My mom has recurrent/chronic UTI's, constantly. Any advice?

Dear OP, some suggestions:
1) Watch really carefully to see how she is wiping her bottom after a bowel motion. If she wipes from back to front at any stage, she is transferring the (I think it’s) ecoli from the feces forward to where the bladder empties just by the vagina. She should be reaching behind her, not backwards between her legs. That will cause a fresh UTI. She might have started to do this because it’s actually an easier movement, but it’s a seriously bad move.
2) This could be one where drinking cranberry juice regularly could help. It’s not strong enough to cure anything, but it probably makes the bladder a bit more resistant.
3) Are you sure that her UTIs are being cultured and tested fully? I had one that didn’t clear up in spite of the antibiotic that the doctor prescribed immediately. When the full test came back from the lab, it was a different unusual infection, and cleared up with a different antibiotic.
4) To help her empty her bladder completely, she should sit on the toilet seat with her knees apart, lean forward to compress her stomach, and push.

I hope this helps a little bit. Yours with sympathy to both!

They COMMONLY used to put such elders on a daily prophylactic dose of Cipro. Now you are lucky to get Cipro at ALL as some side effects that were exceptionally rare put it out of favor. Sadly this is seldom done anymore, and more sadly, this inability to empty the bladder makes these infections more frequent.

I had frequent bladder infections that often moved to my kidney, and was under threat of daily doses a bit more than a decade ago. It was recommended I try D-Mannose, one capsule daily. I had no faith in this as, as an RN, I don't really believe in supplements and vitamins without a very good reason. I tried it and I haven't had a single UTI in over a decade. Works much like cranberry but not acidic. Keeps bacteria from adhering to the bladder wall. Easy to take and if capsule too large to swallow break open and put in food. Very slight sweet to tasteless. Worth a try. Has worked for others I have recommended it to I would say 80% of the time. I use Source Natural, about 30.00 for 120 capsules on Amazon, but I suspect they are all much the same.

Take her to see a gyno-urologist.

The low dose Cipro might help. I don’t think either the cranberry or D-mannose does anything except keep the nutraceutical companies in business. I was taking both and had more utis than I did after I stopped taking them. Go figure.

My mother gets them too. She’s had at least three this past year. She responds well to Cipro.

My aunt is bedridden and on Hospice care at home. She just got her catheter last week. What a blessing because she is heavy and it was very difficult to move and keep her dry & clean.

Summernole, I don't suggest cranberry. Most is full of sugar and that's a no no for someone already having infection. Trader Joe has some without sugar but it isn't well tolerated. It's acidity is way too much for most elders. There are many things that do the same thing cranberry does and I am surprised, as she has a urologist, he hasn't suggested some to you. I would check on that. Glad that the cultures are being done. Sounds like you are doing all you can. Bladders for the elderly go all neurogenic and result is often frequent infections, sadly.

Cranberry juice is not good because of the sugar. My Mom was on cranberry tablets and a probiotic daily for a year before she passed and had no UTIs in that year,

My daughter says doctors start out with a broad spectrum antibiotic. What you to make sure is done is that a culture is taken to see what bacteria they are dealing with so the correct antibiotic is given. If she leans foward, that helps to void. Sitting a little longer may give her the urge to go again. My Moms doctor asked that she get a sling to out her bladder back in place. She refused. A catheter maybe her best bet but as Alva says, they can also cause UTIs.

I've been told that just getting the urine more acidic will help. Therefore, eating oranges or any fruit high in vitamin C or taking vitamin C tablets will help. I augment my mother's meals with any high water fruit, e.g. watermelon, grapes, etc. My mother will not drink cranberry juice, however she will drink orange juice, mango juice, etc. She doesn't like the taste of water or coffee. However, she will drink tea. I try to pump her full of fluids.

She resists taking in all this fluid because it makes her go to the bathroom more often. For me, the Vitamin C tablet has worked the best.

She already has a urogynochologist so why are you asking us non physicians? Does she have diabetes? A permanent cath requires daily anticeptic practices als also can contribute to infections.Why go to the PCP to get antibotics? The urologist should already doing best practices? You can also ask for a second consult with a urologist.

My Mom’s doctor prescribed Hiprex to help acidify her urine. She also takes Azo capsules. She’s been doing this for a couple of years now. She went from having back to UTI’s for several years to having only one in two years.

So, the urologist recommended a sling and mom refused?

I remember my mom's gynecologist put her on a probiotic called rePhresh. And prescribed a hormonal vaginal cream to be applied a few times a week.

A constant low dose antibiotic is not a good idea. I had constant UTIs, strep, and ear infections as a kid. Back then (early 1970s) there was no evidence of this causing problems later.

