Urinary Tract Infections - Symptoms & Causes
A urinary tract infection is when your bladder, urethra or kidneys become infected with bacteria.
UTIs are common in women but affect men too. While most people experience mild symptoms, UTIs can have serious health implications.
What is a UTI?
A UTI is a urinary tract infection, which means that the bladder, urethra or kidneys have become infected. The most common symptoms are changes to your pee or pain when you pee, but you can also have a high or low temperature and pain in your back or tummy.UTIs have different names for the parts of the body they affect:
- bladder infection: cystitis
- urethra infection: urethritis
- kidney infection: pyelonephritis
You might also hear doctors refer to the lower urinary tract (the urethra and the bladder) and the upper urinary tract (kidney and the tubes that connect the kidney to the bladder). Upper UTIs are less common but can be more severe.Both men and women can get UTIs. However, studies suggest that they are more common in women and affect 8 women for every 1 man. This is because of men's and women’s physical differences. For women, getting a urinary tract infection is easier because women have a shorter urethra (the tube that takes urine away from the bladder).
What are the symptoms of UTIs?
Symptoms of UTIs in adults include:
- a burning sensation or pain when peeing
- more frequent peeing
- peeing more suddenly and urgently than usual
- needing to pee more frequently than usual, including at night
- blood in your pee
- pee that has a strong smell or is cloudy or darker than usual
- feeling feverish (hot and shivery)
- a high or very low temperature
- pain in your back or lower tummy
- vomiting
These symptoms are the same for men and women. Men can also experience rectal pain with a UTI, and women can experience pelvic pain.
In older adults who have memory or concentration issues, UTIs can cause additional symptoms:
- incontinence that is worse than normal
- behaviour that is agitated or confused
- shivering and shaking that is unusual
What are the early signs of UTIs?
Any of the symptoms listed can be an early sign of a UTI. UTIs can develop within 24 hours of infection, but it can also take several days for symptoms to develop.
Are UTIs painful?
The symptoms of a UTI can be painful, but it is also possible to have a UTI and not experience any symptoms or pain.
How long does a UTI last?
Mild UTIs can clear up in a few days with rest and drinking plenty of fluids. However, if the symptoms do not clear up and the UTI is not treated, it can worsen and last for much longer.
A review from 2017 found that 25-42% of uncomplicated UTIs will go away without antibiotics. Antibiotics can reduce the length of time you get symptoms and their severity, but you must finish the course to ensure that the infection has gone.
Can there be complications from having a UTI?
UTIs that are not treated can lead to a severe kidney infection (called pyelonephritis). This can damage the kidneys and spread the infection to your bloodstream (called septicemia).
If you are pregnant and have an untreated UTI, complications can include pre-term delivery and low birth weight. It is simple and safe to treat a UTI if you are pregnant but you should always contact your midwife or doctor for advice and treatment.
When should I talk to a doctor about a UTI?
Seek urgent medical attention if you think you or someone you care for has a UTI and any of the following occur:
- not been for a pee for a day
- blood in the pee
- confused, drowsy or having difficulty speaking
- a very high temperature and fever
- a temperature below 36 degrees celsius
- pain in the back or lower tummy just under the ribs
- vomiting
If you think you have a UTI talk to your doctor or a pharmacist if:
- it is the first time you have experienced the symptoms
- your symptoms are getting worse
- you are a man
- you are pregnant
- the UTI has returned after you finished treatment
- you have just had surgery
- you have any conditions or take any medications that affect your immune system
If you are caring for a child or older person and suspect that they have a UTI, talk to their doctor immediately.
What causes UTIs?
A UTI is usually caused by bacteria entering the urinary tract. This bacteria often comes from poo and is moved into the urinary tract through sex or wiping. Other factors can irritate the urinary tract and make it more susceptible to infection.
Women are more likely to get a UTI because their urethra (the tube that connects the bladder to the outside of the body) is shorter. Therefore, it is easier for bacteria to reach the bladder or kidney.
It is estimated that UTIs only affect 3% of men each year worldwide. When a man gets a UTI, it is usually because of bacteria already present in his body.
