Recurring urinary tract infections or chronic urinary tract infections (UTIs) occur when the infection either does not respond to treatment or keeps coming back. It might either come back right after treatment or later as a new infection. Infections which only affect your bladder are typically minor illnesses that respond well to treatment. But if it spreads to your kidneys, you could experience severe health problems and even need hospitalisation.
What causes recurrent urinary tract infections?
A urinary tract infection (UTI) is the result of a bacterial infection. In most cases, the bacteria enter the urinary system through the urethra, and then they multiply in the bladder. Hence, this means that you can get a UTI due to urethral and bladder infection.
Now, let us understand the causes of recurring urinary tract infections. The urinary tract, divided into an upper and lower urinary tract, is made up of several tubes and organs that eliminate urine from the body:
- The upper urinary tract, including kidneys and ureters
- The lower urinary tract, including the bladder and urethra.
Any area of the urinary tract can have a UTI. The urethra—the tube that allows urine to exit from the bladder—is where bacteria usually enter the urinary tract and cause infection. Infections that begin in the urethra and bladder are typically not dangerous and go away after appropriate and timely treatment. A UTI, however, might become more severe if it affects the kidneys. An upper urinary tract infection may require hospitalisation for treatment.
Recurring urinary tract infections (UTIs) can be frustrating and uncomfortable. Several factors can contribute to their recurrence. Here are some common causes –
- Incomplete treatment: Not completing the full course of antibiotics prescribed for a UTI can allow the infection to persist or return.
- Antibiotic resistance: Frequent or improper use of antibiotics can lead to the development of antibiotic-resistant bacteria, making future UTIs more challenging to treat.
- Anatomical factors: Certain anatomical characteristics, such as abnormalities in the urinary tract structure or the presence of urinary tract stones, can create an environment conducive to recurrent infections.
- Bladder or kidney stones: The presence of stones in the bladder or kidneys can provide a site for bacteria to attach and multiply, leading to UTIs.
- Sexual activity: Sexual intercourse can introduce bacteria into the urinary tract, increasing the risk of infection, especially in women as the urethra is short.
- Hormonal changes: Hormonal fluctuations, such as those occurring during pregnancy or menopause, can affect the urinary tract’s natural defenses, making it more susceptible to infection.
- Catheter use: Indwelling urinary catheters can introduce bacteria into the urinary tract and increase the risk of UTIs, particularly in individuals with long-term catheterisation.
- Weakened immune system: Conditions that weaken the immune system, such as diabetes, HIV/AIDS, or certain medications, can impair the body’s ability to fight off infections, including UTIs.
- Poor hygiene: Inadequate personal hygiene, such as wiping from back to front after using the toilet, can introduce bacteria from the anal area to the urethra, increasing the risk of UTIs.
If you experience recurrent UTIs, it is advisable to consult a doctor who can assess your situation, identify the underlying cause, and recommend appropriate preventive measures or treatments.
What are the risk factors for urinary tract infections?
Risk factors for recurring urinary tract infections (UTIs) include:
- Gender: Women are more likely to have UTIs due to their shorter urethra. It allows bacteria to reach the bladder more easily.
- Sexual activity: Engaging in sexual intercourse can introduce bacteria into the urinary tract, increasing the risk of UTIs.
- Urinary tract abnormalities: Structural abnormalities in the urinary system, such as kidney stones or urinary tract strictures, can create a favorable environment for bacterial growth and recurrence of UTIs.
- Menopause: Hormonal changes during menopause can lead to changes in the urinary tract, making it more susceptible to infection.
- Catheter use: Having a urinary catheter in place for a prolonged period increases the risk of UTIs.
- Poor hygiene: Inadequate personal hygiene, such as improper wiping after using the toilet, can introduce bacteria into the urethra.
- Weakened immune system: Conditions like diabetes, HIV/AIDS, or immunosuppressive therapy weaken the immune system, making the body more susceptible to recurrent infections.
- Previous UTIs: Having a history of UTIs increases the likelihood of future infections.
