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Urinary tract infection - Lifestyle Changes

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of urinary tract infections.

Alternative Names

Cystitis; UTI

Lifestyle Changes:

Although there is no evidence that good hygiene makes a real difference in preventing UTIs, it is always a wise practice. The following are some hygiene tips:

  • Clean the genital and urinary areas from front to back with soap and water after each bowel movement.
  • Keep the genital and anal areas clean before and after sex. Urinate before and after intercourse to empty the bladder and cleanse the urethra of bacteria.
  • Avoid tight-fitting pants.
  • Wear cotton-crotch underwear and panty hose, changing both at least once a day. (Mild detergents are best for washing underwear.)
  • Take showers rather than baths.
  • Avoid bath oils, feminine hygiene sprays, douches, and powders. As a general rule, do not use any product containing perfumes or other possible allergens near the genital area. Douching is never recommended as it may irritate the vagina and urethra and increase the risk of sexually transmitted diseases.
  • Choose sanitary napkins instead of tampons (which some doctors believe encourage infection). Napkins and tampons, in any case, should be changed after each urination.
  • Drink plenty of fluids and urinate frequently.
Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. Females are especially vulnerable to this, because the urethra is in close proximity to the rectum. The genitals should be cleaned and wiped from front to back to reduce the chance of dragging E. coli bacteria from the rectal area to the urethra.
Prevention of cystitis

Sexual Precautions

The following recommendations may reduce the risks from sexual activity:

  • In women using contraceptives, consider alternatives, particularly if exposed to spermicides from condoms or diaphragms. Discuss the best contraceptive choice with a doctor.
  • Avoid sex with multiple partners. This can cause many health problems, including sexually transmitted diseases and UTIs.

Cranberries, Blueberries, and Lignonberries

Cranberries, blueberries, and lignonberry, a European relative of the cranberry, are three fruits that may have protective properties against urinary tract infections. These fruits contain compounds called tannins (or proanthocyanadins). Tannins may prevent E. coli bacteria from adhering to cells in the urinary tract, thereby inhibiting infection. Cranberry juice is the best-studied home remedy for UTIs. Some studies have indicated that cranberry juice may help decrease the number of symptomatic UTIs, especially for women with recurrent urinary tract infections.

It is not clear what the optimum dosage is for cranberries, or whether it is best to use juice or tablet form. Some research recommends drinking at least 1- 2 cups of cranberry juice daily, or taking at least 300 - 400 mg in tablet form twice daily.

Probiotics and Lactobacilli

Probiotics are beneficial microorganisms that may protect against infections in the genital and urinary tracts. The best-known probiotics are the lactobacilli strains, such as acidophilus, which is found in yogurt and other fermented milk products (kefir), as well as in dietary supplement capsules. The probiotics bifidobacteria and GG lactobacilli may also be helpful. Other probiotics include the lactobacilli rhamnosus, casel, plantarium, bulgaricus, and salivarius, and also Enterococcus faecium and Streptococcus thermophilus. Not all studies show a benefit for probiotics in preventing urinary tract infections. More research is needed.

Resources

References

Azzarone G, Liewehr S, O'Connor K. Cystitis. Pediatr Rev. 2007 Dec;28(12):474-6.

Colgan R, Nicolle LE, McGlone A, Hooton TM. Asymptomatic bacteriuria in adults. Am Fam Physician. 2006 Sep 15;74(6):985-90.

Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier RW, Keren R. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. JAMA. 2007 Jul 11;298(2):179-86

Faust WC, Pohl HG. Role of prophylaxis in vesicoureteral reflux. Curr Opin Urol. 2007 Jul;17(4):252-6.

Foster RT Sr. Uncomplicated urinary tract infections in women. Obstet Gynecol Clin North Am. 2008 Jun;35(2):235-48, viii.

Hodson EM, Wheeler DM, Vimalchandra D, Smith GH, Craig JC. Interventions for primary vesicoureteric reflux. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001532.

Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD001321.

Lin K, Fajardo K; U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2008 Jul 1;149(1):W20-4.

Litwin MS, Saigal CS, editors. Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2007; NIH Publication No. 07-5512.

Modgil G, Baverstock A. Should bubble baths be avoided in children with urinary tract infections? Arch Dis Child. 2006 Oct;91(10):863-5.

Moore KN, Fader M, Getliffe K. Long-term bladder management by intermittent catheterisation in adults and children. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006008.

Mori R, Lakhanpaul M, Verrier-Jones K. Diagnosis and management of urinary tract infection in children: summary of NICE guidance. BMJ. 2007 Aug 25;335(7616):395-7.

Norrby SR. Approach to the patient with urinary tract infection. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap.306.

Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005131.

Peterson J, Kaul S, Khashab M, Fisher AC, Kahn JB. A double-blind, randomized comparison of levofloxacin 750 mg once-daily for five days with ciprofloxacin 400/500 mg twice-daily for 10 days for the treatment of complicated urinary tract infections and acute pyelonephritis. Urology. 2008 Jan;71(1):17-22.

Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003237.

Roussey-Kesler G, Gadjos V, Idres N, Horen B, Ichay L, Leclair MD, et al. Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study. J Urol. 2008 Feb;179(2):674-9; discussion 679. Epub 2007 Dec 20.

Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, Hoberman A, Wald ER. Does this child have a urinary tract infection? JAMA. 2007 Dec 26;298(24):2895-904.

U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2008 Jul 1;149(1):43-7. Ann Intern Med. 2008 Jul 1;149(1):W20-4.

Williams GJ, Wei L, Lee A, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2006 Jul 19;3:CD001534.

  • Reviewed last on: 8/4/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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