I am now 51 and am antibiotic resistant. Any time I need antibiotics, I have to take a very high dose. And the pill itself is huge, like swallowing a rock. Sometimes they hurt my stomach. I hate it.

Granted, at your mom’s age, getting resistant may not be as much of an issue.

My mom had reoccurring UTI’s as well, they were all caused by fecal matter and her PCP would give her the instructions about wiping, what to use to wipe etc. then she had several back to back. While we don’t actually know for sure since they never tested to see if it was cured after the course of antibiotics, I’m convinced it was the same infection. She would get better on the antibiotic and then a few days after the course was finished her behavior would change again (this is the only way we know or suspect UTI since she never feels it). She was sent to a urologist who put her on a heavier duty antibiotic and once it was done and her UTI cleared up she started Hiprex and D-Manose which has seemed to do the trick!

Not everyone is the same but it sounds like your mom (and you) could use a trip to A urologist who deals with elderly paitents.

Is your mother a diabetic? Female diabetic patients usually get recurring UTIs. Also, using too much antibiotics could cause it to become resistant. Toileting the proper way is an important factor in preventing UTIs. Women should wipe from the front to the back in order to avoid contamination.

Your mom needs to have a check with a urologist.

In the meantime, she should try using Greek yogurt with live cultures.

If she is not emptying completely, that could very well be the problem. I was having chronic UTIs for several years until a great urologist found this.

I just went through this with my husband. Even the low dosage antibiotic. The antibiotics quit working. What they have him on now Is Methenamine along with vitamin c. Supposedly it turns his urine into something the bacteria doesn’t like. I know they have prescribed this to women too.

Good luck.

In addition to you finding the best Urologist possible to treat your mom and making sure she is drinking plenty of water, I think taking a look at her bathroom routine might be warranted. Lots of folks are suggesting drugs and drinks, but no one is talking about the dirty word of "cleanliness."

My mom does not remember to wipe, nor does she really know how when you remind her. Have you thought about installing a bidet onto her toilet? You can get one for about $100 and it's a relatively easy installation. I think if you have elderly folks who do not bathe frequently and have accidents in their pants and who don't wipe well or at all, I think flushing the area with water from a bidet might be helpful at keeping their bottoms clean. I don't know how involved you are when she uses the toilet, but you would more than likely need to be involved in the use of the bidet (pushing the button and helping her dry off) unless your mom is really high functioning. Making sure she is changing her underpants daily or several times a day if needed is also a good idea.

This is a hard one because they still want their privacy and you don't want to be insulting, but you also don't want them back in the hospital.

Make sure that she is properly hydrated.

Dehydration is a risk factor for a UTI.

What I do for my mother is make sure that she drinks enough water daily, which isn't a problem for her, because I add a little bit of lemonade flavor. Also, when I make her water bottle, I add Vitamin C, Magnesium Chloride, a pinch of salt and a pinch of sugar.

I also wipe her bottom 100% of the time to make sure that it's wiped from front to back.

She is 96 and has not had a UTI.

Peace.

Me too

Saw this commercial recently
https://www.youtube.com/watch?v=901R1dGMdII

As one whose bladder stopped working, my doctor encouraged me to learn intermittent catherizing. Just in, drain, and out. Better than wearing a bag strapped to your thigh. Anyway, I had a problem with frequent UTIs and my doc prescribed low dose Cipro seven days a week. But the look on his face said he wasn’t happy with that. So I took it on my own to reduce it to 3 days a week and it works just as well. Cranberry juice helps, but get the one that just has 5 mg of sugar. There’s a big 5 on the front of the bottle. I’ve also heard others rave about D-Mannose. I’m also using that and so far, so good!

I feel your pain! Since my Mom's stroke she has had recurring uti's which as you know are horrific for the elderly! I did it all, hydrate, cranberry juice, pills and finally her urologist prescribed a medication called methenamine. He said it makes bacteria impossible to grow in the bladder. He also said nothing was 100% but...It works! Knock on wood, Mom hasn't had a uti in a very long time! Like over a year! And as a preventative to avoid falls and in my Mom's case, seizures, when she gets her blood work done they also do a urine culture to check for a uti. This way we can get antibiotics fast if she should have one.
Best of luck to you!

My mother went through the same thing. She was at a memory care center, and once we discussed with administration the proper ways to wipe her after fecal matter, and all urine needs to be cleaned it helped. Once the doctor prescribed cranberry pills, she had no more UTIs at all.

I recently read that pink slime/ mold growing in toilet or shower can cause repeated UTIs. I have no ideas if it’s true, but it’s worth checking some sources.

