UTI - why does it keep coming back?!

uti
bladder
cystitis
sexual-health
antibiotics

#1

Hi @Dr_Paula - I’ve suffered with recurrent UTIs for years. I get one roughly every 2 months and it’s excruciatingly painful. I find that the symptoms come on really quickly. I can feel fine first thing in the morning, but within 2 hours can barely move with the pain! I’ll feel like I need to pee every 5 minutes, with the feeling that my bladder is never fully empty and a pressure pain on my lower abdomen, with burning when I do pee. Sometimes I can get shivery and feel under the weather too…

I’m always prescribed a courses of antibiotics (doing at-home remedies never works for me), and I’m worried I may be developing resistance if I have multiple courses of antibiotics in a year?

There’s no obvious cause either… I used to think it was linked to sex (even though I always pee after sex and wipe front to back!) but haven’t had sex in more than 6 months and still getting the infections! Does anybody else have this problem?? Any advice to stop them from coming back? Should I be doing anything differently or are there other treatments available?


#2

Hi @nikki

I also went through a spell of UTI’s years ago so I can sympathise with what you went through. Luckily they’ve stopped for me but I can’t pinpoint what I have been doing differently.

One thing I used to always do to try and keep them at bay was to drink cranberry juice…I have no idea whether there is any science behind this!!! could have been mind over matter but might be worth a try if you haven’t tried it already?


#3

Sounds awful … sorry to hear it. You said you have tried home remedies - can you share on here which ones? I have a friend who had this problem, quite seriously, even in hospital a couple of times with it, and in the end she swears the thing (now) keeping it under control is taking high dose cranberry capsules, very regularly (every day, very consistently). These are much more concentrated than the juice and are encouraged by her consultant. Obviously if she does get an infection she still needs to take antibiotics but she seems to get them much less frequently now and she puts it down to these capsules. have you tried those?


#5

In response to the question from @Nikki on whether to take antibiotics - this is what NICE says:

Cystitis is inflammation or irritation of the bladder, which may be caused by a bacterial infection (a lower urinary tract infection, or lower UTI). Symptoms include needing to pass urine more often or urgently, pain or burning when urinating, and cloudy or strong-smelling urine. Other symptoms are feeling tired or weak and pain in the lower abdomen (tummy area). Cystitis may clear up on its own after a few days but some people need antibiotics.

Using antibiotics when they are not needed means they may not work as well in the future. This is a serious health risk so NICE has written advice about when to offer antibiotics for some common conditions, including cystitis.

Pregnant women, men, and children and young people aged under 16 with cystitis should be offered antibiotics straightaway.

Women who are not pregnant may not be offered antibiotics straightaway. Instead you may be offered a ‘back-up’ antibiotic prescription. You can use this to get an antibiotic if you don’t start to feel better within 2 days, or start to feel worse.

You can also help your symptoms in other ways, for example by taking a painkiller like paracetamol, or ibuprofen if this is suitable for you. You may want to try cranberry drinks or products that lower the acidity of your urine (called urine alkalising products), but NICE found no research on using these to treat urinary tract infection.

Hope this is helpful.

Paula


#6

Hi @katrina! I have tried taking the cranberry tablets (every day for 6 months or so) and didn’t notice a difference, but do find drinking cranberry juice soothing during an infection (maybe psychological like you said @O.C! I had wondered whether it might be triggered by taking The Pill… Could the change in hormonal levels or maybe vaginal dryness trigger infections??


#7

Hello All

I’ve been looking up more evidence on prevention of UITs - this is what I have found so far.
This information refers to pre-menopausal women - the guidelines are different for post-menopausal women.

UTIs are very common - 50% of women will experience them at some time and 25% of women will have a recurrence.

In terms of preventive treatment - not much evidence to support cranberry juice as discussed above or pro-biotics.

Similarly there is not much evidence to support a lot of the things that are advised like passing urine before or after sex or wiping patterns.

The mainstay of prevention at the moment is a single dose of antibiotics taken after sex for women whose UTIs are related to sex or continuous antibiotics for women where UTIs are not related to sex. As @Nikki pointed out this can be linked to increased antibiotic resistance.

There is an interesting mention of Methanamine salts - with some evidence to support its effectiveness - this is converted to ammonia and formaldehyde in acid urine and reduces bacterial growth - does anyone have any experience of this?

Many thanks

Paula


#8

This is really helpful, thanks @Dr_Paula! I haven’t heard of Methanamine salts… Has anyone else?? Are these dissolved in water like the cranberry bicarbonate sachets you can get at Boots? Would they ease the pain/symptoms or actually treat the infection?


#9

Just seen this - seems to be mainly vitamins and probiotics (D-Mannose, Vit C…) but quite interested in the first ‘target’ stage dissolved in water… Not sure if it’s available in the UK though!


#10

Hello @nikki

Many thanks for sharing this.

I have looked at the list of ingredients: -

the ‘prevent’ option contains D-mannose, vitamin C, vitamin B6, calcium, magnesium, potassium, natural Lemon flavour, citric Acid, organic stevia, silicone dioxide, beet juice powder.

the ‘control’ option contains: Curcumin, D-mannose, green tea extract, black pepper powder, vegan capsule

the ‘promote’ option contains: two types of lactobacilli, probiotics, hypermellose, rice flour and magnesium stearate

I have to say that when I was searching for evidence on the prevention and treatment of recurrent UTIs I found no evidence at all for the effectiveness of any of these compounds at preventing or treating UTIs.

It is really good to know that they are out there, but I personally would like to see evidence for their effectiveness before I would suggest them as things to try.

It would be interesting to hear the experience of anyone who has tried these products.

Many thanks for sharing this.

Paula