The Truth about Chronic or Recurrent Urinary Tract Infection (UTIs)?

Have you had multiple UTIs? Have you been waking all night long to go to the bathroom? Is it hard to drive any distance or get on an airplane because you need to use the restroom yet again? You may have a chronic UTI! I can help you figure this out. If this article is helpful, please share it with others. You can also leave questions on my Facebook Page https://www.facebook.com/drdeannaberman/

What is a UTI?

A UTI is an infection in any part of the urinary tract, including the urethra, bladder, ureters and kidneys. In the bladder, a UTI is called infectious cystitis. In the urethra, urethritis. In the kidneys, pyelonephritis.

Most infections occur in the lower urinary tract - the bladder and urethra. If untreated, the infection can move into the kidneys. A UTI occurs because bacteria that do not belong in the urinary tract enter through the urethra and get into the bladder.

Now, it is important to understand that it is natural to have bacteria in the bladder. This is called the “bladder microbiome” or “urinary microbiome”. This microbiome is comprised of various strains of bacteria and plays a protective role for most individuals.

Originally it was believed that the urinary tract was a sterile environment, meaning there were “no” bacteria in the urinary tract. Since the Human Microbiome Project (HMP), we understand that many bacteria live in a healthy urinary tract. The difference between the “healthy” bacteria and those that cause an infection is that the healthy bacteria live in a balance with other bacteria and do not cause symptoms for the individual. The bacteria that cause a UTI are considered “pathogenic” bacteria. Pathogenic bacteria cause symptoms.

There are many different strains of bacteria and some strains of the same bacteria can be pathogenic, while others are not. The most common cause of a UTI is Escherichia coli (E. Coli), a bacteria that is part of the healthy gastrointestinal tract microbiome. E. colidoes not cause any symptoms in the gastrointestinal tract, but causes symptoms in the urinary tract. There are many other bacteria found to cause symptoms in the urinary tract, including Staphylococcus saprophytic, Proteus mirabilis, Klebsiella pneumonia, and more. There are too many to list here.

Acute vs Recurrent UTI?

If you get a UTI, it will usually come on strong. You will have bladder pain and urgency and it can be severe. You cannot think about anything else. This is a standard acute UTI.

When we talk about recurrent or chronic UTI, it is less clear.

After that first infection a few things could happen:

  1. You get treatment and your symptoms go away and do not come back. This would indicate a acute cystitis and complete elimination of the pathogenic bacteria, resulting in a cure.

  2. You get treatment and your symptoms do not go away. This would indicated that the infection is still present. This is called Chronic Cystitis.

  3. You get treatment and your symptoms go away but then come back within a short time. This is called Recurrent or Persistent Cystitis.

Who gets UTIs?

UTIs are a very common infection, affecting 8-10 million people a year. Women are more likely to get UTIs than men. Most women will experience at least one UTI over the course of their lives. Men can get UTIs, but it is less common. Children get UTIs as well. Up to 8% of girls and 2% of boys will get a UTI by age 5.

What increases your risk for UTI?

  1. Being female - Women have a shorter urethra than men, shortening the distance bacteria must travel leading to increased risk of UTI.

  2. Pregnancy - The uterus sits over the bladder and as it grows, the weight can block the drainage of urine from the bladder causing an infection.

  3. Menopause - The decrease in estrogen causes changes to the vaginal wall that increase the risk of UTIs.

  4. Certain types of birth control - The use of a diaphragm or other internal device or spermicide can increase the risk.

  5. Sexual activity - Women who are sexually active tend to have more UTIs. Having a new sexual partner or multiple sexual partners can increase the risk. Having an STI, such as chlamydia or gardnarella

  6. Urinary Track abnormalities - Babies born with urinary track abnormalities may have increased risk

  7. Blockages in the urinary track - These can be caused by any physical blockage to the flow of urine, including kidney stones or enlarged prostate.

  8. A suppressed immune system - Chronic infections, diabetes, and other diseases that effect the immune system may leave an individual susceptible to a UTI.

  9. Aging - Women over 65 years old have an increased risk of UTI. As women get older, the risk continues to increase. Men over the age of 65 also have an increased risk, but the risk significantly increases for both men and women over 85 years old.