Advice and Information

What is asthma?

Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. When you come into contact with something that irritates your lungs, known as a trigger, your airways become narrow, the muscles around them tighten and there is an increase in the production of sticky mucus (phlegm). This makes it difficult to breathe and causes wheezing and coughing. It may also make your chest feel tight.
A severe onset of symptoms is known as an asthma attack or an ‘acute asthma exacerbation’. Asthma attacks may require hospital treatment and can sometimes be life-threatening, although this is rare.

For some people with chronic (long-lasting) asthma, long-term inflammation of the airways may lead to more permanent narrowing.

Common triggers

A trigger is anything that irritates the airways and brings on the symptoms of asthma. These differ from person to person and people with asthma may have several triggers.

Common triggers include house dust mites, animal fur, pollen, tobacco smoke, exercise, cold air and chest infections.

What to do in an asthma attack

Sometimes, no matter how careful you are about taking your asthma medicines and avoiding your triggers, you may find that you have an asthma attack.

Recommended steps

The following guidelines are suitable for both children and adults and are the recommended steps to follow in an asthma attack:

  1. Take one to two puffs of your reliever inhaler (usually blue), immediately.
  2.  Sit down and try to take slow, steady breaths.
  3.  If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
  4.  If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
  5.  If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3.

If your symptoms improve and you do not need to call 999, you still need to see a doctor or asthma nurse within 24 hours.

You’re having an asthma attack if any of the following happens:

  • Your reliever inhaler does not help.
  • Your symptoms are getting worse (cough, breathlessness, wheeze or tight chest).
  • You are too breathless to speak, eat or sleep.

Do not be afraid of causing a fuss, even at night. If you go to A&E (accident and emergency) or are admitted to hospital, take details of your medicines with you if possible.

After an emergency asthma attack:
  • Make an appointment with your doctor or asthma nurse for an asthma review, within 48 hours of your attack.
  • You will also need another review within one or two weeks to review your current asthma treatment and ensure your asthma is well controlled.  http://www.asthma.org.uk/all_about_asthma/
Other types of asthma

There are other types of asthma that can be made worse by certain activities:

  • Work-aggravated asthma is pre-existing asthma that is made worse by dust and fumes at work.
  • Occupational asthma is caused by exposure to specific substances at work. For example, some nurses develop occupational asthma after exposure to latex, and some workers in the food-processing industry develop occupational asthma as a response of exposure to flour.

While there is no cure for asthma, symptoms can come and go throughout your life. A number of treatments can help control the condition very effectively. Treatment is based on two important goals:

Blood pressure

When your heart beats, it pumps blood round your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes. ( http://www.bpassoc.org.uk/BloodPressureandyou/Thebasics/Bloodpressure )

Blood Pressure – Understand Your Blood Pressure

Your blood pressure directly affects your health and careful measuring with the right equipment is essential for accurate readings

High Blood Pressure affects millions of people in the UK increasing the risk of stroke and heart attack. It has no symptoms. The only way for you to know if you have low, normal or high blood pressure is to have it measured using an accurate blood pressure monitor.

A recent study showed that people who measure their blood pressure at home have better control of their condition. It found that blood pressure was lower in people who had been checking their blood pressure at home.  http://www.blood-pressure-monitoring.org/

What is measured?

The doctor measures the maximum pressure (systolic) and the lowest pressure (diastolic) made by the beating of the heart.

  • The systolic pressure is the maximum pressure in an artery at the moment when the heart is beating and pumping blood through the body.
  • The diastolic pressure is the lowest pressure in an artery in the moments between beats when the heart is resting.

Both the systolic and diastolic pressure measurements are important – if either one is raised, it means you have high blood pressure (hypertension).

How is blood pressure measured?

To take a blood pressure reading, you need to be relaxed and comfortably seated, with your arm well supported. Alternatively, you can lie on an examination couch.

