Wednesday, November 30, 2022
Wednesday, November 30, 2022
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Can Parkinson’s Disease Cause Urinary Problems

How Does Parkinsons Impact The Risk Of Getting Utis

Urinary Dysfunction and Parkinson’s with Arun Mathur

In Parkinsons, the brains control of the urinary sphincter can become disrupted, leading to difficulty holding urine. As a result, people with Parkinsons may experience storage symptoms, which can increase the frequency and/or urgency of urination and lead to nocturia when you wake up multiple times at night to go to the bathroom. Another set of urinary symptoms, called voiding symptoms, can cause urination hesitancy, straining, interrupted stream, and double voiding . You may experience symptoms in both sets, which puts you at a higher risk of developing a UTI.

Voiding symptoms often go unnoticed for longer than storage symptoms do, and they can play a significant role in the development of UTIs. For example, if they keep you from fully emptying your bladder each time you urinate or keep you from urinating as often as you should, bacteria can grow and spread in the remaining urine, leading to UTIs.

Parkinsons motor symptoms can also impact your ability to urinate as frequently. Slowness and stiffness can make it difficult to get to the bathroom. In addition, if you experience significant balance issues, you may not travel to the bathroom as often as you need to for fear of falling.

Epidemiology And Clinical Impact

Patients with PD are twice as likely to be admitted for UTI compared to non-PD controls . Although the risk of UTI increases with age and is generally more common in women, PD-associated UTI occurs in relatively equal proportions between older men and women, consistent with the notion that PD, and the secondary effects inherent to the disease, supersede sex as a risk factor for UTI . PD-associated UTI is likely under-reported, as it is often classified as a urinary disorder rather than as an infection . Furthermore, the reason for hospitalization in patients with PD and UTI may be categorized under a related incident, such as a fall secondary to UTI, rather than the UTI itself , thus underestimating the actual incidence and significance of PD-associated UTI. PD is the second most common neurodegenerative condition after Alzheimers disease and is the fastest growing neurologic condition overall . With PD cases expected to double by 2030 , PD-associated UTI is expected to only increase in importance to health care providers and planners in the coming decades.

Identifying And Reporting Uti In Pd

Cognitively intact patients with urinary symptoms should have testing with a urinary dipstick as an initial measure to evaluate for the presence of nitrite or leukocyte esterase or, alternatively, a urinalysis to detect pyuria. Although urinary culture is not required in all cases of uncomplicated UTI, it is preferred to document speciation and susceptibility to antibiotics . In cognitively impaired patients in whom self-reporting of urinary symptoms may be limited, an acute change in mental status, with or without localizable genitourinary symptoms, such as dysuria, urgency, or suprapubic pain, should prompt diagnostic testing for UTI . Heightened suspicion for UTI is appropriate when these symptoms occur in combination, as demonstrated in a study of nursing home residents that showed that the combination of dysuria with either a change in the character of the patients urine or mental status predicted the presence of bacteriuria plus pyuria in 63% of cases . In the future, new technologies may evolve to allow for serial monitoring or automated detection of UTI, perhaps with the use of smart-diapers with built in urinalysis capability .

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What Are The Natural Causes Of Bladder Problems

Age is the main factor in these disorders, which affect men and women differently.

Around the age of 50, women can develop urinary incontinence disorders mainly due to a change in pelvic musculature following pregnancy. In these cases, the muscles that allow the valve to properly close the bladder may be damaged. Coughing, laughing or pressure on the stomach can lead to slight urine leakage.

In men, urinary problems are linked to an enlarged prostate, which then crushes the duct that connects the bladder to the outside. This makes it harder to urinate.

Related To My Parkinsons Disease

Parkinson

Waking up at night with the need to urinate, known as nocturia, can occur in nearly 60% of individuals with Parkinsons disease. This can result from either a small sized bladder or result from overactivity of the muscle lining the bladder wall called the detrusor , or it can occur from increased production of urine in the night . The assessment of nocturia may nececitate filling in a 3-day diary so that we can better understand the frequency of urination and volumes of urine voided. You may also need to undergo a test of bladder function called urodynamics. Having ankle swelling , medical conditions such as diabetes, heart failure or obstructive sleep apnoea, and alsosome types of medications such as diuretics can increase the chances for developing nocturia.

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Coping With Urinary Problems In Parkinsons Disease

If you have Parkinsons disease, you may end up having to deal with urinary problems which research shows are common in addition to other symptoms of Parkinsons disease.Since urinary symptoms can lead to other problems, such as disrupted sleep and disruption to social activities, its important to be aware of these problems and know what you can do to help with this

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When Should I Tell My Doctor About These Problems

Generally speaking, people urinate 4 to 7 times a day and once a night. If you urinate more or less often than this and you have some of the symptoms identified above, you should talk to your doctor.Age is the main factor in bladder problems. Other conditions, such as a urinary tract infection, certain medications or prostate problems in men can also cause urinary problems.A complete urological examination will help rule out other potential causes. Your doctor may ask you to keep a voiding diary to assess your bladders storage capacity. To keep this diary, you will need to collect your urine in a measuring cup for a few days and record the amount you urinate and the time of day.

