If you haven’t experienced a urinary tract infection (UTI) before, take note: while the infections are uncommon in older men, they can be common in older women, occurring in 10% of women ages 65 or older, and in 30% of women ages 85 or older. For up to a third of women who have a UTI, the infection comes back within six months.
“E. coli bacteria [which live in the intestines] cause approximately 80% of all recurrent UTIs and continue generating microbe strains that are resistant to antibiotics. The ability of the bacteria to stick to the urinary tract can sometimes make them very difficult to eliminate,” says Edward Doherty, who spent 10 years working on potential vaccines for recurrent UTI and other conditions at Harvard’s Wyss Institute and is now CEO and co-founder of vaccine maker Attivare Therapeutics.
UTIs can arise anywhere in the urinary tract — the kidneys, bladder, ureters (the tubes that take urine from the kidneys to the bladder), or urethra (the tube that carries urine out of the body).
Female anatomy — specifically the short urethra, which opens to the outside world just above the vagina — affects women’s susceptibility. That’s because bacteria from the rectum, especially E. coli (formally called Escherichia coli), can be pushed to the opening of the urethra through wiping or sexual intercourse. Then, they can travel up the urethra to the bladder.
“Men rarely get UTIs because of their longer urethra,” explains Dr. Michael O’Leary, a urologist at Harvard-affiliated Brigham and Women’s Hospital. “But sometimes a man’s enlarged prostate gland impedes the flow of urine from the bladder, causing urine to pool and creating a breeding ground for bacteria.
Symptoms and treatment
UTI symptoms usually include a burning feeling with urination, an urgent need to urinate, frequent urination, bloody or cloudy urine, or fever.
Sometimes doctors treat UTIs based only on symptoms. But the most accurate diagnosis requires a urine test to check for white blood cells and bacteria, and then a urine culture to grow bacteria in a lab and see which types are present. A course of antibiotics should clear up the infection.
One complication: older women can carry bacteria in their bladders without an infection or symptoms, a condition called asymptomatic bacteriuria. “Women with asymptomatic bacteriuria should not be treated,” Dr. O’Leary says. “It’s not necessary, and this causes antibiotic resistance.”
Vaccines in the works
Doherty and his team started their company to license the vaccine technology developed at Harvard and then test it in humans. This vaccine and others being tested generally aim to prevent recurrent UTIs by targeting the mechanism bacteria use to stick to the lining of the urinary tract.
Some doctors, including Dr. O’Leary, are skeptical a vaccine could ever completely prevent UTIs. “There are many different bacterial causes, and one vaccine may not cover them all,” he says. Still, given how commonly the responsible bacterium is E. coli, a vaccine targeting E. coli could go a long way toward preventing many, if not all, recurrent UTIs.
Some women are prone to frequent or recurrent UTIs. Here are strategies that can help ward them off:
- Drink lots of water each day to flush out the urinary tract.
- Empty your bladder immediately after sexual intercourse.
- If you’re a postmenopausal woman, consider using vaginal estrogen cream to help inhibit “bad” bacteria from living near the urethral opening.
- If you’re a woman of any age, wipe front to back after going to the bathroom; wiping from back to front carries “bad” bacteria toward the urethral opening.
- Consider a daily long-term, low-dose antibiotic (although this has a risk of encouraging antibiotic resistance).
- If your UTIs often follow sexual intercourse, take a single dose of an antibiotic after sex.
What about supplements that claim to ward off UTIs?
There’s mixed evidence that cranberry products can help. Cranberries contain natural chemicals that may keep bacteria from adhering to the urinary tract lining. “But cranberry juice is very high in sugar. Stick with tablets instead,” O’Leary says.
The American Urological Association notes it’s okay to try cranberry to avoid UTIs. But the group has not found evidence that any other supplements — including D-mannose, herbs, hyaluronic acid, or chondroitin — will help prevent UTIs.
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
2 Corinthians 13:9 For we rejoice when we ourselves are weak but you are strong; this we also pray for, that you be made complete.
Colossians 1:28 We proclaim Him, admonishing every man and teaching every man with all wisdom, so that we may present every man complete in Christ.
Colossians 4:12 Epaphras, who is one of your number, a bondslave of Jesus Christ, sends you his greetings, always laboring earnestly for you in his prayers, that you may stand perfect and fully assured in all the will of God.
2 Corinthians 10:15-16 not boasting beyond our measure, that is, in other men’s labors, but with the hope that as your faith grows, we will be, within our sphere, enlarged even more by you, so as to preach the gospel even to the regions beyond you, and not to boast in what has been accomplished in the sphere of another.
2 Thessalonians 1:3 We ought always to give thanks to God for you, brethren, as is only fitting, because your faith is greatly enlarged, and the love of each one of you toward one another grows ever greater;
2 Peter 3:18 but grow in the grace and knowledge of our Lord and Savior Jesus Christ To Him be the glory, both now and to the day of eternity. Amen.
Ephesians 1:17-18 that the God of our Lord Jesus Christ, the Father of glory, may give to you a spirit of wisdom and of revelation in the knowledge of Him. I pray that the eyes of your heart may be enlightened, so that you will know what is the hope of His calling, what are the riches of the glory of His inheritance in the saints,
Ephesians 3:16-19 that He would grant you, according to the riches of His glory, to be strengthened with power through His Spirit in the inner man, so that Christ may dwell in your hearts through faith; and that you, being rooted and grounded in love, may be able to comprehend with all the saints what is the breadth and length and height and depth, read more
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