Recurring UTIs Explained

UTIs are miserable, but the worst part for many people is the feeling that they never really end. We’re digging into the real reasons recurrent urinary tract infections happen, why they’re so common for women, and why the usual “take antibiotics and move on” approach can turn into a frustrating cycle that keeps repeating.

We walk through what’s going on inside the body when a UTI starts, including why E. coli is the most common culprit and how certain strains use tiny “hooks” to stick to the bladder lining. From there, we connect the dots on the biggest drivers of recurrence: hygiene habits, sexual activity, spermicide or diaphragm use, menopause and estrogen changes, incomplete bladder emptying, urinary tract abnormalities, diabetes, and more. We also talk honestly about the downside of frequent antibiotic use, including microbiome disruption and rising antibiotic resistance.

Then we get practical. We break down D-mannose for urinary tract health, why it’s getting attention from urologists and pharmacists, how it may help prevent E. coli from attaching in the first place, and what the research is saying so far. We also cover hydration, urinating after sex, and supplements with some supportive data such as cranberry extract, hibiscus, and dandelion, plus the red-flag symptoms that should send you to a clinician quickly.

If this helps you, subscribe to the Frontline Health Podcast, share it with someone who keeps battling UTIs, and leave a review so more people can find evidence-based health education. 

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Transcript

Why Recurring UTIs Matter

SPEAKER_00 0:01

Today on the Frontline Health Podcast.

SPEAKER_01 0:06

Antibiotics are similar in the sense that if you've got a bacterial infection, it's going to kill that bacterial infection, but it doesn't necessarily keep those infections from coming back because they'll continue to attach to the bladder lining. And that is, especially if you've got an underlying risk factor, is one of the reasons why we see so many people coming back again and again and again with UTIs, but they're continuing to also develop an antibiotic resistance over time just because they're being treated with antibiotics so often.

SPEAKER_00 0:43

Welcome back to the Frontline Health Podcast, where we share news, tips, and insights to help you take ownership of your health. I'm Evan Patrick, Troy Duell, founder and CEO of Centurion Health, is here with me. If you've ever had a urinary tract infection, you probably remember it. They're painful, inconvenient, and unfortunately for many people, they just don't happen once. Some women seem to get them over and over again. They finish their antibiotics, feel better for a while, and then a few months later, or even a few weeks later, they're dealing with another one. Today we're asking a simple question: why do some people keep getting urinary tract infections? And perhaps more importantly, is there anything you can do to help break that cycle?

SPEAKER_01 1:27

Yeah, I think this is uh one of those topics that is incredibly important because those recurring urinary tract infections affect millions of people each year. And it it seems to be one of the most um talked about when you talk about antibiotics and probably one of the things that can have even greater detrimental effects on our health if we're taking antibiotics too much. And hopefully, there as we get done with this podcast, we'll have some ideas on ways that you can go about helping to prevent them and um keeping from having those recurrent UTIs if you already have them. Uh, so excited about talking about uh UTIs.

SPEAKER_00 2:14

Yeah, absolutely.

How Common UTIs Really Are

SPEAKER_00 2:15

And uh, as we kind of get started here, I really would just like to shine a little bit of light on how big of a problem UTIs are for many people. It's not something that has personally affected me, and so for a long time I really didn't realize how big of a problem they are, and um that they're really one of the main one of the biggest reasons for hospitalizations in the United States. Um, my personal experience with it came when uh my grandma, as we've mentioned before, that's me mom, because we're from the south. But she started dealing with them, and for a while it seemed like she was getting one really every few months, and it just continued to be something that was coming up and just making her life more difficult, causing her pain, just disrupting things that she had planned and just disrupting her life and leading to kind of some scary, unwanted trips to the doctor. So I really started digging into it a little bit more, learning more about these recurring UTIs, and a lot of women really struggle with these. And so uh so if you're a woman out there and you're listening to this, uh hopefully this will be helpful. And um, Troy, could you share just a little bit more information with our audience? Maybe if you're not familiar with how widespread UTIs are, just to help them understand how big of a deal this is.