- Genetic factors: Some individuals may have a genetic predisposition to recurring UTIs.
It’s important to consult a doctor for proper diagnosis, treatment, and prevention strategies tailored to individual circumstances.
What are the symptoms of recurrent urinary tract infections?
The symptoms of a chronic urinary tract infection affecting your bladder include:
- Urinary frequency
- Urinary urgency
- Blood in urine
- Dark urine
- Cloudy urine
- Burning sensation while urinating (burning urination)
- Pain in your kidneys, which means in your lower back or below your ribs
- Pain in your bladder region
If the UTI spreads to your kidneys, it might cause:
- Nausea
- Vomiting
- Chills
- A high fever, over 101°F (38°C)
- Fatigue
- Mental disorientation
How can I prevent recurring urinary tract infections?
You can make some lifestyle changes to reduce UTI recurrence by doing the following:
- Urinate immediately before and after having sex
- Clean genital and anal areas before and after sex
- Drink lots of water to flush bacteria out of the bladder
- Find alternatives to diaphragms or spermicide as birth control
- Wear cotton underwear and loose clothing
- Wipe from front to back after going to the toilet
- Avoid scented body washes or douches
How are recurrent urinary tract infections diagnosed?
You most likely previously had a UTI if you have a chronic UTI.
- Urine culture test – The most common method doctors diagnose UTIs is by running lab tests on a urine sample. Urine routine tests identify the bacteria present in the urine, while in Urine culture tests, the urine sample is added to a medium to promote bacterial growth. It will then be examined for the bacteria after 1-3 days, and checked for sensitivity to decide the most effective treatment.
- Computed tomography (CT) scan of the urinary tract – You maybe requested to do X-rays and renal scans if your doctor suspects kidney injury. These imaging tools capture images of internal body parts.
- Cystoscopy – It might be recommended by your doctor if you frequently have UTIs. It’s a long, thin tube with a lens at the end that is used to see inside your urethra and bladder. Your doctor will check for any abnormalities or problems that might be causing the UTI to reoccur. 1 2
Are there any home remedies for treating recurrent urinary tract infections?
Natural remedies for UTI include:
- Take antispasmodics to reduce pain and fever
- Place a hot water bottle on the lower stomach to ease discomfort
- Drink lots of water to flush out the bacteria
- Get plenty of rest to help the body fight the infection
- Avoid sex to decrease discomfort
You can also consume probiotics for UTI. Probiotics, or helpful bacteria, can aid in maintaining a healthy and bacterial-free urinary system.According to a 2017 research, probiotics in particular from the Lactobacillus group may aid in the treatment and prevention of UTIs.
Although home treatments for UTIs may include drinking cranberry juice, there is not much scientific proof that it works. However, D-mannose for UTI, a sugar included in cranberries, shows promise as a non-prescription treatment for a UTI. According to a 2014 study, D-mannose powder decreased the chance of developing UTIs again and may be helpful in UTI prevention. You can even use cranberry supplements for UTI treatment. But, these results need to be confirmed by other research.
What are the complications of recurrent urinary tract infections?
People who have chronic UTIs may develop problems. Eventually, a recurrent UTI may lead to:
- Kidney problems – It can cause kidney infection, kidney disease and other permanent kidney damage, particularly in young children.
- Sepsis – It is a life-threatening complication due to infection.
- Septicemia – It is a condition in which bacteria enter your bloodstream.
- Birth problems – UTIs in pregnancy can cause an increased risk of premature delivery or of having a baby with a low birth weight.
Can men get recurrent urinary tract infections?
Men are far less likely than women to have an acute or chronic UTI. The most common cause of chronic UTIs in men is an enlarged prostate. The bladder does not entirely empty when you have an enlarged prostate, which can encourage the growth of bacteria. Due to urine retention, both men and women with neurogenic bladders, or problems with the bladder muscle, are at risk for developing persistent UTIs. Injury to the spinal cord or the bladder’s nerves can both result in this condition.
How long can a recurrent urinary tract infection last?
