Sunday, March 29, 2015

Urinary Tract Infection in Aging Men

Although urinary tract infections (UTIs) are much more common among women, older men who develop the condition are more likely to be hospitalized as a result, the new research has found. The study summarized that the aging U.S. population, higher rates of diabetes and other conditions, as well as resistance to antibiotics among the most influencing factors that contributed to the trend.

What is a urinary tract infection?

A urinary tract infection (UTI) is caused by bacteria that get inside your urinary tract. Most bacteria that enter your urinary tract are expelled when you urinate. If the bacteria stay in your urinary tract, you may get an infection. Your urinary tract includes your kidneys, ureters, bladder, and urethra. Urine is made in your kidneys, and it flows from the ureters to the bladder. Urine leaves the bladder through the urethra. A UTI is more common in your lower urinary tract, which includes your bladder and urethra.

How common are urine infections?

About 3 in 100 men in their 60s, and about 1 in 10 men in their 80s, will have a urine infection.

Urine infection is much more common in women. This is because their urethra (the tube from the bladder that passes out urine) is shorter and opens nearer the back passage (anus) than in men. Infection also becomes more common as you get older. Half of all women will have a urine infection that needs treating in their lifetime.

UTI Reasons, Associated with Aging

As people age, there is a slow, steady decline in the weight of the kidneys. After about age 30 to 40, about two thirds of people (even those who do not have kidney disease) undergo a gradual decline in the rate at which their kidneys filter blood. However, the rate does not change in the remaining one third of older people, which suggests that factors other than age may affect kidney function.

As people age, the arteries supplying the kidneys narrow. Because the narrowed arteries may no longer supply enough blood for normal-sized kidneys, kidney size may decrease. Also, the walls of the small arteries that flow into the glomeruli thicken, which decreases the function of the remaining glomeruli. Accompanying these losses is a decline in the ability of the nephrons to excrete waste products and many drugs and an inability to concentrate or dilute urine and to excrete acid. Despite age-related changes, however, sufficient kidney function is preserved to meet the needs of the body. Changes that occur with age do not in and of themselves cause disease, but the changes do reduce the amount of reserve kidney function that is available. In other words, both kidneys may need to work at nearly their full capacity to carry out all the normal kidney functions. Thus, even minor damage to one or both of the kidneys may result in a loss of kidney function.

The ureters do not change much with age, but the bladder and the urethra do undergo some changes. The maximum volume of urine that the bladder can hold decreases. A person's ability to delay urination after first sensing a need to urinate also declines. The rate of urine flow out of the bladder and into the urethra slows. Throughout life, sporadic contractions of bladder wall muscles occur separately from any need or appropriate opportunity to urinate. In younger people, most of these contractions are blocked by spinal cord and brain controls, but the number of sporadic contractions that are not blocked rises with age, resulting sometimes in episodes or urinary incontinence. The amount of urine that remains in the bladder after urination is completed (residual urine) increases. As a result, people may have to urinate more frequently and have a higher risk of urinary tract infections.

Risk Factors for UTI?

* Urinary tract problems: If you are not able to control when you urinate, your risk for a UTI increases. Your risk also increases if you have had a UTI or if you have had surgery on your urinary tract in the past.

* Blockages: A blockage in your urinary tract stops your urine from flowing freely. Causes of a blockage include kidney and bladder stones.

* Not being circumcised: The foreskin of the penis makes it easier for germs to get trapped and enter your urinary tract.

* Prostate problems: An enlarged prostate gland or an infected prostate (prostatitis) increases your UTI risk.

* Sexual intercourse: You are more likely to get an infection if your sex partner has an infection. Anal sex also increases your UTI risk.

* Weak immune system: Your immune system is your body's defense against infection and disease. A weak immune system may not be able to fight the germs that can cause a UTI. Your immune system may become weak when you have a long-term illness, such as HIV or diabetes.

* Drink less than needed: Do not drink enough water or other clear, non-caffeinated liquids (caffeine can “dry you out”).

What are the signs and symptoms of a UTI?

* Urinating more often or waking from sleep to urinate
* Pain or burning when you urinate
* Pain or pressure in your lower abdomen
* Urine that smells bad
* Leaking urine

How is a UTI diagnosed?

