Urinary tract infections (UTIs): Causes, symptoms and treatment

UTIs are infections of the bladder, kidneys or the tubes that carry urine. They're quite common in older people, but they're easily treated and there are steps you can take to prevent them.

What are the types of UTIs?

Urinary tract infections (UTIs) can be roughly divided into 2 main types: lower UTIs and upper UTIs. 

What are lower UTIs?

Lower UTIs are infections of the bladder or the urethra (the tubes which carry urine out of the body) – or both. If lower UTIs are left untreated, they can progress into upper UTIs. 

What are upper UTIs?

Upper UTIs are infections of the kidneys or the ureter (the tubes which connect the kidneys to the bladder) – or both. Upper UTIs are more serious and can lead to kidney damage if they're left untreated.

What are the symptoms of UTIs?

Given that lower and upper UTIs affect different parts of the body, there are also some important differences between their symptoms.

What are the symptoms of lower UTIs?

Lower UTIs can have the following symptoms:

• pain or burning when peeing
• needing to pee suddenly or more often than usual
• dark and smelly urine
• cloudy urine
• blood in your urine
• lower tummy pain
• loss of bladder control
• a mild temperature.

If your only symptom is dark or smelly urine, you might just not have been drinking enough water. 

What are the symptoms of upper UTIs?

Symptoms of upper UTIs include:

• a high temperature, or feeling hot and shivery
• feeling or being sick
• pain in your lower back or in the sides of your abdomen
• feeling very weak or tired. 

How do UTI symptoms differ in older people?

In older people, UTI symptoms may be mistaken for another condition, such as dementia. This is because UTIs can cause severe confusion which develops quickly over a few days, especially in older people. However, it's important not to jump to conclusions – if you're at all worried, you should see your doctor or another healthcare professional.

What causes UTIs?

UTIs are caused by bacteria entering the urinary tract, most commonly bacteria from poo – wiping back to front after going to the toilet, urinary catheters or having sex can increase the risk of developing a UTI.

Older people are more susceptible to UTIs due to a weaker flow of urine, meaning the bladder doesn't fully empty. 

UTIs in men

In men, an enlarged prostate can also make it difficult to empty the bladder completely. This can lead to bacteria building up in the urine and bladder.

UTIs in women

Women are more likely to develop UTIs than men, as bacteria can reach the bladder more easily in women.

Risk factors for UTIs

As well as the above, there are some other things which put you at a higher risk of contracting a UTI, such as: 

• being pregnant 
• going through menopause 
• having a weakend immune system – if you have diabetes or are having chemotherapy, for example
• having a condition that blocks the urinary tract, such as kidney stones
• not drinking enough fluids. 

Are UTIs contagious? 

Whilst having sex can increase your risk of getting a UTI, UTIs are not contagious.

What treatment is available for UTIs?

If you're experiencing UTI symptoms, make an appointment with your doctor or other healthcare professional. You may need to give a urine sample to help them diagnose what's causing your symptoms.

If you do have a UTI, you'll probably be prescribed a course of antibiotics. Your doctor should advise on how long you should take the antibiotics.

How long do UTIs last? 

If you're prescribed antibiotics, symptoms will usually begin to improve within 3 to 5 days.

If you suspect you have a kidney infection or an upper UTI, call 111.

The symptoms may include: a very high or very low temperature, confusion, pain in the lower tummy or back, and blood in your urine. The professionals you speak to will be able to advise on the best course of treatment depending on your symptoms. If the infection is severe, you may be referred to a hospital for further tests and treatment.

As well as any treatment prescribed to you, you should also rest and drink lots of fluids. You can also take paracetamol for the pain. Seek advice from your pharmacist if you're unsure about the best type of pain relief. 

How can I prevent UTIs?

Although it's not always possible to prevent UTIs, there are certain things you can do to minimise your risk of developing one.

• Wipe from front to back when going to the toilet.
• Maintain good hygiene by washing daily using unperfumed soap. If you can, avoid using perfumed soaps or talcum powder. 
• Try to empty your bladder fully when peeing and empty your bladder after having sex.
• Wear cotton underwear instead of underwear made of synthetic materials, as cotton allows more airflow than other materials.
• Drink plenty of fluids – aim for 6 to 8 glasses of water a day.
• Change incontinence pads regularly. 
• Avoid putting it off when you need to pee.
• Avoid wearing tight trousers.

If you or someone you look after needs help washing, going to the toilet or getting dressed, it's important to get the help that both you and them need.

Find out more about finding and arranging care and support

How do UTIs affect people with dementia?

If someone with dementia or memory problems develops a UTI, they may quickly become more confused or agitated, or you might notice a sudden change in their behaviour. This sudden confusion is also known as 'delirium'.

Find out more about sudden confusion (or 'delirium') on the NHS website

A person with dementia may not be able to communicate how they feel, so if you notice a sudden or drastic change in them, seek medical advice. Infections can speed up the progression of dementia, so it's important to get help quickly if you suspect someone has a UTI.