What is the best urinary tract infection (UTI) treatment protocol? Official guidelines suggest a 5-day course of antibiotics, while naturopathic doctors recommend ten days of D-Mannose and a variety of other supplements. Moreover, every year there is a new drug or a supplement promising to cure UTI better, safer, and faster.

Why There is No One Best UTI Treatment Option

Whenever I hear about a new emerging “magic bullet” solution for UTIs, I have mixed feelings. First of all, I’m excited about new options, given that antibiotics are increasingly failing us. But at the same time, I feel we are missing the big picture when hoping for a single drug to cure a chronic health issue.

I believe, if you are experiencing chronic UTIs, the acute infection is often a symptom of a bigger problem.

Your body is a complex system with many mechanisms of self-defense and a powerful ability to heal itself. Therefore, if you see a repeated breach, know that lots of things had to go wrong, long before the chronic problem manifested itself.

You Don’t Know What Causes Your UTIs

Many times when I ask fellow UTI patients “What causes your UTIs?”, the answer is usually “sex” or “E. coli bacteria”. While this may sometimes be true, it is not a complete answer. In fact, according to a urologist Dr. Melissa Kaufman, most healthy females may have E. coli bacteria in their bladder at any given moment in time without presenting symptoms of a UTI.

“For the most part, the women who don’t get infections have the same bacteria [compared to women] who do,” says another practicing urologist, Dr. Mike Hsieh, “We don’t understand the real pathophysiology of the [UTI] disease process and how this occurs.”

Furthermore, Dr. Mike Hsieh says it’s all about balance.

“…Urine quite possibly might never be sterile, and asymptomatic bacteriuria may be a universal state,” he says. “I think an infection [happens] when the negotiated truce between bacteria and the body has been broken”.

Ultimately, however, regardless of the true source of UTI symptoms, Dr. Kaufman agrees: it’s about the underlying issues.

“Sometimes it’s as simple as a problem with chronic diarrhea: if we solve the bowel problems the infections go away. Sometimes it’s a problem with the environment of the vagina, so we solve that problem. The infections are reduced but overall what we’re not solving is how we’ve created that imbalance.”

UTI Treatment Starts With Right Diagnosis

The best UTI treatment protocol starts with gaining an understanding of the main causes of  UTI. After that, you’ll need to set up a holistic plan to address not only the issue at hand but commit to a general wellness program to help your body restore its innate balance.

“We don’t understand the real pathophysiology [of chronic UTIs] so to speak, or what the disease process, and how this occurs. Part of the issue is that we have had a very deficit in our understanding of who we are as human beings, that we are composed not just of human cells. We have a greater burden of bacteria and viruses, and other types of organisms within us than even outnumber our own cells. And it is really a true symbiotic relationship that’s occurring. And what we are probably doing with our diet, with our environmental influences and with inappropriate medical interventions like the rampant use of antibiotics is we are disrupting homeostasis, we’re disrupting a balance and we’ve put our own bodies out of balance,” Dr. Kaufman says.“And the things that normally are protective are no longer available to protect.”

It should come as no surprise that chronic UTI and IC patients also often have other health issues such as hormonal imbalance, vaginal infections, allergies, and more.

Here are several main areas that deserve attention when evaluating your own health in connection with chronic UTIs:

• Vaginal Flora (females). This is especially important if you keep getting UTIs after sex. Ask your urologist or OB-GYN to culture your vaginal flora, but most importantly, address the risk factors, such as:
  • Antibiotic use
  • Douching
  • Hormonal changes
  • Lubricant use
  • Contraceptives with Nonoxynol-9 spermicide
  • Using an IUD
  • Stress
• Stagnant urine in the bladder. You may not be emptying your bladder completely, allowing bad bacteria to grow and fester, especially if:
  • If your pelvic or bladder muscles are too tense or too weak
  • If there are any structural anatomic abnormalities that prevent normal urine flow
  • The presence of any physical objects that could obstruct urine flow such as an incorrectly installed diaphragm, large tampons, menstrual cups
  • Bladder and urethra scarring
  • Blood clots
  • An enlarged prostate
  • Bladder stones
  • Constipation
  • Dehydration
• Healthy intestinal flora. If the concentration of the bacteria in your stool is too high, it increases your chances of contracting a UTI. There are several causes of an overgrowth of bad bacteria in the intestines:
  • Constipation
  • Poor diet and lack of fluids
• Healthy bladder microbiome. it is expected that we have a variety of bacteria present in our bladder at all times, but certain factors could shift the balance and provoke an acute infection:
  • Acidic urine due to poor diet
  • Surgeries
  • Overuse of antibiotics and prescription drugs
  • Use of catheters, a surgical mesh or other foreign objects
• Systemic health issues that could make your body more prone to inflammation and infection:
  • Immune system disorders
  • Chronic autoimmune disease, like diabetes
  • Leaky gut (intestinal permeability)
  • Chronic allergies
  • Chronic stress
  • Environmental toxins
  • Lack of essential microelements

The Best UTI Treatment Protocol is Systemic

While I believe that attacking a chronic issue requires a holistic approach, it’s the answer that neither patients nor physicians like to hear.

Unfortunately, we live in an era of immediate gratification. Everything is faster than ever before and we demand the same from our healthcare. Patients are looking for quick solutions and a pill that could cure it all. Once acute symptoms are gone, many patients rush to return to their comfortable lives and unhealthy habits.  

Also, our healthcare system was not built around prevention, but with a focus on treatment procedures. Therefore physicians have neither the skills nor the time to help patients understand and comply with major long-term changes that are often required in order to achieve a long-term successful outcome.

Common lifestyle changes that a patient with any chronic health problem should consider include:

• A healthy diet, one that includes plenty of vegetables and greens, enriched with prebiotics and probiotics
• Regular exercise routine
• Effective stress-management
• A path to cut down or get rid off bad habits such as smoking, alcohol, a sedentary lifestyle
• The inclusion of essential vitamins, minerals, and microelements
• Antibiofilm enzymes and natural antibacterials

Therefore, no matter how excited you are about a new supplement or a drug that seemed to have cured your UTI for now, keep in mind that basic principles of a healthy lifestyle should not be ignored. Otherwise, you’ll be constantly fighting the flares without ever getting to the root of the problem.