  • A cuff that inflates is wrapped around your upper arm and kept in place with Velcro. A tube leads out of the cuff to a rubber bulb.
  • Another tube leads from the cuff to a reservoir of mercury at the bottom of a vertical glass column. Whatever pressure is in the cuff is shown on the mercury column. The mercury is held within a sealed system – only air travels in the rubber tubing and the cuff.
  • Air is then blown into the cuff and increasing pressure and tightening is felt on the upper arm.
  • The doctor puts a stethoscope to your arm and listens to the pulse while the air is slowly let out again.
  • The systolic pressure is measured when the doctor first hears the pulse.

Coughs, Colds & Flu

Colds and flu are caused by viruses. Colds and flu are caused by viruses. There are more than 200 common cold viruses, and three types of flu virus with many different strains, so they’re hard to avoid. These viruses can be spread through droplets that are coughed and sneezed out by an infected person.

These viruses work by getting into your body, attacking your cells and using them to build more identical copies of themselves. This causes the familiar miserable symptoms of colds and flu, such as a runny nose, sneezing, a sore throat and a high temperature.

You will get better with or without a medicine, but over the counter remedies may help relieve your symptoms.
Antibiotics don’t work against viruses, and there is nothing you can do to cure a cold or flu. You have to wait for your body to fight and destroy the virus itself. However, you can relieve the symptoms and make yourself feel more comfortable while your body fights the virus. Ask your pharmacist for advice on treating the symptoms of colds and flu. http://www.chic.org.uk/chicmco/feelingunwell/cold_flu.htm

Our Advice
  • Cold and flu products may improve your symptoms.
  • They contain many different ingredients: ask your pharmacist for the best product for you.
  • For severe colds and flu, have plenty of rest and drink lots of water.
  • If symptoms are severe or include a rash, confusion or drowsiness, ask your pharmacist for advice.
  • If you are diabetic, elderly or have a long-term chest or heart condition visit your doctor for a flu jab every year.
  • Colds and flu rarely need antibiotics from your doctor.
  • If you have just returned from a country where malaria is a problem and have flu-like symptoms see your doctor.
  • If you are worried about your symptoms, ask our pharmacist for advice.


Diabetes is a condition which results in too much sugar in the blood. Also known as Diabetes Mellitus, it occurs because the body does not produce enough of the hormone, insulin, which controls the blood sugar levels.

There are two types of diabetes:

Type 1 affects children and young adults and is often referred to as Insulin Dependant Diabetes (IDDM).
Type 2 comes on in later life, especially in the overweight and often runs in families. This is also referred to as Non Insulin Dependent diabetes (NIDDM).

What are the symptoms of diabetes?

Type 1 diabetes symptoms often appear suddenly and include high levels of sugar in the blood and urine, frequent urination, hunger, thirst, weight loss, weakness, tiredness, mood swings, nausea and vomiting.
Type 2 diabetes symptoms include thirst and regular need to urinate, tiredness, irritability and nausea. Skin infections, blurry vision, tingling or dry skin are also common symptoms.

Often symptoms are very mild.

If you have any of these symptoms you should consult your doctor so he/she can do a blood test to check whether you are diabetic.

Diabetes can be caused by various factors:

It can be genetic, meaning it is in your family history.
It can be caused by a disorder of the pancreas which is the organ which produces insulin.
It can be drug-induced e.g. by steroids and certain diuretics.
Obesity or remaining overweight is a contributory factor in type 2 diabetes.

Type 1 diabetes requires the use of regular insulin injections. This will need to be taught to you but most people manage it themselves after a very short time. You will develop an understanding of the different doses needed when more activity takes place or in situations where you are unable to eat.

Type 2 diabetes can often be controlled by diet alone. It is important to get your weight down to a reasonable level. You will need to take medication if diet alone is not sufficient and this usually involves one or more tablets per day.

Diabetes can affect the blood vessels, the eyes, the heart, the nervous system and the kidneys but this usually follows years of poor blood sugar control.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

Our Advice
  • Stick to a diet which does not include sugary food or drinks
  • Take responsibility for your own day-to-day management of your condition
  • Take time to understand your diabetes and how it affects you. This will make you more able to control it and prevent any complications
  • Diabetes can adversely affect the blood vessels, as can smoking. If you smoke, try to stop
  • Our pharmacist can advise you on dietary products which can be purchased and advise you about any of your diabetic medications
  • If you show any of the symptoms of diabetes go to your doctor to be diagnosed
  • If you need to use insulin then follow the prescribed regime exactly to prevent poor blood sugar control
  • We also have a range of blood glucose testing kits available for home testing
How is diabetes controlled?

