Prevent urinary tract infections

If you’ve ever had a urinary tract infection, you know how painful and frustrating they can be, especially if they keep coming back. While antibiotics generally clear up a UTI within a few days, there are also some simple measures you can take to help prevent getting one in the first place.

To say goodbye to burning, frequent urination, and other unpleasant symptoms, start with these changes today. The key is to keep bacteria out of your system.

  1. Drink plenty of water, and relieve yourself often. The simplest way to prevent a UTI is to flush bacteria out of the bladder and urinary tract before it can set in. If you’re well-hydrated, it will be tough to go too long without urinating.
  2. Wipe from front to back. Bacteria tend to hang around the anus. If you wipe from front to back, especially after a bowel movement, they’re less likely to make it to the urethra.
  3. Wash up before sex and urinate after it. Use soap and water before sex. This keeps bacteria away from the urethra. And urinating afterward pushes any bacteria that entered the urinary tract back out.
  4. Steer clear of irritating feminine products. Skip douches, deodorant sprays, scented powders, and other potentially irritating feminine products.
  5. Rethink your birth control. A diaphragm, spermicide, or spermicide-lubricated condom can make you more likely to get a UTI because they all can contribute to bacterial growth. If you often get UTIs and use one of these birth control methods, switch to a water-based lubricant for vaginal dryness, and consider trying another birth control method to see if it helps.

Some doctors also advise women who get a lot of UTIs to wear cotton underwear, take showers instead of baths, and avoid tight clothes that can trap bacteria near the urethra. While these are simple enough to do, none of them are supported by scientific data.

10 Ways You Can Prevent Urinary Tract Infections

If you find yourself having to pee frequently or feel the need to go immediately when the urge comes; if it hurts or burns when you go to the bathroom; or if there’s blood in your urine, you might have a urinary tract infection (UTI). Abdominal pressure and cloudy or bad-smelling pee can also be signs of UTIs.

Once you’ve had a UTI, there’s a good chance you’ll have one again. Read below to learn what UTIs are, who gets them most, and what you can do to prevent them.

What Is a UTI

A UTI is caused by bacteria in the urinary tract—the kidneys, bladder, and the tubes that connect them and then get rid of the urine.

Most UTIs are in the bladder, which holds your urine before you pee. They can also happen in your kidneys, where urine is created before it goes to the bladder.

It’s important to be aware if you have symptoms of urgency and pain plus fever, back pain, and nausea or vomiting, you might have a kidney infection.

Who Gets UTIs and Why

Anyone can get a UTI, but women get them more often. About 25-35 percent of women between the ages of 20 and 40 get UTIs. Since they’re a result of getting germs in your urinary tract, they can be caused by things that bring germs in close contact with your urinary tract. For example:

  • Wiping from back to front after you’ve had a bowel movement
  • Sexual intercourse
  • Using a diaphragm or condoms and spermicides for birth control
  • Having a catheter (a tube used to drain urine from the bladder)

They can also be caused by:

  • Waiting too long to pee, allowing germs to grow in your bladder
  • Having a kidney stone that makes it hard to empty your bladder
  • Physical conditions like diabetes that makes it hard for your immune system to fight germs
  • Menopause, which reduces the hormone estrogen that helps keep infection at bay

How To Prevent UTIs

If you’re someone who gets a lot of UTIs, you want to stay clean (without using harsh products) and avoid irritation of the urethra – which can make it easier to get infections.

Here are some things you can try:

  1. Make sure you urinate when you need to (every four hours).
  2. Stay clean by wiping the right way (front to back) after going to the bathroom and washing your bottom with soap and water every day.
  3. Some urologists recommend you stop drinking caffeine and soft drinks. They irritate the urethra (the tube that lets urine leave the body).
  4. Change your birth control if you use spermicides, which can cause irritation.
  5. Avoid feminine hygiene products and douching: they’re irritants too.
  6. Ask your doctor about vaginal estrogen if you’re past menopause.

Although there’s no medical evidence the below tips work, they fall into the “can’t hurt to try” category:

  1. Drink lots of water – aim for six to eight glasses a day. It may help you flush out the germs and keep them from growing.
  2. Take showers instead of baths.
  3. Wear cotton underwear (or cotton crotch) and avoid tight fitting pants that hold moisture.
  4. Go to the bathroom right before and after you’ve had sex.

What To Do If You Think You Have a UTI

See your doctor, especially if you have a fever along with nausea or vomiting. They’ll take a urine sample to find out what’s going on. An untreated UTI can cause serious problems with your kidneys, so you don’t want to ignore it.