SPEAKER_01 3:30

Yeah, it's a it's a really big deal. Obviously, it's one of the most common bacterial infections that we see out there, and they can actually be incredibly devastating if they occur in the elderly because they can cause an altered mental state. I don't know if you've been around anybody who's had a UTI before and they're a little older, but they can actually begin to hallucinate, start saying some really crazy things, and they're often admitted to the hospital. And family members are really kind of freaking out because they're totally out of the ordinary for those individuals to act that way. And they wonder what's going on. And, you know, thankfully, a lot of times they'll catch it early and they don't have to go through that uh for a long time. But it's certainly one of those things that that happens more often than we'd like to see happening. And like you mentioned, it happens in women much more often because of uh the anatomy of a woman than uh it does in men, but it can happen in men as well, and especially older men when you start to talk about catheters and everything else. But on average, a woman will experience about one UTI during their lifetime, and they'll often have uh recurrent infections, and unfortunately, some of them will have to be hospitalized or visit the urgent care because of them.

SPEAKER_00 4:52

Yeah, thank you for for sharing that, Troy. And I think all this really just goes to show, and the point we want to start with is just that this is not some rare problem. It is it is very common.

SPEAKER_01 5:03

Uh very, very common, and primary care physicians see it constantly. A lot of the urgent cares out there see this on a regular basis, so it's not something that uh is a very rare occurrence.

SPEAKER_00 5:18

Absolutely. So uh what we're gonna get into is the the causes and treatments that are available for UTIs in just a minute. Uh, but it seems odd to me so many women who get UTIs get them over and over again. So let's start by just talking about what exactly qualifies as recurrent.

What Counts As Recurrent

SPEAKER_01 5:38

Uh typically when we say something is recurrent about a UTI, it means that they've had two infections within about six months or they have three within one year. Um, once somebody reaches that point, it's kind of really uh if your physician isn't looking to other reasons as to why that infection keeps rec recurring, then they're doing you a disservice. And instead of just treating the symptoms, you need to start looking at what is actually causing this UTI and is there a way to keep it from happening again?

SPEAKER_00 6:12

Okay, so um we're talking about these infections of the urinary tract, and uh, you know, as you just mentioned, recurring is is uh you're you're having these over and over again within a certain time frame. But what

How A UTI Starts In The Body

SPEAKER_00 6:25

actually causes a UTI to start with? So let's start there. When someone gets a urinary tract infection, what's actually happening in their body?

SPEAKER_01 6:34

Yeah, most of them start with a bacteria. The most common uh bacteria that we see that cause UTI is actually E. coli, that same bacteria that we always talk about with chicken. Um, but it normally lives in the digestive tract, but then it can get to the urethra and it travels into the bladder. And once it gets to the bladder, that's when the infection really begins. So not every exposure, just like uh not every time you're exposed to a virus or a bacteria, do you get a cold or the flu? Not every time that your body is exposed to E. coli in that area, do you get an infection? But it first really has to attach to the lining of the urinary tract. And once it attaches, that's when it can start to spread and cause that infection.

SPEAKER_00 7:25

So that's kind of when when the problem comes in, that back not just the presence of that bacteria, but that bacteria actually grabbing onto the lining. How does how does that even kind of happen?

SPEAKER_01 7:35

Yeah, so there are strains of E. coli that have tiny hair-like structures called fembriae. And those fembriae kind of act like hooks or velcro that attach to uh the lining of the bladder, and then it can't be flushed out with urine, and then it just starts to grow.

SPEAKER_00 7:56

Okay, so that that seems pretty simple, right? You've got uh the E. coli and other bacteria attaching to the uterine wall and that the uterine lining, and that's how an infection starts in the first place. But as we kind of introduce this conversation, you know, many women do not just experience one UTI and get better. So what are some of, you know, you you defined kind of there the it the frequency within a certain time frame, they're getting these infections again. What are some of the main reasons that someone may be getting these over and over again? And it's not just a one-time thing that happens, they get better and move on.

