My Mom has frequent bladder/UTI infections. Could this combination of meds or either med on its own be contributing to this problem? Any help would be appreciated. Thanks.
Both of these drugs should HELP with frequent UTI's. Nitrofurantoin is a bladder specific antibiotic. It acts on infections in the bladder only-it wont help infections in other areas of the body. If a person has frequent UTI's, sometimes Drs will give this drug on a daily basis prophylatically to prevent UTI's from occuring. Toviaz is for over active bladder symptoms, urinary incontinence and urge/frequency. As a person who has suffered with frequent UTI's since I was 2 years old, I have learned a bit on how to help prevent them and what can cause them (plus I have been an RN for over 20 years) What I suspect may be going on with your mother is that she probably doesnt empty her bladder completely when she urinates. This tends to compound UTI problems. Since the bladder never empties completely, urine can reflux back from the urethra into the bladder carrying bacteria with it, which then sets up shop and Bam! UTI. She needs to be sure that when she urinates, she takes her time, and is sure her bladder empties fully-as we get older our muscles there get weak and we dont empty fully. Sometimes it helps to lean forward a bit and even push down on the bladder area with her hands to help to expel urine. Kegal exercises can help to strengthen those muscles giving her better control and strength to have a strong stream. When the bladder doesnt empty fully, we start having to urinate more frequently because our bladder is already partially full so it fills quicker. Having it not empty fully also invites bacteria a nice environment to grow in. Also when a woman has to urinate frequently she stops drinking fluids because she doesnt want to have to pee all the time or have a dreaded, embarrassing accident. It is of utmost importance that she drink lots and lots of water, unless she has heart problems, and her Dr has her on fluid restrictions, she should be drinking around 64 oz of fluids per day and the majority should be plain water. Coffee and tea dont count as fluid replacement because they are natural diuretics and remove more fluid than they replace. Juices are ok but they are high sugar and bacteria LOVE sugars! If she cant drink plain water, flavored waters are ok and better than some other drinks-certainly better than nothing! Even something like Crystal Light can help. People tout cranberry juice as the "be all" for UTI's and it certainly doesnt hurt, but most juice drinks are "cocktails" with high sugar content-most people cant palate cranberry without suger as it is VERY tart! Cranberry pills are ok but really the ingredient in cranberry that helps most is the Vitamin C. For some reason, Vitamin C makes it difficult for bacteria to adhere to the bladder wall, so she can try cranberry pills or just a plain vitamin C tablet-whichever she can obtain for the least amount of cost. When a person first increases their water intake they will have the need to urinate quite frequently. For women who have urgency, frequency and incontinence, this is the last thing that they want, so they tend to NOT to drink so they wont pee and this gets to be a viscious cycle and makes them more prone to UTI. Reassure her that she will need to urinate frequently in the beginning but after the body gets used to being well hydrated she wont be urinating as frequently. Hydration helps to expel toxins and keeps the bladder flushed so that bacteria doesnt have a chance to colonize the bladder. So hydration is top priority for a UTI sufferer. Many people dont care for the taste of plain water but I find as people force themselves and they get used to it, they soon find that is what they want when they are thirsty! The body doesnt have to process water, it can be used immediately so that makes it superior to other drinks. Hygiene is important too. All little girls are taught to wipe from front to back after urinating. This is important because the anal area is a breeding ground for bacteria. The digestive tract is full of bacteria, some good, some bad, and this bacteria is left behind even if we wipe clean. If we urinate and wipe back to front the paper can carry bacteria from the rectal/anal area up to the bladder opening (meatus) and this can then travel up the urethra (the tube that goes from the bladder to the meatus or bladder opening where the pee comes out). If you have a UTI that is confirmed to be E. Coli, which the majority of UTI's are from E. Coli, it was likely bacterai migrated from the rectal area. Our digestive systems are full of E. Coli bacteria. It is transferred to that area when we have a bowel movement or poop. Drinking plenty will help flush this out but we must be careful not to introduce it by wiping back to front. I really prefer to wipe with the moist wipes that are flushable. I find these are more gentle than dry T.P. and do a better job of cleansing the area. I'm going to get more graphic and personal here but I find it is important, so bear with me. Another hygenic issue is to be sure that a woman voids (urinates or pees) after sexual activities. Sex, either oral or intercourse, introduces bacteria into the urethra via the urinary meatus which is located directly above the vagina. Penetration and friction during sex can drive bacteria into the urethra, so voiding afterwards will flush that bacteria out before it can colonize and cause a UTI. NEVER allow anal penetration followed by vaginal penetration! This just asks for trouble! If anal penetration is an enjoyable activity in your sexual repertoire, using a condom for anal penetration, then removing and discarding it after anal penetration, before going back into the vagina will keep unhealthy bacteria from being introduced into the bladder via the urethra. I also find that the best practice is to bathe (both partners) before any sexual activity. This helps reduce the skin's bacterial load and can help decrease the liklihood of UTI. You can make it a part of foreplay to get into the shower together and soap each other up... well just use your imagination there! lol Being clean really does help, including oral hygiene prior to sexual activity, especially if oral sex is part of your repertoire. Using a minty mouthwash adds a nice little tingling cooling effect to cunnilingus-who knows? It might become something VERY enjoyable that you never considered before. It will cut down on the bacterial load in the mouth that can help to reduce UTIs be reducing the amount of bacteria a woman is exposed to during sex. Another thing, in speaking of hygenic practice, some women find it better to shower rather than tub bathe so as to not introduce bathwater bacteria into the urethra. I also recommend the use of VERY mild cleansers in the perineal area (vaginal and anal areas) Harsh cleansers, bubble bath and douches can irritate the meatus and can lead to bladder spasms and UTI. A woman should NEVER douche unless a Dr advises her too. The vaginal canal is self cleansing and only the outer parts need to be cleansed regularly to prevent odor and remove discharges. If vaginal discharge is malodorous then a visit to the gynecologist is in order because this indicates something is wrong. Douching upsets the natural balance of the vagina-it alters pH and kills good bacteria that allow bad bacterias take over, leading to vaginal infections which can mimic or contribute to UTI because of irritation to the meatus and urethra.
Is your mother seeing a urologist? she should be! Sometimes, in some women, the bladder opening (the meatus) is too small leading to UTIs. They may need to dilate the urethra-this can sometimes help to alleviate the frequent UTI cycle. He can also check her for structural problems like prolapse etc. He can test to see if her bladder empties fully or if urine is refluxing back from the urethra to the bladder (which, remember, can carry bacteria).
I know this is a long response but UTI's are miserable but I guarentee if she follows my suggestions, it will help reduce or hopefully stop her bladder problems. It does take vigilance but it can be done. You might want to print this for her to read because talking to your mother about sexual practices is not usually a comfortable thing for most people!
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