On the Coast – Over 55 Issue 34 I March/February 2020 | Page 20

Urinary Tract Infection
BY DR GEORGIA PAGE
A
urinary 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 Fever
ƒ Chills
ƒ Lower abdominal/pelvic pain
ƒ Back pain
ƒ Cloudy and/or smelly urine
ƒ Urinary incontinence/leakage of urine
ƒ Blood in the urine
ƒ Fatigue
ƒ Nausea
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 Weaker immune systems
ƒ Associated 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 Incontinence of the bladder or bowel.
ƒ The presence of a urinary catheter
ƒ A history of recurrent UTI’s.
ƒ Lower levels of estrogen (in post-
menopausal women)
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ON T H E C OA S T – OVER 5 5
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 Taking a alkalinising agent (such
as ural) to help reduce burning or
stinging when going to the toilet
ƒ Paracetamol 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 Urinating immediately after sexual
intercourse
ƒ Avoiding caffeine and alcohol
ƒ Do not ‘hold on’ or delay going to the
toilet when you need to .
ƒ Vaginal estrogen may reduce risk in
post-menopausal women
ƒ Preventative antibiotics (taking a low
dose antibiotics every day for 3 – 6
months)
ƒ Non antibiotic prevention – 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.