Here is some advice that could help you:

  • Try to go to the bathroom at set intervals
  • Plan your trips based on bathroom accessibility
  • Go to the bathroom before the urge to urinate becomes overwhelming
  • Avoid drinking coffee, or any other diuretic drink
  • Limit water intake before bedtime
  • Do not reduce the amount of water you drink during the day, you may become dehydrated. Split your water intake
  • Try doing pelvic muscle strengthening exercises

Consult a physiotherapist, kinesiologist or nurse continence advisor. These specialists can recommend exercises to strengthen the muscles around the bladder.If you suffer from incontinence, you can use protective underwear. There are several models available to suit your needs. Your doctor or pharmacist can help you make the right choice.

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Treatment For Over Active Bladder In Parkinsons

Overactive bladder affects up to 27% of men and 43% of women of the global population. Now, add a neurological condition and the problem becomes more challenging. First, there is a list of medications which make the problem worse, so should be avoided. Then, a thorough evaluation and physical exam. Treatment depends on the cause, but evaluating all medications and an adjustment of dopamine medication is often necessary. If you are still having problems, five further treatment options are included.

Parkinsons Disease And Your Bladder

Parkinson’s Disease and the Bladder

Many diagnosed with Parkinsons disease experience urinary tract issues. A Michigan Medicine urologist discusses treatment options for patients to consider.

Anne Pelletier-Cameron, M.D., often jokes to her patients that shes a female plumber of the lower urinary tract. On a more professional note, however, shes a urologist in the Michigan Medicine Department of Urology.

In this role, Pelletier-Cameron treats patients with a variety of lower urinary tract symptoms. Some of her patients have been diagnosed with Parkinsons disease, a progressive nervous system disorder that impacts movement. But the breakdown of nerve cells that characterize Parkinsons disease can also cause non-movement symptoms, including bladder issues.

Half of all women and 17% of men will experience urinary incontinence, or the inability to hold urine, she says, noting that for Parkinsons disease patients, those numbers escalate.

Many of my PD patients end up having other bladder problems, including issues with urgency and frequency, says Pelletier-Cameron. Nocturia, or the need to urinate many times during the night, is also common, along with difficulty in emptying the bladder.

Pelletier-Cameron says the impact of bladder symptoms cant be ignored.

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What You Need To Know About Urinary Tract Infections And Parkinsons

Your autonomic nervous system regulates your bodys automatic functions, such as controlling blood pressure, sweat and temperature, digestion, heart rate, and urination. In Parkinsons, these are referred to as non-motor symptoms. And of these, one of the more common ones people with Parkinsons face are those related to urination, such as urgency, frequency of urination, incontinence, and nocturia. Together, these symptoms put people with Parkinsons at greater risk of developing urinary tract infections .

Although UTIs are common, especially in women, people with Parkinsons have a higher risk of these infections than people without Parkinsons. UTIs can also significantly impact your Parkinsons symptoms and increase your risks of falls, cognitive decline, and hospitalization. For this reason, you must understand the risk factors, symptoms, prevention strategies, and treatment options available. The good news is that there are numerous ways you can decrease your risk of developing a UTI and treat the infection if one occurs. In this post, we share information about the causes and symptoms of UTIs and how Parkinsons increases your risk of developing one so you can recognize symptoms, get proper treatment, and prevent UTIs from developing in the first place.

Treating And Managing Bladder Problems

It is important to discuss any bladder difficulties, including those listed below, with your doctor, even if this may appear embarrassing. Your doctor will then be able to properly assess and treat any problems, for example:

  • inability or difficulty emptying the bladder even when it feels full
  • significant, uncontrolled leakage of urine at any time
  • unusually frequent urination
  • an urgent, immediate need to urinate, or urine leaking if you do not immediately do so
  • pain when urinating.

It may be helpful to write notes to discuss with your doctor, for example, the type of difficulties experienced, their frequency, when you first noticed a change, and your normal eating and drinking habits.

Bladder problems can occur for a number of reasons, so the first approach will be to eliminate causes other than Parkinsons, such as urinary infections and prostate problems in men.

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How Can I Prevent Utis

Prevention is key to avoiding UTIs and the complications that may arise from them. Fortunately, there are several actions you can take right away to keep your urinary tract flowing correctly.

  • Drink plenty of water. Drinking water dilutes your urine and makes you urinate more often. This keeps bacteria moving steadily through your urinary tract before they can multiply and cause infection.Suzette Sutherland, MD, director of female urology at the University of Washington School of Medicine, says that one of the top reasons people develop urinary tract infections is simply not drinking enough fluids and keeping their urinary tract flushed.
  • Track your symptoms. Use our bladder worksheet to track your urinary symptoms and help you plan a conversation with your physician about any urinary concerns.
  • Visit a physical therapist. A physical therapist can teach you pelvic floor exercises, such as Kegels, that can help you manage incontinence or other urinary challenges. Regular pelvic floor exercises can help strengthen and retrain the muscles associated with urination and defecation.
  • Take preventative measures regarding sexual activity. Sexually active women can minimize their risk of developing UTIs by urinating soon after intercourse and avoiding birth control methods like diaphragms, unlubricated condoms, and spermicidal agents.
  • Bladder And Bowel Problems

    What Are The Early Stages Of Parkinson

    Bladder and bowel problems are common in men and women of all ages, but people with Parkinsons are more likely to have these problems than people who dont have the condition.

