Feel the burn when you pee – and nothing seems to help? Read on for our expert advice on how to deal with persistent and recurrent UTIs.
By Dr Rini Chakrabarti (Mbchb, Bsc, RCGP, RACGP, Aesthetics) and Medically reviewed by Dr Juliet McGrattan
If you’ve ever had a urinary tract infection (UTI), you will know just how uncomfortable and downright inconvenient they can be. But what if your UTI persists, even after a course of antibiotics?
Dr Rini Chakrabarti, GP at Your Doctor, looks at the causes and symptoms of persistent and recurrent urinary tract infections, plus how to treat and prevent UTIs in the future:
What is a urinary tract infection?
A UTI is an infection (usually bacterial, but it can be fungal or viral), which can involve the kidneys, ureters, bladder or urethra.
Symptoms may include a burning feeling when you urinate, an urgent need to urinate even if very little comes out, back or abdomen pain, dark, cloudy or smelly urine and possibly a fever.
Nearly 50 per cent of women in the UK will get at least one UTI during their life and most UTIs do clear up on their own within four to five days, but you may need antibiotics.
What is a recurrent UTI?
Typically, more than two UTI episodes in six months or more than three UTI episodes in 12 months is classed as recurrent.
More than two UTI episodes in six months or more than three in 12 months is classed as recurrent.
If you suspect that you have a UTI seek advice from your GP as soon as possible. In order to confirm the diagnosis of UTI, a urine sample should be supplied and sent away for culture.
Recurrent UTI symptoms
The symptoms of a chronic UTI can include:
- Frequent urination
- Cloudiness to the urine or a distinctive smell
- Dark urine or blood in the urine
- A burning sensation when urinating
- Pain in the kidneys: usually in the lower back area
- Pain in the bladder region
What causes recurrent UTIs?
There are several factors that will make you more susceptible to recurrent or persistent UTIs:
- Kidney or bladder stones
- Hormonal changes, during the menopause in particular
- Sexual intercourse – bacteria can enter the tube that carries urine away from your body (urethra) during intercourse
- Genetic disposition to recurrent UTIs – check with relatives to see if they have suffered
- Tight fitting clothing and thongs – wear looser cotton underwear instead.
Recurrent UTI complications
Recurrent UTIs could be an indicator of kidney or bladder stones, so further investigation via ultrasound may be required. A comprehensive set of blood tests is also recommended, to look at any other indicators which could be a factor in causing the UTIs.
Recurrent UTI treatment
Contact your GP if you have a UTI for more than 48 hours. They can test your urine and send it off for analysis. Once diagnosed, a short course of oral antibiotics is usually prescribed to treat the infection.
If a particular cause of the infection has been easily identified, then lifestyle modifications can also be made to prevent future episodes from occurring.
If the infection persists or if you are getting recurrent symptoms, then further review and tests will be required. Your doctor may prescribe you some single doses of antibiotic to take if there is a known trigger for your UTIs, for example, sexual intercourse. If the menopause is felt to be the cause then vaginal oestrogen creams are suggested. A longer term course of antibiotics with a low daily dose may be required to keep infections away and your doctor will discuss the risks and benefits with you.
Self-help tips to ease UTI symptoms
To help with a UTI at home try the following:
- Drink plenty of water, to stay hydrated and dilute your urine – passing urine more frequently helps to flush outany bacteria from your urinary tract.
- Avoid foods that may irritate the bladder, such as acidic or spicy foods.
- Avoid caffeine and alcohol.
- Wear comfortable clothing.
- Try a hot water bottle or heat pad to relieve pain.
- Take painkillers, such as paracetamol, if necessary.
Cranberry juice and UTIs
Many people used to swear by drinking unsweetened cranberry juice, as it is suggested there is an active ingredient in cranberries that stops some bacteria attaching to the bladder. However, a recent Cochrane review of cranberry juice showed it did not appear to have a significant benefit in preventing UTIs. Other possible remedies, such as taking probiotics, were found to be inconclusive, too.
How to prevent UTIs
Try these simple lifestyle tips, which may help to prevent the recurrence of UTIs:
✔️ Wipe from front to back after urinating and bowel movements, to prevent bacteria spreading.
✔️ Do not delay passing urine.
✔️ Empty your bladder soon after intercourse.
✔️ Don’t use products on your genitals.
✔️ Stay hydrated – low fluid intake and infrequent urination are both linked to recurrent UTIs.