Type 1 diabetes is controlled with insulin, whereas type 2 diabetes can be controlled through diet and exercise.

I’m worried that I may have diabetes, what should I do?

If you are concerned about your health, see a doctor as soon as possible. Diabetes UK, the leading UK diabetes charity, also operate a Diabetes Careline http://www.diabetes.co.uk/what-is-diabetes.html

What is Eczema

Eczema is an itchy inflammation of the skin, associated to a varying degree with other features such as:

  • redness of affected areas of skin
  • generally dry skin, which is often thickened in the areas that have been scratched
  • lumps or blisters in affected areas
  • signs of superficial infection, such as weeping or crusty deposits.
  • Atopic: the ‘allergic’ type often seen in people who also have hay fever or asthma.
  • Allergic contact: due to skin contact to a substance to which the individual is sensitive. The same substance does not cause eczema in a person who is not sensitive to it.
  • Irritant contact: due to skin contact with irritating chemicals, powders, cleaning agents, etc. Contact with such a substance is likely to cause eczema in any person, although a degree of individual variation still exists.
  • Discoid: appears as discrete islands of eczema on a background of normal skin.
  • Seborrhoeic: in infants appears in the nappy area and the scalp. In adults, also appears on the scalp and in the skin creases between the nose and sides of the mouth. It can be caused by an increased sensitivity to yeast living on the skin.
  • Others: a miscellaneous group including eczema of the legs caused by varicose veins and pompholyx – an intensely itchy form located on the hands and composed of small or (sometimes) large blisters.
Eczema in practice

Eczema is a common condition. Atopic eczema affects about 10 to 20 per cent of schoolchildren and 3 to 5 per cent of adults in the UK, and it’s getting more common.

Eczema affects people with dry and rough skin (keratosis pilaris) and may be caused by a variety of allergens. It often starts in early childhood, around three months of age, and tends to run in atopic families.

An increase of between two- and five-fold has been seen over the past 30 years, for reasons that are far from clear.

It is unusual to be able to identify and eliminate a single agent causing the skin reaction, and most of the time we have to settle for improving the condition rather than getting rid of it altogether.

What are the causes of Eczema?

Possible causes include:

  • Food allergy, which plays an important role in children under one year but not in adults
  • Cow’s milk, hen’s eggs and peanuts are the foods most likely to exacerbate infantile eczema
  • House dust mites tend to aggravate eczema in older children and adults
  • Pet dander exposure, such as to cats, dogs and other furry animals, may play a role
  •  Certain bacteria may cause sudden, severe outbreaks of eczema
Eczema symptoms

In mild cases, eczema is nothing more than a slightly irritating patch of sore skin, but in severe cases extensive areas of skin may become inflamed and unbearably itchy.

Some people with these symptoms develop problems such as depression with low self-esteem, and have difficulty coping at school or work.

People with eczema are also more prone to herpes, skin fungal and wart infections.

Up to half of all babies with widespread atopic eczema will later develop asthma and rhinitis as the eczema improves. This phenomenon is referred to as the ‘allergic march’.

Eczema treatments

Completely avoid the substance that triggers the eczematous rash and treat any existing rash with medium potency steroid ointments and moisturising emollients.

Atopic eczema is usually a little more difficult to treat and you may need to try a number of different treatments, or a combination of treatments, before finding which one works best for you.

