Urinary Tract Infections (UTI)

Symptoms

Symptoms of a urinary tract infection (UTI) may include:

• pain or a burning sensation when peeing (dysuria)
• needing to pee more often than usual
• needing to pee more often than usual during the night (nocturia)
• needing to pee suddenly or more urgently than usual
• pee that looks cloudy
• blood in your pee
• lower tummy pain or pain in your back, just under the ribs
• a high temperature, or feeling hot and shivery
• a very low temperature below 36C

Your pee may also be dark or smell. If this is your only symptom, it might be because you've not been drinking enough water.

Children

Children with UTIs may also:

• have a high temperature – your child is feeling hotter than usual if you touch their neck, back or tummy
• appear generally unwell – babies and young children may be irritable and not feed or eat properly
• wet the bed or wet themselves
• be sick

Older, frail people or people with a urinary catheter

In older, frail people who have problems with memory, learning and concentration (such as dementia), and people with a urinary catheter, symptoms of a UTI may also include:

• changes in behaviour, such as acting agitated or confused (delirium)
• wetting themselves (incontinence) that is worse than usual

• new shivering or shaking (rigors)
  

Causes

Urinary tract infections (UTIs) are usually caused by bacteria from poo entering the urinary tract.

The bacteria enter through the tube that carries pee out of the body (urethra).

Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.

Risk Factors

Things that increase the risk of bacteria getting into the bladder include:

• having sex
• pregnancy
• conditions that block the urinary tract – such as kidney stones
• conditions that make it difficult to fully empty the bladder – such as an  enlarged prostate in men and constipation in children
• urinary catheters (a tube in your bladder used to drain urine)
• having a weakened immune system – for example, people with diabetes or people having chemotherapy
• not drinking enough fluids

• not keeping the genital area clean and dry
  

Treatment Options

If a GP thinks you may have a urinary tract infection (UTI), they may do a urine test, although this is not always needed.

A GP may also:

• offer self-care advice and recommend taking a painkiller
• give you a prescription for a short course of antibiotics
• give you a prescription for antibiotics, but suggest you wait for 48 hours before taking them in case your symptoms go away on their own

It's important to take all the medicine you're prescribed, even if you start to feel better.

Treatment for UTIs that keep coming back (recurrent UTIs)

If your UTI comes back after treatment, or you have 2 UTIs in 6 months, a GP may:

• prescribe a different antibiotic or prescribe a low-dose antibiotic to take for up to 6 months
• prescribe a vaginal cream containing oestrogen, if you have gone through the menopause
• refer you to a specialist for further tests and treatments

Chronic UTIs

In some people UTI symptoms do not go away. Short-term antibiotics do not work and urine tests do not show an infection.

This might mean you have a chronic (long-term) UTI. This can be caused by bacteria entering the lining of the bladder.

Because urine tests do not always pick up the infection and the symptoms can be similar to other conditions, chronic UTIs can be hard to diagnose.

Chronic UTIs might be treated with antibiotics that you take for a long time.

Chronic UTIs can have a big impact on your quality of life. If you have been treated for a UTI but you still have symptoms, speak to your GP about chronic UTIs and ask to be referred to a specialist.

Things you can do yourself

To help ease symptoms of a urinary tract infection (UTI):

• take paracetamol up to 4 times a day to reduce pain and a high temperature
• you can give children liquid paracetamol
• rest and drink enough fluids so you pass pale urine regularly during the day
• avoid having sex

Some people take cystitis sachets or cranberry drinks and products every day to prevent UTIs from happening, which may help. But there's no evidence they help ease symptoms or treat a UTI if the infection has already started.

Prevention Tips

There are some things you can try to help prevent a urinary tract infection (UTI) happening or prevent it returning.

Do:

• wipe from front to back when you go to the toilet
• keep the genital area clean and dry
• drink plenty of fluids, particularly water – so that you regularly pee during the day and do not feel thirsty
• wash the skin around the vagina with water before and after sex
• pee as soon as possible after sex
• promptly change nappies or incontinence pads if they're soiled

Do not:

• do not use scented soap
• do not hold your pee in if you feel the urge to go
• do not rush when going for a pee – try to fully empty your bladder
• do not wear tight synthetic underwear, such as nylon
• do not drink lots of alcoholic drinks, as they may irritate your bladder
• do not have lots of sugary food or drinks, as they may encourage bacteria to grow
• do not use condoms or a diaphragm or cap with spermicidal lube on them – try non-spermicidal lube or a different type of contraception

Other ways to prevent some UTIs coming back

If you keep getting a bladder infection (cystitis), there's some evidence it may be helpful to take:

• D-mannose – a sugar you can buy as a powder or tablets to take every day
• cranberry products – available as juice, tablets or capsules to take every day

Speak to your doctor before taking any of these during pregnancy.

Be aware that D-mannose and cranberry products can contain a lot of sugar.

If you're taking warfarin, you should avoid cranberry products.

When To See A Doctor

See a GP if :

• you have symptoms of a urinary tract infection (UTI) for the first time
• your child has symptoms of a UTI
• you're a man with symptoms of a UTI
• you're pregnant and have symptoms of a UTI
• you're caring for an older, frail person who may have symptoms of a UTI
• you have symptoms of a UTI after surgery
• your symptoms get worse or do not improve within 2 days

• your symptoms come back after treatment