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I am 61yrs old. I have suffered from recurrent UTI’s for past 30yrs since having last child by C section. I have had dozens of antibiotics, 3 urethral dilutions, and bladder installation. I have tried all the self help such as hygiene,oestrogen cream,no sex,no alcohol,good balanced diet, probiotics etc. But still i would get 2-3 infections a year. GP’s and urologists not very helpful.
For the past year I have been under Prof ML. I had a bad bout last July that took until October to get sorted to find correct AB . Have been taking Trimethroprim since September. So have been on AB since last July!
All was going well. Saw Prof ML 2 days ago and was advised to start reducing dose but last night problems started out of the blue. What I would like to know iis it possible to have a urine count of neg to leucocytes, Pyuria 2 only, and within 36 hours get another infection/flare. Could it just be inflammation from something in the diet.
What is the best way to treat a flare...I know this may be very individual. Could you please define a “flare” for me.
I want to visit my daughter in Australia but cannot face travel or feeling so unwell indefinitely. To make things worse I react to AB with rash and shortness of breath. Taking antihistamines helps which makes me believe I have a histamine problem from either the infection or drug. I tested negative for allergy . Is this something others have experienced?
I am hoping this present episode is just me overreacting and is just me stressing out.I have informed Prof ML as he requests and so await advice.
Thanks to all who post on this forum. It is of great support and very informative.

Posts: 1,141
Reply with quote  #2 
Good to read your news that things are slowly turning the corner after such a long period of time and all that you have been through and tried.

Prof often likes people to reduce down or stop their abs after a period of good health and test the reaction of the bladder. Don’t be disheartened if you flare up, this is very common, it can take several goes before things really calm down. You have done the right thing in contacting Prof, he will advise what to do.

Flares can be common and triggers can include:

when not on medication
having had sex
eaten or drunk a trigger food or alcohol
under extreme stress causing the immune system to lower
during periods of travel such as flying
the bladder lining naturally shedding and releasing bacteria
when taking antibiotics or antimicrobials early in treatment due to the bacterial reaction
the hormonal effects of the menstrual cycle, perimenopause or menopause
When the bladder is irritated, bacteria from within the biofilm/intracellular infection can be released and cause pain. These active (known as planktonic) bacteria in the bladder. Additionally, bacteria release toxins into the bladder causing more pain.

The following advice for a flare and also whilst you are travelling may help:

Try to relax
Take lots of deep breaths to avoid stress
Drink lots of water and soothing herbal teas such as camomile
A teaspoon of baking soda, bicarbonate of soda or potassium citrate in a glass of water 2-3 times a day can relieve pain by reducing the acidity of urine (please check with a GP if on a low sodium diet).
Azo Urinary Pain Relief can help (this can be purchased online if not in the USA where it is available over the counter)
An ice pack will numb and distract the nerves causing pain and provide relief. A hot water bottle can be placed on the abdomen or lower back
Over the counter pain relief will help with pain and fever
An antihistamine to calm the histamine release which will agitate the bladder nerve endings
If at all possible please rest

If symptoms deteriorate significantly, breathing issues are experienced, there is chest pain, loin or back pain and high fever immediately seek assistance via Accident and Emergency or the Emergency room. Always take any medications currently prescribed to show the emergency doctors including those that are for non-bladder related conditions.

What essentials should be packed for a holiday?
Its probably best to pack meds in hand luggage in case hold luggage goes astray. Also adequate travel insurance and/or a European Health Insurance card (if based in the UK travelling to the EU) in case of the need for GP or medical assistance whilst away.

Any antibiotics or natural antimicrobials currently prescribed – always pack enough to cover in case of travel delays at the end of a holiday
Any natural supplements – D Mannose, Oil of Oregano, Urva Ursi etc. Do not assume these can purchased in the holiday destination
Prescribed meds for other non-related bladder conditions – again enough to cover in case of travel delays
Probiotics and Sacchro B – ideally those that don’t need to be refrigerated
Pain relief
A tub of bicarbonate of soda or potassium citrate to help with flares and to alkaline the urine or Cystitis relief sachets
A mini hot water bottle
Antihistamine tablets
Thrush or Bacterial Vaginosis medication
The latest correspondence from your specialist to the GP (either in electronic format or hard copy).
A repeat medication letter from your GP to cover for non-bladder related meds should they run out and you need to seek medical assistance.
Rehydration sachets and diarrhoea medication in case of holiday tum
A meditation or mindfulness app for the phone or tablet to help with stress or flares

Why does the bladder flare when travelling – particularly on a flight? It is thought that stress in general can cause bacteria to be released by the bladder wall into the bladder as the host immune system defences are weakened. A combination of the additional bacteria and histamine release picked up by the nerve endings in the bladder causes an increase in pain, leading to a flare up in symptoms. Additionally, the build up to a holiday can cause additional stress with extra work hours, trying to organise the family to pack, remembering those all important pre holiday checklist items or simply worrying about a holiday flare.

Mast cells in the bladder react to any form of vibration, change in cabin pressure or eating reheated, pre-prepared high histamine airline meals and can release histamine into the bladder causing a flare up. It may be worth packing and/or taking an antihistamine for a few days beforehand such as Ranitidine or Cetirizine which are over the counter medications. This may also help with pre-holiday stress which can also trigger a histamine release.

Remember gut bacteria produce histamine so any change in diet on holiday or a case of holiday tum can alter the gut bacterial balance causing histamine release and gut inflammation. Make sure a good probiotic is packed to help settle the gut and to keep histamine/gut bacterial overload in check.

When you next see Prof and before you travel, ask him to include in his letter what you should do if you experience a flare up in symptoms. That way if you do travel you have the letter and if needs be can go to a GP and get meds if things flare up and you haven’t travelled with enough meds. Prof can also fax a prescription through to either a pharmacy or your daugther’s GP practice but you will need to see the GP to convert it into an Australian prescription as they cannot accept international prescriptions and issue meds. Should add that they sell Hiprex over the counter in Australia with no prescription needed.

If its any help, I spent 3 months last year in Oz and NZ with a very well behaved bladder. I was dreading travelling as I had had a nasty E. coli infection a couple of weeks previously which took its time to settle just before and the first few days of the holiday. Ironically I had to take some antihistamines for mosquito bites at the same time and within 24 hours my bladder had calmed completely., Looking back now would do it all over again in a heartbeat. Go see your daughter.

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