Frequent bladder infections – here's how to help

Dealing with  frequent bladder infections can be debilitating and confusing. Read on to learn more and hear what our expert, Dr. John S. Young Urologist of Teesside University, has to say. 

Many people suffer from Urinary Tract Infections (UTIs) regularly, with some even contracting a UTI every month. Although persistent UTIs are a problem for many people, it is important to remember that such frequency is not normal, and UTI symptoms should always be investigated and treated.  

Much of the confusion surrounding frequent bladder infection stems from  the different terms used to describe constant UTI infections, with the terms ‘chronic’ and ‘recurrent’ being the most commonly used.  

Recurrent UTI 

A recurrent UTI is defined as three episodes of a UTI over 12 months or two episodes over 6 months. A recurrent UTI is likely to be the same infection coming back again and again, but it may also be a continuous infection which ‘flares up’ periodically. In both cases, this is likely to be because of ineffective UTI remedies. 

Chronic UTI  

A chronic UTI is a long-lasting, persistent infection that doesn’t go away. The most common chronic UTI cause is ineffective treatment that does not completely remove the infection, allowing the bacteria and symptoms to re-establish. 

Dr John S. Young remarks that:  

“The overlap between these two definitions is confusing and suggests similarities in the underlying cause or our body’s response.” 

It could be either a chronic or recurrent bladder infection, if you’ve had two or more bladder infections in six months or three or more infections in a year. 

Symptoms of recurrent or constant UTI infections are similar to acute or ‘one-off’ UTI and include:  

• Frequently passing urine  
• A constant sensation of the need to pass urine (‘urinary urgency’)  
• Pain passing urine (dysuria)  
• Urge Incontinence  
• Pain: in the lower abdomen (below the belly button) and/or down into the legs  
• Blood in the urine or changes in urine colour and smell  
• A burning or painful sensation while urinating (dysuria)  
• Pain in the lower back or sides of the back  
• In an individual who still has periods, these symptoms can often be worse before the period.  

On recurrent and chronic UTI symptoms, Dr John said:  

“Symptoms will differ from person to person. If someone has one or more of these symptoms, irrespective of the cause, it’s important to speak to your GP. That’s because while most recurrent UTIs don’t spread beyond the bladder, it’s essential to begin treatment as soon as possible to avoid the risk of damage to the kidneys”.  

In many cases when a patient has a UTI, antibiotics are effective. After a few days of antibiotics, impactful symptoms of UTIs go away. Antibiotics for recurrent UTI offer only temporary relief – for a week or so – before symptoms return and the infection cycle begins again.  

Recurrent UTIs are particularly difficult to diagnose, because of the limitations of the tools available to most healthcare practitioners. The reasons for recurrent UTIs are being researched, but there is growing evidence that a recurrent UTI has a different basis than an acute, ‘one-off’ UTI.   

Professor John explains the current medical consensus to us, saying:  

“In the case of a recurrent UTI, we believe that bacteria become ‘embedded’ – either forming a colony on the lining of the bladder or within the cells that make up the bladder wall. By being embedded in this way, very few bacteria find their way into the urine itself where they’d be detected using the methods used for an acute UTI.”  

New tests are becoming available, aiming to detect indicators of bacteria that have become embedded and could cause a recurrent UTI. 

Until we understand the exact causes of recurrent UTIs, it is not possible to recommend effective ways to prevent constant UTI infections. As of now, doctors do not believe that lifestyle factors play a part in recurring UTIs, meaning there is no convincing evidence that making simple changes to what we eat and drink or how we clean ourselves (for example, after sex) will prevent recurrent UTIs. 

Recurrent UTIs can be effectively treated, but for many people, it can take some time and it’s often necessary to try several treatment options before symptoms are fully resolved. One of the main recurrent UTI treatments involves taking a longer course of antibiotics at a lower dosage.  

If you believe you are suffering from a recurrent UTI, it is important to see a specialist to understand all the recurrent UTI treatment options available, as they will differ depending on the suspected underlying cause of your condition. Within the NHS, you can request to be referred to a specialist, so do ask your GP for help arranging this. We’ve provided a link below to explain the process, including the NHS e-Referral Service.  

Men can also experience recurring or constant UTI infections. Although much more uncommon in males, those with an enlarged prostate have an increased chance of experiencing frequent bladder infections. Learn more about the specific causes of UTIs in men, and how males are affected by UTIs here.

Recurrent UTIs can affect women of all ages and are generally more common in women than men, due to their increased chance of experiencing UTIs in general. For more information on UTIs, including the symptoms and causes of acute UTIs, read our guide on female urinary tract infections here.