People with atopic eczema should bath regularly using liberal amounts of emollients (moisturising creams, ointments, lotions and bath oils) to soften and hydrate the skin. Ointments work much better than creams on dry eczematous skin, but are greasy

If you have atopic eczema you may find the following useful:

  • Take lukewarm baths with emollients, but don’t stay in the water too long
  • Pat the skin dry with a towel – never rub eczematous skin dry
  • Avoid soap, detergents and shampoo – use aqueous cream instead of soap
  • Wear cotton fabrics next to your skin – avoid wool and polyester
  • Wear loose rather than tight-fitting clothes
  • Clip your fingernails and don’t scratch or rub your skin
  • Avoid sports that make you sweat a lot
  • Try to stay calm and relaxed because stress can make eczema worse
Our Advice
  • Constant use of emollients such as unscented creams and bath oils is the best prevention of an eczema flare-up.
  • Treat the flare-up as soon as you can, ask our pharmacist for the best product for you or your child.
  • Synthetic clothing e.g. polyester and elastane worsen eczema. Try to wear cotton clothing.
  • Avoid the use of soap. Use aqueous cream as a soap substitute.
  • Avoid perfumed products and cosmetics and use a non-biological washing powder.
  • Lanolin and wool fat can worsen some people’s eczema.
  • Avoid physical contact with any trigger factors, e.g. pets, washing up liquid.
  • At times of high anxiety eczema usually flares up.http://www.rowlandspharmacy.co.uk/page/advice/index.cfm?event=shop.shopfront.advice.condition.view&categoryId=295


What is hay fever?

Pollen is the name given to the fine powder that is produced by plants, trees or flowers to fertilise other plants, trees or flowers of the same species. Strictly speaking, hay fever is caused by an allergy to grass or hay pollens. Grass pollen is the most common cause and tends to affect people every year in the grass pollen season from about May to July

Symptoms are due to your immune system reacting to the pollenHay fever is also called seasonal allergic rhinitis because symptoms tend to occur at the same time, or in the same season, each year.

Who gets hay fever?

Hay fever is very common. It affects 2 in 10 people in the United Kingdom. It often first develops in school age children and during the teenage years. Symptoms return for a season each year, but it eventually goes away or improves in many cases

What are the symptoms of hay fever?
  • Common symptoms – These include a runny and itchy nose, a blocked nose, sneezing, itchy and watery red eyes, and an itchy throat. In some cases only nose symptoms occur, and in some cases only eye symptoms occur.
  • Less common symptoms – These are loss of smell, face pain, sweats, and headache.
  • Asthma symptoms – Symptoms such as wheeze and breathlessness may get worse if you already have asthma. Some people have asthma symptoms only during the hay fever season. If you have hay fever, you are more likely to develop asthma
How is hay fever diagnosed?

You doctor or nurse can usually diagnose hay fever from your typical symptoms that can occur during the hay fever season. They may also ask if there is a history in your family of hay fever, asthma or eczema.


Hay fever cannot be cured completely, but there are a number of treatments available to relieve the symptoms. These include antihistamine tablets, nasal (nose) sprays and eye drops. Some can only be prescribed by a GP, but many are available over-the-counter (OTC) in pharmacies.

Treatment of hay fever

You can reduce your symptoms by staying indoors on days when the pollen count is high so you have less contact with allergens.

There are a range of treatments available. You can buy some of these in shops and supermarkets. Others are available in pharmacies, while for some you will need a prescription from your GP. Get advice from your GP or pharmacist before starting any medication, even if you don’t need a prescription for it.

Nasal sprays
If you only get hay fever symptoms now and again, and they only affect your nose, you could try an antihistamine nasal spray such as azelastine

Tablets that contain an antihistamine are an alternative treatment. They should reduce symptoms of sneezing and a runny nose, but are less effective at relieving a blocked nose

Eye drops
If you suffer from itchy or sore eyes, eye drops that contain antihistamines or sodium cromoglicate can help

Head lice treatment

What are lice?

The head louse is a tiny greyish-brown insect, about 2.5mm long.Head lice cling to hair and are usually found on the scalp. They live on blood from the host, which they get by biting through the scalp

What is the best way of looking for head lice?

You can part the hair and look for nits, but the lice will move quickly into hiding. The best way to search for head lice and nits is to buy a specially designed detection (nit) comb from a pharmacy. This is a fine-toothed plastic comb with spacing of less than 0.3mm.

What if I find lice?

