Urinary tract infections: what can you do?

If you have a urinary tract infection (cystitis), your bladder is inflamed. This is usually due to a bacterial infection. Women are more likely to suffer from UTIs. Their urethra is shorter, and closer to the vagina and anus, which makes it easier for bacteria to get into the bladder. More than half of women experience a UTI at least once in their lives. UTIs often cause unpleasant symptoms, and they may occur repeatedly. This is known as a “chronic” or “recurring” UTI.

What causes UTIs? The causes of UTIs are the same for men and women. The culprit is usually an E. coli infection. E. coli bacteria are mainly found in the gut. A UTI can also be caused by staphylococcus bacteria, viruses and fungi.

There are a number of different risk factors for UTIs, some of which are similar for men and women:

• Sexual intercourse: bacteria from around the anus can get into the opening of the urinary tract as a result of sexual activity. Because of this, frequent sex increases the risk of UTIs.
• Poor genital hygiene: wiping from back to front after a bowel movement makes a UTI more likely, because this makes it easier for gut bacteria to get into the urethra. It is better to wipe from front to back (from the vulva to the anus).
• Low liquid intake: if you don’t drink enough, your body can’t flush your urinary passages properly. This makes it easier for bacteria to get into the urethra. You also shouldn’t wait too long when you feel the need to urinate. The longer the urine is in the bladder, the more pathogens will multiply and take hold.
• Strict genital hygiene: do you use soap frequently or in large quantities when cleaning your genital area? This harms the mucous membranes and impairs their protective function.
• Antibiotics: antibiotics can sometimes facilitate UTIs. They may be the cause of a UTI if they were taken two to four weeks before the UTI emerged.
• Cold: cold temperatures themselves don’t cause UTIs, but they can facilitate them. They weaken the immune system, raising the risk of UTIs.
• A weak immune system: diseases that weaken the immune system also increase the risk of UTIs, because sufferers are more susceptible to infections. These diseases include diabetes, multiple sclerosis and HIV. Urological conditions such as urethral stricture or an enlarged prostate also facilitate UTIs.
• Mental strain: a UTI can sometimes have mental causes. Ongoing stress and severe mental strain weaken the immune system, which makes sufferers more susceptible to infection.
• Certain medical procedures: cystoscopies, bladder irrigation and other procedures involving the urinary passages increase the risk of UTIs.

The typical risk factors for UTIs in women are:

• Pregnancy: hormonal changes during pregnancy make UTIs more common.
• Disrupted vaginal microbiome: women who clean their vagina poorly or excessively encourage the spread of pathogens.
• Vaginitis: if the vagina is inflamed, this can also result in a UTI in some cases. 

The typical risk factors for UTIs in men are:

• Enlarged prostate: an enlarged prostate makes it harder for urine to drain out of the bladder. This means that the bladder doesn’t empty completely, and bacteria proliferate in the urine that remains.
• Inflammation of the foreskin: inflammation of the foreskin that is left untreated for too long can sometimes lead to a UTI. The infection migrates to the urethra, where it causes more inflammation.
  

The symptoms of UTIs are similar in men and women. The symptoms of UTIs are:

• Pain when urinating: UTIs typically cause a burning sensation when urinating.
• A frequent urge to urinate: people with UTIs need to go to the toilet frequently. This is another characteristic symptom of UTIs in both women and men. Some sufferers also feel the need to urinate at night (nocturia).
• Back pain: if a UTI spreads to the kidneys or prostate, this can sometimes lead to pain in the lower back. For some, the pain can even spread to the pubic bone.
• Fever: in some cases, a UTI is accompanied by a slight fever.
• Discharge: women may experience heavier discharge when they have a UTI. This happens if the inflammation spreads to the vagina.
• Blood in the urine: one possible sign of a UTI is blood in the urine. It is rare for this to be visible to the naked eye, however.
• Protein in the urine: if you have a UTI, there can sometimes be too much protein in your urine. You can tell if there are significant quantities of protein in your urine because it will be foamy. 

By the way, UTIs can sometimes be symptomless. If this is the case in younger people, the UTI is only mild and doesn’t cause any complications. This is not the case for the elderly, however, who often don’t experience any of the typical symptoms of a UTI. In many cases they suffer from other symptoms such as feeling unwell, fatigue or increased forgetfulness – even when they have a serious UTI. 

Most cases of UTIs are mild and without complications. These can be treated using home remedies. If this is not the case you should consult a doctor, because acute or chronic UTIs can have serious consequences if left untreated. You should seek out a medical professional if:

• The UTI doesn’t improve within a day when treated using home remedies
• You have a fever
• A child is affected
• The UTI is causing nausea
• You are also experiencing pain in your kidneys in addition to a UTI
• You have a weak immune system or diabetes
• The UTI is recurring
• The UTI develops during pregnancy
• You are a man, as men are more likely to experience complications as a result of a UTI
• Your doctor has prescribed you antibiotics to treat the UTI and there has been no improvement after three days.

