Michelle O'Driscoll: What are UTIs and can you prevent them? 

Urinary tract infections are one of the most common types of infections globally, coming second only to respiratory tract infections.

Urine is usually sterile, with no bacteria present. Bacteria, viruses or fungi can enter the urinary tract, but typically the flushing out of the urine will wash them away. This doesn’t always happen effectively, however, leading to infection.

UTIs can affect different parts of your urinary tract. Infection in your bladder is called cystitis, in the urethra is urethritis, and these are both known as lower UTIs. A kidney infection is called pyelonephritis and is considered to be an upper UTI.

Women are more likely to experience a UTI than men, because of their shorter urethra, making the pathway for bacteria to enter the body easier to navigate. Kidney stones, pregnancy, enlarged prostate in men, the presence of a catheter, or a weakened immune system are all other potential causes of infection.

You’ll recognise a UTI by experiencing symptoms such as needing to urinate more frequently than normal, a feeling of urgency around getting to the toilet on time, experiencing a burning sensation when passing urine, or urine that has an odour, is cloudy, or contains blood. You may also feel lethargic or unwell, and have pain in your tummy and/or lower back. Confusion might indicate infection in elderly people, while babies may be more irritable than usual. UTIs can cause significant discomfort and affect daily living, as well as having the potential to become something more serious, like sepsis, if a UTI that isn’t resolving is not appropriately treated.

Easing the symptoms of a mild UTI can be achieved yourself with the support of your pharmacist, by taking paracetamol for any pain, drinking lots of fluids to flush out the infection, and using heat, e.g. hot water bottle to ease discomfort of the tummy. The use of cranberry juice has limited evidence, but anecdotal claims state that it prevents the bacteria from adhering to the lining of the urethra.

Usually, cystitis cases can resolve themselves over time, but most UTIs that don’t can be treated effectively with antibiotics.

Men, children, pregnant women and those who haven’t had a UTI before, who aren’t seeing the symptoms improve after a few days, or are experiencing frequent UTIs should go to their doctor for further investigation. An urgent appointment should be sought by anybody with pain in lower back, temperature or feeling hot or shivery, or if there’s vomiting or diarrhoea with the UTI symptoms. A urine sample can rule out other causes of symptoms and can allow for bacteria sensitivity testing. This allows for an appropriate antibiotic to be prescribed if the first-line choice isn’t working.

Antibiotics should clear the symptoms within five days, and it’s very important to finish the course, even if you start to feel better. This will ensure that the bacteria don’t build up a resistance to the antibiotic, which would become very problematic if the infection isn’t fully resolved or returns.

If symptoms are severe, an antibiotic by mouth might not be enough to hit the infection, and you may need to get IV antibiotics in the hospital, have further tests done, and be monitored for a number of days.

Prevention is better than cure, and although not all UTIs are preventable, there are things you can do to reduce the risk of infection, such as fully emptying your bladder when you urinate, passing urine immediately after intercourse, wiping front to back, and wearing breathable cotton underwear.

For some, UTIs may be recurrent, which can be very debilitating. It’s possible to discuss with your GP the options available to you.

If in perimenopause or menopause, and the UTIs are hormone-related, oestrogen could be really effective at preventing these.

For some women, the starting of oestrogen has transformed their lives, and eliminated urinary tract infections. Otherwise, a preventative antibiotic may be prescribed.

It’s worth chatting to your doctor to explore all options and find the best approach for you.

For most, a urinary tract infection is a temporary annoyance that will pass. However, it’s important to recognise when you should be going to your doctor to seek treatment and further support.

Recurrent UTIs shouldn’t just be tolerated, and further investigation to find an effective solution is warranted.