Water Infections: Signs and Symptoms

Contents

• Signs of a Water Infection
• D-Mannose and UTIs
• Buy a UTI Test Kit
• Causes of UTIs
• Diagnosing a UTI
• Treating UTIs
• Alternative and Natural UTI Remedies
• Treating Chronic and Recurrent UTIs
• How Does D-Mannose Work?
• Managing UTI Triggers
• Lifestyle Changes to Prevent Recurrent UTIs
• When to See a Doctor
• UTIs in Men
• Conclusion

You may have read or heard about water infections, sometimes referred to as a urinary tract infection or UTI, cystitis, or bladder infection. If you’ve never experienced one of these infections, you may not understand exactly what a UTI is or how painful and debilitating it can be.

Symptoms of water infection are troublesome to anyone affected by them, but women are more likely to develop UTIs than men, partly due to the anatomy of the female urinary tract. Many women experience a UTI during their lifetime, and some may experience them frequently. These types of infections can be treated with antibiotics, but they are not always needed.

Signs of a Water Infection

• Intense urge to urinate frequently
• Need to get up several times a night to urinate
• Passing small amounts of urine at a time
• Intense pain or burning during urination, especially near the end
• Lower abdominal pain
• Bloody or cloudy urine
• Strong and/or unpleasant smelling urine

Treatment depends on the symptoms and risk of complications. Some non-pregnant women with uncomplicated lower UTIs may be offered a back-up antibiotic prescription, while others need immediate antibiotics. Do not delay medical assessment if symptoms suggest a kidney infection.

D-Mannose and UTIs

Your grandma probably drank lemon barley when she thought she might be developing a water infection. Today, some women who are especially prone to these infections keep a jug of cranberry juice in the refrigerator for the same purpose. Cranberry products may help prevent recurrent UTIs in some women, but they do not treat an existing infection. Evidence does not support relying on D-mannose to prevent or treat UTIs.

D-mannose is a naturally occurring sugar that has been investigated for UTI prevention. However, a large UK trial found that taking it daily did not significantly reduce recurrent UTIs compared with a placebo.

D-mannose has not been shown to provide quick relief from UTI symptoms and should not replace assessment or prescribed treatment. See the 2024 clinical trial for more information.

Buy a UTI Test Kit

If you are concerned that you may have a water infection, speak to your GP or pharmacist, especially if you are prone to frequent infections. A home test kit is available on this website that checks urine for infection-related markers. It is a screening aid, not a diagnosis: a negative result does not rule out a UTI, and a positive result does not always confirm one. Do not delay seeking advice because of a home test result.

Causes of UTIs

UTIs are caused by bacteria, most commonly E. coli from the gastrointestinal tract, entering and infecting the urinary tract. Women are more prone to UTIs than men for several reasons:

• The urethra is shorter in women, allowing bacteria quicker access to the bladder
• The opening of the urethra is closer to the anus in women, increasing bacteria transfer
• Sexual intercourse can transfer bacteria to the urethral opening
• Pregnancy increases UTI risk due to hormonal changes and increased bladder pressure

In addition to gender, other UTI risk factors include:

• Family history of UTIs
• Diabetes
• Blockage of the urinary tract from kidney stones, tumours, etc.
• Compromised immune system
• Use of spermicides
• Use of diaphragm for birth control

Diagnosing a UTI

If you suspect you have a UTI based on symptoms, it is important to seek advice from your GP or pharmacist when appropriate. They will ask about your symptoms and medical history. Tests are not always needed for a straightforward lower UTI in a non-pregnant woman, but may include:

• Urinalysis: Checks for bacteria, blood cells and pus in the urine
• Urine culture: Cultures bacteria from a urine sample to identify the type and guide treatment
• Imaging: Ultrasounds or CT scans check for abnormalities or blockages

Treating UTIs

UTIs are often treated with antibiotics, but the need for immediate treatment and the duration depend on the person and the infection. Treatment is aimed at eliminating infection and preventing complications.

For lower UTIs, UK guidance includes antibiotics such as:

• Nitrofurantoin, where suitable
• Trimethoprim, where local resistance risk and individual circumstances permit
• Other options, including fosfomycin, where recommended by the prescriber

Antibiotic choice depends on pregnancy, kidney function, previous results and local resistance patterns. More severe kidney infections may need hospital treatment and intravenous antibiotics.

In addition to antibiotics, recommendations to help manage symptoms include:

• Drink enough fluid to avoid dehydration
• Urinate when you need to, rather than holding urine for long periods
• Consider paracetamol for pain or fever if suitable for you
• Follow the advice given with any prescribed antibiotics

Alternative and Natural UTI Remedies

While antibiotics are sometimes needed to treat UTIs, increasing bacterial resistance has prompted interest in prevention and self-care. The following products and approaches have been discussed, but none should be used instead of treatment for an active infection:

Cranberry Juice / Extract: Cranberry products may reduce the risk of recurrent UTIs in some women, but they are not proven to treat an existing infection. Evidence does not establish that juice is better than supplements.

Probiotics: Evidence that probiotics prevent recurrent UTIs is uncertain. They should not be used to treat an active infection.

D-Mannose: This natural sugar has been studied for preventing bacterial attachment, but good-quality evidence does not show a clear benefit for preventing recurrent UTIs or relieving symptoms.

Vitamin C: There is insufficient evidence that vitamin C supplements prevent or treat UTIs. They are not a substitute for antibiotics when antibiotics are needed.