Check every other member of the family, including any adults who have close contact with the child.You can work out when the lice first moved in by judging how many centimetres from the scalp you find the nits. Hair grows at about 1cm a month; so a nit 2cm from the scalp was laid about two months ago.

How are head lice treated?

The three main treatments for head lice are listed below, but no method is 100 per cent effective.

Insecticides that kill head lice are available in lotion, mousse and shampoo form. You can buy them from the pharmacy or get them on prescription.

Silicone-based products
These are relatively new products that work in a different way to conventional insecticides for head lice. There are currently three available:

  • Hedrin lotion (containing dimeticone)
  • Itax lotion (containing cyclomethicone)
  • NYDA pump spray (containing dimeticone).

Instead of poisoning the parasites by chemical means, these products kill the lice by physically coating their surfaces and smothering them. As these products work in this physical way, head lice cannot become resistant to them.

Wet combing
Wet combing removes lice without using chemicals. It involves wetting the hair, applying conditioner, then combing it with a fine-toothed comb for at least 30 minutes every third or fourth day over a two-week period.

Travel Vaccinations

You don’t always need vaccinations to travel abroad. If you do, the recommended vaccinations will vary, depending on:

  • which country you’re visiting and, in some cases, which part of the country,
  • the season or time of year when you’ll be travelling, for example, the rainy season,
  • whether you’ll be staying in a rural area or an urban or developed area,
  • what you’ll be doing during your stay, such as working in or visiting rural areas,
  • how long you’ll be staying, and
  • your age and health.
Get advice well in advance

It’s best to get advice about vaccinations at least eight weeks before you’re due to travel. If you do need new vaccinations, some jabs need to be given well in advance so that they can work properly.

You also need to make sure your existing vaccinations for the UK are up to date, such as polio and tetanus. If they’re not, you can arrange booster jabs.

Where to get advice and information

See your GP or practice nurse for advice about travel vaccinations. They can also tell you about protecting yourself from malaria.

When you have your check-up at your local surgery, it’s a good idea to review your medical history, present state of health, medications and any allergies. Keep your immunisation certificates (and list of current medication) with your passport for use during your travels and as a record for the future.

Find out more detailed information about travel vaccinations in Health A-Z, including those available on the NHS and those you have to pay for.

The NHS Fit for Travel website has vaccination information for every country in the world.

MASTA (Medical Advisory Services for Travellers Abroad) can help you find your nearest private travel health clinic.

NaTHNaC (National Travel Health Network and Centre) can help you find a yellow fever vaccination centre.

Some countries have adopted HIV/AIDS-related entry restrictions. Travellers with HIV should consult their GP for a detailed assessment and advice before travelling.

These are some of the vaccines sometimes recommended. Get more specific advice from your travel health expert.

An oral vaccine is available in the UK for travellers to endemic or epidemic areas, where the risk of cholera is greatest. In most cases, a cholera vaccination certificate is no longer required. If it is, your travel company should alert you.

Diphtheria is one of the childhood immunisations in the UK, but protection may not be lifelong. There have been recent outbreaks in some parts of the world – if you’re travelling to one of these areas, a booster may be recommended.

Hepatitis A
The hepatitis A virus is present in faeces and can be spread from person to person, but it’s usually caught by consuming contaminated food or water. Those travelling to places where sanitation is poor need to be especially aware of the risk of infection.

A vaccination can help to reduce the risk, but it’s also vital to be scrupulous about personal hygiene. Be careful what you eat and drink, and wash your hands after using the toilet and before handling or eating food.

Hepatitis B
This serious infection of the liver is common in many parts of the world. It’s caught via contact with contaminated blood – including sharing needles, blood transfusions or inadequately sterilised equipment – and intimate sexual contact.

Immunisation is available but not routinely recommended for travellers unless they’re likely to be at increased risk through work or other activities.

Japanese encephalitis
This viral disease spread by mosquitoes occurs throughout south-east Asia, mainly in rural areas and during the monsoon season. A vaccine is available for those who are travelling to rural areas in the monsoon season and staying more than two weeks. However, it isn’t usually free on the NHS.

