What are UTIs?
A urinary tract infection is an infection of any part of the urinary system – the kidneys, bladder, or urethra. It occurs when ‘bad’ bacteria – usually E. cioli – enter the urethra, sometimes travelling up through the bladder and causing trouble in the kidneys. Your urinary system is pretty good at keeping out unwanted bacteria by consistently flushing it out via urination – but when this fails, the bacteria can multiply where they aren’t wanted and cause the nasty infection. UTIs more commonly affect women, as the urethra is shorter, and thus the distance bacteria needs to travel is shorter, as well as older adults, as incontinence is a leading risk factor for UTIs.
Causes and risk factors for UTIs
The causes of a UTI can be varied. In many cases, where E. coli is the culprit, it is because bacteria has spread from faeces into the urethra – even a trace amount. Older adults may struggle with incontinence and thus are more at risk of E. coli from faeces getting into the urethra. They also may have less sensory input for pain, and so classic UTI symptoms go unnoticed for longer, thus worsening the severity of the infection. People with disabilities that affect the bladder are also at greater risk of UTI. This is because they may use a permanent or intermittent catheter in order to urinate, and using these aids carry a greater risk of infection, as they are a foreign object going into the urethra in order to allow urine to come out, and that becomes an entry-way for the bacteria to enter the urethra. Sexual activity can be a main culprit for contracting a UTI, too, especially in women, as this can introduce new bacteria into the area. Sexually transmitted infections can also spread to the bladder and cause an uncomfortable UTI.
What are the symptoms of a UTI?
UTI symptoms include pain during urination, burning during urination, blood in urine, a frequent and constant urge to urinate, and lower abdomen pain. If the infection has spread to your kidneys, the pain may be in your lower back or in your side, and you’ll have the symptoms of a more widespread infection – like nausea, headache, fever, chills, and the general feeling of malaise.
For the older adult
Signs and symptoms of UTI in older people differ widely from the general population. Because older adults may struggle with sensory input in many areas of their body, they may not be able to feel or experience the classic UTI signs and symptoms to lead to a diagnosis. While they may experience some of the classic symptoms, the most usual sign of a UTI in the elderly is confusion or disorientation. It can be tricky to assess whether an older person’s confusion is due to infection if they are already experiencing cognitive decline. Any slight changes in an older person’s behaviour should be investigated as a potential symptom of infection.
The impact of UTIs
While UTIs are generally easily treated and non-life-threatening, they rarely have longer-term impacts. Contracting frequent UTIs can begin a snowball effect in which you become more susceptible to UTIs in the future. Untreated UTIs that have spread to the kidneys can result in permanent kidney damage. If further left untreated, UTIs that have spread to the kidneys and resulted in systemic infection can lead to sepsis – an infection of the blood that can be fatal if left untreated long enough. However, there is plenty you can do to keep yourself or a loved one at low risk for contracting a UTI and being aware of the signs and symptoms, as well as when to consult a GP, will ensure to mitigate any serious consequences of UTI.
General UTI prevention
There are a number of preventative measures you can take to reduce your chances of getting a UTI. Drinking plenty of water is the first one – this is to ensure your kidneys and bladder can adequately do their job of flushing toxins from your body properly. Avoid any potential causes of exposing your urethra to bacteria – this means always wiping front to back and emptying your bladder after sexual activity to eliminate any residual new bacteria. Urinating as soon as you feel the urge, instead of holding on, ensures your body is frequently flushing out any bad UTI-causing bacteria. For women, making sure you treat any gynecological infections such as STIs or thrush as soon as you can is important to prevent bacteria from migrating to the urethra.
UTI prevention in vulnerable people
For the older adult
As aforementioned, the older adult can obtain and experience UTIs differently. Managing the risk factors of a UTI, for which there are many more for older people, is imperative to prevent them. Managing continence in the older person is an important part of this, as it contributes to the causes of a UTI. Making sure your loved one has adequate incontinence tools in place and knows how to use them, or has someone to assist them with their personal care, is important. UTI prevention for the older adult can also include diet supplementation, like oral probiotics or cranberry formulations, both of which are proven to have an effect on minimising the occurrence of UTIs. If someone you love does end up with a UTI, it’s important that the people involved in their care are able to recognise the nuanced signs and symptoms of an older person with a UTI and that any changes in behaviour or cognition or flagged with a doctor so that infection can be picked up on and treated.