What increases your risk of getting a UTI?
Your risk of bacteria in your urinary tract causing a UTI increases with the following:
Having sex
A large body of evidence links sex with UTIs in women. Sex can transfer bacteria from the genitals and anus into the urinary tract. Research has also shown that using diaphragms, spermicides and condoms can increase your risk because these can all introduce bacteria.
Age
Studies suggest that older people are more likely to get a UTI. Bladder and pelvic floor issues, lower oestrogen levels in women and weakened immune systems are more common the older you get. These factors make it harder for your body to fight bacteria in your urinary tract.
Pregnancy
A review of UTIs in pregnancy indicates that the chance of getting bacteria in the urineI in pregnancy is similar to women who are not pregnant. However, if you have had a UTI before, there is a much higher chance (estimated at 25%) of developing another one. However, changes in your body due to pregnancy such as pressure on your bladder from the foetus mean your body is more likely to develop a UTI.
Constipation, incontinence or holding on
If you are constipated, there can be pressure on your bladder causing bacteria to be trapped inside it, which can cause a UTI. Studies show there is a higher chance of bacteria being around the urinary tract if you are incontinent and that holding on to your urine allows bacteria to remain in your bladder rather than being flushed out.
Dehydration
If you are dehydrated, you do not frequently urinate, which means that the bacteria which would usually be flushed away, will stay in your urinary tract. Drinking enough fluids allows your body to flush everything out of the bladder regularly, so bacteria cannot grow.
Conditions which impact the bladder
Conditions that put pressure on the bladder (such as enlarged prostate) or those that impact how the bladder functions (for example, bladder stones or having a urinary catheter) can increase your risk of a UTI. If the bladder is under pressure or cannot empty itself properly, bacteria can be trapped in it. A urinary catheter can allow bacteria to enter your bladder through the catheter.
Kidney stones
Kidney stones can block the urinary tract, allowing urine (and any bacteria) to build up and cause a UTI.
Diabetes
People with Type 2 diabetes are more likely (46.9 per 1,000 people) to have a UTI than those without (29.9 per 1,000). Excess sugar in your blood is removed through your urine, and this excess sugar can make bacteria grow, causing a UTI. People with diabetes also often have a weakened immune system, making it harder for their bodies to fight the infection.
Having had a previous UTI
A review from 2010 found that specific genes may make someone more likely to get a UTI and to have recurring UTIs.
Weakened immune system
If your immune system is weakened due to auto-immune disease, cancer treatment or other factors, it makes it harder for your body to fight bacteria when it is in your system.
Why does sex cause a UTI?
During sex, bacteria from the genitals and anus can be introduced to the urethra. You can reduce the chance of this happening by:
- going for a pee as soon as possible after sex
- washing the skin around your vagina with warm as soon as you can after sex
- using different contraception instead of a condom
- avoiding using lubricant
What is a recurrent UTI?
A recurrent UTI is when you have 3 or more UTIs within one year or 2 or more within 6 months. Studies suggest that recurrent UTIs are caused by reinfection by the same bacteria. Having sex is the most significant risk factor for a recurrent UTI, but all the factors listed above that increase your risk of getting a UTI can be reasons for recurrent UTIs.
How are UTIs diagnosed?
UTIs are diagnosed using a urine sample tested to see if the bacteria that cause infection is present. Your doctor can test your sample or you can use a home test kit to check for signs of bacteria available from Superdrug Online Doctor.
You must use a sterile container and take your urine sample midway through your stream. This is because the first part of the stream can contain bacteria from your genitals. It is also recommended to take the sample first thing in the morning.
If you are experiencing recurrent UTIs, your doctor may carry out other tests. It is a good idea to test every time you have symptoms to be sure that you have a UTI.
How is a UTI treated?
UTIs can clear up by themselves. The sooner you notice your symptoms and take action, the higher the chance that the UTI will clear up without the need for antibiotics.
