That UTI — was it caused by MS or was it the meat?
A recent study looks at links between UTIs and E. coli found in supermarket meats
Many people with multiple sclerosis (MS) have experienced urinary tract infections (UTIs) at some point. It’s a common problem with MS and can be caused by a number of things, such as the inability to fully empty the bladder or the need to self-catheterize. Symptoms can include urinary frequency and urgency, a burning pain while urinating, abdominal pain, and foul-smelling urine that looks milky or cloudy.
UTIs can be simple or serious
UTIs are often just a nuisance and easily treatable with antibiotics. Fortunately, I’ve had only one that occurred when I was being treated with Lemtrada (alemtuzumab), and it was quickly cured with a few days of antibiotic pills. But sometimes, UTIs can be life-threatening.
That was the case for MS News Today columnist John Connor earlier this year. He was hospitalized for weeks, followed by weeks of rehabilitation, apparently due to his recurring UTI problems. At one point, John says, he was ready to phone his wife to say goodbye.
“I had just spent three weeks in a fever-driven fugue and thought I was surely beyond help. Only the gloom of death made any sense,” he wrote.
Fortunately, John is now back home, recovering well and writing his column again.
Could it be due to something you eat?
A recently published study in the journal One Health suggests that a strain of the E. coli bacteria that is carried in food may be responsible for more than 480,000 UTIs in the U.S. each year. This number was derived after researchers compared E. coli found in samples of raw chicken, turkey, and pork from nine major grocery chains in Flagstaff, Arizona, with blood and urine samples from patients at a hospital in that area. They found that about 8% of the E. coli in the lab samples were the strains also found in the meat. The scientists say that 8% works out to roughly 480,000 cases nationwide.
The fact that UTIs are caused by E. coli is nothing new. Information on the UCSF Health website tells us that E. coli is the cause of about 90% of UTI infections. But the fact that a number of these infections may be due to bacteria in some of the food that we eat — rather than due to retaining urine in the bladder or failing to cleanse sufficiently while catheterizing — is something that people with MS should be aware of.
To be clear, I’m not suggesting that my friend John’s UTIs were caused by meat. He’s been a vegetarian for the past few years, and he told me that he believes his UTIs — and he’s had many — have been caused by catheterizing and the suppression of his immune system by disease-modifying therapies.
A 2020 study by researchers in Taiwan, published in the online journal Scientific Reports, indicates that John is probably doing the right thing with his diet. The study suggests that a vegetarian diet can lower the risk of having an uncomplicated UTI.
Both studies are reminders that what’s in our gut is important, especially when we have MS. Let us know in the comments below what you think about the possibility of a food-UTI link. You’re also invited to visit my personal blog at www.themswire.com.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
Ok, not a comment about food and UTIs, but related to the theme: I can't fully empty my bladder, and have had trouble catheterizing, but cathetrizing can an lead to them anyways! I've been hesitant to get fully onboard with intermittent cating or installing a suprapubic tube, because I seem to be managing mostly well with a urinal and undergarments.There doesn't seem to be a clear answer as to what is absolutely the best to do. Each carries risks.
I totally understand, Michael. For years I've been toying with the idea of intermittent cathing but I've never taken the plunge. Over the past couple of years, however, my urgency, frequency and not fully emptying have all improved. I attribute this to a combination of Lemtrada treatments about six years ago and regular exercise to help my core muscles.
I believe my UTI is caused by sugar and carbs. As soon as I cut them out of my diet I haven't gotten an UTI. I do believe that some may Be caused by certain meats.
I was diagnosed in 1984 but looking back I could have had it years earlier. I unfortunately have had UTIs many times over the years. I now use Neomycin and Polymyxin B Irrigation but I do not inject it into the bladder. I use a small syringe only and inject the solution into my urethra. Using this method It protects me from UTIs and lubricates at the same time. I have now gone many years without a UTI.
