Water Infections (UTIs)

A urinary tract infection (UTI) is an infection in any part of the urinary system — the kidneys, the ureters (the tubes that carry urine from the kidneys), the bladder, or the urethra (the tube that carries urine out of the body). Many people call this a "water infection".

Most UTIs affect the bladder (a lower UTI or cystitis). Infections that reach the kidneys (a kidney infection or upper UTI) are more serious and need prompt medical care.

• Pain, stinging or a burning feeling when you pass urine.
• Needing to urinate more often than usual, or feeling a sudden urgent need to go.
• Only passing small amounts of urine, or feeling you have not fully emptied your bladder.
• Cloudy urine.
• Blood in your urine.
• Pain low down in your tummy (lower abdominal pain).
• Pain in your back or side.
• A high temperature, shivering, or feeling generally unwell.

Strong-smelling or dark urine on its own is not always an infection. It can simply mean you have not had enough to drink. Try drinking more water for a day — if the smell settles and other symptoms are not present, it may just have been mild dehydration.

UTIs are much more common in women because the urethra is shorter, so bacteria can reach the bladder more easily. Many women will have at least one UTI in their lifetime.

UTIs in men are less common and are usually taken more seriously by GPs. Men with possible UTI symptoms should contact a GP or NHS 111 rather than waiting to see if things settle. An infection can sometimes involve the prostate and may need a longer course of treatment.

UTIs in pregnancy need extra care because they can affect both the pregnant person and the baby if left untreated. If you are pregnant and think you have a UTI, contact your GP, midwife or NHS 111 the same day rather than waiting. Do not take any medicine (including over-the-counter cystitis sachets) without checking that it is safe in pregnancy.

Signs of a UTI in a child can be less obvious than in adults. Look out for:

• A high temperature or feeling generally unwell.
• Being irritable, unusually tired, or off their food.
• Being sick or having tummy pain.
• Wetting themselves after being dry, or crying when passing urine.
• Smelly, cloudy or blood-stained urine.
• A baby not feeding well or having fewer wet nappies than usual.

A child with possible UTI symptoms should be seen by a GP the same day. If they are very unwell, drowsy, floppy, breathing fast or have a rash that does not fade under pressure, call 999.

Older adults and people who are frail, live with dementia, or have a long-term catheter can be more prone to UTIs and can feel more unwell with them. However, sudden confusion, drowsiness or a change in behaviour should not be assumed to be caused by a UTI without a proper assessment — many other things (including medicines, dehydration, pain and other infections) can look similar.

If you are worried about a relative in a care home or at home, ask staff or the GP for a full check. See also Delirium and Sudden Confusion.

Some people have UTIs that keep returning. Speak to a GP if you have had two or more UTIs in six months, or three or more in a year. A GP may:

• Ask about your pattern of symptoms and any triggers.
• Send urine samples for testing.
• Discuss self-care and prevention.
• Consider a longer or different course of antibiotics, or preventive medicines, if suitable.
• Refer you to a specialist for further investigation if needed.

A kidney infection (upper UTI) is more serious than a bladder infection. Signs can include:

• Pain in your back or side, under the ribs.
• A high temperature, shivering or feeling very unwell.
• Feeling sick or being sick.
• Diarrhoea.
• Confusion, agitation or restlessness (especially in older people).

Contact a GP or NHS 111 the same day if you think you may have a kidney infection. Call 999 if someone is very unwell, breathing fast, extremely drowsy, or shows any signs of sepsis. Repeated or severe kidney infections can, over time, affect kidney function — see Chronic Kidney Disease.

Depending on your symptoms and history, a pharmacist, GP or NHS 111 may:

• Ask about your symptoms and any previous UTIs.
• Ask for a urine sample. This can be tested straight away (dipstick) and sometimes sent to a lab.
• Recommend pain relief such as paracetamol, and drinking plenty of water.
• Prescribe a short course of antibiotics if an infection is likely.
• Arrange follow-up if symptoms do not settle or the infection comes back.

Antibiotics are not always needed — mild bladder symptoms sometimes settle with self-care and plenty of fluids. When antibiotics are prescribed, take them exactly as directed and finish the course, even if you feel better.

Important: Do not take leftover antibiotics, and never use antibiotics that were prescribed for someone else. The wrong antibiotic can fail to treat the infection, cause side effects, and add to antibiotic resistance.

• Drink enough fluids through the day so your urine stays a pale straw colour.
• Do not hold on when you need to pass urine.
• Wipe from front to back after using the toilet.
• Try to empty your bladder fully, and pass urine shortly after sex.
• Keep the genital area clean with plain water; avoid strongly perfumed soaps and bubble baths.
• Change out of damp swimwear or sweaty clothes promptly.
• Manage constipation, as this can affect bladder emptying.
• Speak to a GP or menopause specialist if vaginal dryness after menopause is causing repeated UTIs — treatments can help.

A pharmacist can give advice on symptoms and, through the NHS Pharmacy First service in England, may be able to supply treatment for uncomplicated UTIs in some women aged 16–64 without a GP appointment. They can also tell you when you need to see a GP.

A GP should be contacted for children, men, people who are pregnant, people with diabetes or a weakened immune system, anyone with signs of a kidney infection, and anyone whose UTIs keep coming back.

NHS 111 (call 111 or use 111.nhs.uk) can help when you cannot see a GP quickly, out of hours, or you are not sure how urgent things are.

Use Find Local Services to locate your nearest GP, pharmacy, A&E or urgent treatment centre. See also our GP Services page for booking advice.

• Delirium and Sudden Confusion — sudden confusion needs a proper check, not just antibiotics.
• Chronic Kidney Disease — how the kidneys work and long-term kidney health.
• GP Services — booking, appointments and what to expect.
• Care Homes — help for relatives worried about a resident.
• Diabetes — why infections may need extra care.

Main sources used on this page:

• NHS — Urinary tract infections (UTIs)
• NHS — Kidney infection
• NHS — Sepsis
• NICE NG109 — Urinary tract infection (lower): antimicrobial prescribing
• NHS 111 online

This page provides general information and cannot diagnose a condition or replace professional medical advice. Always speak to a pharmacist, GP or other qualified health provider about your own symptoms. In an emergency, call 999.