RECURRENT URINARY INFECTIONS IN WOMEN
Every woman has heard of urinary tract infection and is common knowledge among the population that sex can be a factor in obtaining a urinary tract infection. This is known in the medical community as “Honeymoon Cystitis.” Women have a lifetime risk of 60.4% for being diagnosed with a urinary tract infection. The reality is that most infections are recurrent, and these infections are usually caused by the same bacteria. In this article, we shall touch upon the signs and symptoms of urinary infections and how to prevent these infections in different age groups.
SIGNS OF URINARY TRACT INFECTIONIn the medical community urinary tract infection is divided into complicated and uncomplicated infections. It is further broken down into lower and upper tract infections. The urinary system is made up of the kidneys and the tubes that drain them into the bladder called the ureters, they comprise the upper tracts. The kidneys clean our blood and carry the byproducts from their cleansing into the bladder through the tubes called the ureters. The bladder and the urethral channel where the urine is stored and then expulsed are part of the lower tracts. The female urethra is smaller than the male urethra and it opens into the vaginal vault, which is filled with bacteria, hence its propensity for infections. The bacteria simply climb up the urethral channel to enter the bladder and start the infection also known as cystitis. We shall concentrate on the simple lower tract infections that are more common in the population and the more common cause of urgent care visits. The common symptoms are the following:
- A strong, persistent urge to urinate
- A burning sensation when urinating
- Passing frequent, insignificant amounts of urine
- Blood in the urine (hematuria)
- Passing cloudy or strong-smelling urine
- Pelvic discomfort
- A feeling of pressure in the lower abdomen
- Low-grade fever
These symptoms can worsen if not treated appropriately. Now many women can resolve the issue with some simple over the counter therapies and learn to prevent future infections as discussed below. However, if the symptoms persist, become recurrent or worsen one must seek medical advice. It is always an innovative idea to be seen by your doctor if you have or have had a urinary infection.
Some diseases can mimic the symptoms of urinary tract infections but are less common in the population and are already being evaluated by a urological specialist.
These are some of the known diseases that can mimic the above symptoms:
- Interstitial cystitis
The cause of this chronic bladder inflammation, also called pelvic pain syndrome, is assumed to be autoimmune in nature. Most cases are diagnosed in women between the ages of 18 to 45. The condition can be difficult to diagnose and treat and it is usually chronic.
Certain medications, particularly the chemotherapy drugs cyclophosphamide and ifosfamide, can cause inflammation of your bladder as the breakdown products of the drugs exit your body.
Radiation treatment of the pelvic area can cause inflammatory changes in bladder tissue.
Long-term use of a catheter can predispose you to bacterial infections and to tissue damage, both of which can cause inflammation.
Some people may be hypersensitive to chemicals contained in certain products, such as bubble baths, feminine hygiene sprays or spermicidal jellies, and may develop an allergic-type reaction within the bladder, causing inflammation.
WAYS TO AVOID URINARY INFECTIONS
Here are some measures that may help to prevent the recurrence of infection. However, the effectiveness of these measures isn’t entirely clear: If you get frequent UTIs, these are some things to try:
- Avoid using scented soap or talcum powder around the genital area.
- Showering rather than bathing reduces the amount of time the genitals are exposed to the chemicals in soap.
- Go to the bathroom the moment you feel the urge to void. Always empty your urinary bladder fully.
- Stay hydrated by drinking lots of fluids. This may help stop the bacteria from multiplying in the urinary bladder.
- Always wipe front to back to prevent the spread of bacteria from the anus to the urethra and vagina.
- Void as soon as you can after having sexual intercourse.
- Don’t use a diaphragm as a method of contraception.
The following are some more common ways that urinary tract infections are suppressed or avoided as recommended by clinicians.
There is evidence that cranberry supplements can help in the prevention of urinary infections. This is true that cranberry overall is acidic and can acidify the urine; however, studies have shown that store bought cranberry juice is less likely to prevent urinary infections than cranberry supplements or actual cranberries. The reason is that store bought juices are more additives and coloring and less healthy components of cranberry. According to the National Kidney Foundation, raw cranberries contain antioxidant proanthocyanidins or PACs, that can prevent bacteria from attaching to the walls of the urinary tract. This is due to the fact that they actually attach themselves to the bacterial feet called pili and make them too slippery to attach and hence easily voided out. So in 2013, there was a systematic review with meta-analysis of the literature that showed Cranberry-containing products are associated with a protective effect against urinary tract infections.
