UTIs

You should all thank Dr. Oz for serving as my muse.

Yesterday I was reading Fit Pregnancy magazine when I came upon Dr. Oz’s monthly article on pregnancy -- a physiological state which I’m sure was covered extensively by his training in cardiothoracic surgery.

Anyhow, it was his answer to “why women get more UTI infections during pregnancy” that got me. I cannot post what he wrote verbatim because I threw the magazine away shortly after. His answer was basically: the pregnancy hormone relaxin causes the pelvic floor to loosen (so the baby can slide out!) which allows more bacteria in the body.

As if the pelvic floor creates an impenetrable seal to the body. As if the hormone relaxin affects muscle. As if you know what you’re talking about, Dr. Oz.

P.S. That “baby slide out part” wasn’t my add. It was in the article.

After posting something along these lines as my Facebook status, I got a lot of comments asking about UTIs. So, let me do a little splainin' of the often-overlooked inner workings of the urinary system.

Setting the rare incidence aside, let’s talk about the more frequently occurring UTI. If you’ve got chronic bladder or UTI infections, this post is for you.

Here is a fabulous drawing of your urinary tract, starting with the kidneys and ending with the bladder.

It’s even more helpful shown from the side (upper image). Wait. Is that a woman or a snowman?

The lower pic in the drawing above is most important though. This image shows how the ureter interfaces with the bladder. Urine moves down from the kidneys, through the ureter, where it empties into the bladder. The urine, before it enters the bladder, is sterile.

Here's the section called: Alignment has very little to do with Fitness or Sport, and more to do with HEALTH and if you're helping people with their HEALTH you should learn the mechanics that drive the body's functions.

Like bones and muscle, organs have their own neutral position. Their function depends on physical forces like gravity and pressure. You change their relationship to the force of gravity, you change their behavior. We don't think we're moving our organs around that much, but remember they are housed in the trunk of the body. Using the bladder as an example, when you tuck the pelvis, the organs inside it come with. Your postural preferences can screw with, for example, the fluid dynamics of the UTI system.

At the end of the ureter is a one-way valve that prevents upward flow. This valve, similar to the valves in the veins in your legs, is designed to take a certain amount of pressure from the bladder.

Using my high-tech software to rotate the picture a little,

you can (hopefully) see that now the angle of the ureter-bladder interface has changed, which creates a slight overload to the valve.  Just like the valves in our lower legs fail under excessive pressure over time (the mechanism of varicose veins) the ureter valve can also fail and allow backflow. The movement of urine from the bladder to the ureter (opposite to the biological norm) is called vesicoureteral reflux. Vesicoureteral reflux gets a big thumbs down.

The reflux is problematic if there are any bacteria in the bladder, as moving unsterile urine into the more-sterile area of the ureter can cause an infection. And no, bladder bacteria cannot be reduced by doing super-kegels.

I’d hypothesize that during pregnancy,  the pregnant woman tends to post tilt more than her norm, usually under some instruction to do so, creating an even-less favorable angle and greater pressure on the valve. Add the pressure of the heavier uterus on the bladder and you’ve got a greater quantity of upward urine-streaming, increasing the chance of bacteria spread.

If anyone asked me, I’d say that in conjunction with whatever your Dr. tells you to do for your UTI (hoping and praying you aren’t seeing Dr. Oz), consider this to-do list:

1. Understand and then work on establishing a neutral pelvis to help normalize your organ position.

2. Take a probiotic to help your body maintain the correct flora. I know the bladder is presented as sterile, but as researchers take a closer look, it turns out that this isn’t the case.

3. Consider Mayan Abdominal Massage and reach out to a local practitioner to aid you in organ positioning.

4. Put “A BUTT” on your wish list. And then get one. Why? Read up on uterine ligaments here: (click)

5. Don't "hold it in" when you have to pee. Bladder fullness can increase valve pressure.

6. Pee before movement classes and watch your valsalva. Bearing down during exercise (especially during core work done in conjunction with pelvic floor contraction) can also send an upward stream into the ureter. Imagine that much pressure on the bladder while keeping it closed! High-pressure habits can damage the valve over time.

7.  Squatting, yo. You want the bladder to drain completely and research shows the squatting position offers the most complete void.

Now can I please have my own TV show, magazine column and a million dollars?

(And, I figure that Dr. Oz didn’t even write that article. I’m sure he has a staff of health writers do it. But if you’re going to put your name on it, I’ve got to tag you, sir.)