You should also contact your doctor if you experience atypical symptoms. A UTI does not cause itchiness, for example. If you experience a burning sensation when urinating, you may not have a UTI, but rather a sexually transmitted disease such as chlamydia. 

There are a number of different medical tests that can be carried out to determine whether you have a UTI. A test strip provides initial results. A medical professional holds the strip in the patient’s urine: elevated levels of white blood cells and nitrites indicate a UTI. Examining the urine under a microscope helps with the diagnosis. Ultrasound examinations provide information about the cause of the UTI and its potential consequences for your body.

There are lots of different treatments available for UTIs, ranging from various home remedies to medications. We will now look at the best ways to treat a UTI.

What medications are used to treat UTIs?

No medication is required for a UTI that is mild and without complications. However, if the UTI does not go away by itself or with the help of household remedies, it may need to be treated with medication.

• Antibiotics: antibiotics generally work well against UTIs. Doctors often prescribe nitrofurantoin. Courses of this antibiotic generally take three to seven days. One may be enough, however, depending on the medication in question. In some cases, a UTI may recur despite the use of antibiotics. This may be due to resistance to the active ingredient.
• Painkillers: painkillers are also often used to treat UTIs. Ibuprofen and paracetamol, for example, can be used to relieve the symptoms. 

Urinary tract infections: household remedies

What else can you do if you have a UTI? Various different household remedies alleviate the symptoms and promote healing in a natural way.

• Mannose: D-mannose provides relief with UTIs. D-mannose is a monosaccharide made from glucose. In cases of acute UTIs, two grams are usually taken three times a day for three days. The frequency is reduced to twice per day on the fourth and fifth days. The dosage may differ for you. You should therefore discuss how to take D-mannose with a medical professional.
• Berry juice: cranberry juice may help with UTIs. It contains proanthocyanidin, which can prevent the spread of pathogens in certain cases. Blueberry and lingonberry juice may help with UTIs, as they also contain proanthocyanidin.
• Apple cider vinegar: apple cider vinegar can have antibacterial properties in certain cases, and may help with UTIs. Drink a tablespoon of apple cider vinegar three times a day, diluted in a glass of water.
• Baking powder: another home remedy for UTIs is baking powder. This has a similar effect to apple cider vinegar, and may prevent pathogens from spreading. Dissolve a pinch of baking powder in a glass of water and drink this mixture three times a day.
• Tea: diuretic tea may also be beneficial with regard to UTIs. Diuretic tea can be found in chemists and pharmacies. The mixture varies depending on the product. Some teas have antibacterial properties, and contain birch leaves or goldenrod. You can also get teas specifically for UTIs containing bearberry leaves, nettles, juniper or horsetail. Drinking diuretic tea can help if you have a chronic UTI. People with chronic kidney or heart conditions should consult their doctor before they start drinking diuretic tea to treat a UTI, as some medicinal plants have a strong diuretic effect. Unsweetened teas are also suitable for children with UTIs. You should always consult a paediatrician first. 
• Staying hydrated: it is particularly important that you get enough to drink if you have a UTI. Drinking plenty of fluids means frequent trips to the toilet, which helps flush out the pathogens. Drinking at least two litres of water or unsweetened herbal tea every day is recommended.
• Hot water bottle: if you have a UTI, a hot water bottle can relieve any associated cramps and pain. For children, you should use a hot water bottle with a cover.
• Sitz bath: a sitz bath may help relieve the convulsive pain associated with a UTI. Opt for a bath additive containing chamomile, sea salt or essential oils. 

Please note: UTIs in children can often be treated using home remedies. You should still consult your paediatrician, however. They will know what treatment is suitable for your child. 
What else helps with UTIs? Avoid coffee, as this irritates the urinary passages and can facilitate a UTI. Avoid alcohol and very sugary drinks, and opt for water or unsweetened tea instead.

It is not possible to completely avoid UTIs. There are steps you can take to prevent them, however. Some plant-based remedies have a preventive effect, for example. But there are also certain day-to-day behaviours that may reduce your risk of developing a UTI.

• Go to the toilet after sexual intercourse and avoid using spermicides or diaphragms (non-hormonal contraceptives that are inserted into the vagina). This may help protect you against developing a UTI after sexual intercourse.
• Wash your genital area using just warm water or a pH-neutral lotion.
• Regularly wash your underwear at 60 degrees Celsius.
• Don’t wait until you feel the urge to urinate. Go straight to the toilet and empty your bladder completely.
• Products containing cranberry, such as capsules or powders, can help slightly reduce the risk of developing a UTI. Talk to a medical professional before consuming this kind of product.
• If you have a recurring UTI, a course of antibiotics may help (on the advice of your doctor).

Vaccination against UTIs

There is also a vaccination to prevent UTIs. It comes in the form of a capsule containing dead E. coli bacteria. Your doctor will know whether this vaccine is a suitable option for you. 
UTIs are unpleasant, but fortunately there are a lot of tried-and-tested ways to treat them. There is no miracle cure for UTIs, but by taking the right steps you can quickly alleviate the symptoms. Drink plenty of water, use home remedies and seek medical advice.