Dr. Hive---UTI's in 73yr old female

[4everHis]

My mom has been on an antibiotic for UTI's off and on for 2 years.  I think the longest she's gone w/o taking antibiotic is 2 mths. They have done scans, scopes, ultrasounds  and everything is negative. I want them to find the cause and quit treating the symptoms. She has quit her every morning coffee. She takes cranberry, D'Manose, garlic. Drinks lots of water and is not big on dairy or sugar. Does anyone have any more thoughts or ideas? She does not have heart/blood pressure meds and is not diabetic.

 

 

[GailV]

So, they actually find bacteria?  Or does she have pain, like in interstitial cystitis, but no other sign of infection.  I'm not sure from what you're saying.

 

A friend was diagnosed with the latter, and was able to take a medication specifically for that.

[Ethel Mertz]

Here's the advice my gynecological oncologist gave me: If your Mom experiences any burning during or after urination, that is a sign that the pH balance is off. You can adjust the pH balance by taking a scant teaspoon of baking soda and mixing it into 4 or 5 ounces of water and drinking it down. I do this at the 1st sign of any burning (which can be a precursor to a UTI) and it seems to help. Next step would be to seek out specifically a gynecological urologist (so that you get a urologist who only deals with female anatomy). I also avoid citrus as that seems to be a trigger. Hope your Mom finds some relief.

[4everHis]

Some times she has had pain but in this most recent case she was just having a checkup and the culture was positive. No pain or symptoms. 

[4everHis]

Here's the advice my gynecological oncologist gave me: If your Mom experiences any burning during or after urination, that is a sign that the pH balance is off. You can adjust the pH balance by taking a scant teaspoon of baking soda and mixing it into 4 or 5 ounces of water and drinking it down. I do this at the 1st sign of any burning (which can be a precursor to a UTI) and it seems to help. Next step would be to seek out specifically a gynecological urologist (so that you get a urologist who only deals with female anatomy). I also avoid citrus as that seems to be a trigger. Hope your Mom finds some relief.

 

I will mention this to her again. It doesn't help that I am 1,100 miles away and can't truly check on her. I know I mentioned this once. 

[Calm37]

Have they ruled out vaginal atrophy?

[GailV]

I thought recent research has shown that urine is rarely sterile, and there's a lot more bacteria in a normal person's urinary tract than we thought.  However, I don't recall where I heard this  so I don't have any context -- probably on NPR and I missed the rest of the discussion.

 

 

[hornblower]

Asymptomatic Bacteriuria - recommendations for practice from  AFP http://www.aafp.org/afp/2006/0915/p985.html


Fwiw, if it was my mom, I'd consult a certified European herbalist & start on some herbs which support kidney & bladder health. 

[4everHis]

Have they ruled out vaginal atrophy?

I  will ask her. That is not a term I remember her mentioning.

[4everHis]

I thought recent research has shown that urine is rarely sterile, and there's a lot more bacteria in a normal person's urinary tract than we thought.  However, I don't recall where I heard this  so I don't have any context -- probably on NPR and I missed the rest of the discussion.

I hadn't heard this but was starting to wonder if  'some' bacteria isn't normal and should they medicate if she has no symptoms?

[4everHis]

Asymptomatic Bacteriuria - recommendations for practice from  AFP http://www.aafp.org/afp/2006/0915/p985.html

 

 

Fwiw, if it was my mom, I'd consult a certified European herbalist & start on some herbs which support kidney & bladder health. 

Forwarding this info to her. and I agree. I'd love for her to see someone who is open to something other than another antibiotic.

[TranquilMind]

So, they actually find bacteria?  Or does she have pain, like in interstitial cystitis, but no other sign of infection.  I'm not sure from what you're saying.

 

A friend was diagnosed with the latter, and was able to take a medication specifically for that.

 

I was wondering this too?  Are they actually finding bacteria each time? 

 

Also, found out by personal experience that UTI's do not manifest normally in the elderly.  In our case, the woman, who was perfectly fine, became disoriented. 

 

 

Edited August 19, 2016 by TranquilMind

[ktgrok]

I hadn't heard this but was starting to wonder if  'some' bacteria isn't normal and should they medicate if she has no symptoms?

 

Depends on how much "some" is. People can die from bladder infections that are left untreated. Heck, it's how Pope John Paul II died. They can also cause dementia symptoms in the elderly. 

[Roadrunner]

Do they resolve on their own? Mine go to my kidneys, so I have to treat them, but some people can fight them without drugs.

[Laura Corin]

Does she take aspartame/NutraSweet in anything? My reaction to it mimics a urinary infection. It's sometimes in medicines too.

Edited August 19, 2016 by Laura Corin

[4everHis]

Does she take aspartame/NutraSweet in anything? My reaction to it mimics a urinary infection. It's sometimes in medicines too.

 I don't think she does but I will make sure she's not. Thanks for the heads up.

[4everHis]

Do they resolve on their own? Mine go to my kidneys, so I have to treat them, but some people can fight them without drugs.

She has had one progress and I think that scares her. But how long can you take antibiotics before it impacts your health? 

[Denisemomof4]

I had my mother's urine cultured several times. The results showes that the type of meds prescrived were not meds to help.

 

Do everything you can naturally to prevent them.

[Katy]

Is she diabetic?

[EmseB]

She really needs to have some kind of in-person advocate talking to doctors with her every time. I know you said you aren't there, but is there anyone that can help manage her health care and be an advocate for her? I'm not even saying this because she's 73; my husband is in his 30's, he's a smart guy, and was completely lucid and I caught a mistake the doc made just because I could google.