Treatment usually requires antibiotics (drinking cranberry juice doesn’t do the trick). If one antibiotic doesn’t work you might have to try a different one or other approaches.

Urinary Tract Infections: Prevention

Can urinary tract infections be prevented?

There are some steps you can take to reduce your risk of developing a urinary tract infection:

  • Follow good hygiene practices of the genital area (especially women). After a bowel movement, the genitals should be wiped from front to back to reduce the chance of dragging E. coli bacteria from the rectal area to the urethra.
  • Urinate frequently. This flushes bacteria out of the bladder and may reduce the risk of cystitis in those who are prone to urinary tract infections. Drinking plenty of fluids encourages frequent urination. Avoid fluids and foods that irritate the bladder, such as alcohol, citrus juices, drinks containing caffeine and spicy foods. Also avoid smoking during this time.
  • Urinate immediately before and after sex. This may help flush out bacteria that may have been introduced during intercourse. Wash the genital area with warm water before having sex.
  • Apply an estrogen-containing vaginal cream in post-menopausal women to reduce the risk of a urinary tract infection. Your physician will decide with you if this is something that may benefit you. The estrogen cream changes the pH of the vagina to make one less susceptible to infections.
  • Drink at least 6-8 glasses of water a day
  • Don’t douche
  • Don’t use feminine deodorants on your genital area
  • Change tampons and feminine pads often
  • Use a water-based lubricant during sex if you have vaginal dryness
  • Check with your doctor if you think your diaphragm is causing infection
  • Wear cotton underwear
  • Take showers instead of baths
  • Avoid tight-fitting clothing and pantyhose

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Urinary tract infection (UTI) – including symptoms, treatment and prevention

Urinary tract infection (UTI) is an infection of the urinary system. The normal urinary system consists of:

  • two kidneys
  • two ureters (the tube connecting the kidney to the bladder)
  • one bladder
  • one urethra (the tube connecting the bladder to the outside of the body).

Infection may occur in the kidneys (pyelonephritis), bladder (cystitis) or urethra (urethritis) or a combination of these.

The most common cause of a urinary tract infection is a bacterium commonly found in the gut called Escherichia coli (E. coli). It is usually spread to the urethra from the anus (back passage).

How a urinary tract infection is spread

Urine is normally free from bacteria, however, the normal human body is covered with bacteria and the normal intestine (bowel) contains large numbers of harmless bacteria. The structure of the urinary system prevents urine flowing upwards from the bladder to the kidney, so most urinary tract infections are in the bladder and are not usually serious.

However, if not treated, the infection may travel from the bladder up the ureters to the kidneys and cause a more serious infection which needs prompt medical attention.

Groups at risk

Some groups are at increased risk of having urinary tract infections:

  • women are vulnerable because the urethra is only 4cm long and bacteria only have to travel this short distance from outside the body to the inside of the bladder
  • people with urinary catheters, such as the critically ill, who cannot empty their own bladder
  • people with diabetes have altered immune systems and are more vulnerable to infection
  • men with prostate problems, since an enlarged prostate gland can cause the bladder to only partially empty
  • babies, especially those born with congenital abnormalities of the urinary system.

Signs and symptoms

Urinary tract infections are very common, particularly in women, babies and the elderly. Around one in two women and one in 20 men will get a UTI in their lifetime.

Common symptoms of a UTI include:

  • burning or scalding sensation or lower abdominal discomfort when passing urine
  • passing urine much more frequently than usual
  • feeling an urge to urinate, but being unable to, or only passing a few drops
  • feeling the bladder is still full after urination
  • foul smelling urine
  • urine that is cloudy, bloody or dark
  • fever.

A person with a kidney infection can also experience:

  • chills
  • fever
  • loin (lower abdominal) pain
  • back pain.

A UTI in a child needs to be investigated as it may indicate a more serious condition.

Vesico-ureteric reflux

The most common urinary system condition is vesico-ureteric reflux. This means the valve between the bladder and ureter is not working properly and allows urine to flow back to the kidney, increasing the risk of a kidney infection.

Since this disorder tends to run in families, it is important to screen children as early as possible if a close relative is known to have the problem.

Vesico-ureteric reflux and the associated infections can scar or permanently damage the kidney. It can also lead to:

  • high blood pressure
  • toxaemia in pregnancy (raised blood pressure, swelling and protein in the urine of the mother).
  • kidney failure.

