February 2012 Health Bulletins
Ask the Doc
Dr. P. Davis Smith, medical director at Wesleyan University’s Davison Health Center, answers questions submitted by our readers.
Q: How can you avoid a urinary tract infection (UTI ) besides drinking lots of fluids? What should you do if you keep getting one? —Marina, Boston University
A: Happily, and not discounting the annoyance and discomfort, there don’t seem to be serious adverse consequences of frequent/recurrent urinary tract infections (UTIs). The problem is not uncommon. I periodically have conversations about this with patients. There is no simple answer that fits everybody and no definitive guidance from the medical literature. Here are some things we usually cover:
The basics: Most UTIs are caused by E. coli. This is an organism that is a normal denizen of the intestinal tract. Sometimes it can colonize the area around the urethra. The act of sex, especially penile-vaginal intercourse, helps push these bacteria up the relatively short female urethra into the bladder, a normally sterile environment, where they can cause an infection. Changes in the normal vaginal flora may predispose women to getting these infections.
Some women are just prone to these infections. Current theory suggests that the cells of their urinary tract are just stickier to bacteria, allowing more ready adherence and, hence, colonization and infection. Also, some women are anatomically more at risk but not, as I’ve been telling patients for years, because their urethras are shorter. Rather, it appears to have to do with the distance from the urethra to the anus.
Behavioral risk factors: Sexual intercourse is the usual pre-cursor. Use of spermicide is a co-factor, including use of spermicide-coated condoms or use of spermicide with diaphragm. Recent antibiotic use, which may impact on the balance among the different bacteria that normally live in the vagina, is also a risk factor. One large recent study found frequency of sexual intercourse to be the strongest risk factor for recurrent UTI. Other risk factors identified were: spermicide use during the past year, having a new sex partner during the past year, having a first UTI at or before 15 years of age, and having a mother with a history of UTIs. These last two reinforce the idea that some of the risk may be intrinsic and inherited. Interestingly, this and other studies have found no risk or benefit of urinating before and/or after sex, waiting a long time before urinating, wiping one way or the other, douching, using hot tubs, frequently wearing pantyhose or tights, or having an elevated body mass index.
So what does help?
Abstinence is protective.
Non-spermicide contraceptive options should be explored.
Even though there isn’t good data to support it, most of us still recommend post-coital voiding (urinating soon after sex, putatively to “flush out the urethra”). Liberal fluid intake to increase the frequency of urination might also be helpful. Again, these interventions haven’t been proven to be of benefit but are unlikely to cause harm. A 2008 Cochrane Review concludes: “There is some evidence that cranberry juice may decrease the number of symptomatic UTIs over a 12-month period, particularly for women with recurrent UTIs.”
Join a Quidditch Team for a Wizardly Workout
If you’re looking for fitness with some fantasy thrown in, you might consider grabbing a broom and signing up for the Quidditch team at your school. What? You’re not a wizard? Don’t worry. Muggles around the world have now adopted the magical sport. With the immense popularity of Harry Potter, more than 460 Quidditch teams have sprung up in the U.S. alone, according to the International Quidditch Association, and many are on college campuses.
How to Play Quidditch
Students at colleges around the country (including Harvard University, Elmhurst College, Middlebury, and Ball State) are competing in Quidditch. While players cannot fly, they run on a soccer-type field with broomsticks between their legs and try to throw a small ball called the quaffle through the opposing team’s hoop. One player is the golden snitch, and he or she wears a belt with a flag or sock and hides anywhere nearby. Players on both teams try to find the snitch and grab the flag/sock for 150 points and to end the game. To find out more and see a film on how to play, CLICK HERE.
Eating Disorders: How to Help Yourself and Others
Nearly 10 million females and 1 million males in the U.S. are battling eating disorders such as anorexia and bulimia, while millions more suffer from binge eating disorders, according to the National Eating Disorders Association. More than one in three normal dieters progresses to pathological dieting. With National Eating Disorders Awareness Week starting on February 26, take the time to find out more about this serious health issue, which affects many college students. For information, CLICK HERE.
Posture Check: Stop Your Computer Slouch
Are you slumped over your computer for a good part of the day? Take a moment to straighten up your act. Proper alignment of your body can make you look and feel better by:
• Reducing back and neck stiffness and pain
• Helping digestion
• Increasing energy
• Optimizing breathing and muscle performance
To find out ways to improve posture while at the computer, CLICK HERE.
