Probiotics for UTIs

Urinary tract infections (UTIs) can be uncomfortable, and if you have one, you’ll likely want treatment fast. While antibiotics are the standard treatment, there are other ways to support your health while experiencing a UTI, including hydrating often and using probiotics.

Probiotics offer a natural way to support your health during and after antibiotic treatment, helping to maintain a balanced and healthy urinary tract.

In this blog, we’ll explore how probiotics may aid in the prevention and management of UTIs, and how to incorporate probiotics into your routine.

Understanding UTIs and their causes

If you’ve ever had a UTI before, then you’ve likely experienced their hallmarks — urinary urgency, pain, stinging, and in severe cases, back pain.

Other common symptoms of UTIs include:

• Foul-smelling urine
• Cloudy urine
• Passing only small amounts of urine despite feeling an urgent need to go
• Pressure or cramping in the lower abdomen

While it can happen to anyone, women are more likely to get a UTI than men. This is because UTIs are usually the result of Esherichia Coli (E. Coli) bacteria migrating from the rectum to the urinary tract. Since women have shorter urethras than men, the bacteria has a shorter distance to travel to enter their urinary tract.

Women experience other factors that can also increase their risk. For example, the decrease in estrogen that perimenopause triggers can thin the tissue of the vagina and decrease its natural lubricants. This, in turn, can affect the natural pH of the vagina, making it easier for problem bacteria to thrive there.  

Sexual activity is another big driver of UTIs since it can transport bacteria from the skin to the opening of the urethra. Similarly, improper hygiene practices like wiping from front to back can import bacteria from the anus into the urinary tract. And, anything that can affect the bacterial composition of the vagina or alter its pH — like douching or using spermicide — can also be a source of trouble.

Beyond these, additional risk factors include:

• Diabetes
• Taking certain epilepsy and diabetes medications (SGLT-2 inhibitors)
• Catheter use
• Immunosuppression
• Pregnancy 

The role of probiotics in UTI prevention

There’s no one ideal microbiome. A variety of different factors can affect it including your diet, age, whether you take certain medications and yes, antibiotic and probiotic use. As a result, the composition of microorganisms that call each one of us home is as unique as its host.

However, while each person’s bacterial composition is different, a healthy urinary tract should contain specific populations of bacteria.

If your inner microbiome is out of balance, whether it’s in your urinary tract or your gut, it can lead to health issues and an increase in infections.

Probiotics can help to rebalance your body’s colonies of beneficial bacteria. For starters, these beneficial bacteria can actually form a protective film on the inside walls of the urinary tract. This makes it more difficult for pathogens to gain a toehold there, helping to enhance your body’s response to harmful pathogens in the urinary tract.

That’s not the only way that probiotics contribute to immune system function. Since upwards of 70 to 80% of your immune system is located in your gut, taking probiotics may improve your body’s overall ability to respond to infections.

In the same vein, rebalancing your gut microbiome may help to lower the number of E. coli bacteria in your digestive tract. Since this is the bacteria that’s most often responsible for causing UTIs, reducing its numbers lessens your risk of contracting one in the first place.

Types of Probiotic Strains for UTI Prevention

If you’ve taken probiotics before, you’ve likely heard of Lactobacillus. However, you might not know that there are more than 160 different species of Lactobacillus out there.

Not all of these have been researched in depth. However, of those that have, data confirm that at least some of them are helpful at preventing UTIs.

If you’re looking to take a probiotic to reduce your UTI risk, some studies have shown benefits with the following species of Lactobacillus on its label:

• L. rhamnosus GR-1

• L. reuteri RC-14 (previously known as L. fermentum RC-14) 

1. casei shirota and L. crispatus CTV-05 were effective in some small studies, while L. rhamnosus GG had a negligible effect.

Effectiveness of Probiotics in UTI Treatment

While behavioural changes and good hygiene practices can help to minimize your risk, they can’t always stop you from getting a UTI. The microbes in your urinary tract also play a key part. They can help protect you against pathogenic microbes if they’re robust.

On the flip side, if you don’t have enough beneficial bacteria in your urinary tract, you can become more susceptible to UTIs. The good news is that probiotics can help.

Probiotics restore the bacterial balance in your body by promoting the growth of beneficial microorganisms. And studies show that they work —women who took probiotics had fewer UTIs than those who didn’t.

Probiotics help do this in a few different ways. For starters, having certain “good” strains of bacteria means that there’s less room for “bad” bacteria to take up residence.

Lactobacillus are especially important in this equation because they’re lactic acid bacteria. This means that they ferment carbohydrates to produce lactic acid. In addition, they also produce antibacterial peptides or bacteriocins which, together with lactic acid’s antimicrobial properties, kill “bad” bacteria.

Lactobacillus also increases the acidity of the urinary tract. While this may sound like a problem, a slightly acidic pH actually makes the urinary tract less hospitable for UTI-causing bacteria.

Combining probiotics with antibiotics

The discomfort of a UTI makes speedy relief a must. Thankfully, antibiotics are a highly effective treatment option that goes to work almost immediately. Most people begin to experience some symptom relief within 24-48 hours of beginning their course of antibiotics.

However, antibiotics don’t just kill the harmful bacteria that’s infecting your urinary tract. They also eliminate many of the beneficial organisms that inhabit the gut, disrupting its natural balance. Studies back this up, showing that individuals treated with antibiotics had higher levels of pathogenic species and lower microbial variety afterwards. 

Since antibiotics can unintentionally affect beneficial bacteria and their intended targets, you might think there’s no point in taking probiotics while on antibiotics. However, you can effectively combine the two treatment modalities— you can either take them together or leave two hours of time between when you take your antibiotic and probiotic.  

How to incorporate probiotics into UTI prevention

Beneficial populations of bacteria may provide protection against infection. Unfortunately, since they often end up as collateral damage during antibiotic treatment, it’s a frustrating truth that treating a UTI can increase your risk of developing a future UTI.

Luckily, incorporating probiotics into your daily routine can be an effective way of maintaining good urinary tract health and avoiding recurrent urinary tract infections. In fact, studies show that taking probiotics preventatively may reduce recurring UTIs by as much as half. 

Since probiotics are live microorganisms, make sure to store them according to their label’s direction. For example, if they’re supposed to be refrigerated and you leave them on the counter, this could reduce their potency — or even stop them from working altogether.

Probiotics can provide a valuable complement to antibiotics when it comes to treating urinary tract infections. They can also be a potent tool for preventing future ones.

However, if you’re dealing with the discomfort of a UTI right now, antibiotics could be your best treatment option. Connect to a primary care provider on Maple today for advice from a Canadian-licensed doctor or nurse practitioner in minutes, no matter where you are in Canada. 

The information presented here is for educational purposes and is not meant to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency, like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.