Beyond the Bathroom: How I Conquered Chronic UTI with Breathwork, Diet and a Holistic Approach

Could an innocent fall in the playground with my children really have caused an 18-month UTI nightmare?

Well, that’s one version of events. The other version is a little less children’s playground and a little more adult in nature but either way, it seems there was a price to pay for fun back in 2022. And the payment was 18 months of Chronic Urinary Tract Infection, more antibiotics than my gut microbiome cares to recall and at times, real exasperation feeling lost at sea with a health condition that no-one seemed to understand.

UTI is one of the most common types of bacterial infection, particularly amongst women. The NHS reported 1.8million UTI related hospital admissions in the last 5 years. One in 5 of us will have at least one UTI in our lifetime and 30% of those lucky devils will end up having recurrent UTIs. Joy. It seems the unjust laws of nature and the uncharitable female anatomy are once again culpable for the prevalence of the condition. From urethra length to hormonal changes during menopause, chuck in the unwelcome receipt of a little gut bacteria during sex, it’s easy to see why home dipstick kits have become a bathroom cabinet staple.

But this is no new phenomenon. UTI statistics haven’t suddenly surged. Pesky bacteria entering and colonising in the urinary tract has always been a frustrating driver of many a doctor’s visit but like plenty of other female health related issues, our awareness is only just peaking. We are only now removing ridiculous taboos and asking why on earth this condition that effects so many of us isn’t better understood?

Because I love a wee chat in the gym changing rooms with my female acquaintances and clients (the most reliable of scientific surveys) I now understand how common this is.  I also realise how fortunate I was to get through the first 4 decades of my life without so much as a burning trickle. But since I got my first UTI in Spring 2022, my poor bladder has been through the mill and more people have peeked between my legs than any respectable girl ought to admit. So, take this as your cue to grab a cranberry juice and buckle up for the UTI Chronic-les. It’s a real party down there, folks.

My debut infection came on fiercely. I went from wine tasting on an Essex vineyard one sunny Spring Saturday (true story) to shivering under a blanket on the sofa before I could say Chardonnaaayy (with an Estuary ‘aaay’). It was an NHS 111 emergency by evening and I had an infection confirmed and broad spectrum antibiotics in my handbag by midnight (god bless our NHS.) Naively thinking that my foray into water woes was done and dusted, I forgot all about it after 3 days of Nitrofurantoin and the revival of BAU down south. But lo and behold, not even 3 weeks passed until I was back on the sofa with the chills and the return of my one peculiar symptom that had my urine smelling like I’d eaten a tub of Haribo mixed with a vat of asparagus. (Which to be fair, I assumed was a legit side effect of the new super powered vitamin supplement I was experimenting with at the time, AG1 Greens.) Copy and paste the above and apply it to the next 6 months. I didn’t get through 1 month without an infection rearing its ugly head. No sooner had I popped my last antibiotic and celebrated a week or 2 of untroubled waters than the dreaded symptoms returned. Triggered often by sex or alcohol, and always by sex and alcohol, was the Universe trying to elbow me into abstinence and sobriety? Not without a fight, Universe.

Needless to say, by this point, feeling confused and fed up, I took things to the next level and went to see a Urologist. To date, my urine hadn’t been sent to a lab to be tested for specific bacteria so the treatment I’d been having was definitely a roll-of-the-dice style approach. Diagnostic investigations included a cystoscopy (a peek around the bladder with a camera), urine flow rate measurement (ie – length of time taken to empty said bladder and speed at which that occurs), kidney scan and urine culture (growing microorganisms in a lab to find out which bacteria are causing infection.) Findings were Interstitial Cystitis (IC), which is severe inflammation of the bladder wall and a painfully slow flow rate caused by a narrow urethra, resulting in me not emptying my bladder fully (because it’s more fun to watch paint dry and I’m a busy woman, init.) And as it transpired, the guilty party of bugs in my bladder proved, in fact, to be resistant to most of the antibiotics I’d been taking. Brilliant! Not only did this explain the infection-boomerang but it’s also a fast-track plus speedy boarding pass, into the world of Chronic UTI.

UTI is considered ‘chronic’ when two or more infections occur in 6 months or more than 3 in one year. I was off the charts chronic averaging 1 infection per month! What an accolade. The mischievous bacteria responsible for chronic UTIs can be understood as the squatters of the urinary tract, not only stubbornly refusing to vacate, but often, making themselves way too comfortable that they become immune to any eviction notice. In other words, they become resistant to antibiotics. This is where it gets science-y and pretty complicated, not only to me but seemingly, also to the medical professionals. UTI can become ‘embedded’. This unwelcome phenomenon occurs when the bacteria manage to penetrate the protective layers of the bladder, establishing a stubborn foothold within the tissue. They form a kind of networked community and become shielded by a protective slimy material known as a ‘biofilm’. The biofilm protects the bacterium from antibiotics and therefore enables its survival. It’s akin to an ongoing battle between the body’s natural defences and these persistent microbes, resulting in an infection that lingers and challenges conventional methods of eradication. Not only is embedded UTI difficult to diagnose but it is equally difficult to treat.

