Five tips from a pelvic medicine doctor to keep your bladder healthy

Is it a UTI or is it not? That is the question

Urinary tract infections, or UTIs, are a major cause of distress for women — especially for women past menopause. But it can be difficult to know when a UTI is present or if it is something else.

What is a UTI?

“By strict definitions, a UTI may be an infection anywhere along the urinary tract which includes the kidneys, ureters or bladder,” says Dr. Erika Hunter, a board-certified in female pelvic medicine and reconstructive surgeon, with HCA Midwest Health. “The most common is bladder infection.”

Dr. Hunter says sometimes a person may have no symptoms, and in many situations, this means treatment may not be necessary.

“This is called asymptomatic bacteria,” she says. “The bladder normally has some bacteria floating around in it, but if the conditions are just right or a particular species of bacteria is persistent, then the bacteria attaches to the lining of the bladder, sets up shop and causes inflammation and damage to the bladder lining, which often leads to the symptoms of a UTI or bladder infection.”

Dr. Hunter says these symptoms might include bladder awareness, irritation around the urethra, bladder pain, blood in the urine, burning after urination or increased frequency of urination.

How can I prevent UTIs?

Dr. Hunter says there are proven ways of preventing bladder infections and some of them do not even require a visit to the doctor.

“For example, D-Mannose has good evidence for the prevention of UTIs. It can help prevent UTIs even better than taking a daily antibiotic,” she says.

Bacteria preferentially attach to this molecule rather than your bladder lining and are flushed out of the body. D-Mannose is a simple sugar found in many fruits, such as cranberries, and can also be taken as a supplement. It comes in 500mg capsules or tablets and maybe taken two to four times a day.

Dr. Hunter says another over-the-counter supplement which has good medical evidence behind it to treat UTIs is methenamine.

Don’t go on a supplement shopping spree yet. Dr. Hunter recommends talking to your physician before beginning a supplement routine.

What causes UTIs?

“UTIs are more common in women generally because they have a shorter urethra,” Dr. Hunter says. “But there are several other possible causes which may need to be investigated.”

She says prolapse or falling of the bladder may lead to bladder infections or UTIs because a woman is not emptying her bladder efficiently, so bacteria is hanging around a bit too long and has more opportunity to act. Other less common causes are previous sling procedures, kidney stones, fistulas or even cancer.

“Fistulas and cancer are rare causes but sometimes your doctor might recommend further investigation,” she says. “After menopause, there is another increase in risk due to loss of estrogen.”

How does estrogen loss lead to UTIs?

Dr. Hunter says there are estrogen receptors in the urethra and the lower third of the bladder so with the changes in loss of estrogen in these areas, your natural defense mechanisms are not as robust.

“That is why your doctor sometimes recommends using an estrogen cream to help strengthen these defense mechanisms,” she says.

There are other situations that may lead to what is termed recurrent UTIs. Dr. Hunter says the definition of recurrent UTIs is two or more in six months.

“This leads to quality of life issues for women but also may increase morbidity and therefore your doctor may recommend seeing a urologist or urogynecologist if you are having more than two UTIs in a six-month period,” she says.

What are irritative bladder symptoms?

Dr. Hunter says many times a person feels like they have an infection, but no infection is present.

“This can be due to things like overactive bladder, interstitial cystitis, kidney stones or, in rare cases, bladder cancer,” she says.

 What can be done about irritative bladder symptoms? Dr. Hunter says the first thing to do is have a look at how much or how little fluids a person is drinking. Too little fluid intake and the urine is concentrated which irritates the bladder making it feel like a bladder infection. Too much fluid intake and a person are going to the toilet all the time which may be confused with a bladder infection. It is helpful to start with one and a half to two liters of fluid a day.

“Also, there are so many things in our delicious modern diet that can also irritate the bladder like carbonated drinks, lemon, lime, alcohol, tomatoes, pineapple, fizzy drinks, caffeine and certain medications as well,” she says.

The bladder is sensitive. A good rule of thumb: If the food or drink you are enjoying is irritating your mouth, then it will probably also irritate the bladder. “We all want to enjoy our favorite beverages occasionally and one thing you can do is purchase an over-the-counter acid reducing supplement and take it 30 minutes prior to ingesting irritating food or drink. This neutralizes the acids, then you can enjoy.” Says Dr. Hunter.

Dr. Hunter recommends these five tips to keep your bladder healthy:

• Empty your bladder fully.
• Drink the right amount of fluid; not too much or too little. One and a half to two liters of fluid a day is ideal.
• Check your diet for anything that might be irritating your bladder.
• D-Mannose supplements may prevent a UTI. Talk to your doctor.
• If you feel something else may be going on, check with your doctor to be sure.