Ways to manage recurring urinary tract infections

Mercy, in her late thirties, has been battling Urinary Tract Infections (UTI) for many years. She is always in and out of hospital, in a bid to get relief from the uncomfortable symptoms of the disease which include the following: frequent urge to urinate, pain while urinating and lower back pain.

“This is a problem that I have been dealing with for long. I keep getting medication which makes the symptoms to disappear for some time, then the condition comes back again. This is really frustrating,” she says.

A UTI can involve any part of the urinary system, including the urethra, ureters, bladder and kidneys. Symptoms typically include needing to urinate often, having pain when urinating and feeling pain on one’s side or lower back.

Mercy is among the many women worldwide who remain fearful and discouraged by the limited options currently available for managing UTIs, despite the high prevalence of the condition.

Experiences of many more women suffering from the condition have been aptly captured in a new study published in the Journal of Urology.

This new study sought to bring to the forefront the voices of those that have been suffering in silence. The researchers note that the findings of the study will go a long way in helping scientists to come up with better ways of managing the problem.

“We were inspired to conduct the study due to the large number of women coming to us feeling hopeless and helpless when it came to the management of their UTIs,” said Dr Victoria Scott, the lead author of the study and a urologist at the Female Pelvic Medicine and Reconstructive Surgery Clinic at Cedars-Sinai Medical Centre in the US.

During the study, the researchers led a focus group study comprising of women who had experienced recurrent UTIs to learn about gaps in their care.

Women who participated in the study were critical of healthcare providers, for failing to understand their experiences while over-prescribing antibiotics as a treatment option.

As a result, a majority of these women were concerned and expressed their fears in regard to the potential adverse and long-term effects of the medication.

“Many of the participants were aware of the risks of bacteria developing resistance to antibiotics. They were also aware of the collateral damage of antibiotics and disruption they can have on the normal balance of good and bad bacteria throughout the body,” stated Dr Scott.

Further discussions in the focus groups revealed that women were also concerned with the medical system and limited research efforts to investigate new non-antibiotic management strategies.

Participants voiced their frustration and resentment toward their medical providers for ‘throwing antibiotics’ at them without presenting alternative options for treatment and prevention, and for not understanding their experience.

In addition, many women indicated that they had sought advice on alternative ways of managing the condition from herbalists and acupuncture practitioners, as well as from peers in online forums and chatrooms.

Although studies show that antibiotics are often the most effective treatment option for managing urinary tract infections, the researchers noted that studies also show that up to 40 percent of bladder infections can be cleared using non-prescription approaches.

Some of these interventions include increased water intake and the use of over-the-counter pain relief medications such as ibuprofen.

“Taking these steps when UTI symptoms initially develop and urine test results are pending can be important for avoiding unnecessary antibiotics and ensuring that appropriate antibiotics are prescribed when needed,” stated the researchers.

Other strategies for preventing UTIs include taking cranberry supplements or a low-dose antibiotic after sexual intercourse, as well as using vaginal oestrogen for those who are postmenopausal.

While over-the-counter treatments are preferred by many, Dr Scott recommends seeing a doctor if a fever develops or symptoms persist beyond a day.

“This is because antibiotic therapy can be crucial for some infections to ensure they don’t spread from the bladder to the kidneys.”

“Antibiotics are amazing drugs and in certain settings are lifesaving. There are absolutely some instances in which antibiotics are necessary, but it’s also important for women to be educated on all the available options for addressing the UTI challenge,” said Dr Scott.

Based on the observations of the researchers, some healthcare providers might not think that a single episode of a urinary tract infection could have a significant impact on a patient’s life.

“But when UTIs recur, often without warning, they can have a negative impact on social life, work, families and relationships,” they note.

Drawing from the findings of the study, the researchers recommend that physicians should modify their UTI management strategies so as to address women’s concerns and to devote more research into improving non-antibiotic options for the prevention and treatment of recurrent urinary tract infections.

“Unfortunately, we see many women who blame themselves for developing UTIs. It’s important to understand that UTIs are a very common problem and should not invoke shame,” said Dr Scott.

“If you are experiencing recurrent UTIs, I encourage you to connect with a doctor who specialises in female pelvic medicine and reconstructive surgery to work together to come up with individualised prevention and management strategies.”

Dr Scott notes that while less common, men can also experience urinary tract infections and should therefore be considered as discussions ensue on improved ways of managing the condition.

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