Urinary Tract Infection

BY DR GEORGIA PAGE

Aurinary tract infection (UTI) is an infection of part of the urinary tract which includes the urethra, bladder, ureter and kidneys. UTI’s are one of the most common infections in older adults with over 10% of women older than 65 years reporting one in the last 12 months. Seniors have a higher incidence of UTI’s than younger adults and symptoms can be more severe.

Classical symptoms of a UTI can include: ƒ Burning on urination ƒ Going to the toilet more frequently ƒ Urgency/the feeling of needing to urinate ƒ F ever ƒ Chills ƒ L ower abdominal/pelvic pain ƒ Back pain ƒ Cloudy and/ or smelly urine ƒ U rinary incontinence/leakage of urine ƒ Blo od in the urine ƒ Fa tigue ƒ Naus ea

Older adults however, are more likely to experience changes in behaviour such as confusion and agitation or may present with falls.

What causes Urinary Tract Infections? Most urinary tract infections occur when bacteria or fungi enter the urinary tract. The bacteria E coli (which is present in stool) is the most common type of bacteria that causes UTI’s and enters the bladder via the urethra. Infections are more common in females then males as they have a short uretha. In some cases, and if treatment is delayed, the infection can then spread to the kidney. Seniors are at more at risk of UTI’s because they may have; ƒ Weak er immune systems ƒ Ass ociated medical conditions that causes you to retain urine more such as Alzheimer’s Disease, Parkinson’s disease, Diabetes, prolapsed bladder or an enlarged prostate. ƒ Inc ontinence of the bladder or bowel. ƒ The pr esence of a urinary catheter ƒ A history of recurrent UTI’s. ƒ L ower levels of estrogen (in postmenopausal women)

Complications of UTI’s If a UTI is left untreated it can spread to the kidneys and cause damage. It can also causes sepsis which is when infection spreads to the bloodstream which if not treated can be life threatening. In the elderly it can lead to extreme confusion.

Diagnosis and Treatment If you or a loved one has symptoms or you suspect a urinary tract infection it is best to see a doctor who can check your urine. The urine sample needs to be a ‘’mid stream urine’’ and must be caught in a sterile jar in the middle of a urination not at the start (which can be tricky!). This is to make sure that the urine isn’t contaminated with other bugs that live around the surrounding skin. The urine sample is sent to the laboratory for testing to confirm if there is an infection and to determine which bug is present and which antibiotic is suitable for treatment. Urinary tract infections are treated by; ƒ Drinking plenty of water to help flush out the bladder. ƒ T aking a alkalinising agent (such as ural) to help reduce burning or stinging when going to the toilet ƒ P aracetamol or anti-inflammatories ƒ Antibiotics are usually prescribed if the doctor suspects or confirms a UTI to treat the infection quickly and prevent complications.

If recurrent urinary tract infections occurs, further medical tests may be required, so please see your doctor.

Prevention For those that get frequent UTI’s, methods to help prevent them can include: ƒ Drinking plenty of water ƒ Wiping from front to back after going to the toilet

ƒ U rinating immediately after sexual intercourse ƒ Av oiding caffeine and alcohol ƒ Do not ‘hold on ’ or delay going to the toilet when you need to . ƒ Vaginal estr ogen may reduce risk in post-menopausal women ƒ Pr eventative antibiotics (taking a low dose antibiotics every day for 3 – 6 months) ƒ Non antibiotic pr evention – Further scientific evidence is required but Cranberry , Methenamine salts, Ascorbic acid (Vitamin C), D-Mannose, and probiotics may be of benefit.

SUMMARY ƒ Urinary Tract Infections are one of the most common infections in the elderly ƒ It can cause symptoms such as burning, urgency, going to the toilet more frequently, cloudy or smelly urine, fevers and pain. In the elderly however if can cause non classical symptoms such as confusion, agitation and falls. ƒ If you suspect you have a urinary tract infection please see your doctor to prevent serious complications.

Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has lovely new rooms and has a fabulous team of Doctors and Nurses, some of whom are accepting new patients. They pride themselves on delivering good quality health care, with that special personal touch. For more information call 4365 4999, check the website www.yourfamilydoctors.com.au or like them on facebook.

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