Bathroom Behavior Periodically emptying the bladder by urinating every two to three hours may help to prevent UTIs.

Diet The use of cranberry products seems to decrease the ability of bacteria to adhere to the lining of the urethra and bladder. As cranberry juice can have a high amount of sugar, cranberry extract can be taken in capsule or pill form instead. Increasing water intake by one or two glasses per day may help limit the length of time that you have symptoms  and reduce the infections. However, drinking large amounts of water has not been proven to reduce UTIs.

Hygiene Proper hygiene in caring for the urethral area is another way to limit the amount or type of bacteria that can be drawn into the urethra. This is especially true in people who have decreased sensation in the  perineal region such as those with MS or who experience any amount of fecal incontinence. Using soap and water or commercially available cleansing wipes several times per day and frequent changing of incontinence pads as they become wet can minimize the amount of bacteria in the urethral area. Women should always wipe from the front of the vagina to the back of the anus after urination or a bowel movement.

Sexual Activity Ensuring proper lubrication to the vagina and voiding before and after intercourse are tactics to help prevent infection. Using diaphragms and spermicidal jelly and/or foam may increase the risk of infection, so it is important to evaluate what type of birth control you use. Some physicians encourage women who have a history of recurrent   infections to take an prophylactic antibiotic after intercourse, as it reduces risk of recurrent UTI by about 85%. Restricting the number of sexual partners can lower the risk of recurrent UTIs.

Vaginal Estrogen Estrogen reduces risk of recurrent UTI by repopulating the normal vaginal lactobacilli that keep bacteria from the rectum from multiplying and causing a bladder infection. Forms of vaginal estrogen are available at very low dosages that have minimal systemic absorption.Vaginal estrogen is a medication that needs to be prescribed by Dr. Portera. 

Catheter Use Proper cleansing and storage of catheters is important in one who intermittently catheterizes, as the catheter can be a vehicle to introduce infection. 

Pharmaceutical Depending on the severity of infection, Dr. Portera may prescribe an oral antibiotic. A simple UTI can be treated with a 3- or 7-day course of antibiotics. Length of an antibiotic treatment depends on the severity of the infection as well as the type of antibiotic prescribed.  As with most prescriptions, you should complete the full course of medication prescribed by Dr. Portera.  You may supplement pain relief by taking urinary analgesics, Tylenol, or non-steroidal anti-inflammatory medications. 

Urinary Tract Infections in the Elderly Because the elderly often do not experience or report obvious symptoms that younger people have, urinary tract infections can be easily overlooked. Confusion, feelings of general discomfort, disorientation, fatigue, weakness, behavior changes, falling, or new, acute incontinence are reported as common complaints.  Because these symptoms are so general, this often results in a delaying treatment, inviting the complication of sepsis to occur. UTIs can cause a change in behavior in older people and people with dementia. Masquerading as confusion, agitation, or withdrawal, UTIs may actually be the cause of behavioral shifts. The person may not be able to communicate how they feel, therefore it is very important to be familiar with the symptoms of a UTI and seek medical help to enable appropriate treatment.
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Delirium In some cases, UTIs can cause a significant and distressing change in someone’s behavior. Usually developing over a day or two, when someone’s mental state changes drastically it is commonly referred to as an acute confusion state or delirium. If someone you know exhibits agitation or restlessness, increased difficulty with concentration, hallucinations or delusions, or becoming unusually sleepy or withdrawn they may be dealing with delirium. If the delirium is due to an UTI, treatment with an appropriate course of antibiotics may help to alleviate the symptoms. Regardless of what has triggered the delirium, seek medical help immediately.