At this stage, about a year into my bladder misfortunes, infection rate a distressing double figure reckoning and ratio of questions to answers entirely lopsided, it was time to level-up once again. My own late-night scouring of the internet for information and resources on embedded UTI, led me to an appointment with renowned Consultant Urogynaecologist at King’s College Hospital, London, Mr Dudley Robinson. Similar to being whisked into a First-Class Business Lounge from an Easy Jet economy nightmare (one can only imagine) you’ll be as relieved as my gut microbiome to know that answers and solutions were but (another) cystoscopy away.

Robinson, Consultant Obstetrician, Gynaecologist and specialist Urogynaecologist who undertook a research Fellowship under the late and great Professor Linda Cardozo, was a breath of fresh air. His approach was holistic, citing the likelihood of other contributing factors such as hormone levels and pelvic floor functionality. Who knew? The next level investigations involved ‘enhanced urine testing’ (to screen for less common, more fastidious bacteria), a bladder biopsy (to look for those critters embedded deeper in the tissue) and ‘urodynamics’ testing which is a procedure that looks at how well the bladder, urethra and associated musculature store and release urine. This last method is not for the faint-hearted nor the prudish. Thankfully, I am neither, and frankly, I’ll take a rectal catheter over chronic UTI any day. IYKYK.

Just when I thought things would NEVER end (a bit like this article) and things couldn’t get more convoluted (apply same comment), a firm diagnosis and plan of action was put into place. HALLELUJAH! The detection of a ‘fastidious’ (less common and more sneaky) bacteria, confirmation of embedded infection, and, rather more pleasingly, diagnosis of a ‘hypertonic’ pelvic floor. This occurs when muscles of the pelvic floor become too tense. (Is it ok to be proud of this one, two children later? Or am I clutching at straws?)

Mr Robinson’s treatment plan involved long-term low dose antibiotics, long-term Hiprex, which is an antibacterial medication that changes the pH of the urine making it an unfriendly home to bugs and a referral to a Pelvic Health Physiotherapist. But it didn’t end there. In fact the real treatment had only just begun. I decided, it was time to kick those unwelcome guests out with a wellness crusade. Kill them with kindness, if you will. My urinary tract, my gut health and my entire body was given the VIP treatment for the next 3 months. Complete with cranberry cocktails, D-Mannose mocktails, daily doses of fermented foods and high fibre fancies, a formidable army of antibiotics, zero (ish) booze and plenty of hydration, it was a UTI showdown and I was there to reclaim my health! You may well be asking what fermented foods have got to do with UTIs and you’d be right to do so. Kimchi, sauerkraut and kefir have all been flying off the supermarket shelves in the past few years, thanks to the advice of nutritional and scientific thought-leaders and, well, Instagram. But the significance and impact of our gut health is definitely not just a grid-shaped fad. As cited by the scientists behind ZOE, the leading health-science and nutrition study; “a healthy gut microbiome is vital for a healthy immune system. It plays an important role in regulating your immune system so that it responds to injury or infection but doesn’t attack healthy body tissue.” Needless to say, a total of 18 months of antibiotics would have annihilated my ‘good’ gut bacteria, so it was time for the ultimate microbial makeover.

Circling back to my attention-grabbing headline, I refer to a fall I had whilst showing off doing the monkey bars in the park with my kids. I fell, rather spectacularly, right on to the left side of my coccyx leaving me with pain in my left glute, hip and lower back, even to this day. How is this relevant you may be asking? Bear with, Dear Reader, bear with. The last but by no means least noteworthy stop on the UTI Express sojourned wearily at Lidder Therapies, for an appointment with the very lovely Bally Lidder, Pelvic Health Physiotherapist. To my relief and gratitude, Bally was so knowledgeable about UTI and hypertonic and overactive pelvic floor but she was also interested in the fall and associated pain I had been experiencing. And lo and behold, on examination, she found that all the internal muscles around the left side of my coccyx, core, pelvic floor and glute were super ‘grippy’ and in a state of constant contraction, causing an overactive pelvic floor. Bally explained that my body may have gone into spasm as a trauma response after the injury resulting in the surrounding deep tissue muscle over-functioning. Not only could this have been causing the pain but it was also responsible for the increased pressure on the urethra and subsequent difficulty in fully voiding my bladder. Huzzah! It was all making sense! At last. The body really does keep the score, doesn’t it? Bally focused on releasing my glute with acupuncture and she prescribed daily breathwork to relax, let go and lengthen the pelvic floor. Now this was my language! As a yoga teacher and a breathwork and meditation convert, I was right on it. Part of my night-time routine has since been breathwork (whereby you relax and soften the PF on every diaphragmatic inhale) in positions like happy baby, child’s pose and malasana. I’ve eased off over-training my core in the gym too, and always make sure I get a deep stretch into my glutes, on Bally’s recommendations.

So, there you have it – the epic saga of the UTI Chronicles. From bathroom battles, to hospital procedures via a labyrinth of catheters, an army of antibiotics, a side of kimchi and a belly of breath, I’m VERY happy to declare my bladder is officially a UTI-free zone! It’s time to retire my honorary membership to the “Frequent UTI Flyers Club” with the very real take-home that addressing medical issues is very often, multifactorial. It’s like playing 4D chess – it’s not a one-move checkmate. Just as life isn’t a single-note melody, health concerns often require a symphony of interventions. So, if you’re feeling lost at sea with a condition; accept the complexity, embrace the nuance and compose a multi-dimensional solution that orchestrates well-being in harmony.

UTI – it’s been real.