SPEAKER_01 8:35

Yeah,

Risk Factors That Keep UTIs Returning

SPEAKER_01 8:36

I think there are a couple different reasons that are out there. Obviously, we talked about uh anatomy earlier being a part of the reason that women have that happen more often, and that really comes with hygiene. Making sure that you're teaching your kids how to have good hygiene and proper wiping techniques uh after going to the bathroom, that is a big part of what happens. But then there are some bacteria that are really better at sticking around or re-establishing itself on that on the bladder, um, then that can cause another infection. And then there are certain risk factors that also come into play. So if you have an increased sexual uh lifestyle or sexual activity, if you use certain forms of birth control like diaphragms or spermicides, if you're of the age that you're at menopause and you're starting to see a decline in estrogen, we know that that tends to lend itself to seeing more infections. If you haven't emptied your bladder completely, uh, you could have urinary tract abnormalities. And if you have diabetes, those can all add up to meaning you'll have a greater frequency of UTIs. And then, of course, if you've already had a UTI once, there's a greater chance that you're gonna have a UTI again. And then finally, um, it's good to remember that repeated courses of antibiotics are really necessary to treat an active infection, but they can disrupt that beneficial bacteria, disrupt the gut microbiome, and that causes you to actually be more susceptible to getting another infection because your body can't fight off the bad bacteria with the good bacteria. So making sure that uh you're not just taking antibiotics just to take them, but that there's a reason for it, and then you're replacing it with some probiotics is a big part of this strategy.

Subscribe And Share Topic Requests

SPEAKER_00 10:35

Hey, Frontline Health family. If you're enjoying this conversation, please go ahead and like this episode and subscribe to the Frontline Health Podcast. It really helps us reach more individuals who want to take ownership of their health. And comment down below what is a health topic you'd like us to investigate in a future episode. Leave your suggestions in the comments, and I promise we do read all of them. Together, we're building a community that values health stewardship. And now, let's get back to the episode. Yeah, it's pretty easy to see how that can become a cycle. Like you said, if the antibiotics that, you know, are seen as sort of the cure can also then contribute to more infections down the road, that can be a vicious cycle that kind of repeats and repeats. And we'll get into some of the lifestyle aspects of this later on in the episode. But I know one of the big things for people I have known is hydration. They don't drink enough water, and so uh they're not flushing those things out of their system frequently enough, and uh, and some other things that people can do just to kind of you know help their lifestyle and even some things that they might be able to take uh before they're experiencing an active infection, if they know that they're they're susceptible to that, that might be able to help as well. Um,

Why Antibiotics Are Not Enough

SPEAKER_00 11:48

but we do know antibiotics, if somebody gets a UTI and they go to the urgent care or they go to their primary care physician, their urologist, whoever, uh, antibiotics are going to be the first thing that they go to. So why why are why are antibiotics not just kind of like the answer? If that is, if that is what we're going to, why are antibiotics not always enough?

SPEAKER_01 12:09

Yeah, I think it's um similar to if you have an issue with your car and you treat it just long enough, say it's your battery, and you jump it, and you're able to get to another place, but maybe it's uh an underlying cause that your car is not able to recharge that battery, then it's gonna keep happening again and again. Antibiotics are similar in the sense that if you've got a bacterial infection, it's gonna kill that bacterial infection, but it doesn't necessarily keep those infections from coming back because they'll continue to attach to the bladder lining. Um and that is, especially if you've got an underlying risk factor, is one of the reasons why we see so many people coming back again and again and again with UTIs, but um they're continuing to also develop an antibiotic resistance over time just because they're being treated with antibiotics so often.

SPEAKER_00 13:08

Yeah, and I think it's important to highlight uh what we're talking about here really kind of gets at the heart of this podcast and of, you know, our company as a whole is taking ownership of your health and not necessarily waiting until things start happening in order to, you know, try to fix a problem, but really taking ownership of your health and being proactive to uh to do what you can do to make sure that you're you're gonna stay in the best health possible and being aware of those things that can happen. Um, and and we know, as you've just kind of laid out for us, treating an infection and reducing the chance of another infection aren't necessarily the same thing.

