Recurrent urinary tract infections (UTIs) can significantly impact quality of life, but new options are available for management, according to Dr. Ellie Cannon, a Mail on Sunday columnist and GP.
For women, particularly those who have gone through menopause, a decrease in estrogen can lead to changes in bladder tissue, making it more vulnerable to infection. Vaginal estrogen, prescribed by a doctor, is one approach to reduce the frequency of UTIs.
Constipation is another contributing factor. When the bowel is full, it can prevent the bladder from emptying completely, creating an environment where bacteria can multiply. Similarly, pelvic organ prolapse, a condition where the bladder or womb may drop slightly, can have the same effect and is common in older women.
Staying well-hydrated by drinking approximately one and a half liters of water daily can help flush bacteria from the bladder. It is also advised to avoid soaps or bath products that may irritate intimate skin areas.
For some individuals, the supplement D-mannose may help reduce UTI recurrences, though its effectiveness can vary. Another option is a nightly preventative antibiotic prescribed by a GP. If these methods are not suitable or effective, methenamine hippurate, marketed as Hiprex, can act as an antiseptic to inhibit bacterial growth in the bladder.
Older women experiencing recurrent UTIs should also undergo an ultrasound scan to examine the ovaries and bladder, as these symptoms can, in rare instances, be an indicator of cancer.
Regarding pain management, if tramadol, a prescription opioid, is no longer being provided, patients should seek an urgent phone consultation with their GP surgery. Pharmacists can also offer advice on pain management strategies. Gradual dose reduction, alternating tramadol with paracetamol, or taking it only at specific times can help manage withdrawal symptoms. Other prescription pain relief options may include naproxen or other anti-inflammates, depending on individual health conditions, or weaker opioids like codeine. Over-the-counter ibuprofen and paracetamol can be combined for enhanced pain relief, and heat pads or cooling gels can be used alongside oral medication.