Herbs: Products such as bearberry, goldenseal and buchu have been promoted for urinary symptoms, but reliable clinical evidence of benefit is lacking and some may cause harm or interact with medicines.

Essential Oils: Laboratory antimicrobial effects do not establish that essential oils treat UTIs in people. Do not apply them to sensitive genital tissue or use them as a UTI treatment.

Always check with your GP or pharmacist before using supplements, especially during pregnancy or if you take medicines. Seek medical advice if symptoms persist or worsen. Natural remedies should not delay necessary treatment.

Treating Chronic and Recurrent UTIs

For some individuals, urinary tract infections can become a recurring problem. If you experience frequent UTIs, defined as two or more within six months or three or more within a year, your GP may recommend additional testing and preventative measures. Kidney infections and other complications need prompt treatment, but recurrent lower UTIs do not inevitably cause kidney damage.

Some potential causes of recurrent UTIs include:

• Abnormalities in the urinary tract, such as kidney stones or structural issues
• Incomplete treatment of previous infections
• Suppressed immune system
• Inadequate bathroom hygiene habits
• Spermicidal contraceptives

Your GP may consider a urine culture and, when clinically indicated, imaging tests such as an ultrasound to check for abnormalities contributing to recurrences. Treatment can be guided by culture results.

In addition to antibiotics during active infections, preventative treatments could include:

• Vaginal oestrogen for perimenopausal or postmenopausal women, where appropriate
• Methenamine hippurate as an alternative to daily antibiotic prevention for suitable patients, after discussion with a clinician
• Single-dose or daily preventative antibiotics in selected cases, following assessment

How Does D-Mannose Work?

D-mannose is a simple sugar related to glucose that occurs naturally in some fruits like cranberries. When ingested as a supplement, some D-mannose is excreted in the urine.

Laboratory research suggests D-mannose can interfere with the attachment of some E. coli bacteria to cells lining the urinary tract. However, this proposed mechanism has not translated into reliable evidence that supplements prevent UTIs in everyday use.

D-mannose and cranberry products are different substances. A 2024 placebo-controlled trial in UK primary care found no meaningful reduction in recurrent UTIs from daily D-mannose. It has not been shown to work as well as antibiotics for treating an active UTI.

For people with recurrent UTIs, taking D-mannose daily or at the first sign of symptoms should not be relied on to prevent or treat an infection. Supplements can cause side effects, and their long-term safety is not fully established.

Managing UTI Triggers

While not a cure for chronic UTIs, making certain lifestyle adjustments may help reduce recurrence frequency by minimising common UTI triggers:

• Practise good toilet hygiene, including wiping front to back
• Consider urinating after sex
• Avoid spermicides if they seem to contribute to recurrent infections
• Stay hydrated and avoid regularly delaying urination
• Manage conditions like diabetes that increase UTI risk

Identifying factors that seem to aggravate your urinary symptoms through a food or activity diary can be helpful. Caffeine and alcohol may irritate the bladder in some people, although they are not established causes of bacterial UTIs.

By combining suitable prevention strategies, lifestyle adjustments and prompt treatment of acute infections when needed, many women can better manage recurrent UTIs.

Lifestyle Changes to Prevent Recurrent UTIs

For those plagued by chronic repeat infections, making certain lifestyle adjustments can help reduce UTI frequency by minimising risk factors:

• Urinate after intercourse if this is helpful for you
• Stay hydrated and urinate when needed
• Wipe front to back after using the toilet
• Avoid potentially irritating feminine products, such as douches and sprays
• Consider switching from spermicidal contraceptive methods
• Discuss recurrent infections and prevention options with your GP

When to See a Doctor

Some uncomplicated lower UTIs improve without immediate antibiotics, but symptoms must be monitored. Seek urgent advice through your GP or NHS 111 if you experience:

• Fever, shivering or feeling very unwell
• Pain in your back or side, particularly under the ribs
• Nausea or vomiting with urinary symptoms
• Blood in the urine
• Symptoms that worsen rapidly or do not improve within 48 hours of starting antibiotics
• Suspected UTI during pregnancy, in a man or in a child
• Confusion, drowsiness or difficulty passing urine

Seek emergency help if someone is severely confused, difficult to wake, has trouble breathing or shows other signs of sepsis. If you are pregnant and suspect a UTI, contact your GP or maternity team promptly.

A kidney infection or severe infection can lead to complications including sepsis if left untreated. Recurrent infections may also warrant further testing. Seek further medical advice if your UTI is not improving within 48 hours of starting antibiotics or comes back shortly after treatment.

UTIs in Men

While women are disproportionately prone to UTIs, they can and do occur in men as well. Some key differences:

• Enlarged prostate gland in older men increases UTI risk
• Structural issues like kidney stones or blockage raise risk
• Certain medical procedures can introduce bacteria into the urinary tract

Symptoms are similar but may also include:

• Rectal pain
• Urgency but inability to urinate
• Painful ejaculation

Men with suspected UTIs should seek medical assessment, particularly if they have difficulty passing urine, fever or pelvic pain. Prompt treatment is important where infection is confirmed.

Conclusion

UTIs are common, especially in women, and can recur frequently in certain individuals. Antibiotics remain important when clinically indicated, while some uncomplicated lower UTIs may be managed with a back-up prescription and appropriate advice. Lifestyle measures may help reduce recurrence. At-home tests can provide additional information but cannot diagnose or exclude an infection. New symptoms, worsening illness or symptoms that persist after treatment should prompt medical advice.

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