SPEAKER_01 13:44

That is exactly right, and hopefully that's what you get from this podcast and from us as a company is the idea that we want to get to the root problem of what's going on and try to avoid going towards an antibiotic if at all possible.

SPEAKER_00 14:01

Absolutely.

D-Mannose And How It Works

SPEAKER_00 14:02

So one thing that we know uh has been getting a lot of attention from urologists lately and from you know pharmacists, from anyone who has uh patients or uh or or people coming in that they are trying to help with these recurring UTIs that they're having. One of the things that is starting to be recommended is something called D-Nose. Um, there are a lot of natural ingredients, but this is one of the most studied and one that is is gaining a lot of attention today. So, Troy, I would love it if you could just talk about, you know, what D-minose is and kind of how it can help.

SPEAKER_01 14:38

Yeah, it's kind of crazy when you think about it because Dimonose is really just a simple sugar. And that simple sugar is found in a lot of fruits like cranberries, apples, peaches, and even oranges, and could be why we see so many people doing well when they drink cranberry juice or something else in trying to avoid getting uh these further bacterial infections or UTIs. So, but what is interesting about demonose is that it's not really used by the body the same way glucose is. So it's not one of those sugars that's used like glucose, but it's typically absorbed and then filtered by the kidneys into the urine, which means it's gonna end up where the urinary tract uh support is most needed. So it hits the place that we really need it.

SPEAKER_00 15:28

Yeah, and uh, and it it's really I love the way that this works. I was gonna ask if you can can kind of explain what's actually happening with the the biology of how DMOs is interacting with that bacteria, um, because it's it's really really a pretty simple mechanism.

SPEAKER_01 15:43

Yeah, so we mentioned earlier that E. coli is the main bacteria that we see with UTIs. And what E. coli does when it gets into the bladder is it actually binds to what's called a manose-containing receptor. So what researchers found is that free demonose in the urine. We just talked about how demonose is broken down and excreted through the urine and gets into the bladder. The demonose binds to those bacterial structures instead. And then that bacteria latches onto that demonose instead of the bladder lining, which means it's then flushed out during urination, and you no longer have that bacteria attached to your bladder.

SPEAKER_00 16:28

So instead of like the antibiotics that are trying to kill the bacteria, what the manose basically does is it just binds with that bacteria so that your body is able to flush it out a little bit easier and it doesn't have the chance to bind to the lining.

SPEAKER_01 16:44

That's right. And and it gives your body enough time to really break down that bacteria on its own and making sure that it's not multiplying on the lining to then cause that urinary tract infection.

SPEAKER_00 16:56

Makes a lot of sense. And uh, and it really is cool how simple some of these things uh can be when you when you look at it. Um,

What The Research Shows

SPEAKER_00 17:04

I know one of the things that we always want to ask, there are a lot of fad supplements that hit the market. You know, there are stories, people go crazy about them. Some of them uh there is a lot of promise behind, and people get great results from, but some of these uh these things that people talk about online are not necessarily backed by research. So we want to ask the question what is the research saying to us about demonos?

SPEAKER_01 17:28

Yeah, I think uh the evidence on this is really pretty encouraging. So there have been several clinical studies that have shown demonose may actually help recurrent UTIs in some individuals, particularly those infections that are caused by E. coli, which we already talked about because E. coli goes to and binds with the demonose as opposed to the bladder wall. And other trials have shown that recurrent rates have gone down comparable to certain preventative antibiotic strategies. So instead of taking an antibiotic on a regular basis to try to prevent that, they're giving them demonose, which is super promising and super helpful because you're not going to have antibiotic resistance that builds up. So I think it is certainly a potential tool for urinary tract health that deserves our attention and probably deserves to be tried. But understanding that just like with any medication, even if it's a prescription, whatever you take may not work for you. It's not going to work for everybody, but it is, and it may depend on what the uh bacterial infection actually is. Because if it's not E. coli, there's a good chance it may not work for you.