Your primary physician will ask about your signs and symptoms. He may press on your stomach, sides, and back to check if you feel pain. You may also need the following:

* Urine tests: A sample of your urine is collected and sent to a lab for tests to learn what germ is causing your infection. You may be able to give a urine sample by urinating into a cup.
* Blood tests: You may need blood tests to check if you have a prostate infection.
* Imaging tests: You may need imaging tests if your UTI does not get better or you get another UTI. Imaging tests are pictures of your urinary tract that may show if your infection is in your kidneys. Imaging tests may also show if you have damage, blockages, or other problems in your urinary tract. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

How is UTI treated?

* Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
* Urinary tract medicines: These decrease pain and burning when you urinate. They will also help decrease the feeling that you need to urinate often. These medicines will make your urine orange or red.
* Painkillers. Paracetamol or ibuprofen will usually ease any pain, discomfort, or high temperature (fever).
* An underlying cause such as an enlarged prostate or constipation may be found and need treatment.

What is the outlook (prognosis)?

Most people improve within a few days of starting treatment. See a doctor if you do not quickly improve. If your symptoms do not improve despite taking an antibiotic medicine then you may need an alternative antibiotic. This is because some germs (bacteria) are resistant to some types of antibiotics. This can be identified from tests done on your urine sample.

What are the risks of a UTI?

If you take antibiotics for a long time, bacteria in your body can become resistant. Bacteria that are resistant to antibiotics are very hard to kill. Even after you take medicine to treat your UTI, your infection may come back. Without treatment, your infection and symptoms may get worse. The bacteria may spread to your kidneys and cause pyelonephritis. This can be a very serious condition, and you may need treatment in the hospital. The infection can spread to your blood, which can be life-threatening.

Urinary problems in older men are gathered under the medical abbreviation 'LUTS' (lower urinary tract symptoms). These complaints can have a range of causes. An enlarged prostate is probably the best-known cause of urinary problems among older men. Other causes could be a weaker sphincter muscle of the bladder, a bladder infection or kidney- or bladder stones.

It is important to know that urinary problems with an enlarged prostate is not a risk factor for developing prostate cancer. Men without prostate cancer have urinary problems just as often as men, diagnosed with prostate cancer. The doctor can examine your prostate for signs of prostate cancer and if there are any indicators can order follow-up testing.

How can I prevent a UTI?

* Urinate when you feel the urge: Do not hold your urine. Urinate as soon as you feel you have to. Try to take enough time for urination to prevent not complete emptying the bladder.
* Drink plenty of liquids: This may help you urinate more often. Ask how much liquid you should drink each day and which liquids are right for you.
* Wear appropriate outfit: Bladder infection remedies can include how you dress. Think casual, relaxed, and flowy. Clothing that lets your skin breathe can help keep the bacteria in your urinary tract at bay. Moisture is a breeding ground for bacteria, in the bladder and elsewhere. Cotton underwear and loose pants promote air circulation and reduce the chances of bacteria growth.

Home Remedies for UTI

* Sip cranberry juice or take cranberry supplements. Cranberry juice also helps to flush away bacteria and keeps them from sticking to the bladder wall, so it can be effective for UTI prevention. Be sure to choose the unsweetened juice, however, because sugar adds nothing but calories.
* Load up on vitamin C. Vitamin C makes your urine more acidic, which fights bacteria in your urinary tract. If you have an active UTI, taking vitamin C supplements may help.
* Blast bad bacteria with good bacteria. Yogurt contains probiotics, which is the good bacteria that helps to keep bad bacteria that can cause UTIs at bay. It is always a good idea to eat yogurt regularly, but it is particularly important when you are taking an antibiotic for UTI treatment, which can wipe out your body’s natural good bacteria. You can find yogurt with live active cultures that can do the job or take probiotic supplements in pill form.
* Soothe the pain with heat. The inflammation and irritation from UTIs cause burning, pressure, and pain around your pubic area. Applying a heating pad can help soothe the area. Keep the heat setting low, and limit it to 15 minutes at a time to avoi burns.
* Ban the burn with baking soda. If painful, burning urination is a problem for you during a UTI, it may help to drink half of a teaspoon baking soda mixed with a glass of water.
* Cut out irritants. Things like caffeine, alcohol, spicy food, nicotine, carbonated drinks, and artificial sweeteners can irritate your bladder further and make it hard for your body to heal. Focus on healthy foods, such as high-fiber carbohydrates and healthy fats like olive oil, which are good for your digestive health.
* Use herbal remedies. You may find some relief from taking the herb urva ursi, which works as an anti-inflammatory. In addition, the herbs goldenseal and Oregon grape root can help your body fight E. coli, common bacteria that causes UTIs. However, be sure to tell your doctor about any herbs you are taking, because side effects can sometimes be serious.

Sources and Additional Information:

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