What is a chronic urinary tract infection?
Chronic urinary tract infections (UTIs) are prolonged urinary tract infections that either don’t respond to treatment or keep repeating. They may either continue to affect your urinary tract inspite of getting the appropriate treatment, or they may come back after treatment.
Your urinary tract is the pathway of removing urine. It includes the following organs:
- Your kidneys filters blood and excrete your body waste in the form of urine.
- Your ureters are tubes that transport urine from the kidneys to the bladder.
- Your bladder collects and stores urine.
- Your urethra is a fibromuscular tube that carries urine from the bladder to the outside of your body.
A UTI can affect any part of your urinary system. When an infection only affects your bladder, it is generally a minor illness that can be easily treated. However, if it reaches to your kidneys, you may suffer from serious health complications, and may even need to be hospitalized.
Although UTIs can occur to anyone at any age,but they’re more common in women. In fact, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that 1 in 5 young adult women have repeating UTIs.(1)
What are the symptoms of a chronic urinary tract infection?
The symptoms of a chronic UTI affecting your bladder are:
- frequent urination
- bloody or dark urine
- a burning sensation during urination
- pain in your kidneys, that means in your lower back or below your ribs
- pain in your bladder region
If the UTI spreads to your kidneys, it might lead to:
What are the causes of chronic urinary tract infections?
A UTI is caused by a bacterial infection. In most cases, the bacteria enter the urinary system through the urethra, and then they divide in the bladder. It is helpful to stop UTIs into bladder and urethral infections to better understand how they develop.
The bacteria E. coli is a common cause of infections of the bladder, or cystitis. E. coli normally live in the intestines of healthy people and animals. In its normal state, it doesn’t cause any issues. However, if it goes out from the intestine and enters the urinary tract, it can cause infection.
This generally happens when very small or even microscopic bits of feces get into the urinary tract. This might happen during sexual intercourse. For example, this can occur if you switch between anal and vaginal sex without proper cleaning in between. Anal sex increases your UTI risk remarkably. Bladder infections can also develop from toilet water backsplash or by wiping from back to front. Foamy urine can also signal an issue.
Also called as urethritis, infections of the urethra could be due to infections of bacteria such as E. coli. Urethritis can also occur due to a sexually transmitted infection (STI), however, this is not frequent. STIs include:
Who is at risk for a chronic urinary tract infection?
Chronic UTIs are mostly occur common in women. This is due to difference in the anatomical structures of men and women.
First, the urethra is close to the rectum in women. Because of this reason, it is easier for bacteria from the rectum to reach the urethra, especially if you wipe back to front instead of front to back. This is why young girls often get UTIs. They have not learned how to wipe properly.
Second, a woman’s urethra is shorter than a man’s. This means that bacteria have to travel a smaller distance to enter into the bladder, where they can grow in number and more easily cause infection.
There are certain lifestyle factors that can put you at extra risk of developing a chronic UTI, like using a diaphragm during sex. Diaphragms push up against the urethra, making it more difficult to complete emptying of your bladder. The urine that doesn’t empty is more likely to grow bacteria.
Another example is constantly changing the bacterial makeup of the vagina. This can increase your chances of getting a chronic UTI. If you regularly use any of the following products, then you’re changing your vaginal bacteria:
Men have much lower risk than women to getting UTI, either acute or chronic. The most common reason men develop chronic UTIs is an enlarged prostate. When the prostate is enlarged, the bladder does not empty fully which can lead to bacterial growth.
Both men and women that have problems with bladder muscle function, known as neurogenic bladder, also have chances of getting chronic UTIs due to retention of urine. This condition can happen as a result of injury to the nerves to the bladder or injury to the spinal cord.
Menopause can cause similar problems in some women. Menopause leads to hormone changes that can cause changes in your vaginal bacteria. This can increase your chances of getting chronic UTIs. There are also other risks for UTIs in older adults.
How is a chronic urinary tract infection diagnosed?
If you get a chronic UTI, you probably had a UTI in the past.
In a urine culture test, a technician places a urine sample in a tube to support the growth of bacteria. After one to three days, they’ll look at the bacteria to find out the best treatment.
If you have recurring UTIs, your doctor may need to perform a cystoscopy. In this procedure, they’ll use a cystoscope which is a long, thin tube with a lens at the end used to look inside your urethra and bladder. Your doctor will look for any abnormalities or problems that could cause the repeating or reccuring UTI.
How is a chronic urinary tract infection treated?
The main course of treatment for UTI is antibiotics taken over one week is the primary tratment for UTIs.
However, if you have chronic UTIs, your doctor may probably recommend long-term, low-dose antibiotics for more than one week after the initial symptoms go down. In many cases, this helps prevent symptoms from repeating. Your doctor may also suggest a course of treatment in which you take antibiotics after every time you have sexual intercourse.
Along with antibiotics, your doctor will want you to watch your urinary system more closely. For example, they may suggest you to do regular home urine tests to check for infections.
If your symptoms don’t subside even after antimicrobial treatment (like antibiotics), the American Urological Association (AUA) recommends that your doctor repeat the urine culture test.
If your chronic UTIs occur with menopause, you may want to consider vaginal estrogen therapy. This can control your risk of getting future UTIs, although it does have some dilemmas. Make sure to discuss it with your doctor.
If you have an active infection, you may experience burning sensations during urination. Your doctor may recommend pain medication to numb your bladder and urethra. This will lower the burning sensation.
Your doctor may also recommend other medications for treatment that are not based on antimicrobials.
According to some studies, drinking cranberry juice daily can help reducing recurrences among those who have chronic UTIs. More research requires to be performed, but it can’t hurt if you enjoy the taste. You can find a great selection of cranberry juice here. Consult with your doctor first if you take blood-thinning drugs.
Another natural remedy that can help treat a UTI is to drink sufficient water. Drinking enough water can help dilute your urine and flush out the bacteria through it.
Placing a heating pad or hot water bottle on your bladder may relieve the pain. There are also more ways of treating a UTI without antibiotics.
What are the complications of a chronic urinary tract infection?
People who suffer from chronic UTIs may feel complications. Repeating urinary tract infections may gradually lead to:
- kidney infections, kidney disease, and other permanent kidney damage, particularly in young children
- sepsis, which is a dangerous and fatal complication due to infection
- septicemia, which is a condition in which bacteria have infected the bloodstream
- increased chances of premature delivery or of having babies with low birth weight
What is the long-term outlook?
Urinary tract infections are irritating and painful. Most chronic UTIs will cure with a long-term course of antibiotics, but monitoring for further symptoms is essential since the chronic UTIs generally repeat. People with UTIs should monitor their bodies and look up urgent treatment with the onset of a new infection. Early treatment of infection lowers your risk for more serious and prolonged complications.
How can I prevent a chronic urinary tract infection?
If you’re prone to recurring UTIs, make sure to:
- urinate as often as required (particularly after sexual activities)
- wipe front to back after urination
- drink plenty of water to flush bacteria out of your body
- drink cranberry juice daily
- wear cotton underwear
- don’t wear tight-fitting pants
- avoid using diaphragms and spermicides for birth control
- avoid drinking fluids that may irritate your bladder (such as coffee, citrus fruit drinks, soda, alcohol)
- use lubrication during sex, if required
- avoid bubble baths
- wash foreskin regularly if you are uncircumcised