Cystitis

Signs and symptoms of cystitis 

Cystitis is a common type of urinary tract infection (UTI). Mild cases will often get better by themselves within a few days.

However, some people experience episodes of cystitis very often and may need regular or long-term treatment.

There's also a chance cystitis could lead to a more serious kidney infection in some cases. It's important to seek medical advice if your symptoms don't improve.

The main symptoms of cystitis include:

• pain, burning or stinging when you pee
• needing to pee more often and urgently than normal
• urine that's dark, cloudy or strong smelling
• urine that contains blood
• pain low down in your tummy
• feeling generally unwell, achy, sick and tired

Symptoms of cystitis in children 

It can be difficult to tell whether a child has cystitis. This is because the symptoms can be vague and young children cannot easily communicate how they feel.

Possible symptoms of cystitis in young children may include:

• a high temperature (fever) of 38C (100.4F) or above
• weakness and tiredness
• irritability 
• reduced appetite
• vomiting

Children with cystitis can sometimes also have symptoms usually found in adults. These include pain when peeing, peeing more often than normal and pain in their tummy.

When to see your GP 

You should see your GP if you or your child have symptoms of cystitis for the first time. Cystitis isn't usually a cause for serious concern. However, the symptoms can be similar to several other conditions, so it's important to get a proper diagnosis if you're not sure whether you have it.

If you're a woman who has had cystitis before, you don't necessarily need to see your GP again. Cystitis is very common in women and mild cases often get better on their own. 

You can try the self-help measures listed below, or ask your pharmacist for advice.

See your GP if:

• you're not sure whether you have cystitis
• your symptoms don't start to improve within a few days
• you get cystitis often
• you have severe symptoms, such as blood in your urine, a fever or pain in your side
• you're pregnant and have symptoms of cystitis
• you're a man and have symptoms of cystitis
• your child has symptoms of cystitis

Your GP should be able to diagnose cystitis by asking about your symptoms. They may test a sample of your urine for bacteria to help confirm the diagnosis.

Causes of cystitis 

Most cases are thought to occur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body). Women may get cystitis more often than men.

This is because their anus (back passage) is closer to their urethra, and their urethra is much shorter, which means bacteria may be able to get into the bladder more easily.

It's not always clear how this happens, but it can be caused in women by:

• having sex
• wiping your bottom after going to the toilet – particularly if you wipe from back to front
• inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder)
• using a diaphragm for contraception

In men it can be caused by:

• abnormalities of urinary tract, such as vesicoureteric reflux (causes abnormal flow of urine) or urinary stones
• having a catheter (a tube to collect urine from the bladder into a bag)
• not emptying your bladder completely (for example, an enlarged prostate in men can cause bladder obstruction previous urinary tract procedures or surgery
• being immunocompromised (less able to fight infections)

Treatments for cystitis 

If you see your GP with cystitis, and the diagnosis is confirmed as being a bacterial infection, you'll usually be prescribed antibiotics to treat the infection. These should start to have an effect within a day or two.

If you've had cystitis before and don't feel you need to see your GP, you may want to treat your symptoms at home.

Until you're feeling better, it may help to:

• take paracetamol or ibuprofen
• drink plenty of water
• hold a hot water bottle on your tummy or between your thighs
• avoid having sex

If you keep getting cystitis, your GP may give you an antibiotic prescription to take to a pharmacy whenever you develop symptoms, without needing to see your doctor first. Your GP can also prescribe a low dose of antibiotics for you to take continuously over several months.

Preventing cystitis 

If you get cystitis often, there are some things you can try that may stop it coming back. However, it's not clear how effective most of these measures are.

These measures include:

• going to the toilet as soon as you need to pee and always emptying your bladder fully
• staying well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder 
• always wiping your bottom from front to back when you go to the toilet
• emptying your bladder as soon as possible after having sex
• not using a diaphragm for contraception – instead using another method of contraception 
• wearing underwear made from cotton, rather than synthetic material such as nylon, and not wearing tight jeans and trousers

Drinking cranberry juice has traditionally been recommended as a way of reducing your chances of getting cystitis or treating the symptoms. It is no longer recommended as large studies suggest no significant difference.

If you have long-term or frequent pelvic pain and problems peeing, you may have a condition called interstitial cystitis.

This is a poorly understood bladder condition that mostly affects middle-aged women.

• Find out more about cystitis on the NHS website

More useful links

• How to use your health services