recurrent UTIs — Reeve Connect
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recurrent UTIs

Bryan
Bryan Member Posts: 2
First Comment
What do you recommend for a woman with mobility issues with recurrent UTIs which land her in the hospital? She has a foley catheter. Her dr refuses to prescribe antibiotics until the culture comes back at which point she is so sick, she has to be hospitalized for IV meds. Dr. thinks the UTIs come from her lack of bowel control which results in fecal material getting into her urethra. 

Comments

  • AskNurseLinda
    AskNurseLinda Moderator, Information Specialist Posts: 158 Information Specialist
    100 Comments 25 Likes First Answer Name Dropper
    Hi, Bryan, thank you for posting. I am sorry I did not get to your question in the webinar today.
    Definitely, contamination is a risk factor for infection with an indwelling foley. A foley catheter increases risk of infection as it is an open conduit for bacteria to crawl right up into the bladder. But it has its benefits for skin care if the individual is incontinent and is an alternative for urine containment for women who have a difficult time with intermittent catheterization. Stool is a contaminate so most certainly it is a risk.
    Just as urine has to be contained, so does stool. A bowel program helps control the containment of bowel as it becomes predictable.
    How to conduct the bowel program should be determined individually by the healthcare professional. Here is a link to the basic principles; https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/bowel-management (sorry, you will need to copy/paste as I can't hyperlink it.) There is also a bowel care booklet that can be obtained for free from the Reeve Paralysis Resource Center.
    As soon as a bowel incontinence occurs, the area should be cleaned to prevent UTI and skin breakdown.
    A diet high in fiber will help solidify the stool. 
    That should be a good start. If the individual cannot sit on the commode for the evacuation part of the bowel program, have her lay on her left side for the most complete evacuation.
    The bowel program takes some effort. It must be performed at the same time everyday to be effective as you are 'training' the bowel to work. Most individuals use a dulcolax or magic bullet suppository but if this woman is older, a glycerin suppository might be strong enough. It can take several weeks to get into a regular, successful bowel routine. The goal is to create a time when the bowel works which will avoid accidents.
    Since she has a foley, if she has no fluid restrictions, you can inquire if fluids, especially water, can be increased which will help the bowel function. You don't want to increase dramatically, just a little extra over time. Heart disease and other medical conditions can prevent increasing fluids so be sure to check this before starting. 
    Success is at hand. You are on the right track. This is a solvable issue. It does take patience. Nurse Linda

    I'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

    Leave a comment any time below. Let's get the discussion going!

    Nurse Linda

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  • Bryan
    Bryan Member Posts: 2
    First Comment
    thanks so much!
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