A urinary tract infection (UTI) is characterised by burning on passing urine, the urge to pass urine frequently and pain. Such infections occur when the normally sterile urine becomes infected with bacteria or other microorganisms. The most common bacteria causing a UTI is called E.coli, though other conditions such as Staphylococcus and Chlamydia can also cause infection.
Such bacteria or organisms enter the urethra – the tiny tube that links from the vulva to the bladder – and cause irritation (urethritis). The infection can then spread back to the bladder causing cystitis (inflammation of the bladder).
If a UTI is left untreated the infection can track even further back to the kidneys, via two small tubes called the ureters (one connects between each kidney and the bladder). This kidney infection is called pyelonephritis and can be a serious health problem.
With correct treatment, a urinary tract infection can be cleared quickly – in just one or two days. Even if symptoms are quickly alleviated, always finish any antibiotic course ordered by the doctor to ensure bacteria do not recur in a stronger or different form.
UTIs are much more common in women, than men because their urethra is very close to the vagina and anus so bacteria can spread easily. Women also have a shorter urethra than men which means bacteria can travel to the bladder quicker. Sexual intercourse can also irritate the urethra in a woman and increase the incidence of a UTI, and after the menopause UTIs can also become more common in women because of changes in the urethra, bladder and vagina due to hormonal fluctuations.
In men, UTIs can be indicative of prostrate problems, kidney stones or a sexually transmitted disease, and in the elderly UTIs can cause confusion and falls.
If the infection ascends higher up the urinary tract towards the kidneys (known as pyelonephritis) you may get pain in one side of your lower back or loin, depending on which ureter or kidney is affected. You will likely feel quite unwell, with fever, chills and possibly vomiting.
A UTI and its associated symptoms can clear just by drinking plenty of water to help dilute the acidic urine, and also flush out infection from the bladder and urinary tract. Aim to drink about one pint of water (or half a litre) every two hours, taking regular and frequent sips. You can use painkillers if you need to, they may help.
If you think you have symptoms of a UTI, you should speak with your doctor or pharmacist. Depending on the severity of the symptoms, you may feel well enough to try some self-treatment, but your doctor may also consider a course of antibiotic tablets are appropriate.
There are certain situations that require a more urgent discussion with your doctor. If you are pregnant, you will need to see your doctor or midwife and any antibiotics will be considered depending on which trimester your pregnancy is in. UTIs are common in pregnancy and can be treated without harming your baby. If left untreated they can cause kidney problems, and increase the risk of preterm labour and infection of the newborn at birth.
If you have symptoms of pyelonephritis with fevers, vomiting, and pain in your loin or back, you should see your doctor urgently, as there's a risk of becoming quite unwell with this, and of damage to the kidneys.
Your doctor will ask about your symptoms and examine you. It's likely they will want to do a urine test in the practice and they may send this off to the lab. Depending on the possible diagnosis, they may order blood tests or imaging (X-ray, ultrasound, CT, MRI scans), or you may be referred to a specialist department. The doctor may also prescribe some medication such as antibiotics to help with your symptoms.
UTIs may need to be treated with antibiotics, although these only help your immune system do its job - your immune system alone can sometimes clear a UTI. Assess how severe your symptoms are and how long they are lasting, and discuss things with your doctor as needs be.
It's rare to clear a pyelonephritis without antibiotics, so if you have symptoms of this, contact your doctor urgently.
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