For those who use catheters
Those who use catheters, whether permanently or intermittently, are more at risk of UTIs due to the bigger chance of bacteria entering the urethra. If someone using a catheter also has an injury or disability that results in less sensory input from the area, then identifying the signs and symptoms of a UTI may be more difficult for them until it’s reached a systemic infection stage, and so it’s important that extra care is taken to avoid the infection. If you self-manage your catheterisation, it’s important to take good care of keeping the catheter aseptic – that is, making sure new catheters are opened in a way that prevents them from coming into contact with surfaces before catheterisation or disinfecting connecting bags or drains before connecting to an indwelling catheter. It’s also important that catheters are drained or emptied adequately to prevent back-flow of urine into the bladder and kidneys, which can encourage infection. If you or a loved one needs help managing catheterisation at home, there are plenty of options to employ a trusted nurse to provide assistance in the privacy of your own home. UTI prevention can also include oral cranberry and probiotic supplements, as aforementioned.
Home remedies for UTIs
Experiencing UTI symptoms can ruin your day or your week! They can be uncomfortable, alarming, and interrupt your day-to-day functioning. Water is your best friend for flushing out the bad bacteria and keeping the pain to a minimum – ensuring you have an adequate amount to urinate will help ease the burn and pain of going to the bathroom. For truly minimising symptoms, the best UTI home remedy is Ural. Ural is a cranberry-flavoured drink that neutralises your urine to help those painful and burning symptoms dissipate, which can be bought from supermarkets or pharmacies. It works by alkalising the urine – that is, making it less acidic – so that you can manage your symptoms while seeking treatment. In some cases, flushing out the bacteria with Ural and water is enough to get rid of it altogether – but only in the case of mild ones. Pain relief is also safe to use while you’re experiencing the symptoms of a UTI. Paracemtol, or anti-inflammatories like ibuprofen, can help with managing the lower abdomen pain and burning associated with a UTI.
How do I cure a UTI?
So you or your loved one has a UTI – and the only thing you want to do is get rid of it as soon as humanly possible! While yes, it is possible to flush them out with water and Ural, this becomes trickier if you are an older adult or someone who consistently uses catheters. Antibiotics are particularly effective and safe for curing UTIs.
See your GP
Your GP will run a urinalysis – assessing a urine sample for signs of infection or traces of blood – to confirm the UTI and then send the sample to the lab. Antibiotics are required to rid you of the infection. If your UTI symptoms are distressing, your GP may begin you on a course of broad-spectrum antibiotics to ease the symptoms while they wait for the result from the lab. The lab will ensure they find out the exact bacteria causing the infection so that more specific antibiotics can be prescribed to better fight the bacteria. It’s important that you finish the whole course of antibiotics, as using only half-courses, or only until symptoms resolve, can lead to antibiotic resistance. If the pain cannot be attributed to an infection, as seen in the urinalysis, then other causes will be investigated, like STIs, pelvic floor disorders, or kidney stones.
If the UTI has progressed to pain in the lower back or flank, with associated high fever, nausea or chills, it’s best to visit the Emergency Department of your local hospital. If the infection has travelled to the kidneys, you may need a more urgent course of antibiotics, as well as more adequate pain relief. It’s also important to seek medical attention urgently for this kind of a pain to prevent the infection from developing into sepsis, which can deteriorate quite quickly without urgent medical attention.
Consider the causes for recurring UTIs
While the causes of UTIs can vary and are usually innocuous, sometimes there are more insidious causes of frequent or recurring UTIs. These can include prostate issues for men or things like anatomical kidney issues. Recurrent UTIs may also be related to hormone levels in post-menopausal women, and these can be medically managed with the help of a GP. If you are experiencing frequent UTIs, your GP may refer you to a urologist to rule out any underlying issues that could be contributing to the UTIs.
While UTIs are infamously painful and irritating, they are not a major cause for concern. They are easily treated and easily prevented – you just have to know what to do. Remember that in the elderly, symptoms manifest differently, so make sure you’re keeping an eye on your loved ones and advocating for their changes in cognition to be thoroughly assessed.
- Better Health. (n.d.). Urinary tract infections (UTI) – Better Health Channel. Www.betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/urinary-tract-infections-uti#types-of-urinary-tract-infections-utis
- Kodner, C., & Thomas, E. K. (2010). Recurrent Urinary Tract Infections in Women: Diagnosis and Management. American Family Physician, 82(6), 638–643. https://www.aafp.org/afp/2010/0915/p638.html
- Mayo Clinic. (2019). Urinary tract infection (UTI) – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
- Rowe, T. A., & Juthani-Mehta, M. (2013). Urinary tract infection in older adults | Aging Health. Aging Health. https://dx.doi.org/10.2217%2Fahe.13.38