Urinary tract infection is one of the most common types of infection in humans.
Although they can affect people of all ages, they are more common in older people, who may experience more severe symptoms.
A urinary tract infection (UTI) is an infection, usually bacterial, but can also be fungal, viral or parasitic, that affects any part of the urinary system: kidneys, ureters, bladder or urethra. There are three main types of UTIs:
- Cystitis: bladder infection.
- urethritis: infection of the urethra (the tube that sends urine from the bladder to the outside of the body).
- pyelonephritis: kidney infection.
As we pointed out, bacteria are usually the main responsible for UTIs, especially the Escherichia coli. They can infect the urinary system in many ways:
- Poor hygiene: Women who wipe from back to front after a bowel movement can make it easier for bacteria to reach the bladder.
- sexual intercourse: Bacteria from the vaginal area are pushed up the urethra and eventually end up in the bladder.
- Use of products that favor the bacterial community: The use of diaphragms or condoms treated with spermicides can facilitate the presence of bacteria in the urinary tract.
Other factors that can cause a UTI are those that reduce bladder emptying or irritate the urinary tract, such as:
- Prostate enlargement.
- Kidney stones.
- Reduced mobility or rest after an accident.
- Kidney obstruction.
- Weakened immune system.
- Previous urinary infection.
What are the symptoms of UTIs
UTIs, unlike sexually transmitted diseases, are not contagious. They are characterized by causing the following symptoms:
- Urgent need to urinate.
- Increased urination.
- Burning, pain, or discomfort when urinating.
- Fever that can be mild or high.
- Cloudy, thick or odorous urine (in the worst case bloody).
- Pressure in the lower abdomen or pelvis.
- Pain in the lower abdomen, side or back.
- Feeling of a full bladder, even after urinating.
- Tremors and fatigue.
- Vomiting and nausea.
How do they affect the elderly?
In addition to the previously developed symptoms, older adults are more likely to experience:
- Behavior changes.
- Delirium or hallucination.
Experts don’t know for sure what causes these additional symptoms in older adults, although they suspect they may be related to weak blood vessels supplying the brain.
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UTIs can develop in older adults due to other factors, such as:
- Changes in the immune system.
- Exposure to bacteria in hospitals or care facilities.
- Having other health conditions, such as incontinence.
- Using a urinary catheter, a tube that connects the bladder to a bag outside the body to allow urine to drain.
Although UTIs are common and in most cases harmless, they can cause serious complications if left untreated:
- Renal disease: A condition that causes the kidneys to lose their ability to remove waste and balance body fluids.
- sepsis: life-threatening condition in which the infection spreads into the bloodstream and then throughout the body. It can cause organ dysfunction, amputations, and chronic pain disorders.
How to treat UTIs
If older adults experience any of the symptoms listed above, they should consult a doctor as soon as possible to clear up any doubts.
Through a urine test, it will be identified if it is really a UTI and if it is in the bladder or has spread to the kidneys, in order to later determine its severity.
Generally, the treatment for a UTI is to use antibiotics to kill the bacteria that cause it. Antifungals may also be prescribed if the UTI was caused by a fungus.
If the infection is accompanied by other symptoms, such as severe confusion, hallucinations or delirium, the health professional may use antipsychotic medications to reduce anxiety and agitation.
If the UTI is very advanced, antibiotics may be given intravenously. In rare cases, surgery is needed (usually because the infection is caused by a problem with the structure of the urinary tract).
If so, a urostomy (opening in the abdominal wall) is used to divert urine away from the bladder that is diseased or not working as it should.
How to prevent UTIs
UTIs can be treated quickly and effectively, however, specialists agree that the best way to avoid problems is to prevent them. To do this, older adults can resort to the following measures:
- Drink a lot of water.
- Avoid applying products containing perfumes in the genital area.
- Avoid or limit your intake of caffeine and alcohol.
- Avoid tight clothing in the groin area.
- Wipe from front to back after going to the bathroom.
- Quickly change incontinence pads or underwear when wet.
The consumption of cranberry juice, one of the most popular natural options against UTIs, should be recommended by a health professional. This is because it can cause gastrointestinal problems in some older adults.
Although this drink does not have evidence to support its effectiveness in treating UTI once it has started, it does appear to be helpful in preventing it. This is because cranberries contain chemicals capable of killing certain bacteria that stick to the lining of the bladder, causing infections.
It is important for family members or caregivers in nursing homes to ensure that older adults receive adequate care to prevent or avoid UTI complications.
Sources consulted: Natural Medicines Comprehensive Database, US National Library of Medicine, Centers for Disease Control and Prevention, Mayo Clinic, National Institute of Allergy and Infectious Diseases.