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No More UTIs!

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Here are the best ways for women and men to avoid these common infections…

Anyone who has ever had a urinary tract infection (UTI) knows that it’s extremely unpleasant. The first clue may be that your urine is smelly and/or looks cloudy. You could also suffer burning or pain during urination, have blood in your urine and a fever or chills. To make matters worse, many people suffer repeated UTIs, and some doctors don’t do much more than prescribe an antibiotic each time.

Good news: Studies now show that there are some surprisingly simple steps you can take to help guard against UTIs—whether you have suffered them repeatedly or never even had one.

 

WOMEN AND MEN GET UTIs

Even though UTIs are commonly considered a “women’s problem,” men develop them, too.

What men need to know: About 12% of men will suffer a UTI at some point in their lives, but men over age 50 are at increased risk. Common causes include prostatitis, a bacterial infection of the prostate gland that can also enter the urinary tract…and the use of urinary catheters in medical procedures.

What women need to know: More than 50% of women will experience a UTI at some point in their lives, and one-third of them will suffer recurring infections. Women are more prone to infection around the time of sexual activity due to the spread of E. coli bacteria to the vagina. In postmenopausal women, lower levels of estrogen decrease the amount of Lactobacillus, a “good” bacteria that grows in the vagina and serves as a natural defense against UTIs.

Symptoms are sometimes puzzling: Diagnosis of a UTI can be difficult in older men and women because they often don’t suffer the classic symptoms but instead have atypical symptoms such as lethargy, confusion, nausea, shortness of breath and/or loss of appetite. If you suspect a UTI, ask that your doctor perform a urine culture.

STOP A UTI BEFORE IT STARTS

When a woman or man suffers from recurring UTIs (three or more infections in a one-year period), these steps will help break the cycle…

Go to the bathroom often.

Many people hold their urine longer than they should. This is a bad idea because the bladder may distend, making it more difficult to empty the bladder and preventing bacteria from being flushed out. To protect yourself, try to urinate roughly every four waking hours. Important: People who are rushed when they are going to the bathroom may not fully empty their bladders. Take your time when urinating. Helpful: When you think you are finished, give yourself another moment to see if there’s any urine remaining before leaving the toilet.

Drink a lot of water.

You probably know that drinking water is a good way to help flush bacteria from the urinary tract. However, few people drink enough—you need to consume eight to 10 eight-ounce glasses of water each day. Water is best because it’s pure and has no calories. Caffeine, soda and alcohol can aggravate the bladder.

Other preventives include…

Yogurt.

A 2012 study suggested that lactobacilli, found in probiotic supplements and yogurt, may be an acceptable alternative to antibiotics for the prevention of UTIs in women (with recurring infections, medication may be used for this purpose). The additional lactobacilli are believed to displace E. coli and stimulate the immune system to fight back against the infectious bacteria.

My advice: Consume a cup of yogurt each day—it should be low in sugar (avoid any yogurt that lists sugar as the first or second ingredient) and make sure it contains live cultures. Or take two probiotic capsules each day containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14—the probiotic strains used in the study mentioned earlier. Probiotic supplements with these strains include Pro-Flora Women’s Probiotic from Integrative Therapeutics, IntegrativePro.com…and Ultra Flora Women’s from Metagenics, Metagenics.com.

Cranberry juice or cranberry supplements.

Research has been mixed, but several studies have shown that drinking at least one to two cups of cranberry juice daily may help prevent UTIs. Just be sure to drink real cranberry juice—not cranberry juice cocktail, which has lots of sugar, is diluted with other juices and provides minimal amounts of the actual berry that contains protective compounds known as proanthocyanidins.

You may want to try a cranberry supplement if you have diabetes (even real cranberry juice contains carbohydrates) or if you don’t like cranberry juice. Do not exceed label instructions on dosage—research suggests that high doses may increase the risk for kidney stones.

Estrogen creams.

For postmenopausal women, a small amount of estrogen cream applied inside the vagina several times per week has been shown to significantly reduce the risk for recurrent UTIs. The cream thickens the walls of the urinary tract, making it more difficult for bacteria to penetrate.

Important: Most women who take estrogen in pill or patch form can safely add an estrogen cream—the amount absorbed into the bloodstream is negligible. Women with a history of uterine cancer or certain breast cancers may not be suitable candidates for any form of estrogen therapy. Ask your doctor.

WHEN YOU NEED AN ANTIBIOTIC

If the steps above do not prevent recurring UTIs, you may need a long-term course (six months or longer) of a low-dose antibiotic. To minimize the development of bacterial resistance, it’s wise to start with a milder antibiotic, such as sulfamethoxazole and trimethoprim (Bactrim), if possible. However, more powerful antibiotics, such as ciprofloxacin (Cipro), may be needed to help prevent or treat stubborn infections.

Important: Many women self-diagnose a UTI, call up their doctors and receive a prescription for an antibiotic when in fact they may have a condition, such as vaginitis, that mimics UTI symptoms. Urinalysis and/or a urinary culture is necessary to get an accurate diagnosis.

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Source: Tomas L. Griebling, MD, MPH, the John P. Wolf 33° Masonic Distinguished Professor of Urology at The University of Kansas (KU) School of Medicine in Kansas City. He is a professor and vice-chair in the department of urology and faculty associate in The Landon Center on Aging. He has published more than 200 articles in peer-reviewed medical journals. Date: January 1, 2015 Publication: Bottom Line Personal
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