A UTI can continue or return due to reinfection or if treatment does not completely remove the infection. You have to take antibiotic treatment to get rid of a UTI. The main treatment for UTIs is a course of antibiotics administered over a week. The doctor may recommend long-term, low-dose antibiotics for longer than a week after the initial symptoms go away if you have recurrent urinary tract infections (UTIs).
Is it necessary to see a doctor for recurrent urinary tract infections?
Yes. You have to consult a doctor if your UTI keeps coming back. A recurrent urinary tract infection can lead to fatal consequences like permanent kidney damage or a sepsis, which can be life threatening. Hence, if you have a frequent UTI and your symptoms of urinary tract infection does not go away, it is highly advisable for you to visit a doctor immediately.
Can recurrent urinary tract infections lead to kidney damage?
Yes, a recurrent urinary tract infection can cause a permanent kidney infection if left untreated. It can also cause kidney problems, especially in children. Proper medical attention and treatment are essential to prevent the development of serious kidney problems due to recurrent UTIs.
Can sexual activity cause recurrent urinary tract infections?
It’s more likely to get a UTI due to some specific ways of having sex. If you are having anal sex, you must wash your genitals before engaging in other sexual activities to decrease the spread of bacteria. You can prevent UTI by following hygiene tips like gently cleaning yourself after sex (for both men and women) and washing the area around (not inside) your genitals with warm water. You can try mild soaps, but if you have sensitive skin or you already have an infection, they might dry out or irritate the area. Make sure to urinate before and after having sex to prevent UTIs.
Are antibiotics always necessary for treating recurrent urinary tract infections?
The main course of treatment for UTIs consists of a week’s course of antibiotics. But, if you consistently have UTIs, your doctor may recommend taking low-dose, long-term antibiotics for longer than a week after the first symptoms go away. It often helps stop symptoms of UTI from returning. There are also different treatments available for antibiotic-resistant UTI. Your doctor will advise a course of treatment that involves taking antibiotics each time you have sex. Your doctor will also ask you to regularly check your urinary system in addition to taking antibiotics. For instance, they could ask you to take routine urine tests at home to look for infections.
If your symptoms persist after antibiotics treatment, the American Urological Association (AUA) suggests that your doctor repeat the urine culture test. If your chronic UTIs occur during menopause, you can go for vaginal estrogen therapy. Although it comes with some downsides, this can reduce your risk of developing UTIs in the future. Make sure to talk to your doctor about it. During urinating, you might feel burning if you have an infection that is still active. Your doctor can recommend antispasmodics to numb your urethra and bladder. It will lessen the burning sensation. Furthermore, your doctor can prescribe other medications for treatment that are not antibiotic based such as urine alkalinising agents.
How does recurrent urinary tract infection affect pregnancy?
Pregnant women frequently experience recurrent urinary tract infections, which can have significant adverse effects on both the mother and the developing child. These effects encompass the possibility of premature birth and the birth of babies who are smaller than expected for their gestational age. 3
Can diet affect the risk of recurrent urinary tract infections?
There is currently a lack of research in this area, even though certain studies suggest that a few dietary changes may help lower your risk for UTIs and improve some bladder-related symptoms. Following a vegetarian diet, increasing fluid consumption, and avoiding potential bladder irritants such as soda, alcohol, artificial sweeteners, and coffee may help prevent UTIs and alleviate symptoms. However, further research into the link between nutrition and UTIs is required before drawing significant conclusions. It’s crucial to speak to a doctor if you experience bladder infections frequently so you can receive the right care and guidance. These can aid in your recovery and shield you from UTI-related problems. 4
Can stress cause recurrent urinary tract infections?
Although stress does not directly cause UTIs, it can weaken your immune system, making you more prone to infections and other illnesses. Even if you don’t have a UTI, stress can start or worsen symptoms related to the urinary system. Your urinary system is extremely important to your overall health. You can discuss your risks, protective methods, and treatment options with a doctor if you think stress may impact your urinary health. Also, you can prioritise reducing stress by engaging in yoga, meditation, and psychotherapy. 5
