Written by Dr Zamiel Hussain, Founder and Lead GP at AccessGP
Urinary tract infections are one of the most common reasons people seek GP advice. They are uncomfortable, often painful, and can worsen quickly if they are not treated early. The good news is that most UTIs are straightforward to diagnose and treat, especially when people act promptly.
This GP-written guide explains the symptoms, causes and when antibiotics are actually needed, along with clear advice on when to speak a GP.
What exactly is a UTI?
A urinary tract infection is caused by tiny organisms called bacteria entering part of the urinary system. The most affected areas are:
- The bladder, (often known as cystitis)
- The urethra (which allows the passage of urine from the body)
- The kidneys, (when affected, this is known as pyelonephritis), which is more serious
Women experience UTIs more often due to the shorter urethra, although men can also develop them, especially with age or prostate related issues.
Other factors such as pregnancy, hydration, diabetes, potentially menopausal status and other conditions play a role in the frequency and severity of infections.
Common symptoms of a UTI
Symptoms can vary depending on which area is affected, but typical signs include:
- Burning or stinging when passing urine
- Needing to pass urine more frequently
- Cloudy or strong smelling urine
- Lower abdominal discomfort or pressure
- Blood in the urine
- Fever or back pain in more severe infections
If you have a fever, vomiting or pain in the sides of your back, this can signal a kidney infection and needs urgent medical assessment.
“Most urinary tract infections are simple to treat when caught early. The key is recognising the symptoms quickly and knowing when a GP review is safer than waiting.”
What causes UTIs?
Most UTIs are caused by a common gut bacterium called E. coli (although not always), which can travel into the urinary tract. Risk factors include:
- Sexual activity
- Dehydration
- Menopause related vaginal dryness
- Pregnancy
- Diabetes
- Catheters
- Prostate enlargement in men
Simple habits such as drinking enough water and avoiding holding urine for long periods help reduce the risk. Keeping well hydrated is a key factor we often neglect as busy people.
Do you always need antibiotics?
Not always. Mild bladder infections in otherwise healthy women sometimes improve on their own within forty eight hours, especially with:
- Good hydration
- Simple pain relief such as paracetamol
- Avoiding caffeine and alcohol while symptoms settle
However, antibiotics are usually needed when symptoms are moderate to severe, when they do not improve quickly, or if you have risk factors.
You may need a urine test, particularly if:
- Symptoms keep returning
- There is blood in the urine
- You are pregnant
- You are unwell or have fever
- You are male
- You have a catheter
Treatment options
GPs use a small number of evidence based antibiotics that target the bacteria most likely to be present. These include nitrofurantoin or trimethoprim, depending on your medical history and any resistance patterns in your area.
Most people begin to feel better within twenty four to forty eight hours of starting treatment.
For kidney infections, stronger antibiotics are often needed and sometimes given in hospital if you cannot keep fluids or medication down.
Recurrent UTIs
If you experience frequent UTIs, your GP may recommend:
- A urine culture to confirm the bacteria
- Longer courses of tailored antibiotics
- Vaginal oestrogen for post menopausal women
- Advice on hydration and bladder habits
- Review of any contributory conditions such as diabetes
Recurrent UTIs are common and treatable, so do not ignore ongoing symptoms. This can be a good opprtunity to discuss concerns around menopause or health checks and screening.
When to speak a GP
You should seek medical advice if:
- Symptoms persist beyond forty eight hours
- You have a fever, back pain or vomiting
- You are pregnant
- There is visible blood in the urine
- Symptoms are severe or worsening
- You keep getting infections
Prompt assessment keeps treatment simple and reduces the risk of complications.
How AccessGP can help
At AccessGP, you can speak to a GP quickly and securely from home. We assess your symptoms properly, arrange urine tests when needed and prescribe safe, evidence based treatments. Same day appointments are usually available.
If you are struggling with UTI symptoms, you can book an appointment at a time that suits you.
Key sources: NICE CKS, UTI in women; NICE Guideline NG109, UTI diagnosis and management; UKHSA, Management of Infection in Primary Care; Patient.info, Urinary tract infections.