Urinary Tract Infection (UTI): Symptoms, Causes, Prevention and Bladder Support

A urinary tract infection (UTI) is a very common cause of pelvic pain and discomfort. It is caused by bacteria entering the urethra, which can also travel up to reach the bladder and kidneys. This results in a number of symptoms, including; burning or pain when you urinate, you may need to urinate more often, and you may feel generally unwell.

Types of UTI

• Cystitis - When only the bladder is infected.
• Urethritis - When only the urethra is infected.
• Kidney infection - When one or both kidneys is infected, which can lead to serious kidney damage if left untreated.
• Lower UTI - When both the bladder and urethra are infected.
• Upper UTI - When the bladder, urethra and one or both of the kidneys are infected.

The urinary tract stores urine for long periods of time. When it is healthy it has a tight barrier of epithelial cells which prevent the toxins from your urine entering the blood stream. These cells secrete antibacterial agents and pro-inflammatory substances to prevent bacteria from growing. The urethra is often exposed to bacteria, but is able to resist infections through this natural immune response. The rest of the urinary tract is usually sterile, protected by the bodies natural mucus secretions.

UTI's most commonly develop as a result of Escherichia coli bacteria, from the bowel, reaching the urethra. UTI's usually stay within the urethra and pass within a few days as your bodies natural immune response deals with the infection. However, they can develop into significantly more dangerous conditions; including the formation of pelvic abscesses, sepsis (if the bacteria enters the blood stream), kidney dysfunction and pyelonephritis (inflamed kidneys) if the bacteria reaches higher. This can occur if the immune defences has broken down, or if the bacteria are considered 'opportunistic' and cling to healthy cells which are travelling upwards. As these conditions can be fatal, the development of any UTI should be monitored. If you are worried, a visit to your GP can prescribe a short course of antibiotics which can usually easily treat the infection.

UTI's are non-contagious and relatively common. They can affect men and women of all ages but are 8 times more common in women as their anus and urethra are closer together, and they have a shorter urinary tract for bacteria to travel up. Around 50-60% of women develop UTI's in their lifetime, accounting for 25% of all types of bacterial infections experienced by women.

Help to prevent them by exercising your pelvic floor!

What are the Symptoms of a Urinary Tract Infection?

• Stinging and irritation when you urinate
• A more frequent urge to urinate than normal
• The urge to urinate is more sudden than normal
• Smelly or cloudy urine
• Blood in your urine - Visit your GP if this occurs even once.
• Pain in your lower abdomen
• Tiredness
• In older people it can cause confusion and agitation
• In children it can cause them to:
• wet themselves as they deliberately don't go to the toilet as it stings
• be irritable
• appear generally unwell
• babies may not feed and have a fever of 37.5°C (99.5°F)

A UTI can be a symptom of a more series condition. Seek urgent healthcare if you have suffered from a UTI for longer than a week, or if you also have any of the following symptoms which suggest the UTI has developed into a kidney infection:

• Pain in the sides of your lower back
• A fever
• Vomiting or feeling very sick
• Diarrhoea

What Causes a Urinary Tract Infection?

A UTI is caused by bacteria entering the urinary tract through the urethra. This can happen from:

• Not fully emptying your bladder - The urine that remains allows bacteria to multiply.
• If you have weak pelvic floor you will not have the control needed over your bladder and can often have urine remain after urinating.
• A Front Wall Prolapse (Cystocele) can increase the risk of recurrent UTIs or cystitis because the bladder may not fully empty when you pass urine. Urine left in the bladder can allow bacteria to grow more easily, leading to repeated infections.
• Bladder or kidney problems can prevent full bladder voiding.
• Follow our Double Voiding techniques to make sure the bladder is always fully empty.
• In children, constipation can prevent full bladder voiding.
• In men, an enlarged prostate gland can prevent full bladder voiding.
• A weakened immune system - As is the result of many conditions, including; type 2 diabetes, HIV and going through chemotherapy.
• Faeces reaching the urethra - 80% of UTI's are caused by the bacteria Escherichia coli which is found in faeces and the bowel. This can occur from poor hygiene, diarrhoea, or wiping back to front.
• Pregnancy - Pregnancy increases the pH of your urine. It also weakens your pelvic floor and dilates your renal pelvis (in the kidneys).
• Kidney stones - Blocking the urinary tract and allowing urine to pool within it.
• Urinary catheters - The most common cause of UTI's that develop in hospital. Urine pools allowing bacteria to grow.
• Bacteria from the vagina reaching the urethra - The proximity of the vagina and urethra often allows bacteria to travel between the two. Bacteria can grow in the vagina as a result of:
• A drop in oestrogen, as often seen during the menopause, reduces the vagina's normal protective flora, which can allow bacteria to grow in the area.
• Spermicidal lube contains Nonoxynol-9 which suppresses the growth of normal vagina flora, and encourages bad bacteria to grow.