Malaria is transmitted by infected mosquitos and is common in many parts of Africa, Asia, Central and South America. If you’re visiting or travelling through a country where there’s a risk of malaria, preventative measures are essential.

Antimalarial drugs don’t prevent infection, but do inhibit the parasite’s development and so significantly reduce the risk. In some regions, the parasite is resistant to some of the drugs used. It’s therefore essential to get up-to-date, specific advice about the best antimalarial drugs for your destination.

You should start taking the tablets one to two weeks before departure, to ensure there’s no adverse reaction and to establish an adequate level of protection before exposure. Tablets must be taken as prescribed while in the malarial zone and continued for a further four to six weeks after leaving. It’s essential to finish taking the course of tablets, as the parasite can live in the body for some time after infection.

Remember, none of these precautions gives absolute protection against malaria. It’s therefore vital to know the symptoms, so you can get prompt medical attention should any appear.

Malaria usually starts as a flu-like illness. A pattern of coldness and shivering, followed by fever (38°C/100°F or more), sweating, muscle aches and headaches must be taken seriously.

If you develop a fever or feel ill while abroad or up to eight weeks after returning, seek medical attention immediately. Tell your doctor you’ve been in a country where malaria is a health risk.

Meningococcal meningitis is more common in some areas of Africa and Asia than in the UK. A vaccine is available to protect against some strains. Saudi Arabia requires all pilgrims during the Hajj to be vaccinated. Consult your doctor for more information.

Vaccination against poliomyelitis is usually recommended for all destinations. In the UK, the vaccine is given as an injection as part of the normal childhood schedule. Booster doses are recommended every ten years.

Rabies occurs throughout the world, with most deaths taking place in developing countries, such as those in south-east Asia. Rabies is very rare in the UK, occurring only in quarantined animals and people infected abroad.

It’s usually contracted through being bitten or scratched by an infected mammal, such as a bat, dog, cat or fox. The incubation period is normally two to eight weeks, but can be as long as two years. It isn’t usual practice to inoculate travellers against rabies.

Tick-borne encephalitis
This disease is caught from the bite of an infected tick. It occurs in warm, forested parts of central and eastern Europe and Scandinavia, especially where there’s heavy undergrowth, and is more common in late spring and summer.

Those walking or camping in such areas should wear clothing that covers most of the skin and use insect repellents. A vaccine is available.

If you haven’t been vaccinated against tuberculosis (TB) and staying for more than a month in eastern Europe, Asia, Africa, Central or South America, you should consider a bacille Calmette-Guerin (BCG) vaccination. Preferably, this should be given at least two months before departure.

Vaccination isn’t necessary for short visits if you’re staying in international-standard hotels. Revaccination isn’t necessary for those already vaccinated against TB.

Typhoid is caught from contaminated food, drink or water. A vaccination is recommended for all destinations apart from northern Europe, North America, Australia and New Zealand.

There are three different types of vaccine. Depending on which is given, boosters are required at intervals of one to three years.

Yellow fever
Yellow fever is caught from the bite of an infected mosquito. An international certificate for yellow fever is required for travel to several countries in central and west Africa, and the northern part of South America. The certificate comes into effect ten days after vaccination and lasts for ten years. Certificates after subsequent doses are valid immediately. http://www.bbc.co.uk/health/treatments/travel/before_jabstablets.shtml

Urinary tract infection (UTI)

A urinary tract infection (UTI) is a common type of infection that occurs in the urinary tract. the symptoms of a UTI include:

  • pain or a burning sensation during urination
  • a frequent need to urinate
  • lower abdominal pain
What causes UTI?

In healthy men, urine is sterile (contains no micro-organisms).

The most important factor in maintaining the sterility of the urinary tract is emptying the bladder completely and frequently.

The cause of most UTIs is bacteria that initially settle (colonise) around the urethra (urine tube), and then ascend into the rest of the urinary tract.

What are the symptoms of UTI?

Symptoms differ, depending on whether the infection affects the lower (bladder and urethra) or upper (kidneys and ureters) parts of the urinary tract.