I have always had chronic UTI's which are excruciatingly painful. The only antibiotics that work properly are prescribed after having a culture done. However, because I was prone to them a couple of times a year or more I went to urologist and also. my gyn. They both prescribed a low dosage of estrogen in a vaginal suppository form. I started a couple of years ago initially on a 2-week course of nightly estradiol cream followed by ongoing maintenance therapy twice weekly.  It has been a lifesaver for me. I also make sure I go to empty my bladder frequently, hydrate, proper cleanliness, etc. I'll never go off it. If your mom has insurance she can get a generic version for a lower cost. Also, I get mine through a pharmacy that uses Good RX. Good luck.

Summernole: After the U.T.I. is cleared through the course of antibiotic after a complete urinalysis is performed, she could start an RX of Myrbetriq after having seen her urologist. She should also begin taking cranberry tabs and, if necessary, drink pure cranberry juice (not cranberry juice cocktail). This has worked for me, personally. I had two U.T.I.s one month apart and soon remedied that.

Daily antibiotics will only cause your mom to develop strains of infection that will be near impossible to cure. Catheters also carry their own risk of infection (as a hospital-based RN, we try hard to avoid them). Tactics that can help include:
1 - Putting her on a toileting schedule. Every 2-3 hours while awake, she must be placed an the toilet and encouraged "to go."
2 - Thorough cleaning every time she soils herself with urine or stool. Washing must be from front to back using a mild soap and water. Dirty or wet undergarments must be changed promptly. If she can sit on a commode, a bidet attachment can help with clean-ups.
3 - Plenty of non-caffeinated fluids throughout the day. Many seniors are dehydrated and don't have a good thirst drive when they need more fluids. Make sure she drinks about 2 liters of fluids daily. If she has a fluid restriction from her doctor, use that "number" as your guide.
4 - Some folks have success with low dose hormones in the genital area (vagina and meatus areas) to boost tissues in those areas. Some claim that is helps to thwart infections. I'm not convinced, but talk with her doctor about it.

My husband has UTI's a lot that is when his doctor put him on 250mgs of cephalaxin which he takes at night. Also he is on a cranberry pill that helps too.

Why he takes the antibiotic at night that is when the urine pools and the bacteria grow. Since he has been on this regiment he hasn't had an UTI at all. My husband had a catheter put in all that did was give him a lot of pain and made it where he had a bad UTI which he was on stronger antibiotics.

I would wait and give the low dose of antibiotics a try take them at night and with a cranberry pill too to see if that works for her.

Prayers

My mom is 85, in a NH & has frequent UTIs. She has been hospitalized several times due to UTI w septicemia. Her cognitive function noticeably declines every time this happens. It’s cumulative. She’s had a ureter stent placed & removed a couple of times due to kidney stones. The stent is a foreign body & an optimal place for bacteria to set up housekeeping. It can provide direct access for bacteria. Surgical procedures to place & remove a stent provide optimum times for bacteria to invade & proliferate. Kidney stones also provide a good site for bacteria to grow. Her urine cultures are usually positive for E. coli or MRSA. I think poor hygiene is the primary cause of her UTIs + or - septicemia. The staff @ the NH is lazy. My mother tends to wait to be changed instead of having that done right away. She doesn’t want to piss the staff off by requiring them to change her as needed or frequently. She doesn’t want to get on their bad side so she ends up lying in her own filth for extended periods of time. That is a perfect situation for E. coli/ MRSA to invade the urinary tract. I’ve wondered if MRSA has colonized her urinary tract. If so, she would require a maintenance dose of an antibiotic to keep it in check. Another hygiene problem is bathing. Baths are supposed to be done 3 times a week. I don’t know if she is getting those baths. She does bathe herself, not a member of the staff. In her situation, I think she should be able to bathe daily to ensure EVERYTHING gets clean. I have Sjögrens Syndrome, an autoimmune disease. It’s more common in women & has a genetic link. I’ve tried to get the NH to test mom for Sjögrens. I’ve mentioned this to mom, my siblings & encouraged them to pursue testing. No luck! She has textbook symptoms as do I. If a Dr diagnoses her w Sjögrens & begins treatment, I can’t help but think her health would improve & therefore reduce the incidence of UTIs.
So there are many different variables to consider as to the cause of frequent UTIs. Hygiene, underlying illness including autoimmune disease, bacterial colonization, foreign bodies, (stents, kidney stones), proper treatment without delay & more. Not long ago I came across my maternal grandmother’s death certificate. Listed as a cause of death was UTI with septicemia.