How to Treat a Urinary Tract Infection

If your UTI does not naturally go away in a few days, your GP can help you treat it. If you have a severe UTI you may stay in hospital during your treatment. This is more likely for men and children.

If your UTI comes back, it is likely that the bacteria has combined within epithelial cells, allowing them to rapidly grow once any treatment has stopped. Your treatment will now be more intense, with a longer cause of antibiotics.

• Antibiotics - Not suitable for pregnant women. The symptoms should improve within 2 days in children, and 5 days in adults. It is essential that you finish the entire course, even if you feel better.
• Paracetamol, warm baths and ice packs - To relieve discomfort whilst the bodies natural immune system clears the infection.
• Drink plenty of fluids - To help flush the bacteria out of your body.
• Elimination diet - If you frequently suffer from UTI's you may consider an elimination diet to see if any food or drink is assisting the infection. Stop consuming bladder irritants such as acidic foods and drinks such as citrus fruits, caffeine and alcohol, and then reintroduce them back into your diet one at a time. Consider permanently eliminating any foods that lead to a UTI developing on reintroduction. Elimination diets are most successful when supported by a Nutritionist, and in combination with a bowel regime and lots of fluids.
• Baking soda and potassium citrate - To make your urine more alkaline and reduce pain when urinating. Often available in tablet form in pharmacies.
• Bladder training - To reduce the risk of urge incontinence developing.
• Vaginal oestrogen topical cream or vaginal ring - If you have low oestrogen levels your vagina is less defended against bacteria infections. Taking oestrogen vaginally can boost its immune defence.
• Test at home if you suspect you have a Urine Infection with results in 1 minute.

12 Tips to Help Prevent a Urinary Tract Infection (UTI)

There are several simple lifestyle changes that may help reduce your risk of developing a urinary tract infection (UTI) and support better bladder health.

• Strengthen your pelvic floor – Pelvic floor exercises (Kegels) may help improve bladder control and support more complete bladder emptying.
• Always wipe front to back – This helps reduce the spread of bacteria from the bowel to the urethra.
• Use a toilet stool – A toilet stool may help improve bowel emptying and reduce straining and irritation.
• Fully empty your bladder – Avoid holding urine for long periods and try to empty your bladder completely each time you go. Practice Double Voiding - A Simple Technique to Improve Bladder Emptying
• Drink plenty of water – Staying hydrated helps flush bacteria from the urinary tract.
• Choose showers over baths – This may help reduce prolonged exposure to bacteria around the urethra.
• Wear breathable cotton underwear – Loose, breathable fabrics can help reduce moisture and irritation.
• Urinate after sex – This may help flush away bacteria that can enter the urethra during intercourse.
• Change nappies frequently – For babies and young children, regular nappy changes can help reduce bacterial build-up.
• Avoid spermicidal lubricants – Some ingredients may disrupt healthy vaginal bacteria and increase UTI risk.
• Avoid heavily scented products – Perfumed soaps, sprays and skincare products may irritate the urethra.
• Support healthy digestion and regular bowel movements – Constipation can place pressure on the bladder and pelvic floor and may increase the risk of UTIs.

Making small daily changes to your bladder, bowel and pelvic floor health can make a big difference in helping reduce recurring UTIs.

Can a Stronger Pelvic Floor Help Prevent Recurring UTIs?

A stronger pelvic floor may help reduce the risk of recurring UTIs in some people, particularly if pelvic floor weakness is contributing to incomplete bladder emptying or bladder control problems.

The pelvic floor muscles help support the bladder and assist with healthy bladder function. When these muscles are weak, it may become harder to fully empty the bladder, allowing urine to remain in the bladder for longer. Stagnant urine can increase the opportunity for bacteria to grow.

Pelvic floor exercises may help:

• Improve bladder emptying
• Support bladder control
• Reduce urinary leaks
• Improve pelvic support and function

However, pelvic floor exercises are not a direct cure or guaranteed prevention for UTIs. Recurring urinary tract infections can have many causes, including hormonal changes, menopause, sexual activity, constipation, dehydration and underlying bladder conditions.

For people with frequent or recurring UTIs, strengthening the pelvic floor may form part of a wider bladder health and prevention plan.

Sources

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Borchert, D. Sheridan, L. Papatsoris, A. Faruquz, Z. Barua, J. M. Junaid, I. Pati, Y. Chinegwundoh, F. Buchholz, N. (2008) Indian Journal of Urology. Prevention and treatment of urinary tract infection with probiotics: Review and research perspective. [online] 24(2), p139-144. [viewed 06/12/2024]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2684288/

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NHS Trust. (Reviewed 2022). Urinary tract infections (UTIs). [online] NHS Trust, 2022. [viewed 06/12/2024]. Available from: https://www.nhs.uk/conditions/urinary-tract-infections-utis/

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