Mild symptoms of a UTI can be treated by:
- drinking plenty of water to flush out the bacteria
- taking paracetamol or ibuprofen to manage the pain
- resting to allow your immune system to fight the bacteria
- avoiding sex so more bacteria is not introduced to your urinary tract
If the UTI is not clearing up, you may need an antibiotic to treat it. An antibiotic kills or prevents the spread of the bacteria causing the infection.
The recommended antibiotic for lower UTIs for most people is nitrofurantoin, sold under the brand name MacroBid. Doctors used to prescribe trimethoprim, but the National Institute of Health and Care Excellence (NICE) no longer recommends it as the most effective treatment due to antibiotic resistance.
Studies have found that MacroBid is up to 92% effective at treating a UTI. You usually feel an improvement within 24 hours, and symptoms clear up entirely within 3 to 7 days. It’s essential to finish the course to ensure that all the infection has been treated, even if you feel better.
You can get a prescription for MacroBid without having a face-to-face consultation using Superdrug Online Doctor if you follow these simple steps:
- Complete the online questionnaire.
- Our doctors will review your answers and make sure it is safe to prescribe you MacroBid.
- You can then choose where to deliver your medication or collect it from certain stores.
How can I treat my UTI at night?
Some people find the pain from their UTI worse at night because urine output is the lowest then.
The following methods can help manage the pain at night:
- take painkillers
- use a hot water bottle to ease the pain
- empty your bladder completely before going to sleep
- avoid caffeine, sugary drinks and alcohol during the day
Why won’t my UTI clear up with antibiotics?
If antibiotics don’t clear up your infection, this may mean that a virus or fungal infection is causing your UTI, that you are resistant to that specific antibiotic or that there’s another cause for your symptoms.
Your doctor will consider the options and may prescribe you a different antibiotic or one for a more extended period. If you have gone through menopause, you may be prescribed an oestrogen cream for your vagina.
Can you get rid of a UTI permanently?
You can treat a UTI so your symptoms clear up, but you cannot cure yourself to prevent future recurrences. Being aware of what causes a UTI and the risk factors that may apply to you can help you manage the chances of getting another UTI.
Can you treat a UTI naturally?
The most effective natural treatment for a UTI is drinking plenty of water and flushing the bacteria.
Drinking cranberry juice is often recommended as a natural way to treat a UTI. The evidence is mixed on whether it can treat an established UTI or prevent recurrent infections. And while the chemicals within the cranberries can stop the bacteria from attaching to the urethra, it is very high in sugar.
How to prevent UTIs
You can prevent UTIs by making some simple changes to your lifestyle in terms of how you pee, wash yourself and what you drink:
- practising good genital hygiene, including wiping from front to back and changing nappies or incontinence pads as soon as they are soiled
- drinking plenty of fluids but avoiding caffeine, sugary drinks and alcohol
- not holding your pee in but urinating when you feel the urge
- fully emptying your bladder
- avoiding using scented soap or vaginal douches
When you have sex:
- avoid using condoms, diaphragms or spermicides as contraception
- use water to wash the skin around the vagina before and after sex
- pee as soon as possible after sex
Sources
- Blood in urine NHS [accessed 12 May 2022]
- Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? NCBI [accessed 12 May 2022]
- Cystitis NHS [accessed 12 May 2022]
- The effectiveness of nitrofurantoin, fosfomycin and trimethoprim for the treatment of cystitis in relation to renal function ESCMID [accessed 12 May 2022]
- Kidney infection NHS [accessed 12 May 2022]
- Nitrofurantoin NHS [accessed 12 May 2022]
- Recent advances in recurrent urinary tract infection from pathogenesis and biomarkers to prevention NCBI [accessed 12 May 2022]
- Recurrent Urinary Tract Infections Management in Women NCBI
- Sexual Intercourse and Risk of Symptomatic Urinary Tract Infection in Post-Menopausal Women NCBI [accessed 12 May 2022]
- UTIs NHS [accessed 12 May 2022]
- Urinary tract infections management NICE [accessed 12 May 2022]
- Urinary tract infections in adults Urology Health [accessed 12 May 2022]
- Urinary tract infection in pregnancy NCBI [accessed 12 May 2022]
- Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management NCBI [accessed 12 May 2022]