Diagnosis

A doctor may diagnose a UTI based on the symptoms. A simple test in the doctor’s surgery (urine dipstick) can provide evidence to support the diagnosis of a UTI. Sometimes a urine sample is sent to the laboratory for microscopy and culture to identify the specific cause of the infection and to help determine the correct antibiotic for treatment

Infectious period

(time during which an infected person can infect others)

UTIs cannot be passed from person-to-person except for those infections of the urinary tract that are sexually transmitted.

Treatment

UTIs are usually treated effectively with antibiotics. However, as with any course of antibiotics, it is important to complete the full course prescribed, even if the symptoms have ended.

  • Exclusion from childcare, preschool, school or work is not necessary.
  • Drink lots of fluids to flush the urinary system. Water is best.
  • Urinate as soon as you feel the need rather than holding on.
  • For women and girls, wipe your bottom from front to back to prevent bacteria from around the anus entering the urethra.
  • Urinate shortly after sex to flush away bacteria that might have entered your urethra during sex.
  • Wear cotton underwear and loose-fitting clothes so that air can keep the area dry. Avoid tight- fitting clothes and nylon underwear, which trap moisture and can help bacteria grow.
  • Using a diaphragm or spermicide for birth control can lead to UTIs (in women) by increasing bacteria growth. Unlubricated condoms or spermicidal condoms increase irritation, which may help bacteria grow. Consider switching to lubricated condoms without spermicide or using a non-spermicidal lubricant.

Useful links

  • Avoiding sexually transmitted infection
  • Chlamydia trachomatis infection
  • Gonorrhoea
  • Non-specific urethritis
  • Better Health channel
  • Kidney Health Australia

Probiotics for preventing urinary tract infections in adults and children

Background

Urinary tract infections (UTIs) occur in kidneys, ureters, urethra or bladder. UTIs are one of the most common bacterial infections and can lead to other health problems.

Probiotics (live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host) are thought to work by preventing other infectious bacteria from climbing up the urinary tract and causing infection. We were interested in studying any form of probiotics (bacteria used to change balance of bacteria) compared with no treatment, antibiotics, hormone therapy, cranberry juice or other interventions in people at risk of UTI. To assess if probiotics were effective, we planned to measure how many people had recurrent UTIs.

Study characteristics

We conducted a literature search up to September 2015 and nine studies were eligible for inclusion according to our selection criteria. The nine studies reported data on 735 participants and investigated probiotics for preventing UTI: seven studies involved women or girls with recurrent UTIs, one looked at children with abnormal urinary tracts, and one investigated UTI in healthy women.

Key results

Generally, studies were poor quality with high risk of bias. Aside from the different populations, there were also many different species of probiotics used, different dosage forms such as vaginal and oral, and probiotics were given for varying lengths of time. All of these factors may have affected our results.

Most studies did not collect information on adverse effects so we were unable to estimate any harms associated with probiotic therapies. We found no significant reduction in the risk of recurrent symptomatic bacterial UTI between patients treated with probiotics and placebo and no significant reduction in the risk of recurrent symptomatic bacterial UTI was found between probiotic and patients treated with antibiotics.

Quality of the evidence

The currently available evidence shows no reduction in UTI using probiotics.

How to Prevent Urinary Tract Infections or UTIs

Some daily hygiene habits may help prevent the development of UTIs. Annie Engel/Getty Images

Taking precautions to avoid experiencing a urinary tract infection is always advisable, even if you are not prone to recurring UTIs. (1)

Proven At-Home Preventative Measures

Some strategies that have been proven effective include these:

