Understanding urinary tract infection

Urinary tract infections (UTIs) are common infections that can affect the bladder, the kidneys and the tubes connected to them.

Anyone can get them, but they’re particularly common in women. Some women experience them regularly (called recurrent UTIs).

Symptoms of UTIs
Infections of the bladder (cystitis) or urethra (tube that carries urine out of the body) are known as lower UTIs. These can cause: a need to pee more often than usual; pain or discomfort when peeing; sudden urges to pee; feeling as though you are unable to empty your bladder fully; pain low down in your tummy; urine that is cloudy, foul-smelling or contains blood; and feeling generally unwell, achy and tired.

When to get medical advice
It is a good idea to see your General Practitioner (GP) if you think you might have a UTI, particularly if: you have symptoms of an upper UTI (see above); the symptoms are severe or getting worse; the symptoms haven’t started to improve after a few days; and you get UTIs frequently.

Your GP can rule out other possible causes of your symptoms by testing a sample of your urine and can prescribe antibiotics if you do have an infection.

Antibiotics are usually recommended because untreated UTIs can potentially cause serious problems if they’re allowed to spread.

Treatment for UTIs
UTIs are normally treated with a short course of antibiotics.

Most women are given a three-day course of antibiotic capsules or tablets. Men, pregnant women and people with more serious symptoms may need a slightly longer course.

Your symptoms will normally pass within three to five days of starting treatment. But make sure you complete the whole course of antibiotics that you have been prescribed, even if you’re feeling better.

Over-the-counter painkillers such as paracetamol can help with any pain. Drinking plenty of fluids may also help you feel better.

Return to your GP if your symptoms don’t improve, get worse or come back after treatment.

Causes of UTIs
UTIs occur when the urinary tract becomes infected, usually by bacteria. In most cases, bacteria from the gut enter the urinary tract through the urethra.

This may occur when wiping your bottom or having sex, for example, but often it is not clear why it happens.

The following may increase your risk of getting a UTI: conditions that obstruct your urinary tract, such as kidney stones; difficulty emptying your bladder fully; using a contraceptive diaphragm or condoms coated in spermicide; diabetes; a weak immune system – from chemotherapy or Human Immuno-deficiency Virus (HIV), for example; a urinary catheter (a tube in your bladder used to drain urine); and an enlarged prostate gland in men.

Preventing UTIs
If you get UTIs frequently, there are some things you can try that may stop it coming back. However, it’s not clear how effective most of these measures are.

These measures include: avoiding perfumed bubble bath, soap or talcum powder around your genitals – use plain, unperfumed varieties, and have a shower rather than a bath; going to the toilet as soon as you need to pee and always emptying your bladder fully; staying well hydrated; wiping your bottom from front to back when you go to the toilet; emptying your bladder as soon as possible after having sex; not using a contraceptive diaphragm or condoms with spermicidal lubricant on them – you may wish to use another method of contraception instead; and wearing underwear made from cotton, rather than synthetic material such as nylon, and avoiding tight jeans and trousers.

Speak to your GP if these measures do not work. They may suggest taking a long-term course of antibiotics or they may give you a prescription for antibiotics you can use as soon as you experience symptoms of a UTI.

There is currently little evidence to suggest that drinking cranberry juice or using probiotics significantly reduces your chances of getting UTIs.

Dr. Anthoney Nwaoney is an epidemiologist