Roughly 50 percent of all women will develop at least one UTI during their lives, and once you develop one urinary tract infection, you’re more likely to have another. For some, recurrences become frequent. If you have more than three urinary tract infections within 12 months, doctors will generally say you have chronic UTIs. Repeatedly dealing with the symptoms of urinary tract infections can interfere with your daily life, and understanding the potential causes of chronic UTIs is the first step toward addressing them.

What causes a UTI?

UTIs occur when bacteria get inside the urinary tract, the drainage system that expels liquid waste from the body. Strains of Escherichia coli (E. coli) account for 90 percent of all UTIs, but other bacteria may also cause the infection. E. coli bacteria live inside of the intestines, where they’re harmless. But if they get trapped inside the urinary tract, they trigger an immune response that leads to inflammation. When this occurs, you are likely to experience symptoms of a UTI.

Typically, chronic UTIs affect the lower urinary tract, which includes:

  • Bladder: an organ that resembles a triangle located in the pelvis behind the pubic bone. It stores urine produced by the kidneys. The scientific name for a UTI that impacts the bladder is cystitis.
  • Urethra: the tube that shuttles urine from the bladder to the outside of the body during urination. A woman’s urethra is in front of the vagina, while a man’s travels through the penis. The scientific name for a UTI that impacts the urethra is urethritis.

What causes chronic UTIs?

The causes of chronic urinary tract infections vary. In some cases, more than one thing may be responsible for frequent UTIs, including any or all of the following.

You don’t drink enough fluids every day

Urination plays a crucial role in protecting the urinary tract. Peeing washes microbes out of your urinary tract, decreasing your risk of infection. If you don’t urinate often enough, bacteria may have the opportunity to build up.

Drinking fluids is essential to urine production. When you don’t drink enough, you may not make an adequate supply of urine. It’s possible to be dehydrated enough to slow down urination and not experience any other symptoms. That’s why it’s important that you drink fluids throughout the day.

Most people need to drink six to eight, 8-oz. glasses of fluid to remain hydrated. Water is the best option for preventing dehydration. Caffeinated beverages supply fluid, but caffeine can worsen dehydration. As a result, you shouldn’t include drinks like soda and coffee in your fluid intake.

Examining the color of your urine can give you insight into your hydration levels. Although it’s normal to have darker urine first thing in the morning, dark, amber-colored pee during other times of the day may mean you need to drink more. When you’re properly hydrated, your urine will usually appear light yellow to medium gold in color.

You’re sexually active

Sex increases your risk of developing UTIs, especially for women. During intercourse, bacteria may be forced into the urethra. While you can’t prevent this from happening, you can take steps to reduce the amount of bacteria present after sex by urinating as soon as possible. You may also wish to cleanse your genital area with mild soap and water.

Studies show that diaphragms and spermicides may also increase the risk of urinary tract infections. If you get frequent UTIs, you may want to explore other birth control options or choose condoms and lubricants that are free of spermicides.

You’re wiping wrong

E. coli from the intestines is often present in stool. Wiping the wrong way after you urinate or defecate could carry bacteria from the anus to the urethra. For optimal personal hygiene, always wipe from front to back. If you need to wipe again, fold the toilet paper over, or use fresh paper for the second pass.

You frequently hold your urine

Sometimes, you simply can’t urinate when you need to due to your location or your activities. Occasionally holding it is unlikely to cause medical problems, but frequently ignoring the urge to go could put you at risk for UTIs. Remember that urination helps to wash bacteria out of the urinary tract. Urinating less frequently means your body isn’t flushing out harmful microbes.

If the urge to urinate happens so frequently that it interferes with your ability to sleep or perform your daily living tasks, talk to your doctor. You may suffer from overactive bladder (OAB) or another condition that requires treatment. Otherwise, listen to your body, and go to the bathroom when you need to.