  • Wipe from front to back. When either urinating or moving one’s bowels, it’s important to wipe from the front to the back. This helps to prevent spreading bacteria from the anal area to the vagina and urethra.
  • Urinate frequently. Fully empty your bladder roughly every two to three hours in order to flush bacteria from your urinary tract before an infection has a chance to begin. Do not attempt to hold your urine to the point when your bladder feels full. The longer urine remains in the bladder, the more likely bacteria will multiply. (2)
  • Promptly urinate after intercourse. Vaginal intercourse can introduce bacteria from the genital area and anus into the bladder. Urinating afterward can flush your system and reduce the risk that those bacteria multiply and cause a UTI. (3)
  • Drink plenty of liquids. Consuming fluids, especially water, helps to dilute urine and spur more frequent urination, which flushes bacteria from your urinary tract. Moreover, increasing water intake can halve one’s chance of experiencing a recurrent UTI. A 2017 study looked at women who drank less than 1 ½ liters of water daily (about 6 cups) who also had recurrent urinary tract infections (more than three annually). Fifty percent of the women added 1 ½ more liters of water to their daily routine, while the others did not alter their fluid consumption. A year later, women who upped their water intake reduced their UTI rates by nearly half, experiencing an average of 1.6 infections that year versus 3.1 urinary infections amongst the control group. (4)
  • Drink water after intercourse. In addition to drinking throughout the day, it’s important to drink a full glass of water after intercourse to help flush bacteria from your system.
  • Clean the genital area. This can diminish the presence of bacteria, thus reducing one’s chances of pulling bacteria into the urethra and into the bladder during intercourse. In addition to keeping the area clean regularly, be sure to also cleanse the area pre- and post-intercourse.
  • Avoid diaphragms or spermicides. If you are prone to recurrent UTIs, consider changing your birth control. Diaphragms, spermicides, and spermicide-containing types of contraception can contribute to bacterial growth and kill the good bacteria present in the genital area that work to protects from UTIs.
  • Use a personal lubricant. Friction during intercourse can sometimes irritate the urethra and introduce bacteria that cause urinary tract infections. Using a small amount of water-based lubrication during sex can help reduce friction and the risk of infection. (5)
  • Avoid products that irritate the urethra. Feminine deodorant sprays, vaginal douches and powders, bubble bath liquids, and bath oils can irritate the urethra and vagina, increasing your odds of infection. Some may also alter vaginal flora and ultimately result in a urinary tract infection. (6)

Preventing UTIs With Drugs

At times, antibiotics are used as a preventative measure for those with frequent UTI recurrences. In addition, postmenopausal women can benefit from a different type of a medicinal prevention strategy.

  • Antimicrobial Prophylaxis In some cases of urinary tract infection recurrences, a physician may recommend antimicrobial prophylaxis, which is the use of antibiotics to prevent another infection. This has been shown to effectively reduce one’s risk of recurrent UTIs in women with two infections over the previous year. (The typical duration of an initial use of antimicrobial prophylaxis is six months.) (7)
  • Postcoital Prophylaxis For those whose UTI recurrences are related to sexual intercourse, taking antibiotics after intercourse (also called postcoital prophylaxis) may be preferable. Depending on the frequency of intercourse, postcoital prophylaxis likely results in less antibiotic use than antimicrobial prophylaxis. (8)
  • Estrogen for Postmenopausal Women The use of a vaginal estrogen cream or an estradiol-releasing vaginal ring have both been shown to be an effective strategy for reducing recurrent urinary tract infections in postmenopausal women. In fact, vaginal estrogen has been shown to reduce recurrent UTIs by 36 to 75 percent. (6)

Possible Preventive Strategies for UTIs

While the research is still out on the preventative strategies below, prospects are promising.

  • Probiotics The probiotic strain Lactobacillis, found in fermented milk products, has been shown to prevent urinary tract infections in laboratory testing. There’s also promising research that shows the strains L. rhamnosus gr-1 and L. fermentum rc-14 could prevent UTIs as well. (6)
  • Cranberry Juice Cranberries contain polyphenols called proanthocyanidins, which may help prevent E. coli from causing urinary tract infections in women, but data is conflicting about the effectiveness. While a meta-analysis published in July 2012 in the journal JAMA Internal Medicine showed a decrease in UTI rates in those who consumed daily cranberry tablets, a few months later, a review published in October 2012 in the Cochrane Database found insufficient evidence to recommend routine use of cranberry. (8,9,10) A study published in November 2016 in the Journal of the American Medical Association looked at the effectiveness of cranberry capsules with proanthocyanidin and concluded that the capsules had no significant effect on urinary tract infections. (11)
  • Diet Adjustment Research has shown that urine with higher pH (more alkaline) levels and higher levels of certain metabolites formed by gut microbes are better able to resist recurrent UTIs. It’s thought that one can improve these levels through diet. For instance, calcium supplements raise urinary pH levels. In addition, consuming foods rich in antioxidants, like tea and colorful berries, may encourage growth of metabolites. (12)

Who Should Pay Special Attention to UTI Preventative Measures

Some individuals are at a higher risk for urinary tract infections than others. Those individuals include:

  • Women who are sexually active
  • Women who are pregnant
  • Menopausal women
  • Those with diabetes
  • Those with kidney stones
  • Those who’ve recently had a catheter

Understanding, Preventing and Treating UTIs

How to Recognize and Manage UTI Symptoms

If you’ve ever had a urinary tract infection (UTI), you’d probably do just about anything to avoid the agonizing burning sensation and constant need to urinate.