The symptoms of lower urinary tract infection are dysuria (burning on passing urine), frequency (frequent need to pass urine) and urgency (compelling need to urinate). The urine can be cloudy with an offensive odour.

In older men, generalised symptoms such as confusion and incontinence can be present.

Urine infections are much commoner in the elderly, due to poor bladder emptying, an enlarged prostate, or incontinence associated with stroke or dementia.

The symptoms of upper urinary tract infection are the same as lower tract symptoms plus loin (flank) pain, fever and chills. The patient is likely to be ill and might require hospital admission.

Types of UTI

A UTI develops when part of the urinary tract becomes infected, usually by bacteria. Bacteria can enter the urinary system through the urethra or, more rarely, through the bloodstream.

There is usually no obvious reason why the urinary tract gets infected, although some women find that they develop a UTI after having sexual intercourse.

There are two types of UTI:

  •  Lower UTI is an infection of the lower part of the urinary tract, which includes the bladder and the urethra. An infection of the bladder is called cystitis, and an infection of the urethra is known as urethritis.
  • Upper UTI is an infection of the upper part of the urinary tract, which includes the kidneys and the ureters. Upper UTIs are potentially more serious than lower UTIs because there is a risk of kidney damage.
How common are UTIs?

UTIs are a very common type of infection in women. In the UK, it is estimated that one woman in three will have a UTI before the age of 24, and that half of all women will have at least one UTI during their lifetime.
UTIs are a lot less common in men. It is estimated that every year in the UK, in otherwise healthy men, only one in every 2,000 will develop a UTI.


The outlook for most cases of UTI is excellent. The infections are usually mild and will usually resolve within four to five days. Antibiotics can be used to help speed up the recovery time.

However, some women find that they experience repeated UTIs, and that they require long-term treatment with antibiotics to prevent the infection returning.

Complications of a UTI are uncommon, but serious, and include:

  • kidney failure, where the kidneys lose almost all of their functioning capability
  • blood poisoning, also known as sepsis

These complications usually only affect people with a pre-existing health problem, such as diabetes, or a weakened immune system (the body’s natural defence against infection).

How is UTI treated?

Treatment depends on how and why the infection shows itself. Most patients respond rapidly to antibiotic therapy and are unlikely to have any other urinary tract abnormality.

General measures

A high fluid intake is essential. Alkaline substances, such as citrates, taken in water might improve symptoms.

By making the urine more alkaline, they make the environment more hostile to bacterial growth and improve the results of antibiotic therapy.

Antibiotic therapy

Antibiotics are the mainstay of treatment.

Trimethoprim (eg Monotrim) is currently the first choice for lower UTI in the UK, because it’s cost-effective, well tolerated and works in 80 per cent of infections.

Cephalosporins, nitrofurantoin and norfloxacin are reserved as second line drugs in patients with lower UTI. But they are the first choices in patients with signs of upper UTI or kidney infection.

Antibiotics, such as amoxicillin, now have resistance levels of 50 per cent in the community because of widespread use over many years.

Based on such experiences, many specialists are concerned about the possible overuse of the more powerful antibiotics as first line therapy in the general community.


Cystitis is inflammation of the urinary tract caused by damage or infection. You will normally suffer with a burning sensation when passing urine and will want to pass water more often than normal.
If there is no improvement after 48 hours, ask our pharmacist for advice.

Our Advice
  • Ask your pharmacist to choose the product which is most suitable for you.
  • Drink more water to help flush the stinging urine through your body.
  • Avoid alcohol, tea and coffee which can irritate the bladder. Cranberry juice can help to treat and prevent cystitis.
  • Always wipe from front to back when you go to the toilet.
  • Wear cotton briefs and loose clothing.
  • Excessive washing of the area can worsen the symptoms; washing morning and night is advised, though.
  • All men and children should seek medical advice from their doctor. UTIs are rare in men, so all cases require investigation. Prostatitis, the infection or inflammation of the prostate (a gland beneath the bladder that produces some components of semen), causes symptoms that can be mistaken for UTI in men.
  • Do not use bath additives in your bath water.