You may at some point experience a burning sensation while peeing and wonder if it could be a sign of a urine infection.
Infections happen when the organisms infiltrate and affect our organs from external sources. Infections of the urinary tract are the most common infections acquired by people, with increased incidence observed in women.
This could be due to the fact that females have a shorter urethra, which is a tube through which the urine flows from the bladder to the outside and also because the urethral opening and the anus are closer together. This makes it easier for the infection causing bugs to move into the bladder from the anus.1
Causes and symptoms
If you have an infection in the bladder, you can hardly miss it unless you are too young or too old.1
If you have bladder infection you may:
- Have a sting or burn every time you pee
- Rush to the loo every time you get the urge to pee
- Visit the toilet more often than usual
- Sometimes have pain the lower tummy
- Pass blood-stained urine.1
Young children with urinary infections may develop a high temperature, vomiting, refusal to eat or excessive tiredness.10
Elderly are more susceptible to these bladder infections because of many factors like incontinence/retention of urine, low immunity levels, and coexisting diseases like diabetes. The range of symptoms in this age-group could be misleading. They may become confused, excessively tired, delirious, or have a fever which doesn’t respond to medicines. Carers should have a high index of suspicion for bladder infection at the onset of any new confusion in older people.11
There are certain conditions where the chances of acquiring a urinary infection increases in females. They are:
- After sexual intercourse
- Having sex with a new partner
- Using spermicides
- Having an episode of urinary infection in the past
- Your mother or sister having frequent bladder infections
- Pregnancy
- After menopause.1
Males in general have less chance of acquiring a urinary tract infection owing to the natural defensive factors in their local anatomy. Therefore, any bladder infection in men is considered more serious. Such infections are observed in men who are sexually active, are uncircumcised, or take part in anal sex.1
The kidneys filter the blood to produce urine. This urine then flows down through long tubes on both sides and collects in the bladder,which is situated in the lower abdomen.
Any infection in the bladder can spread upwards along the long tubes into the kidneys on either or both sides. In this case it becomes more serious or ‘complicated’ and the person is said to suffer from an upper urinary tract infection. It can cause fever with shivering, upper back pain, nausea, and vomiting.1
About 75% to 95% of urine infections are found to be caused by bacteria called ‘E.Coli’. Even though a normal inhabitant of the gut, this bug enters the bladder by contamination around the urethral opening and causes an infection.1
Treatment
If you happen to develop any of the symptoms of a urinary tract infection, you need to see a doctor immediately. Although the symptoms are sufficient in most cases to diagnose a bladder infection, a urine sample is usually required to confirm the diagnosis and decide on the appropriate treatment.
A sterile screw-top container is given at the GP to collect the urine. If you can’t collect the urine at the doctor’s office, you can take it home and return it within one hour of collection.2 If you cannot return the sample with an hour of collection, it can be stored in the fridge inside a sealed plastic bag.2 Storing the urine sample for more than 24 hours will encourage bacterial growth and is not useful for testing.
