Urinary Tract Infection – Resources, Answers, and More

According to the National Center for Biotechnology Information, Urinary Tract Infections (UTI)  are the most common outpatient infections in the United States, with incident rates for those over 65 being around 20%. While those under the age of 65 may see a UTI as something simple, it can be much more challenging to prevent, diagnose and treat in the elder population. Even if you don’t currently suspect that you or someone you care for may have a UTI, it’s important to understand the causes, symptoms, treatments and risks so you can monitor yourself and your loved ones closely.

What is a Urinary Tract Infection?

Urinary Tract Infections, also known as UTIs, are infections caused by bacteria that occur anywhere within the urinary tract. This includes the urethra (where the urine exits the body), the bladder (where the urine is stored until released from the body), the ureter (where the urine travels from the kidneys to the bladder), or the kidney’s themselves.

What symptoms do UTIs cause?

Urinary Tract Infections are tricky because they can cause different symptoms for each person. A typical UTI will cause symptoms such as fever, pain or burning with urination, frequent urination, urgency when needing to go, pressure felt in the area of the bladder, blood in the urine, foul smelling urine, or back pain. Unfortunately, they aren’t always so straight forward. Often times, particularly with those over the age of 65, the “typical” symptoms are not noticed. Infections of the urinary tract can present with subtle symptoms or no symptoms at all. Subtle symptoms may include an increase in incontinence, lack of appetite, confusion, strange and unusual behaviors, vomiting, or lethargy.

UTIs can cause many different symptoms and can look different for different people. It’s important to consult your doctor if you have any reason to suspect that you have a Urinary Tract Infection, or any other health issue.

What caused my UTI?

UTIs are caused by bacteria in the urinary tract. This is particularly an issue for women due to the shape of their anatomy. While most women will never know how the bacteria was introduced to their body, there are some common ways that this occurs. Wiping from back to front after using the bathroom, a habit often adopted by those with difficulty twisting and reaching, can introduce bacteria from the rectum to the urethra, causing infection. If this is the cause of the UTI, it is very important for alternative routes of cleansing to be found, otherwise the infection will continue to re-occur. Additional risk factors include the use of catheters (this can lead to colonization and a phenomenon called Purple Bag Syndrome), change in brand or style of incontinence aids, ineffective bathing, dehydration, Diabetes, or kidney stones.

Who should I see about my UTI?

First and foremost, if you are experiencing an emergency, call 911. If you’re not in an emergency situation, start with your primary care doctor. However, if you are experiencing pain in your back, high fevers, vomiting, lethargy, inability to urinate, or a change in your heart rate or blood pressure, it is important to be seen right away as these symptoms can indicate that the infection has moved to the upper urinary tract. If your doctor cannot see you immediately, a visit to urgent care or the emergency department of your local hospital should be your next choice.

If your doctor believes that you have a UTI, he/she will most likely prescribe an antibiotic to be taken by mouth over the next several days. It is important to let your doctor know if you have allergies, or difficulty taking antibiotics. While you may begin to feel better after only 1 or 2 doses, the infection will continue if you don’t complete the full course of antibiotics.

What interventions can I expect?

If your doctor believes that you have a UTI, he/she will most likely prescribe an antibiotic to be taken by mouth over the next several days. It is important to let your doctor know if you have allergies or difficulty taking antibiotics. While you may begin to feel better after only 1 or 2 doses, the infection will continue if you don’t effectively complete the full course of antibiotics.

Note: Some antibiotic use can lead to diarrhea. Be sure to ask your doctor if you should be taking a probiotic with your antibiotic.

If your infection is more complicated and has moved to your upper urinary tract, it is possible that further intervention will be needed. A hospital stay for antibiotics and fluids through an IV may be necessary. Your doctor may also order blood tests to monitor your level of infection and your kidney function, or a scan to look for kidney stones.

If kidney stones are found, your doctor will customize your care depending on the size and severity of your stone. Some people simply wait for the tiny stone to pass when they urinate. For others, a procedure (done under anesthesia) to place a tube, called a stent, in the ureter may be necessary. If the stone is very large, a lithotripsy may be performed in order to break the stone into smaller pieces. If you’re in need of any of these procedures, your doctor will explain them to you in detail prior to starting. But, rest assured that most of these treatments cause very little pain.

What lifestyle changes will I need to make?

With any diagnosis, you want to be sure to follow your doctor’s recommendations for making any lifestyle changes. However, with UTIs there are a few changes that are commonly suggested.

1. Drink plenty of fluids. Dehydration can lead to Urinary Tract Infections, so drinking plenty of non-caffeinated fluids can help to stave off these pesky infections. Not sure how much to drink? Here is a nifty chart to help you out!
2. Reduce your intake of caffeine. While your daily dose of caffeine may be what keeps you going at 6am and 3pm, it can also be very irritating to the bladder, causing worsening symptoms.
3. Take ALL of your prescribed pills if you’re treated with oral antibiotics for a UTI. Failing to finish the course can land you with an increasingly severe infection that is difficult to treat.
4. Always wipe front to back. While it may be an uncomfortable topic to talk about, it’s important to tell your doctor if you are unable to achieve this. There are tools and resources to help you if this becomes difficult.
5. If you utilize catheters, whether intermittently or have one that stays in place, it’s very important to utilize a clean technique when handling or maintaining them to avoid introducing bacteria to your urinary tract.
6. Change feminine or incontinence products, such as pads, tampons, or briefs frequently as they can harbor bacteria. If you are unable to afford frequent changes, there are resources available to help. Often times, Medicaid (low income, state-funded insurance) will pay for these supplies. There are also incontinence banks available in many states, and if you are utilizing Hospice as a resource, they will most likely provide you with the supplies you need.
7. Avoid bubble baths as they harbor bacteria that can introduce itself to your body during soaking. If you can’t live without a leisurely soak, consider taking a shower after your bath.
8. Take a bathroom break every 2-3 hours, even if you don’t feel that you need to. Aging causes some to lose the sensation that tells them it’s time to go. In order to keep your urinary track flushed and clean, make sure you’re drinking fluids and using the restroom every few hours.

Useful Products

Do you have trouble remembering to drink fluids? These adorable water bottles have timestamps on the side to remind you of how much/little you’ve had to drink!

In order to stay on track with taking medications on time and using the restroom every few hours, you may want to utilize a timer or alarm.

If you’re having a difficult time wiping, you may find this affordable little gadget to be a great addition to your bathroom! It’s a handle that does the reaching for you!

If you’re not interested in utilizing the above gadget, a bidet may give you that refreshing clean feeling that you’re looking for! While the water is room temperature (which may feel a little cool), it’s a great way to get clean without twisting or reaching.

Caregivers and patient’s alike can all help by keeping accurate records of symptoms, effectiveness of medications, and lifestyle changes in a handy notebook that can tag along to doctor appointments.

If making it to the restroom in time due to mobility is an issue that you’re facing, it may be time to consider a bedside commode. These are a great step up from the old chamber pots as they come with removable tubs underneath for easy emptying, a comfortable seat, and grab bars on each side.