Participated in an early clinical trial on botox in bladder. It was in Pittsburgh, Pa. (Go Steelers). Absolutely great experience! Very friendly docs an staff. Watched and participated ( by choice). Not painful, slight pinch). My drive was around 20 min. Knew by the time I was home I had gotten the botox not the placebo. I had stopped at drive through for a drink then proceeded home. Hallelujah I was dry! Almost cried. My neurogenic bladder was grateful. Now for self catheter training. First 10 times were cringe worth. Little painful. After repeated tries I was in. Self catheters come in many sizes. Finding the smallest one was where I started. Took approx a week to get comfortable with this new way of controlling my bladder. Yes, I cried the first day. Now, just routine. 4 X a day. That’s been 20 yrs ago and no intentions of stopping. Still have to use pads but beats the hell out of an in dwelling, bag carrying device which in my opinion is particularly painful and embarrassing as a woman.my humble opinion. Unbeknownst to me at the time was flabbergasted by a letter enclosing a generous check for participating in this groundbreaking trial. Clinical trials are so important in curing ms and so many other diseases. Now that I’m 71, I’m excluded from most all trials. Shame because we could potentially have long term, aging effects of new science. My advice to anyone suffering from ms is to be pro active and participate in these trials. We need all your scientific proof you can muster. Please use your disease for the good of yourself and future generations. Thanks Ed for yet another great episode.
Paula, I'm in furious agreement! Self-cathing now for 9 years, a rocky start but soon got the hang of it. Ah, the relief and confidence of knowing my bladder's empty! And while I still get the occasional UTI, nothing like before. I was advised to self-cath starting 14 years previous but resisted, resisted ... now I advise anyone with residual bladder volume to just get over it and learn how. It's life-changing.
Thanks for all of those details. I'm sure your experience will be useful to people who are considering this. (I'd really like to hear from any man who has tried this!) As for studies, as people remain on DMTs longer and longer it seems logical that studies include older folks. It's a shame they exclude us. I was in the Phase 3 trial of Avonex back in the early 1990s but I don't think, at age 74, anyone wants me for anything now.
Ed, is it from handling the raw meat or eating it insufficiently cooked?
As I read the study, the researchers compared the bacteria strains they found in raw meat they had bought in a supermarket with the strains found in the people with MS who they checked. There was no indication of what meat those people actually consumed or how it was cooked.
My take is that yes, you can get an e. coli bladder infection from another animal (including backyard chickens and members of our own species), but its not so simple. First, you are unlikely to acquire e. coli or other bacterial contaminants from properly cooked food. Nutritionists frequently say that cooking to a sufficient temperature for sufficient time will destroy any bacteria - the stress is on the sufficient bit. Second, the e. coli (or other bacteria) is on the surface of the meat, not in the meat (though it may all be mixed in in ground/minced meat).
How did it get there? That's the complicated bit - and squeamish people may want to skip to the end! E. coli bacteria normally live in the gut of animals, but some strains can survive once they exit as feces. From there they can contaminate the skin or feathers of the animal, and during meat processing of many animals some of the bacteria may populate the environment and land on meat products. It must be assumed that all fresh meat products arriving in the home may have some bacterial contamination, not just e. coli, but as said earlier, proper cooking methods will destroy the bacteria.
The problem starts with cross-contamination in the kitchen during food preparation. Bacteria are spread from raw meat to kitchen tools and surfaces, the cook's hands and mouth, and then ingested. Similarly, they may be passed on to other family members. Careful attention to kitchen hygiene practices is essential, but it cannot entirely eliminate risk.
From there, the bacteria move to the human gut. Fortunately, most e. coli strains are relatively benign here and cause no problem. However, once they exit the gut, they can enter the urethra via fecal contamination and cause a UTI. Here, the key to minimising risk is good personal and bathroom hygiene practices. This doesn't just apply to e. coli from chicken and pigs, but human e. coli, plus klebsiella, pseudomonas and other environmental bacteria.
Note, too, that e. coli and other bacteria can arrive on salad vegetables that don't get cooked, so being a vegetarian can also be a risk.
For most healthy people with a well-functioning immune system, some bacteria making there way up the urethra can be flushed out without getting a toe-hold. Others, unfortunately, still get frequent UTIs. As people with MS, our immune system has a mind of its own, and many of us are now on immune-suppressant medication, so we must be careful. In my view, good hygiene practices are the main consideration, less so the food we eat.
My apologies for such a long post, but I have had to self-catheterize for over 35 years now, even before my MS days, so I am no stranger to bladder infections and associated hygienic practices.
Thanks for all of the detail in your comments and there's nothing wrong with a long post. What you've written is important and is the type of response I had hoped to encourage with my column.