impairing their ability to communicate, and chronic genitourinary symptoms , which make the diagnosis of symptomatic UTI in this group particularly challenging. Furthermore, when infected, nursing home residents are more likely to present with nonspecific symptoms, such as anorexia, confusion and a decline in functional status fever may be absent or diminished . In the setting of atypical symptoms, providers are often faced with the challenge of differentiating a symptomatic UTI from other infections or medical conditions. The high prevalence of bacteriuria plus pyuria in this population often leads to the diagnosis of UTI. Although bacteriuria plus pyuria is necessary for diagnosis of a laboratory-confirmed UTI, alone it is not sufficient for making the diagnosis of symptomatic UTI. To date, universally accepted criteria for diagnosing UTI in this population do not exist, making it difficult for providers to distinguish a symptomatic UTI from other conditions in the presence of new nonspecific symptoms.

How Are Utis Diagnosed

Only a health care provider can treat urinary tract infections. The first thing a doctor will do is confirm that a person has a UTI by taking a clean-catch urine specimen. At the doctor’s office, you’ll be asked to clean your genital area with disposable wipes and then pee into a sterile cup.

The sample may be used for a urinalysis or a urine culture . Knowing what bacteria are causing the infection can help your doctor choose the best treatment.

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Why Are Women And Older Adults More At Risk

E. coli or other bacteria cause UTIs, which are infections in your kidneys, bladder, ureters or urethra. Unfortunately, women are more likely to get them mainly because of their anatomy.

A womans urethra is shorter than a mans and closer to the anus. The urethra is also close to the vagina, which can collect bacteria during sex. So bacteria from both the anus and vagina have easy access to a womans urinary tract.

Post-menopausal women are also at higher risk because pH changes in the vagina make it more susceptible to infection.

Both men and women are more likely to get UTIs as they age. Certain medical conditions, such as bladder prolapse in women and enlarged prostate in men, cause incomplete bladder emptying in older adults. Urine that stays in your bladder too long can encourage bacteria to grow.

Some newer drugs for diabetes can also promote sugar in the urine and create conditions ideal for a UTI, Dr. Vasavada adds.

You Eat A Lot Of Sugar

Bacteria that cause UTIs love feeding on sugar, so you run the risk of providing a feast for them whenever your sweet tooth strikes. Kalas V, et al. Structure-based discovery of glycomimetic FmlH ligands as inhibitors of bacterial adhesion during urinary tract infection. DOI: 10.1073/pnas.1720140115

If you eat tons of added sugars and get a real surge in your blood sugar, you may end up with some of that sugar in your urine, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at the Yale School of Medicine.

Some foods and beverages, like coffee, booze, and chocolate, can also irritate your delicate urinary tract and exacerbate an existing UTI.

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Why Are Urinary Tract Infections Such A Big Deal For The Elderly

For many young women, urinary tract infections are an occasional annoyance. They cause a few painful hours and many trips to the bathroom, but are soon dispatched with medication.

For many young women, urinary tract infections are an occasional annoyance. They cause a few painful hours and many trips to the bathroom, but are soon dispatched with medication.

But they are something else again for the elderly. They send millions of women and men to the hospital every year and can kill if infection spreads to the kidneys or blood.

Pneumonia and urinary tract infections are the biggest infectious reasons for admission to the hospital for older adults, said John Bruza, a geriatrician at Penn Medicine.

UTIs are feared enough that many hospitals are working harder to keep infections from starting on their watch by restricting use of urinary catheters. Infections acquired through catheters tend to be worse than those that patients get at home.

Because overuse of antibiotics can lead to tougher bugs, there is also a campaign to make sure doctors dont assume that vague symptoms in an older person started in the urinary tract.

Its just more complicated for older adults, Bruza said.

Relatively common

Rare in young men, the infections are more common in older men though still not as frequent as in older women.

It speaks to just how medically fragile some of these folks can be, Khelil said.

Weakness, confusion

Hormonal changes

How Utis Are Diagnosed

In most cases, if you think you have a UTI, you should visit a health care provider and give a urine sample for testing. A urinalysis is a test that looks for white blood cells, red blood cells, bacteria, and or other chemicals such as nitrites in your urine. A proper urinalysis can pinpoint an infection and a urine culture can help your health care provider choose the best antibiotic for treatment. It is vital to get a urinalysis and culture performed to make sure you have an infection and require care. Use of antibiotics when not needed, can be tricky, and can lead to greater rates of bacterial antibiotic resistance.

It should be noted that some individuals get a urinalysis result that shows bacteria, but the individuals are not having any symptoms of a UTI. This event is common in older adults. If the individual has bacteria in their urine, but has no symptoms, treatment is not right. Treatment should be given to individuls who have bacteria and associated UTI symptoms.

In closing, it should be noted that studies on cranberry juice and linked supplements are mixed. Some studies show that cranberry supplements can be helpful and other studies show that they dont help stop UTIs before they happen. Be sure to read about the pros and cons of cranberry products, and decide if theyre right for you. For now, practice these tips to lower your risk of getting a UTI.

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