You’re irritating your urethra

Irritation can put you at an increased risk for UTIs. If the urethra becomes irritated, the tissue that lines it may swell. This narrows the pathway from the bladder, making it easier for bacteria to get trapped. Some potential sources of irritation include:

  • Tight-fitting clothing or underwear that rubs against or cuts into the groin
  • Scented feminine care sprays and powders
  • Scented maxi pads and tampons
  • Scented soaps and body washes
  • Detergents and fabric softeners
  • Douches

Changing what you wear or the products you use to care for yourself and your clothing may cut down on irritation and lower the likelihood of recurrentrecurring UTIs.

Your diet is high in bladder-irritating foods

Some people experience bladder sensitivity. If you’re one of them, your bladder may become inflamed due to the foods you eat and beverages you drink. This inflammation increases the risk of infection-causing bacteria growth in the urinary tract. Foods and beverages that can trigger bladder sensitivity include:

  • Alcohol
  • Artificial sweeteners
  • Carbonated beverages
  • Coffee and tea
  • Dairy products
  • Fruits
  • Spicy foods
  • Sugar
  • Vinegar

Your immune system doesn’t function properly

People with compromised immune systems are more likely to develop UTIs. The immune system is the body’s natural defense mechanism against bacteria. When it doesn’t work well, you’re unable to efficiently fight off infections. You may have a compromised immune system if you:

  • Are diabetic
  • Have an autoimmune disease like HIV, lupus, or rheumatoid arthritis
  • Are undergoing cancer treatment
  • Recently underwent an organ transplant
  • Take certain medications like corticosteroids or disease-modifying antirheumatic drugs (DMARDS)
  • You smoke

Elements of your lifestyle can also interfere with the function of the immune system. You can support immunity by:

  • Getting 7 to 8 hours of sleep every night
  • Exercising regularly
  • Eating a well-balanced diet rich in vegetables, fruits, whole grains, and lean proteins
  • Controlling stress as much as possible

You’re a postmenopausal woman

After menopause, your risk for developing UTIs increases due to hormonal changes. Also, your immune system naturally slows down as you age, making you even more susceptible to infections. If you’re postmenopausal and experiencing frequent UTIs, your doctor may recommend that you apply an estrogen cream to your genital area regularly.

You’re pregnant

Hormone changes that occur during pregnancy may also make UTIs more likely to occur. Your primary care provider can develop a pregnancy-safe treatment plan to address chronic UTIs.

You use a catheter

Ongoing catheter use puts you at a greater risk for developing a UTI. Your doctor can review proper catheter care techniques that may lower the likelihood of infection.

Treatment for chronic UTIs

If you have an active infection when you see your doctor about chronic UTIs, you are likely to receive a course of full-strength antibiotics to eliminate existing bacteria. To clear up the infection, you will need to take all of the medication prescribed, even if your symptoms resolve before you run out of pills.

When you are free of an active infection, your doctor may then prescribe low-dose antibiotics to reduce the risk of future infections. You may need to:

  • Take the medication daily for a certain number of days, weeks or months
  • Only take the antibiotics when you have sexual intercourse
  • Only take the antibiotics when you begin to experience symptoms of a UTI

In addition to prescribing medication, your doctor may recommend that you make changes to your lifestyle, such as:

  • Drinking more water
  • Discontinuing use of scented feminine care products and toiletries
  • Modifying your diet
  • Wearing breathable cotton underwear
  • Changing elements of your hygiene routine
  • Urinating more frequently, and right after sex

Because the causes of chronic UTIs are often complex, you may need modifications to your treatment plan over time to put a stop to frequent infections.

How Forward can help you reduce UTIs

Forward acts as your primary care doctor, providing you with one-to-one personalized care. If chronic UTIs are getting in the way of your life, we can perform diagnostic tests and assessments and explore elements of your lifestyle to pinpoint the most likely causes. Then, we’ll create a customized treatment plan that may include lifestyle changes, antibiotics, and other elements, and monitor your health over time to adjust the plan as needed. We are dedicated to helping you achieve all of your health goals, including controlling recurring UTIs.

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