Urinary tract infection (UTI): getting help online

What causes a UTI

The NHS explains that UTIs are usually caused by bacteria from poo getting into the tube that carries pee out of the body. Women have a shorter urethra than men, so bacteria reach the bladder more easily. The risk is higher in pregnancy, after the menopause, with kidney stones or anything that makes it hard to empty the bladder fully, with a urinary catheter, with a weakened immune system, with spermicide used for contraception, and when you are not drinking enough.

Symptoms can include pain or burning when peeing, needing to pee more often or more urgently, waking at night to pee, cloudy pee, blood in your pee, lower tummy pain or pain in your back just under the ribs, a high temperature or shivering, and feeling tired. Children may also wet themselves, be sick or seem generally unwell.

What you can do at home

• Take paracetamol to ease pain and a high temperature, checking the leaflet.
• Rest, and drink enough fluids to pass pale pee regularly during the day.
• Avoid drinks that may irritate your bladder, such as fruit juice, coffee and alcohol.
• To help prevent it coming back: wipe from front to back, pee as soon as you can after sex, do not hold your pee in, and wear cotton underwear.

Cranberry products may help some people who keep getting cystitis, but the NHS says there is no evidence they ease symptoms once an infection has started. Avoid cranberry if you take warfarin.

When a video consultation suits a UTI

The NHS says women aged 16 to 64 who are not pregnant or breastfeeding can often get UTI treatment without seeing a GP, and for them a video call is a sensible first step. The DHA telehealth standard lists urinary tract infections among the common conditions for teleprescribing, with a urine dipstick test recommended. The NHS says a doctor may offer self-care advice, prescribe a short course of antibiotics, or ask you to wait 48 hours in case your symptoms go away on their own.

If the doctor asks for a urine test, see lab services to check whether a home urine test is offered where you live. Expect questions about when the symptoms started, whether you have a temperature or back pain, whether you have seen blood, whether you could be pregnant, and how many UTIs you have had in the past year.

When you need urgent or in-person care

Speak to a doctor urgently, and expect that you may need to be seen in person, if:

• you are a man, are 65 or older, or the patient is a child aged 15 or younger
• you are pregnant, have diabetes, use a catheter or have a weakened immune system
• you have a very high or low temperature, or are shivering
• you have pain in your lower tummy or in your back just under the ribs, or blood in your pee
• your symptoms get worse quickly or do not improve within 48 hours
• you keep getting UTIs: 2 within 6 months, or 3 within 12 months

Some of these can be signs of a kidney infection, which can be serious if not treated because it can cause sepsis. Kidney infection can also cause feeling or being sick, diarrhoea and flu-like aches.

Signs that need 998

Call 998 or go to an emergency department if you or your child have UTI symptoms and are confused, drowsy or have difficulty speaking. Also call 998 for signs of sepsis: breathing very fast, blue, pale or blotchy skin, or a very high or very low temperature with shivering. Do not drive yourself.

Which doctor to see

A general practitioner or family medicine doctor can treat most UTIs. If they keep coming back, or you are pregnant, a gynaecologist may be involved. Doctors on medicAI practise at independent facilities licensed by DHA or DoH, which provide your care, and medicAI is the app that connects you to them.