Urinary tract infections (UTIs) – how to treat them

UTIs are painful, uncomfortable and can happen to anyone, although they’re more common for women. Know the symptoms and next steps.


What are UTI symptoms?

When to seek urgent medical help 

What are the causes and who’s most affected?

Self-care tips 

When to see a doctor

How is a UTI diagnosed?

What’s the treatment?

How to prevent UTIs and stop them coming back

Finding support 

If you’re experiencing pain or a burning feeling when you pee, this could mean you have a urinary tract infection (UTI). Find out which treatments can help plus the causes of UTIs and how to lower your risk. 


A UTI is an infection of your urinary tract system, which is  made up of different parts, including:

- __urethra:__ the tube that takes urine (pee) out of your body
- __bladder:__ stores pee before it leaves your body
- __ureters:__ two thin tubes that take urine from your kidneys to your bladder
- __kidneys:__ small organs at the back of your body above your hips that filter water and waste products from your body, which become urine. 

The most common forms of UTI happen in your lower urinary tract and they are:

- [cystitis](https://www.livehealthily.com/urinary-tract-infections/cystitis): when your bladder is infected
- [urethritis](https://www.livehealthily.com/urinary-tract-infections/non-specific-urethritis): when your urethra is infected by bacteria. But the other main cause can be a [sexually transmitted infection (STI)](https://www.livehealthily.com/sexually-transmitted-infections/whats-the-difference-between-an-sti-and-an-std-sti-questions-answered). 

An upper urinary tract infection is when the bacteria has [infected your kidneys](https://www.livehealthily.com/kidney-infection). This is less common but can lead to more serious problems. 

Anyone can get a UTI but they more commonly affect women.



## What are UTI symptoms?

The main symptoms of a UTI can include:

- burning or pain when you pee
- needing to pee urgently and often, but not much comes out when you go
- needing to pee in the night 
- pee that looks cloudy, like it has blood in it or which is strong smelling
- pressure in your lower belly or back.


Get help with this

## When to seek urgent medical help 
If you think you have a UTI and you have these symptoms, see a doctor urgently:

- a high fever, or you feel hot and shivery
- your temperature is low (below 36C)
- you are confused or you feel drowsy 
- you have lower belly pain or pain under your ribs 
- you have blood in your pee.

This may mean you have a kidney infection, which can be more likely to lead to a severe infection, called [sepsis](https://www.livehealthily.com/blood-poisoning). 


## What are the causes and who’s most affected?

UTIs are caused by bacteria – most commonly from poop – entering your urinary tract, leading to infection.

If you were assigned female at birth (AFAB) you’re more likely to get a UTI. This is because the female urethra is shorter than that in a male, so bacteria has a higher chance of reaching the bladder or the kidneys. 

As well as your gender, several other factors make you likely to get a UTI. These include:

- being sexually active 
- pregnancy
- using certain types of contraception for women such as diaphragms and spermicides 
- having poor toilet hygiene – for example, not wiping from front to back can lead to bacteria spreading to your urethra 
- being dehydrated
- having a weakened immune system. This could be caused by conditions such as diabetes or treatments like chemotherapy 
- conditions such as kidney stones that can block your urinary tract
- having conditions that mean it’s hard to empty your bladder properly, such as an enlarged prostate  
- using a urinary catheter.

## Self-care tips 
In some cases, it’s better to [see a doctor](https://www.livehealthily.com/health-library/conditions/urinary-tract-infection-adults#when-to-see-a-doctor) if you have symptoms of a UTI. Otherwise, there are simple steps you can take at home to help ease the symptoms and feel better:

- __seek help from your pharmacist__ – a pharmacist can give you advice on treatment to help symptoms such as pain and in some cases they may be able to prescribe you antibiotics to treat your infection, depending on which country you live in 
- __take pain relief__ – paracetamol (acetaminophen) can be taken up to 4 times a day to reduce pain and fever. You should speak to your doctor or pharmacist before taking ibuprofen
- __stay hydrated by drinking plenty of fluids__ (your urine should be pale in color). Water helps flush bacteria out of your system
- get plenty of rest
- __avoid bladder irritants__ – drinks like coffee, alcohol, and citrus juices can irritate your bladder and worsen symptoms 
- try a heat pad to soothe any discomfort in your bladder area. Make sure it’s not too hot
- __hold off on sexual activity__ until symptoms have fully cleared as it may cause you discomfort.  

