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Cystitis, Kidney infection, Urethritis - UTI differences, symptoms and treatment

What is a UTI? What do I do if I think I have one?

Often in the pharmacy, people will complain of symptoms of a UTI, the symptoms of which can be really troublesome, and can cause you to feel miserable. A lot of the time, people naturally want a 'quick fix', over the counter remedy that won't interrupt their day, and will allow them to focus at work. UTI is an abbreviation for a Urinary Tract Infection, and usually involves the bacteria E. coli (Escherichia Coli), Proteus or Enterobacter species - all found in the bowel flora (therefore it is not surprising that wiping from front to back helps to stop a UTI from occurring!). A bacterial infection needs to be treated with antibiotics, so I am afraid to say that in Ireland, what is available over the counter will not 'fix' your UTI, and a visit to the doctor will be necessary - and it is better that it is sooner rather than later, even though I know it can be so hard to take time off work, and it costs money. However, we have to listen to our bodies, and respond to them appropriately, and give our bodies the attention they need.

I have included an image of the urinary system below to outline the fact that the term ’UTI’ can mean an infection of any part of the urinary tract, including the kidneys, the bladder, the ureters, and the urethra.

Why are UTI's more common in women than in men?

The reason that UTIs are more common in women than men, is because the female urethra is much shorter in length than the male urethra, and so bacteria can more easily reach the bladder, in fact it is often more of a cause for concern if a man presents with a UTI, because it is less common, and could actually be something else instead, such as an STI.

I also want to point out that UTIs can affect healthy women - it does not mean that there is something wrong with you, and that most women will unfortunately suffer from one in their lifetime, but there are ways to try to prevent this . from happening, which I detail below.

Men Vs Women stick figures
Women suffer from UTI's more often than men do - due to our different physiology (and it can often affect healthy women - it does not mean that your overall health is poor!)

What are the symptoms of a UTI? When should I get it checked out?

While UTIs do not always have symptoms, when they do, you may be familiar with some of the following symptoms. If you have any of the following, you should visit your GP who will determine if it is a UTI, or something else.

1. A very strong, persistent urge to urinate

2. A burning sensation when peeing

3. Strong-smelling urine

4. Urine that looks much different to usual e.g. cloudy, or red, bright-pink or brownish coloured (a sign that blood is present)

5. A change in frequency or volume of urine

6. Pelvic pain, in women

Some more specific symptoms, which are associated with the part of the urinary tract affected, include the following:

1. Kidney infection symptoms:

Lower back pain, or right-sided or left-sided pain, is a key distinguisher here and would be a reason to refer in a pharmacy, also fever, chills, shaking, nausea, and vomiting, can all be symptoms of a kidney infection, although a patient may not experience all of these. Kidney infections are the least common type of UTI, as the first sites bacteria will reach would be the urethra and the bladder, however it is important to monitor for signs of progression to kidney infection as this can make a patient really unwell.

2. Bladder infection – also known as ‘cystitis’

The patient may experience some pelvic pressure, burning when urinating, frequent and painful urinating, blood in urine, lower abdominal discomfort. The most common complaint is the sense of urgency the patient feels to urinate, which comes on suddenly, and is not often relieved after urinating. Also, that when they do urinate, it is. A very unpleasant experience.

3. Infection of the urethra (urethritis)

The patient will complain of burning when peeing and may also experience some discharge. Can also be a symptom of some STI's - so this would have to be ruled out.

How do I treat it? + The cranberry juice myth debunked

For years, and still today, people experience these symptoms, and the first thing they do is drink gallons of cranberry juice. At present, there is absolutely no evidence that cranberry can be used to treat UTI’s. Also, most cranberry juices are absolutely loaded with sugar, which these bacteria will love to feed off. It takes an extremely large amount of cranberry extract to prevent bacteria sticking to the urogenital tract, so even if used in prevention, it needs to be used in very high concentrations, which is not present in the juices we drink (it would be a really tart-tasting cranberry juice - and nobody . would buy that!). The concentration may have been higher in the olden days, where this home remedy originated from, but certainly not nowadays. Cranberry has been shown to be effective in in animals in a lab-setting for the prevention of UTI. (Source: Therefore, taking cranberry extract in the form of capsules, may provide some protection, and may be worthwhile if you suffer from recurring bouts.

As with any illness, we always try to figure out the root cause, in order to treat it and to prevent it from happening in future. While the cause of the UTI may be unknown, some potentially pre-disposing factors can include:

1. Female sex (short distance from the urethra to the anus and the urethral opening to the bladder)

2. Being sexually active (it is important that a UTI is not presumed to be the cause – some sexually transmitted infections can also cause a burning sensation when peeing and discharge, which is why. It is very important to see your GP)

3. Menopause – decline in oestrogen may make some women more susceptible to infection of the urogenital tract

4. Indwelling Catheter

5. Diabetes mellitus

6. Structural abnormalities of the urinary tract (rare)

Recurring UTI

If someone suffers from recurring UTIs (defined as two or more episodes over 6 months or three or more episodes over 1 year (this definition applies only to young women with acute uncomplicated UTIs)), then a cranberry supplement, such as BioKult’s ProCyan supplement, may be suitable.

This is not sponsored, it is just a product which I have had training on through work in pharmacy, and which I have found patients have had success with. Also, ProVen probiotics have a probiotic supplement specifically for women’s health, and their probiotics are ones which I have used in the past, alongside antibiotics, and for prevention of travel-related illness and have had great success with them. They contain higher amounts of important beneficial/’good’ bacterial strains than some other probiotics which are available. So for people who are really suffering with recurring UTI’s, investing in a good probiotic/cranberry all-in-one supplement would be ideal for you. There are also some other approaches, such as taking antibiotics as a preventative measure, which you may wish to discuss with your doctor, however medications, of course come with side effects, so we always have to balance benefit vs risk of taking medication.

Why you need to see your doctor if you have one…

We all know our own bodies, and deep down, we know when we need some kind of professional help. If you’re not 100% sure if you need to see your doctor, what I have always done, is gone to the pharmacist first, who might say, you’re all good, you just need to rest, or here’s an OTC treatment, or it’s fine for now, but if it lasts longer than x amount of time go to doctor…etc. (I’m excited to get to be this person when I’m qualified!).

If a UTI is left untreated, it can lead to serious damage to your kidneys, which are so unbelievably important, and which work so hard to excrete waste in your body, and even sepsis. So go see your pharmacist if you’re not sure, and straight to your doctor if you are. The only way to clear a urinary tract infection (which is an. infection of bacteria!) is to take a course of antibiotics, as prescribed by your doctor, who will usually take a urine sample.

In the meantime, until you get to see a doctor, you can use over the counter remedies, which give some pain relief, which usually come in the form of sachets to add to 200mL water, which neutralise the acidity of your urine. Be careful not to continue to use these once you have been prescribed antibiotics however, as some antibiotics depend on the acidic environment of your urine in order to work. Over the counter anti-inflammatories such as ibuprofen may help with inflammation and pain in the meantime, however it is best to make a doctor’s appointment ASAP. What could be more important than your health? Bring a urine sample, if you think this is the issue.

Here is a more in-depth video explaining UTI's for nerds like me. Skip if you want to, I just love knowing the science behind it all!

That's all for now, thanks for learning with me!

Lauren x

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