Primates and guinea pigs have one thing in common, their inability to produce vitamin C. Vitamin C has been used in the medical community for years as a urinary acidifier. This has helped many women take control of their life and be able to avoid recurrent urinary infections that may be caused by poor emptying, vaginal atrophy due to menopause, sexual intercourse, or other medical causes. The premise is that the urinary acidification kills bacteria and does not allow them from multiplying after they have been able to reach the bladder from climbing the urethral channel. Among its many other health care attributes, vitamin C has been shown to be effective in the prevention and self-care treatment of urinary tract infections. The mechanism of action is probably similar to that of cranberry juice; vitamin C also acidifies the urine.
There is an easy way to get vitamin C quickly into your system and start your preventive therapy. At Frunutta we pride ourselves in a pure, clean, and easy to absorb tablets that are delivered under the tongue without the need for swallowing or chewing. Frunutta vitamin C tablets can be taken on or under the tongue to absorb directly into the bloodstream without unnatural additives or preservatives, just pure goodness!
Probiotics are fairly new to the world of preventive medicine. However, if you imagine that the vaginal vault is the gateway to the urethral channel and all infections start there, then the bacterial flora of the vaginal vault should be of immense importance to a woman. There is a constant battle between the good bacteria and the bad bacteria and yeast in the vaginal vault. When a person takes antibiotics and kills both the good and bad bacteria then the yeast overpopulates and wins, and many women have succumbed to this dilemma after a course of antibiotics for unrelated infections. Hence the addition of good bacteria to your diet to win the fight on your side is a good strategy. Probiotics can be obtained from any source such as tablets, drinks, or healthy natural yogurts are a sure way to improve the health of your vaginal vault especially after a course of antibiotics.
Antibiotics suppression post coitus or chronically have been used by clinicians for many years. The idea is to kill the bacteria that are introduced immediately post coitus or daily and not allowing them to grow into full infections. The issue is that most patients hate taking medication all the time and most commonly resistant strains of the bacteria cause breakthrough infections. The other issue with chronic antibiotics is that some antibiotics such as nitrofurantoin can cause long term lung damage if taken for a very long time. Trimethoprim which is another antibiotic commonly used as a urinary infection suppressant can lead to vitamin B6 deficiency and should always be taken with the appropriate vitamin supplement. Under the tongue absorbed vitamin B6 is a quick way to absorb the needed vitamin without any upset stomach that may already exist due to antibiotic therapy.
Another less known cause of recurrent infections is vaginal atrophy which leads to urethral atrophy, change in vaginal bacteria, and can lead to recurrent infections. This is a very common cause for antibiotic over usage in elderly post-menopausal women. The common future in all these women is that they are not sexually active and are not aware of vaginal dryness and tissue changes. A simple vaginal exam can show the thinning of the vaginal lining, changes in mucosal color and allow the clinician to start therapy locally with vaginal hormone creams, rings, or pellets. Systemic therapy such as oral estrogen tablets should be avoided unless coordinated with patient’s primary physician or gynecologist. Dr. Alavi, a urologist in Southern California, also recommends a detail cancer history in the patient and family should be taken prior to start of any hormonal therapy. In case of high risk for breast or gynecological cancers then hormones should be avoided and vaginal LASER therapies such as Mona Lisa LASER should be instituted instead.
The discussion above touches on the most common simple treatments that are today promoted by Urologists and medical specialists to prevent future reinfections in women prone to urinary tract infections. There are many other methods that are in use and were not touched upon in this discussion. However, it is always prudent to discuss your health care plans with your doctor and come up with a common goal and adjust accordingly.
Remember urinary tract infections can be prevented by these simple steps:
- Drink plenty of water every day
- Drink cranberry juice. Large amounts of vitamin C limit the growth of some bacteria by acidifying the urine. Vitamin C supplements have the same effect. Vitamin C is a powerful antioxidant and immune system booster that can help prevent the occurrence of UTIs and help reduce your symptoms such as painful urination
- Urinate when you feel the need. Do not wait.
- Wipe from front to back to keep bacteria around the anus from going in the vagina or urethra.
- Clean the genital area before and after sex, and urinate shortly after sex
- Cotton underwear and loose fitting clothes help keep the area around the urethra dry. Tight clothes and nylon underwear trap moisture. This can help bacteria grow.
This information is only for educational purposes and is not medical advice or intended as a recommendation of any specific products. Consult your health care provider for more information. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
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