Ask the Pharmacist

In this edition of Ask The Pharmacist, Mounthawk Allcare Pharmacy's Pat Harmon explains how to manage the symptoms of urinary tract infections.

"Urinary tract infections are some of the most common infections that we see inside in community pharmacy. The incidence is higher in women than in men, and previous infection increases the prevalence of them going forward. The urinary tract has many distinct parts eg the kidney, bladder and urethra. For people who have infections of the kidney or the ureter this is classified as an upper kidney infection. These generally can be more serious and will always necessitate a visit to your GP for antibiotics. Those with an infection of the bladder or urethra are said to be suffering from a lower urinary tract infection and these can often be managed over the counter.

Men can also develop UTIs but it is generally rare and will always warrant further investigation. Infection of the prostate gland is often the causative factor and this can be very painful and progress quite rapidly. A male patient experiencing symptoms of a UTI will always need to attend his GP to clear the infection.

The symptoms of UTIs are varied but generally one or more of the following will be present:

• Pain or a burning sensation when urinating (this is called Dysuria)

• Increased urge to urinate but when you attempt to go it stings and very little or no urine at all comes out (this is called Frequency)

•The urine may appear cloudy and have an unusual odour. Occasionally there will be spots of blood visible in the urine and this will always necessitate a trip to your GP •Pain in the lower back with associated fever. This is generally a symptom of an upper UTI and is more serious than an infection of the lower urinary tract and will be harder to treat. Sometimes this nonspecific symptom can be mistaken for something else so it's important to always look at the body as a whole when discussing symptoms.

Luckily in the pharmacy setting we have a variety of products available to help manage the symptoms of UTIs so that they don't progress to something more serious.

The most popular product we sell is called Cystopurin. This is a sachet that is dissolved in water and taken three times daily for two days. The active ingredient is potassium citrate and it has the effect of neutralising the acid in urine that can make it so painful to pass. This works very well for mild cases of cystitis and is generally the first product we will recommend to someone with mild symptoms of cystitis. We will also recommend combining this with increased fluid intake as a way of naturally flushing out toxins from the bladder. Cranberry juice is anecdotally recommended for treating and preventing cystitis and we are big advocates of its use. For those who do not like the taste of cranberry juice we sell cranberry extract in pill form and this will have the same effect. Utipro Plus AF capsules are a relatively new treatment for acute uncomplicated cystitis and have been proven to reduce the need for antibiotics. These should be taken at the first onset of symptoms for best affect. We have received excellent feedback on this product and think it is a handy product to keep in the medicine cabinet for those who are prone to recurrent cystitis.

If in any doubt that you may have a UTI come into us and we will be happy to steer you in the right direction. We sell very affordable home test kits that will tell you if you have a urine infection or not. As discussed mild cases of cystitis can be managed over the counter and paracetamol or ibuprofen can be taken to provide pain relief. More severe cases will require you to visit your GP. There are a range of antibiotics available to treat these infections and sometimes the GP will order sensitivity tests to make sure that they prescribe the right one for you. Unfortunately antibiotic resistance is on the rise and people will sometimes have to try more than one medication to eradicate the infection.

As has been explained urinary tract infection are common and have some general defining symptoms that can help in making a diagnosis. For certain populations, eg men, pregnant women, elderly people etc we always refer to the GP as the complications of untreated infection can be severe. However we will always endeavour to help anyone who comes to us and if we can't we will refer to someone who can. I hope you found this article useful and as always we are available in store to answer any questions you may have. Thank you for reading these articles and I hope you found their content informative and of some use."