Some people use cranberry products or cystitis sachets daily to help prevent UTIs, but there's no evidence that they can relieve symptoms or help treat an infection once you have it.


## When to see a doctor

For some people, a UTI may go away on its own in a few days just following self-care methods. 

However, you should see a doctor if you have symptoms and: 

- this is the first time you’ve had a UTI
- you’re a man or assigned male at birth (AMAB)
- you're pregnant
- you have symptoms of a UTI after surgery
- your symptoms don’t improve, or get worse, within 48 hours without treatment, or within 2 days of starting antibiotics 
- your symptoms have come back within 6 months after treatment for a UTI
- you’ve had 2 episodes in 6 months, or 3 episodes in 12 months
- you could be at risk of an STI
- you have a catheter 
- you have a weakened immune system

Some symptoms such as blood in your urine or a very high fever or low temperature, need [urgent medical attention](https://www.livehealthily.com/health-library/conditions/urinary-tract-infection-adults#when-to-get-urgent-help).


## How is a UTI diagnosed?

A healthcare professional will ask about your symptoms, medical history and do a physical exam. They might do lab tests to confirm the diagnosis. These include: 

- __urinalysis:__ a urine sample will be collected from you to look for signs of infection, like blood or white blood cells
- __urine culture:__ this tests your pee to find out which type of bacteria is causing the infection so your doctor knows how to treat it
- __blood tests:__ sometimes, blood is tested to see if the infection has spread to your kidneys and if your kidneys are working correctly. 

In men, a doctor may also test for a UTI using a swab test, where the tip of the penis is swabbed and the sample is sent for testing. 

In some cases, where you have [recurrent](https://www.livehealthily.com/health-library/conditions/recurrent-uti-in-women) or [chronic UTIs](https://www.livehealthily.com/health-library/conditions/chronic-uti-in-women-why-your-uti-isnt-going-away) – when the infection keeps coming back or won’t go away – you may require further tests such as a CT scan or ultrasound of your abdomen and pelvis. 


## What’s the treatment?

Your doctor may prescribe a course of antibiotics to treat the infection. How long you take these for depends on things such as whether you’re male or female or how severe your infection is.

When you start to take antibiotics you may feel better in a few days, but it’s important that you finish your course of them to prevent the infection coming back. 

If your symptoms come back after treatment, or have a recurring infection (2 UTIs in the space of 6 months) then you may be given: 
- different type of antibiotic
- a low dose of antibiotic to be taken over 6 months
- an estrogen vaginal cream if you’ve been through the menopause
- referral to to a specialist. 

If your UTI doesn’t go away you may have a chronic UTI. This can be difficult to diagnose because urine test may not always pick up the infection, and symptoms can be similar to other conditions. 

Speak to your healthcare professional about the best treatment types for you and about being referred to a specialist.



## How to prevent UTIs and stop them coming back

There are steps you can take to lower your risk of getting a UTI, including:

- __check your toilet hygiene:__ Always wipe from front to back. Keep your genitals clean and dry
- __pee as soon as you get the urge:__ Don’t hold onto your urine and pee regularly as the longer urine is in your bladder, the more time bacteria has to grow. And don’t rush it when you’re peeing – try to fully empty your bladder
- __pee as soon as possible after sex:__ this flushes away bacteria that may be lingering near your urethra
- __think about switching your [contraception](https://www.livehealthily.com/contraception/summary):__ If you use a diaphragm or spermicides it may be a good idea to look at other types of contraceptive 
- __stay hydrated:__ drinking 6 to 8 glasses of fluid per day means you pee more frequently which flushes out infections before they take hold. But avoid sugary drinks, as they may encourage bacteria to grow in your urinary tract
- __avoid tight clothing and synthetic underwear:__ These can trap moisture and create a breeding ground for bacteria in your urinary tract. For the same reason, it’s a good idea to change out of wet swimwear and workout kit
- __avoid douching and using feminine hygiene sprays:__ They can disturb the healthy bacteria in your vagina and make you more prone to infections. Instead, clean your genitals with water or with unperfumed soaps.


## Finding support 

If you're dealing with a bladder condition such as a UTI, know that you’re not alone. There are plenty of charities and organizations out there that support people, such as:

- [Urology Care Foundation (US](https://www.urologyhealth.org/)) offers information in English and Spanish 
- [Bladder Health UK](https://bladderhealthuk.org/) has online resources and links to local support groups


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References

Rosa Bowden

Jo Wheatley

Dr Ewan O'Farrell

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