Urinary infections. What to do about them and how to prevent them.

Urine is made by the kidneys, which filter the blood and take out extra fluid and wastes.  The urine goes to the bladder where it’s stored until you go to the bathroom.  But although urine is a waste product it is in fact sterile.  Bacteria in the urine create an infection.

In this article we’ll look at bladder infections, their treatment and, if you get them often, what you can do to reduce your chances of getting them.

Bladder infections are often called cystitis, water infections, kidney infections (which isn’t accurate as this is something different).

What are the symptoms of a urinary infection?

Some people don’t have many symptoms when they have a urine infection, but may just feel a bit unwell or have a fever without urinary symptoms.  Common symptoms are:

  • Pain or burning when you pass urine
  • Needing to pee urgently and very often but only passing small amounts when you go
  • Being incontinent of urine (not getting to the bathroom on time)
  • Passing bad smelling pee that might look cloudy or be pink (stained with blood)
  • Low belly ache
  • Low back ache
  • Fever, joint aches
  • Feeling tired or shaky
  • Feeling generally unwell.

Urine infections are more common in women than in men because of the differences in anatomy.  In women the openings for the urethra (where the urine exits the body), vagina and anus are quite close together.  Bacteria from the vagina or anus, where they are often not a problem, can get into the urethra and bladder and therefore cause an infection.

In men it’s very common to have an infection in the prostate gland (an abscess or prostatitis) when they have a urine infection.

What is the treatment for a urine infection?

  • If you suspect that you have, or are getting a urine infection, start by drinking more than usual.  This will make you want to pee more often but it will also make the urine more dilute so that it stings/burns less when you go and helps to flush out the bacteria.

The burning and needing to go often is caused by the bacteria-laden urine irritating the lining of the bladder.  This makes the bladder contract which gives you the urge to go.

  • If you have aches and pains and fever then take paracetamol regularly.  Unless you have been told to avoid it by your doctor, you can take 2 paracetamol and/or ibuprofen every 4 hours, no more than 8 in 24 hours.
  • See your doctor for antibiotics.  S/he will take a sample of your pee which may be sent to the lab for testing and an in-surgery urinalysis will show if there are any abnormalities.
  • Antibiotic treatment usually lasts for about a week and is with a drug such as trimethoprim (Sulfatrim, Proloprim, Polytrim, Septra are brand names), or nitrofurantoin (Macrobid and Furadantin are brand names).
  • It is very important that you finish the course of the antibiotics, even when you feel better.  If the bacteria are still present after you start to feel better they will start breeding again if you stop the antibiotics.

How can urine infections be prevented?

Many women get repeated infections so here are some actions to take if this happens to you:

  • Drink plenty of water each day.  This keeps the urine dilute and moving through the bladder and urethra, flushing out any potential infection.
  • The research around drinking cranberry juice in helping treat and prevent infections is conflicting.  It might be worth trying it for yourself to see if it helps you.
  • When you need to pee, don’t hold it in: go when you need to. If you have a ‘smart phone’, look for an app that shows you where public toilets are if you’re out and about a lot.
  • Wipe from front to back, pushing any bacteria from the anal/vaginal area away from the urethra.  The urethral opening is at the front in the perineal area.
  • Avoid strongly scented soaps, any hygiene sprays or douches.
  • If you use spermicide creams or gels then talk to your healthcare professional about alternative contraception as these can add to the problem.
  • Talk to your doctor about long term low-dose antibiotics to prevent infection.

Some people are more at risk of getting urine infections than others.  These include:

  • People who have had a catheter put into the bladder.
  • People who have had cystoscopy, where a medical instrument is put into the bladder to look inside it.
  • Pregnant women.
  • People with diabetes.
  • People who have an abnormality of the urinary tract.
  • People with new or frequent sexual partners.
  • Women with relatives who have the same problem – there may be a genetic component to recurring urine infections.

What are the complications of a urine infection?

Some urine infections are simple and will go away with antibiotics.

But if left untreated or if they’re not treated properly, an infection can cause complications.  These complications include scarring in the urethra and ureters (see the diagram); infection in the kidneys themselves, called pyelonephritis; blood poisoning (septicaemia); kidney failure.

National Institutes for Health and Patient.co.uk have good articles about urinary infections.

If you’re worried about your symptoms or medical problem but don’t want to seek professional help because you feel embarrassed, silly or that it’s your fault, read this page now: How to talk to a doctor about an embarrassing problem.

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