What are recurrent urinary tract infections (UTIs)

Understanding your condition

Urinary tract infections are the infection of any part of the urinary tract (urethra, bladder, ureters, or kidneys). Women experience UTIs more than men (around 50-60% of women will experience one or more), and women are much more likely to experience recurrent infections.

Infections may be due to congenital abnormalities, or they may be due to other health conditions or medical procedures, however, most often the cause is bacterial infection by Escherichia coli (E. coli) in the urethra, bladder, vagina or kidneys. Left untreated, this infection can cause damage to the kidneys and bladder.

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Functional medicine for recurrent UTIs

Up to 60% of women will experience a recurrence of a UTI within a year of the first infection. Recurrent infection is defined as 2 episodes within 6 months or 3 within 12 months. Antibiotics are the usual treatment prescribed, however they can come with side effects such as candida, diarrhoea, nausea, vaginal burning, and headache. Antibiotics are great at killing bacteria, however, they are indiscriminate, killing beneficial gut flora as well as those bacteria that are being targeted.



The good news is there are natural and effective ways to break the cycle of recurrent UTIs with functional medicine. 

Before
After
Before
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Recurrent UTI symptoms

Urinary tract infection, including recurrent or constant UTI symptoms, can include:

  • Burning or pain on urination
  • Frequent urges to urinate, often passing only a small amount of urine
  • Pain in the lower abdomen, or lower back
  • Pain or uncomfortable pressure above pubic bone
  • Cloudy urine (blood, or pus) - this is rare
  • Fatigue/tiredness
  • Vomiting, nausea
  • Dark, cloudy or reddish urine
  • Fever and pain in the side when a kidney infection is present
  • Purulent (pus) discharge from penis  in males
  • Cognitive decline or confusion in the elderly

On some occasions, there may only be frequent urination, or no symptoms at all. 

What causes recurrent UTIs?

Infections of the urinary tract are caused by bacteria proliferating and being poorly controlled by the immune system. This can be:

  • A structural problem
  • Due to a blockage
  • Backflow of the urine 
  • Urine not being fully evacuated from the bladder, providing an ideal place for bacteria to grow
  • Bacteria introduced through surgery
  • Frequent sex 
  • Medical procedures/devices
  • Neurological conditions, which can affect the signal the body gets to empty the bladder, which can result in poor evacuation
  • Immunosuppression can impair the ability of the body to fight off bacterial infections

UTI’s can be characterised into two types: 

Uncomplicated UTIs

An uncomplicated UTI is usually a bacterial infection by Escherichia coli (E. coli) in the urethra, bladder, vagina or kidneys. This type of infection is responsible for more than 80% of UTIs. Staphylococcus saprophyticus accounts for 10-20% of uncomplicated  UTI’s, and Klebsiella pneumoniae, Corynebacterium urealyticum, Proteus, Enterobacter, Pseudemonas spp. are much less common, and are usually associated with other health conditions, or due to medical procedures.

Complicated UTIs

Complicated UTIs, as the name suggests, are due to other complications in the body, such as:

  • Congenital abnormalities causing reflux of the urine (flowing back up the urinary tube), obstruction that blocks the flow of urine, or polycystic kidney disease 
  • Obstruction by ‘stones’, stricture or bladder outlet obstruction
  • Bladder tumour
  • Medical treatment e.g. a stent, catheter, urinary or faecal incontinence, sling procedure, or surgery
  • Poor bladder emptying, increased ‘post void residue’
  • Neurological disease affecting signal to urinary tract, e.g. Parkinson’s disease, MS, spinal chord injury, diabetes, peripheral neuropathy
  • Other health states/conditions - pregnancy, immunosuppression, kidney failure, kidney transplant, fistula between bladder and bowel
  • Hospital acquired infection

What causes eczema?

Genetics

Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.

Hormones

Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

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Risk factors for recurrent UTIs

There is some overlap between the causes of UTIs, and the risk factors for recurrent UTIs, which include:

  • Poor hydration, a common factor in recurrent UTIs
  • Poor personal hygiene, transmitting bacteria from the rectum to vagina
  • Female anatomy i.e. the short length of urethra and the proximity of the vagina to the rectum
  • Pregnancy
  • Coffee (for some people) can stimulate the bladder sphincter to close
  • Immunocompromised people
  • Frequent intercourse, and not urinating after sex 
  • Perimenopause & menopause
  • Urinary incontinence
  • Change of bacterial flora of the vagina (use of diaphragm/spermacides, or personal care products, douches)
  • Personal hygiene of male partners
  • Use of catheters
  • Hospitalisation, or medical procedures
  • Family history (a genetic factor that is related to blood group, and hormone balance)
  • Anatomical factors - a short distance between the vagina and anus 
  • Pelvic prolapse
  • Obstruction - polyps, stones, or stricture causing recurrent blockages
  • Neurogenic bladder dysfunction - related to MS, spina bifida, Parkinson’s disease, stroke, spinal cord injury, heavy metal poisoning, benign prostate hyperplasia, cauda equina syndrome, stroke, syphilis and diabetes mellitis
  • Thickening or loss of elasticity of the walls of the ureters, or bladder

Recurrent UTI treatment - the conventional approach

Women frequently present to their GP with UTIs, and the most common treatment approach is to prescribe antibiotics. 