SPEAKER_00 18:41

Yeah, that's that's absolutely right. And um, you know, we're not giving anybody any medical advice. We would always encourage, you know, anyone who is considering taking something new, you know, talk with your healthcare provider about what is what is right for you. But can you paint a picture for us of, you know, the a candidate who might consider starting to take demonos?

SPEAKER_01 19:01

Yeah, I mean, I think if anybody has been experiencing recurrent UTIs, it's similar to being um told by your doctor to start drinking more cranberry juice. This is just another opportunity to give your body a chance to fight off whatever bacteria it may be. And we know that especially anyone who's had issues with E. coli, that is going to be a super uh target for somebody to take demonos and they will be a great candidate to take it and have some good effect from it. But I think it's always important to remember that if you have persistent symptoms like fever, pain in your sides, if you get blood in your urine, especially, or if you're a man and you start to get infections, those could be signs of something a little bit more dangerous, and you should not wait and go get evaluated by a healthcare professional as soon as possible.

SPEAKER_00 19:57

Okay, so so thank you for breaking that down, Troy. That's um that's a lot on Demonos. Uh we know that there, as we mentioned earlier, there are a variety of things that can that people can do to really take ownership of their health if they have been struggling with recurring UTIs and they want to do everything that they can do within their power to make sure that their body has the best chance of not getting these or of being able to, you know, manage these infections when they do set

Supplements And Lifestyle Prevention Tips

SPEAKER_00 20:26

in. So can you talk about maybe, you know, are there other things you mentioned, cranberry juice a minute ago or lifestyle modifications, things that people can do to really take ownership of their health if they're dealing with or concerned about urinary tract infections?

SPEAKER_01 20:41

Yeah, I think we can start with those supplements. So we talked about cranberry juice, cranberry extract, taking them in capsules, hibiscus is another one, dandelion. So it seems like demonos, cranberry, hibiscus, and dandelion have the best data behind them on how to use a supplement or in order to use a supplement to help reduce UTIs. But you mentioned one, another one earlier, staying well hydrated. I think that is a key because that's gonna help flush all those toxins and bacteria out of your body, you know, making sure that you're emptying the bladder regularly, uh, urinating after sexual activity, uh, because that certainly holds on to bacteria, managing those underlying conditions that we talked about, like diabetes. So if you can get that under control, there's gonna be less likelihood of developing a UTI. And then avoiding using antibiotics while you're uh treating infections. If you don't have to use an antibiotic, that's gonna be big because you're not gonna mess up your gut microbiome and keep your body from being able to fight off those infections on its own. And then, of course, working with your doctor or healthcare provider if you get infections on a regular basis, because they can come in and give you a plan and a strategy, if they're good, to help you overcome these recurrent UTIs that you're having. And hopefully peg what's really going on.

SPEAKER_00 22:13

That's amazing, Troy. Thank you so much for sharing just those helpful tips with people for how they can can take ownership of their health. And,

Warning Signs And Final Takeaways

SPEAKER_00 22:20

you know, today's takeaway, I think, is that, you know, recurring urinary tract infections, they often involve more than simply catching another infection. There's a lot that goes into it. Understanding how bacteria attached to the urinary tract has opened the door to new nutritional approaches like D-Menos that may help people support urinary tract, their urinary tract health. And as always, don't ignore the symptoms of a UTI. If you think you have one, especially if you're experiencing a fever, severe pain, vomiting, or you're pregnant, be sure that you're seeking medical care promptly. If you enjoyed today's conversation, be sure to subscribe, share this episode with someone who could benefit from it. Even if you have not dealt with urinary tract infections, there are so many people who do. And uh, and be sure you leave us a review on this podcast. It helps us reach more people with evidence-based health education like what you heard today. So, as always, go out, take ownership of your health because you are your best health advocate. We'll see you next time on the Frontline Health Podcast.