The National Health Service has issued important guidance for anyone who finds themselves waking up more often than usual to urinate during the night. While for some this is a normal pattern, a sudden or new habit of night-time toilet trips could be a sign of an underlying health issue, most commonly a urinary tract infection (UTI).
Recognising the Symptoms of a Urinary Tract Infection
The NHS outlines that a UTI can affect any part of your urinary system, including the bladder, urethra, or kidneys. The key symptom prompting this latest advice is nocturia – the medical term for needing to pee more often than usual at night. However, this is rarely the only sign.
Other common symptoms of a UTI include:
- A painful or burning sensation when urinating.
- A sudden, urgent need to pee, or needing to go more frequently overall.
- Cloudy, dark, or strong-smelling urine, or urine that contains blood.
- Pain in the lower abdomen or in the back under the ribs.
- A high temperature, or feeling hot, cold, and shivery.
- General feelings of tiredness or weakness.
The health body notes that dark or smelly urine on its own is more likely a sign of dehydration. Symptoms can differ in specific groups: children may seem irritable, have a high temperature, or wet themselves, while older or frail individuals might show signs of confusion or delirium.
When and Where to Seek Medical Help
Knowing when to act is crucial. For women and girls aged 16 to 64 who are not pregnant or breastfeeding, a pharmacist can provide first-line treatment and advice. However, the NHS advises seeking an urgent GP appointment or calling 111 in several specific scenarios.
You should seek urgent medical advice if you, your child, or someone you care for has UTI symptoms and any of the following apply: being 65 or older; being a man, or trans or non-binary and assigned male at birth; having diabetes; symptoms worsening or not improving after 48 hours; recurrent infections; using a catheter; pregnancy; severe pain; visible blood in urine; or a weakened immune system.
Some of these symptoms can indicate a developing kidney infection, which can become serious rapidly and lead to sepsis. Call 999 or go to A&E immediately if someone is confused, drowsy, has difficulty speaking, or has a very high or low temperature. Do not drive yourself in such circumstances.
Causes, Prevention, and Long-Term Management
UTIs are typically caused by bacteria from the gut entering the urinary tract via the urethra. Women are at higher risk due to having a shorter urethra. Risk factors include sexual activity, pregnancy, kidney stones, conditions like an enlarged prostate, urinary catheters, a weakened immune system, and not drinking enough fluids.
To help prevent infections, the NHS recommends:
- Wiping from front to back after using the toilet.
- Drinking plenty of fluids, especially water.
- Urinating as soon as possible after sex.
- Keeping the genital area clean and dry, avoiding scented soaps.
- Not delaying going to the toilet when you feel the urge.
- Wearing cotton underwear and avoiding tight clothing.
For those who suffer from recurrent bladder infections (cystitis), there is some evidence that taking D-mannose powder or tablets daily may help. Cranberry juice, tablets, or capsules are also noted as potential preventative measures. However, the NHS cautions that both can be high in sugar. Crucially, anyone taking the anticoagulant medicine warfarin should avoid cranberry products entirely, and you should always speak to a doctor before taking these during pregnancy.