Your GP may test your urine to look for signs of infection or blood, and it is common for testing to be negative or inconclusive. Testing of mid stream urine quantities of E. coli bacteria can be inconclusive depending on the quantity of bacteria found, and your doctor will most often diagnose UTI’s based on your symptoms and past history. 

Your GP may also refer you for further testing, to rule out other causes of your symptoms.

Antibiotic treatments can be taken in a range of ways; continuous prophylaxis to reduce the risk of contracting UTIs, a single dose after sex, or when an infection is present. 

Treatment of UTIs with antibiotics can have a significant impact on the gut flora, which can lead to candida overgrowth, and for many women with recurrent UTIs, it is a perpetual cycle of alternating UTI and candida infection. This can be very frustrating, and leads people to seek out a specialist for recurrent UTIs who provide lasting and natural solutions.

Recurrent UTI treatment - the functional medicine approach

Chronic UTI natural treatment with a functional medicine practitioner starts with an in-depth and comprehensive investigation to identify the root cause and contributing factors of your UTIs, and why it is recurrent.


In an in depth initial consultation, we investigate:

  • Your lifetime medical history
  • Medications and supplements
  • Surgeries and accidents
  • Family and genetic history
  • Environmental exposures
  • Symptom history 
  • Nutrition, diet and absorption
  • Lifestyle factors and stress
  • Your sleep history, symptoms and sleep hygiene practices

Your natural UTI practitioner may recommend functional testing to help determine the cause of your UTI, or to investigate baseline health, with tests such as:

  • Microbiome and stool testing - looking for gut flora dysbiosis, or parasites 
  • Specific markers for inflammation, digestive function & nutrient absorption
  • Food sensitivities and allergy testing
  • Heavy metal or environmental toxin exposure
  • Hormone levels
  • Mineral analysis
  • Urine metabolite testing

Depending on your results and symptoms, a personalised recurrent UTI functional medicine treatment may target the following causes of recurrent UTIs:

  • Removing causative factors such as food intolerances/allergies, or make dietary changes to a more alkaline diet to alter urinary pH
  • Improve pain and discomfort of urination, or inflammation to urinary tract
  • Restoring a healthy microbiome - many conditions are related to poor digestion and dysbiosis and can precipitate UTIs. Chronic use of antibiotics can disrupt the types and numbers of species of your gut flora, allowing UTIs to occur. Candida infections can also contribute to this dysbiosis
  • Improve stress resilience, depression and anxiety which can inhibit the ability of the immune system to adequately fight infections
  • Regulating blood sugar and insulin levels - unregulated blood sugar can contribute to altering the pH of the bladder, contributing to the infection 
  • Nutrient absorption and vitamin deficiencies - due to poor diet or, digestive dysfunction (or stress) may mean insufficient levels of important vitamins and minerals required for healthy immune function, healthy linings of the urinary system, and resolving inflammation, such as magnesium, iron, vitamin D, zinc and selenium
  • Intestinal hyperpermeability (leaky gut) - can allow foreign particles to cross over from the intestines and into circulation, causing inflammation and triggering the immune system to overreact, creating gastrointestinal disturbances such as indigestion that can contribute to recurrent infections
  • Reduce the impact of medications and other health conditions - with holistic functional medicine treatment strategies

Natural remedies for a recurrent UTI including dietary, lifestyle, herbal and supplemental strategies may include (depending on your condition):

  • Dietary recommendations may include an anti-inflammatory diet, or a specific diet plan personalised to your body’s needs - eliminating any food intolerances, allergies or sensitivities e.g. gluten, dairy, eggs, soy and sugar
  • Eliminate environmental toxins such as heavy metals, chemicals, pesticides, mould which can interfere with digestive function, pH, and hormone balance
  • Reducing or eliminating alcohol consumption, which can impair gut microbiome health
  • Reducing/eliminating coffee 
  • Ensure healthy hydration - a minimum of 2L of water per day can prevent stagnation/concentration of urine in the bladder, and promote healthy urination
  • Improve vitamin status with dietary changes and supplemental medicines, e.g. vitamin C increases acidity of urine, which inhibits bacterial growth
  • Precision probiotic treatment to assist in increasing microbiota species diversity and make-up, which has multiple beneficial effects, including reducing bacterial overgrowth, reducing fungal overgrowth (e.g. candida) and byproducts of some species provide support for endothelial cells that line the urinary tract
  • Supplements such as D-mannose (a naturally occurring sugar found in fruits which can reduce recurrence and symptoms of UTIs) in combination with cranberry extract, vitamin A, zinc (both essential for immune health), magnesium citrate (for alkalinity of the urine), L-arginine (a naturally occurring amino acid required for healthy urinary tract function), N-aceytl cysteine (prevents bacterial biofilm) and quercetin can heal and restore urinary tract health to prevent recurrent UTIs