    If you have Parkinsons, you may be more likely to have problems with your bladder or bowels than people of a similar age without the condition.

    Some of these problems are common in men and women of all ages, whether they have Parkinsons or not.

    Bowel problems are very common in the general public. But any change in bowel habit, particularly if you see blood in your bowel motions, should be reported to your GP.

    Whatever the reason for your bladder and bowel problems, you can usually do something to help. It may be that the problem can be cured completely. But if that isnt possible, there are many different ways of managing the symptoms so they dont rule your life.

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    What You Can Do To Help

    • Discuss bladder problems with your family doctor or neurologist, who may perform some tests to rule out urinary tract infection or other problems.
    • Speak with your family doctor or neurologist about a referral to a urologist . The urologist will be able to look into any bladder symptoms and provide treatment plans.
    • Be aware that bladder difficulties can be a sign of wearing off. Wearing off is where some of the symptoms of Parkinsons occur or worsen between doses of medication and are related to the level of medication becoming too low. Taking your medication on time every time helps reduce fluctuations and that will help reduce bladder difficulties.
    • Managing constipation and making sure that you have regular bowel movements will also assist in minimising bladder problems.

    Reduced Functional Bladder Capacity At Night

    Functional bladder capacity is diminished if the bladder wall compliance is reduced, the detrusor is involuntarily contracting , or if the bladder has incompletely emptied following a void. All three of these are known to occur in PD. Nocturia results whenever the urine volume produced at night exceeds the functional bladder capacity. Urodynamic evidence for detrusor overactivity has been reported in 45% to 93% of PD patients, , and correlates with scores in overactive bladder questionnaires. In urodynamic studies, 81.0% had storage disorder, 54.8% had abnormalities of storage and voiding, whereas 19.0% had only a voiding disorder.,

    A likely mechanism for DO in PD is disruption of the dopamine D1-GABAergic direct pathway and its GABAergic collateral to the micturition circuit,, resulting in loss of inhibition of the micturition reflex and OAB. Severity of OAB symptoms has been shown to correlate with impairments observed on urodynamic testing and dopaminergic deficiency observed in dopamine transporter scans.,

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    A New Toilet Or An Alternative

    If you have real difficulties getting to the toilet, it may be possible to get a grant to build a new one, perhaps downstairs. An occupational therapist can advise you on this.

    Not all homes are suitable for building new toilets, so a commode might be needed. A commode is a moveable toilet that doesnt use running water. It looks like a chair, with a container underneath that can be removed and cleaned after someone has used it. They can be very discreet.

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    What Treatments Are Available For Utis

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    The first line of treatment for many people who develop UTIs is a course of antibiotics. Often, this is the only treatment needed. Several different antibiotics can treat UTIs, and your provider will use results from a urine sample to determine which is right for you.

    If the UTI is considered complicated , your doctor might prescribe a higher dose of antibiotics. If the infection is severe or in your kidneys, your physician may refer you to the hospital for high-dose antibiotics administered through an IV.

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    Addressing Practical Aspects Of Eating And Drinking

    Some people with Parkinsons have problems chewing and swallowing. This can make it difficult to eat a diet with plenty of fibre. A speech and language therapist can give advice about this. Ask your GP, specialist or Parkinsons nurse for a referral. If it takes a long time to eat and your meal goes cold, eat smaller portions and go back for seconds that have been kept warm. You can also get special plates that keep your meals hot the Disabled Living Foundation has more information.

    An occupational therapist will also be able to give you some tips and practical advice.

    What Are The Symptoms Of A Uti

    Sometimes, you can have a UTI and feel no symptoms at all. However, UTIs often cause symptoms such as aburning pain during urination, strong-smelling urine, or a strong, persistent urge to urinate.

    Other symptoms may include:

    • Pressure in the lower pelvis
    • Mental changes or confusion

    If the infection impacts your kidneys instead of your bladder and urethra, you may experience different symptoms, such as nausea, back or side pain, chills, and vomiting.

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    Why Do Urgency And Frequency Occur

    Bladder difficulties in Parkinsons are related to changes in the level of dopamine affecting the function of the bladder muscle. Parkinsons is also thought to affect the nerve pathway between the bladder and the part of the brain controlling bladder function. Some of the symptoms that affect bladder control are related to the level of dopamine in your body which will rise and fall depending on your medication level.

    Other conditions such as weak pelvic floor muscles or an enlarged prostate will contribute to bladder symptoms. Constipation can also worsen bladder symptoms by putting pressure on the bladder.

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