To prevent contamination with germs from the hands or genital area, a clean-catch technique is used. In this technique, the first and last parts of the pee is allowed to pass and a sample is collected from the mid part of the stream.2
People diagnosed with a bladder infection will be prescribed antibiotics by their doctor. There are many antibiotics to treat urinary tract infections. If there is no response to antibiotic treatment after 48 to 72 hours, then further tests may be required.1
Prevention
If somebody develops repeated episodes of bladder infection (for example, at least 2 episodes in 6 months), they usually undergo further testing and may be prescribed long-term antibiotics by a medical practitioner.4
However, there are a few steps we can take to prevent bladder infection.5 These include:
- Drinking adequate amounts of fluids
- Avoiding holding urine for long periods at a time
- Always washing hands before and after visiting the toilet7
- Going for a pee after sexual intercourse
- Wiping the bottom from front to back instead of back to front
- Avoiding tight-fitting underwear
- Hold off ‘douching’, where the insides of the vagina are washed with a stream of water or special fluids.5
- If you suffer from incontinence, the use of incontinence pads is recommended7
- In people using a urinary catheter, regular cleaning of the tube and it’s entry area into the body is needed.7
A study by Luthje et al. also found that oestrogen had a protective effect on bladder cells in postmenopausal women and helped prevent urinary tract infections.6
When to see a doctor
When you have symptoms of a urinary infection, you need to see your GP if:
- You have these symptoms for the first time
- You were assigned male at birth
- You are pregnant
- You suffer from these urine problems after surgery
- These symptoms do not improve after 2 days
- These symptoms come back after treatment.3
However, we should remember that there are certain conditions where the person should call the emergency services 111 or go to hospital. They are:
- Having a high fever
- Having a low body temperature (below 36C)
- Feeling confused and drowsy
- Have tummy pain or upper back pain, under the ribs
- Having not passed urine all day
- Passed blood-mixed urine.3
These are serious signs and could indicate an infection involving the kidneys. Some kidney infections may even require hospitalisation.9
Summary
To summarise, urine infections are very common infections, affecting 150 million people each year worldwide.8 In this article we have seen what comprises a urine infection and what causes it.
By taking a few sensible, logical measures, we may be able to avoid a serious infection of the urinary system. However, we have to remember that once we encounter any symptoms of bladder infection, it is always better to get professional advice. Also, it is useful to bear in mind that the bladder infection presents atypically in the young and the elderly. The serious signs of kidney infection are an indication to contact the emergency services without delay.
References:
- Li R, Leslie SW. Cystitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Nov 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482435/
- How should I collect and store a pee (Urine) sample? [Internet]. nhs.uk. 2018 [cited 2022 Nov 7]. Available from: https://www.nhs.uk/common-health-questions/infections/how-should-i-collect-and-store-a-urine-sample/
- Urinary tract infections (Utis) [Internet]. nhs.uk. 2017 [cited 2022 Nov 9]. Available from: https://www.nhs.uk/conditions/urinary-tract-infections-utis/
- Terms used in the guideline | Urinary tract infection (Recurrent): antimicrobial prescribing | Guidance | NICE [Internet]. [cited 2022 Nov 9]. Available from: https://www.nice.org.uk/guidance/ng112/chapter/terms-used-in-the-guideline#recurrent-urinary-tract-infection
- Pietrucha-Dilanchian P, Hooton TM. Diagnosis, treatment, and prevention of urinary tract infection. Mulvey MA, Stapleton AE, Klumpp DJ, editors. Microbiol Spectr [Internet]. 2016 Dec 23 [cited 2022 Nov 9];4(6):4.6.35. Available from: https://journals.asm.org/doi/10.1128/microbiolspec.UTI-0021-2015
- Lüthje P, Brauner H, Ramos NL, Ovregaard A, Gläser R, Hirschberg AL, et al. Estrogen supports urothelial defense mechanisms. Sci Transl Med. 2013 Jun 19;5(190):190ra80.
- Urinary tract infections and how to avoid them! [Internet]. Kent Community Health NHS Foundation Trust. [cited 2022 Nov 9]. Available from: https://www.kentcht.nhs.uk/about-us/ensuring-quality/infection-prevention-and-control/dont-dry-out/
- Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol [Internet]. 2015 May [cited 2022 Nov 10];13(5):269–84. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457377/
- Kidney infection - Treatment [Internet]. nhs.uk. 2018 [cited 2022 Nov 10]. Available from: https://www.nhs.uk/conditions/kidney-infection/treatment/
- Urinary tract infection (Uti) in children [Internet]. [cited 2022 Nov 10]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-tract-infection-uti-in-children
- Rodriguez-Mañas L. Urinary tract infections in the elderly: a review of disease characteristics and current treatment options. Drugs Context [Internet]. 2020 Jul 8 [cited 2022 Nov 10];9:2020-4–13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357682