Herbal medicines for a recurrent UTI include:

  • Antimicrobials/urinary antiseptics such as berberine, cranberry, garlic (garlic specifically exhibits anti E.coli activity), uva-ursi, gotu kola, goldenseal, thyme
  • Urinary demulcents that soothe the urinary tract such as couch grass, licorice, marshmallow, corn silk
  • Anti-inflammatories such as garlic, turmeric (curcumin), bilberry, yarrow,and  boswellia
  • The herb gravel root that helps to prevent stone formation in the bladder


These are some of the strategies that our functional medicine practitioners may use to resolve recurrent UTIs. Treatment is personalised to each person, and in our unique 6-month program, you’ll have the support of your functional medicine practitioner to guide and direct your treatment, and a health coach to help you navigate the journey back to good health with ease. 

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FAQs

How to get rid of a UTI?

If you are concerned about how antibiotic treatment of your UTI can disrupt your microbiome and create a cycle of recurrent UTI infections, then you’ll be pleased to know that there are recurrent UTI natural treatments. 


Getting rid of a UTI is often a three pronged approach, and depending on your symptoms, may include:


  • Addressing the bacterial overgrowth with antimicrobial herbs like berberine, cranberry, garlic, goldenseal or gotu kola. 
  • Soothing the urinary lining with herbs like licorice, corn silk and marshmallow
  • Reducing inflammation with herbs like garlic, turmeric, bilberry or boswellia


Our functional medicine specialists can help you get rid of your recurrent UTI for good through a holistic, personalised approach that’s natural and effective. 

Why do I keep getting urinary tract infections?

There are a variety of factors that cause and can contribute to getting a UTI , and it becoming recurrent, such as:

  • genetic factors - structural abnormalities
  • poor hydration - not drinking enough water
  • other health conditions - diabetes, pregnancy, perimenopause, menopause, Parkinson’s disease, MS, spinal chord injury
  • medical procedures, catheters, surgery
  • low immune resilience, microbiome dysbiosis, food intolerances, allergies
  • frequent or new sexual activity
  • contraceptive devices such as diaphragm and spermicide use

Natural recurrent urinary tract infection management in women is available at Melbourne Functional Medicine where the practitioners will help to identify why you have chronic UTI infections, and treat them with natural and effective strategies.

Can recurrent UTIs be a sign of cancer?

Bladder cancer can easily be misdiagnosed with a UTI.

If you have any concerns, talk to your GP.

Bladder Cancer Australia has some information on what to look for. If you have blood in your urine, it doesn’t necessarily mean you have bladder cancer, however you should see your GP to check.

Best probiotic for chronic UTI treatment in Australia?

The best probiotic for chronic UTI treatment in Australia is one that will help restore balance to your microbiome, and that will depend on what has caused it to be out of balance. Precision probiotics prescribed by your recurrent UTI specialist will address the underlying causes of your UTI.



They may include strains such as Lactobacillus crispatus LCRO1, Lactobacillus fermentum LF10, and Lactobacillus acidophilus LA02 for women, and/or L. plantarum 6595, L plantarum HEAL9, L. paracasei 8700:2, L. rhamnosus GG, L. acidophilus LA02 and Bifidobacterium animalis subsp. lactis BS01 which can assist in restoring gut flora health during/after antibiotic treatment. 

What is the best natural treatment for recurrent UTIs?

The best natural treatment will be the one that addresses your particular set of circumstances, and investigates why you are getting UTIs, and why they are recurrent, like the recurrent UTI functional medicine approach.

Australians are seeking out the help of a functional medicine specialist for recurrent UTIs to receive holistic, thorough healthcare that gets to the root of their health concerns.

Chronic urinary tract infections can be caused by a variety of reasons. The easiest ones to identify are:

  • Not drinking enough water - studies show a high number of women/girls with recurrent UTIs aren’t well hydrated, causing urine to concentrate, change in pH and allow bacteria to proliferate. 
  • Hygiene - wiping front to back after using the bathroom, can be a simple way of avoiding transferring E. coli bacteria from the anus to the vagina
  • Avoiding spermicides, and personal hygiene products near the vagina

Is there a natural treatment, chronic UTI specialist in Melbourne?

Melbourne Functional Medicine have recurrent UTI naturopath practitioners who are passionate about women’s health, and can treat your UTIs naturally. 

Recurrent UTI functional medicine treatment might include lifestyle medicine, dietary changes, and herbal or other natural medicines. Your UTI specialist will assist you in prescribing the right treatment for you, which includes treating the whole person, not just the symptoms.


If you’d like to find out more, book a free discovery call to see how we can help you feel great again. 

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.