It is important to learn more about the ins and outs of UTIs so you can take proper steps to quickly recognize and manage the symptoms.

What causes UTIs?

Contrary to popular belief, poor hygiene, hot tubs and tampons aren’t the main culprits for UTIs. Typically, a urinary tract infection occurs when bacteria migrate from the rectum, across the vagina, and into the urethra and urinary bladder and cause an infection (cystitis). If the bacteria have very aggressive traits, they can move to the kidneys and cause a febrile UTI (pyelonephritis). This process can happen in any woman, but if the vaginal mucosa is very receptive to bacteria, UTIs will occur more easily. About 20 percent of women are genetically predisposed to have very receptive vaginal mucosa, so they will have frequent recurrent infections. In fact, one in five females will have at least one UTI in their lifetime; nearly 20 percent of women who have a UTI will have another; and 30 percent of those will have yet another, according to the National Kidney Foundation.

Spermicides also make the vaginal surface more receptive, so they should be avoided, alone or with diaphragms. Post-menopausal women have a dry vaginal mucosa that increases bacterial binding and UTIs. This can be rectified by application of vaginal estrogen creams that restore the health of the vaginal mucosa and greatly reduce the chance of a UTI. Sexual intercourse will facilitate bacterial entry into the urinary tract, so it is a good idea to be well hydrated and urinate after intercourse.

How is a UTI Treated?

Most likely, you will need antibiotics as soon as possible to cure the infection and to prevent it from getting worse. Your physician will take a urinalysis to check for bacteria and blood cells. When providing a urinalysis, be sure to follow the instructions exactly to avoid contaminating your urine sample. As soon as you receive a prescription, complete the entire course of antibiotics and follow the instructions exactly as directed, even if you’re feeling better, to prevent recurring infection.

What Can I do to Manage the Symptoms?

  • Drink plenty of water to help flush out the bacteria causing the infection, and to dilute your urine to ease the burning sensation when you pee
  • Make frequent trips to the bathroom to flush your system (the extra fluids will help)
  • Consider using a different form of contraception: diaphragms and spermicidal agents can cause irritations and make it difficult to empty your bladder, creating an ideal environment for bacteria to grow
  • If you have diabetes, keep your blood sugar at optimal levels

Why do UTIs Recur?

With each infection, your chances of recurrent UTIs increases. One reason for recurring UTIs is not properly completing the course of prescribed antibiotics for the original infection. Even if your symptoms have improved, it doesn’t necessarily mean the antibiotic has killed all the bacteria. There could be some lingering bacteria that could become resistant to the medication, so don’t stop taking the antibiotic mid-course.

The main reason for recurring UTIs is increased vaginal receptivity for bacteria, either because of genetic predisposition and/or use of spermicides, or vaginal mucosa aging and lack of estrogens in post-menopausal women.

Are There Considerations for Pregnant and Older Women?

Pregnant women should have a urinalysis in the first trimester. If no bacteria are present, no further urine tests are required during the pregnancy. However, if bacteria are identified in the urine, antibiotics will be needed, even there aren’t any symptoms because asymptomatic bacteriuria in pregnancy can lead to complications for the mother or baby.

Because antibiotic use can have a bad effect on the pregnant mother or fetus, they should only be prescribed by an obstetrician. After the first infection is treated, the patient should have urinalysis every three months for the duration of the pregnancy.

Older women frequently have bacteria in their bladder that cause no symptoms or health risk. The bacteria are usually found by chance when the urine is checked for some other reason. These bacteria should never be treated because they will only return. More importantly, antibiotic use in this setting will cause the bacteria to become resistant and can cause UTI.

Does Drinking Cranberry Juice Prevent UTIs?

There is clear scientific evidence that cranberry products DO NOT prevent or treat UTIs, so save your money and do not use these products for this purpose. Other strategies for preventing UTIs include staying hydrated and urinating frequently throughout the day. Not urinating often enough can lead to more frequent UTIs. Taking vitamin C helps your urine to be more acidic, which can prevent bacteria from growing, and high-fiber carbohydrates in your diet provide good digestive health.

UTIs are common, but adding a few healthy habits to your daily routine may help you to better manage, and possibly prevent, a UTI from interfering with your life.

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