The Christmas gift you *really* don't want

Here's what to do if cystitis strikes

Woman on the toilet with cystitis uti
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You may not be chatting about it at the office Christmas party like some less taboo medical issues, but urinary tract infections are really common. In fact half of all women report having had at least one UTI during their entire lifetime.

Young women by far are the most commonly affected

Firstly, women will always get more urinary tract infections than men and that is down to simple anatomy: the urethra (the tube carrying the urine from the bladder to the outside) is shorter in women so the bacteria have less travelling distance before they can cause a problem in the bladder or the kidneys.

Men are somewhat protected (blessed even) by a longer urethra. But that is not to say men don't get UTIs. Yes they are far less common in men but they can happen spontaneously as well as in relation to intercourse, underlying bladder problems or other conditions such as diabetes.

Infections are more common at Christmas

Some women are plagued with UTIs and suffer with recurrent infections which can be very difficult to treat. But we can all be susceptible to them particularly in certain situations. Around Christmas time, all infections can be more common from the stress, the cold and overtiredness and UTIs are included in that particularly as you add alcohol and sex into the seasonal mix.

The complications

Complications of a UTI are kidney infection, blood poisoning (sepsis) and even kidney failure. But the risks of kidney damage and failure are thought to be low.

However, women who have a background of kidney damage or disease or a condition which affects their ability to deal with infections – for example diabetes – are more prone for a UTI to become a kidney infection.

Pregnancy, antibiotics and new partner

UTIs are more common in pregnancy, in those who have taken a lot of antibiotics and, as many women notice, at the advent of a new relationship.

It is not the sex passing on the infection like with STIs but rather the activity around the vagina and urethra disrupting and moving the healthy balance of local bacteria. This used to be given the charming name 'honeymoon cystitis' and whilst it is rather disturbing to contract this with a new partner it isn't something that tends to recur.

It is also more common in men and women suffering with constipation: the general fullness in the bowels which are actually very close to the bladder and urethra, prevents good flow of urine allowing infections to take hold. We see this quite commonly in constipated children who have to be encouraged to have regular bowels to have a healthy bladder too.

Common in my clinic

Consultation for UTIs are very common in my clinic with figures revealing they may account for up to 3% of all GP consultations. Whilst we are desperately trying not to give out antibiotics anymore unless absolutely proven to be necessary, a woman experiencing UTI symptoms is still one of the rare times when we do hand them out before seeing the result of a laboratory test. In fact, scientific trials show that a specific group of urinary symptoms in women are as accurate as those little strip tests we dip in the urine at predicting whether you really do have an infection.

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What are the symptoms?

Certain symptoms therefore make up a typical picture of a urine infection that would allow a woman really to diagnose herself: passing small, painful quantities of urine very, very, often is the classic case.

Passing blood, smelly urine and pain over the bladder would also be common. If a urine infection has travelled up to your kidneys you then experience lower back pain, chills, fevers and even vomiting.

Vaginal discharge, itchiness and central abdominal pain are not typical features of a urine infection but for some reason account for many consultations I have when patients think this is a possibility.

Terrible timing

UTIs have a habit of appearing at the worst moment usually when the GP surgery is closed and your pharmacist is off for Christmas. Seeing blood in the urine does make everyone panic but if it is accompanied with other classic symptoms there is a high chance it is nothing more sinister than a UTI. The Be Clear on Cancer messages do rightly highlight the worry of blood in your pee, but by far the most common cause particularly if it is accompanied by pain would be an infection rather than cancer.

UTI= antibiotics essential

Essentially if you have a UTI you need an antibiotic. For decades women have self-prescribed and used other remedies: cranberry juice, cranberry extract, alkalinising powders as well as flushing out with plenty of water. Early on in an infection or with a particularly low bacteria count, you may be lucky and find these remedies work.

The health body NICE and other medical guidelines refuse to recommend OTC remedies as the scientific evidence is just not there to prove they work. This is reasonable in terms of what a doctor should recommend in the face of a clear cut UTI: however, with no other help available for example out of hours or bank holidays, it's worth a go.

Cranberry juice or powder sachets are certainly a low harm strategy that may save you some discomfort and a trip to a walk-in clinic on Christmas day.

If you already have symptoms of a kidney infection this is not worth a try, and accessing medical help either via 111 or a local walk in clinic is essential.

Kidney infection symptoms

  • Fever
  • Back, side or groin pain
  • Abdominal pain
  • Frequent urination
  • Strong, persistent urge to urinate
  • Burning sensation or pain when urinating
  • Pus or blood in your urine
  • Urine that smells bad or is cloudy.

At normal times when you can speak to a doctor, a UTI with classic symptoms can be diagnosed and treated over the phone and requires little more than 3 days of an antibiotic for most people.

The power of painkillers

And don't forget the painkillers. Most women know to drink water or get an antibiotic but few remember how important simple paracetamol can be to ease the discomfort of what can be a very painful infection.

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