[DesertBlossom]

I took abx for a uti and I felt like the symptoms hadn't completely resolved by the time I had completed the antibiotics. I went back to the doctor and my urine sample came back negative. Long story short, I had a yeast infection because of the antibiotics. I got that treated and the burning went away.

Edited August 20, 2016 by DesertBlossom

[FriedClams]

I just want to warn you that UTIs at that age made my mom very sick. She'd appear to go crazy, and it was VERY troubling. She's already dealing with Alzheimer's, so with that added in it was nuts (really, nuts!). Just an encouragement to keep them under control. If she departs abruptly from her normal self, get her checked!

[J-rap]

I assume they are growing a culture for 2-3 days to find out exactly what kind of bacteria is causing the infection so that they make sure to treat it with the correct antibiotic.  So then after 7 days, does she take another test to see if the infection is gone?  And is it?  They say that if the UTI returns within 6 weeks, it's usually the same infection that didn't quite go away.  

 

Assuming it's gone, then she needs to work really hard to prevent another one.  Drinking lots of water, emptying your bladder often (go to the bathroom as soon as you feel the urge), and avoiding baths help.  I was told that once you have an infection, you're often more prone to getting another infection because the scar tissue can hold bacteria more easily.  Emptying your bladder often flushes out bacteria that could otherwise grow into an infection.

 

My mother had UTI's for several years and then finally got them under control.  She has't had one now for several years!

[Sandragood1]

The lack of estrogen can make the opening to the urethra loose and floppy which allows bacteria to enter. If this is the cause a low, local dose of estrogen can help. She'd have to weigh the risk of the estrogen versus near constant antibiotics.

 

Also certain probiotic strains have been shown to help.

[ktgrok]

Chronic antibiotics MIGHT be bad long term, untreated UTI in an elderly person is DEFINITELY dangerous, and possibly life threatening. Don't let perfect be the enemy of the good, you know?

[gardenmom5]

Some times she has had pain but in this most recent case she was just having a checkup and the culture was positive. No pain or symptoms. 

 

if there is actual cultured bacteria-

is she consistent about wiping front to back and dropping the tp in the toilet?  any other good hygiene practice? changing underwear every day?  washing everyday?

 

are they doing cultures after she finishes a course of antibiotics to make sure ALL the bacteria has been killed and it isn't a case of antibiotic resistance?

[4everHis]

Is she diabetic?

No. She's in great health except for this. Though it seems like the more antibiotics she has more stomach issues.

[4everHis]

I took abx for a uti and I felt like the symptoms hadn't completely resolved by the time I had completed the antibiotics. I went back to the doctor and my urine sample came back negative. Long story short, I had a yeast infection because of the antibiotics. I got that treated and the burning went away.

 

I will ask her about that. Makes sense.

[4everHis]

if there is actual cultured bacteria-

is she consistent about wiping front to back and dropping the tp in the toilet?  any other good hygiene practice? changing underwear every day?  washing everyday?

 

are they doing cultures after she finishes a course of antibiotics to make sure ALL the bacteria has been killed and it isn't a case of antibiotic resistance?

 

I will ask her about the cultures. I know they have done follow up cultures many times because they had her antibiotics back to back for months at one point because they were never coming back negative.

[EmilyGF]

Bladder prolapse? I know of an older woman who regularly was having UTIs because a prolapse was causing her not to void completely.

 

Emily

[ktgrok]

Bladder prolapse? I know of an older woman who regularly was having UTIs because a prolapse was causing her not to void completely.

 

Emily

 

This is very common, and yes, could cause this. 

[gardenmom5]

I will ask her about the cultures. I know they have done follow up cultures many times because they had her antibiotics back to back for months at one point because they were never coming back negative.

 

 

that's indicative the bacteria is resistant to the antibiotic they are using.   have they changed the type of antibiotic?

at this point - I would be seeking another dr who is more up to date and specialized.

[sassenach]

It's also possible to have asympomatic colonization that does not require treatment. Are the cultures growing out one specific bacteria or mixed flora? Are they alternating the antibiotic used and making sure it matches with the culture?

 

UTI/kidney infections have been ds's problem area for about 2 years now. I've had some success preventing with d-mannose, cranberry, vit c, and asparagus water. I've also heard that uva ursi is effective, but hard on the liver, which eliminates it for Ds (his liver is already taxed by meds).

 

Have they done urodynamic study to see if she's fully emptying when she goes? That would definitely contribute.

 

Hth,

Edited August 21, 2016 by Sassenach

[kiwik]

Can she see a gynecologist?

[NoPlaceLikeHome]

I agree with seeing a gynecologist specializing in urology too. She may want to consider a infectious disease specialist too since she keeps having recurring infections to see if they have any thoughts. Have they ruled out resistant bacteria? 

[4everHis]

Thank you ladies. I'm sending all of these questions to her as they come in. I know she has seen several different doctors but will need to clarify if one is specifically an ob/gyn. I know they've used many different antibiotics. I know I've talked to her about complete emptying of bladder. I'll mention again. Haven't heard the term bladder prolapse from her. Will check. 

[4everHis]

I agree with seeing a gynecologist specializing in urology too. She may want to consider a infectious disease specialist too since she keeps having recurring infections to see if they have any thoughts. Have they ruled out resistant bacteria? 

 

I will ask her about this.