Everything you need to know about UTIs
Need to pee more often than usual, and it burns when you do? Or is your pee cloudy, and accompanied by a high temperature? You might have a urinary tract infection (UTI). While incredibly common, UTI symptoms can be extremely uncomfortable and may make you feel very unwell.
Left untreated, a UTI can develop into something more serious, so it's important to speak to your GP. Here, we speak to Dan Wood, consultant urological surgeon of London Urology Associates at The Princess Grace Hospital, and Dr Chiraush Patel, lead GP at (med)24, about UTI symptoms, common causes, and antibiotics for UTI:
What is a UTI?
There are different types of UTI, ranging from cystitis – characterised by mild but distressing inflammation limited to the bladder – to severe infections of the kidney, such as pyelonephritis, which occurs when the infection has reached the kidney tissue.
'UTI is an infection of the urinary tract which includes the urethra, bladder, ureter or kidney,' says Dr Patel. 'It typically occurs when bacteria enters the urinary tract via the urethra and begins to multiply in the bladder.'
Common UTI symptoms
UTI symptoms can differ depending on whether the infection affects the lower part of the urinary tract – bladder and urethra – or the upper part of the urinary tract, which encompasses the kidneys and ureters. Common UTI symptoms include:
Generally feeling tired and unwell
Cloudy or foul-smelling urine
Increased need to urinate
Pain or burning when urinating
Blood in your urine
Lower abdominal pain
A high or very low temperature
Feeling hot or shivery
Older people are more susceptible to a UTI for a few reasons – a weaker flow of urine (meaning the bladder doesn't empty fully), an enlarged prostate, or incontinence associated with stroke or dementia. Additional symptoms may be present, including:
Behavioural changes
Confusion or agitation
Incontinence that is worse than usual
New shivering or shaking
It's possible for children to contract a UTI. When young children experience UTI symptoms, they may wet the bed or be sick. Babies may be irritable and refuse to feed properly.
UTI causes
A UTI is usually caused by bacteria, often from poop, entering the urinary tract. This can happen when there is a problem with emptying the bladder completely, or if there are stones in the urinary tract.
'Although the body's defence system is designed to keep the bacteria out, there are occasions when this fails, and there are risk factors that can increase this likelihood,' says Dr Patel. These include:
Anatomy
Sexual activity
Menopause
Foreign bodies e.g. birth control
Retention of urine
There's a reason UTI symptoms are much more common in people with vaginas. 'The urethra is much shorter,' says Wood. 'It's rare for men to get infections, and if they do, they need investigation. It's much more common for women, and they would usually only need investigating if they have a severe infection or if the infections are recurrent.'
💡 Women are at considerably greater risk of developing a UTI than are men. However, the risk for men increases with age, with the frequency similar in men and women over 60. 💡
Will a UTI go away on its own?
When UTI symptoms develop, the infection is unlikely to go away without some management, says Dr Patel. 'For mild UTI symptoms, such as cystitis, lots of fluids as well as anti-inflammatories may be enough to manage the condition,' he says. 'However, if symptoms are getting worse or not improving within 48 hours, it is important to see a health professional to consider antibiotic use. If you have an associated fever or loin pain, it's important to seek immediate medical attention.'
Men with a UTI should always see a doctor and be investigated, because they will almost certainly need antibiotics. Following a positive urine sample, your GP or healthcare provider will usually prescribe specific antibiotics for UTI. Sometimes over-the-counter remedies are recommended, too. 'Drinking cranberry juice has traditionally been recommended for treating cystitis, but large studies suggest it does not make a significant difference, so stick to water,' says Wood.
How can I get instant relief from a UTI?
Take these steps to reduce the risk of a UTI, and ease early and mild UTI symptoms:
✅ Drink plenty of water: 'Water helps dilute the urine and ensures you will urinate frequently to help flush out bacteria early and often,' says Dr Patel.
✅ Avoid drinks that irritate the bladder: 'Caffeine, alcohol and carbonated drinks are known to irritate the bladder, which will likely compound symptoms during a UTI,' he says.
✅ Avoid potentially irritating hygiene products: 'Douching, powders and sprays in the genital area can irritate the urethra making symptoms worse,' says Dr Patel. 'They can also affect the pH and 'healthy bacteria' in the genital tract, which can increase UTI risk.'
✅ Avoid sex until symptoms have resolved: 'Not only is sex likely to be painful, but it can introduce new bacteria and push them further into the urinary tract,' he says.
✅ Increase vitamin C: 'Vitamin C strengthens the immune system and may help acidify the urine to prevent infections,' says Dr Patel.
✅ Consider D-Mannose:'This is a type of sugar related to glucose and contained in many fruits such as cranberries,' he says. 'It's thought to help block certain bacteria from growing in the urinary tract.'
Pregnancy and UTI treatment
If you are pregnant, is taking antibiotics for UTI safe? 'The short answer is yes,' says Wood, 'but make sure your doctor knows you are pregnant and how far through your pregnancy you are. It can make a difference to the type of antibiotic that it is safe to give you.'
Potential UTI complications
The most urgent UTI complication is sepsis, which occurs when the infection spreads to the blood. 'Occasionally, infections can cause damage to kidneys if they are recurrent or severe,' adds Wood. Always contact your doctor if you develop any UTI symptoms.
⚠️ Prostatitis, the infection or inflammation of the prostate – a gland beneath the bladder that produces some components of semen – causes symptoms that can be mistaken for UTI in men. ⚠️
How long does UTI last?
How long a UTI lingers for depends on the type of infection. Bladder UTI symptoms typically go away within 24 to 48 hours of starting treatment. If you have a kidney infection, however, it may take one week or more for UTI symptoms to go away.
If a UTI just won't go away, it's essential to identify and treat the underlying cause. 'Patients who have the same infection coming back can sometimes be managed successfully by attending to 'bladder toilet',' says Wood. This means:
Not 'holding pee in', and trying to empty your bladder fully
Always passing urine at bedtime and after sex
Wiping from the 'front to the back' after peeing or pooping
Taking a shower instead of a bath and avoiding bubble baths
If these measures fail, six months of low-dose antibiotics may be required.
Last updated: 26-05-21
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