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Cystitis

Key points

  • Cystitis is a common bacterial infection that causes inflammation in your bladder.
  • Symptoms of cystitis include pain when you pass urine, a frequent, urgent need to urinate, and cloudy or strong smelling urine.
  • The condition usually clears up within four to nine days, but this may happen slightly more quickly if you take antibiotics.

In cystitis, a bacterial infection causes your bladder to become inflamed. It happens when bacteria enter your bladder through your urethra, the tube that carries urine out of your body.

About cystitis

Cystitis is a common type of lower urinary tract infection. Your urinary tract consists of your kidneys, two ureters (the tubes that connect each kidney to your bladder), your bladder and your urethra.

Cystitis is caused by a bacterial infection from a variety of sources. It may also be triggered by having sex. It's most common in women, but it can affect men and young children. Doctors believe it’s less common in men because they have longer urethras and bacteria have further to travel to reach the bladder. Up to four in 10 women will have a bout of cystitis at some point during their lifetime.

Illustration showing the position of the bladder and surrounding structures

Symptoms of cystitis

Common symptoms of cystitis include:

  • pain when you pass urine
  • a frequent, urgent need to urinate, but you only pass small amounts or no urine
  • cloudy, dark or strong smelling urine
  • blood in your urine – this may not always be visible, but can be found by testing the urine
  • pain during sex
  • pain in your lower abdomen (tummy) or lower back
  • feeling tired or generally unwell
  • a mild fever

Overall, the symptoms of cystitis are similar for men and women. Some children may develop a fever, have a reduced appetite and may have bouts of vomiting. However, young children may feel generally unwell but have no other symptoms. If your child has a fever or you think he or she might have cystitis, contact your GP for advice. It’s important to seek medical help as soon as possible because these symptoms may be caused by other, more serious conditions.

These symptoms can also be caused by conditions other than cystitis in adults. If your symptoms don’t get better after two to three days, contact your GP. He or she will be able to rule out any other conditions that could be causing your symptoms.

Complications of cystitis

There is a chance that you could develop a kidney infection called pyelonephritis. This can happen if the infection moves from your bladder into your kidneys. Symptoms of kidney infection often include fever, vomiting, feeling unwell and pain in your lower back. You may also develop chills and shivers.

If you have any of these symptoms, contact your GP. He or she will be able to prescribe you some antibiotics to clear the infection. In men, there is a chance that the infection could travel to the prostate gland. This can cause a condition called prostatitis, which can make you more likely to develop recurrent bouts of cystitis in the future. The condition can be painful, but antibiotics can help to clear the infection.

Causes of cystitis

Cystitis is caused by a bacterial infection. A bacterium called Escherichia coli (E.coli), which usually lives harmlessly in your bowel, causes over seven out of 10 bouts of cystitis.

Bacteria can get into your urinary tract and cause infection in different ways. These can include the following.

  • Sex. Bacteria could pass into your bladder when you have sex. Having sex can also bruise your urethra and bladder, which can cause similar symptoms to cystitis.
  • Poor hygiene. Poor hygiene can cause cystitis. Women have shorter urethras than men. If you’re a women, this means that bacteria have a shorter distance to travel before reaching your bladder. The urethra is also closer to the back passage (anus) in women. This makes it easier for bacteria to get transferred from your anus into your urethra.
  • Pregnancy. If you’re pregnant, your womb (uterus) may put extra pressure on your bladder. This could prevent your bladder from emptying completely. Retaining small amounts of urine in your bladder could encourage bacteria to grow.
  • Diabetes. If you have diabetes, your urine can contain more sugar than usual. Passing urine that contains more sugar than usual can encourage bacteria to grow in your bladder and urethra.
  • Menopause. In women, natural changes after the menopause could affect your chances of getting cystitis. After the menopause, the types of bacteria which usually live harmlessly in your vagina (vaginal flora) may change. This could increase your risk of getting cystitis.
  • Having a catheter. Bacteria could get into your bladder if you have a catheter (a long, thin, flexible tube inserted into your bladder). Your bladder and urethra could also get bruised when your catheter is inserted. This could increase your risk of getting a bacterial infection.
  • Contraception. In women, using a diaphragm (a thin, flexible cap inserted into your vagina) may increase your risk of getting cystitis. This is because your diaphragm could prevent your bladder from emptying properly, which can encourage bacteria to grow.
  • Kidney or bladder stones. These can prevent your bladder from emptying fully, which can encourage bacteria to grow. In men, a common cause of cystitis is passing urine less often because the prostate is enlarged.
  • Abnormalities of the urinary tract. Being born with certain conditions which affect the structure of your urinary tract can increase your risk of getting cystitis. For example, if you have a condition called pelviureteric junction obstruction, your flow of urine can become blocked, which can encourage bacteria to grow.

Diagnosis of cystitis

Cystitis usually clears up on its own. You will usually be able to manage your cystitis at home, especially if you’re a woman and have had it before. However, if you’re a man or your child has symptoms of cystitis, it’s a good idea to contact your GP.

If your symptoms get worse or don’t improve within two to three days, contact your GP for advice. He or she will be able to rule out any other conditions that could be causing your symptoms.

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP will usually be able to diagnose cystitis based on your symptoms. A sample of your urine might be tested using a ‘dipstick’. Depending on the results, a sample of your urine may be sent to a laboratory for further tests.

You can sometimes have cystitis but have no symptoms. This is particularly common if you’re older. Your cystitis may only be discovered when you have a urine test for other reasons, or you develop a kidney infection or fever.

Treatment of cystitis

Self-help
Cystitis usually clears up by itself, without the need for treatment. However, there are several things you can do to reduce your symptoms and feel better.

  • Taking over-the-counter painkillers, such as paracetamol and ibuprofen, may help to ease your pain. They may also help if you have a fever or a temperature.
  • Increase how much fluid you drink, such as water, to help flush out the infection.
  • Placing a warm hot water bottle on your lower back can help soothe any discomfort in this area.
  • Try to rest as much as possible.

Medicine

If your symptoms continue for longer than two to three days, contact your GP. He or she may prescribe you antibiotics to reduce your symptoms and get rid of the infection.

Trimethoprim and nitrofurantoin are antibiotic medicines that are commonly used to treat cystitis. These can be taken as a tablet. Always ask your GP for advice and read the patient information leaflet that comes with your medicine. With antibiotics, your symptoms will usually clear up within three to eight days. On average, antibiotics shorten the time you have symptoms by about a day.

If antibiotics don't work, it's possible that you may have a different type of cystitis, called interstitial cystitis. This is a long-term condition in which you have ongoing inflammation in your bladder. This condition isn’t caused by bacteria, so it can’t be treated with antibiotics. For more information, see our frequently asked questions.

Prevention of cystitis

There are several things you can do to help prevent cystitis. Some examples are listed below.

  • Make sure you drink enough fluid.
  • Drinking cranberry juice may reduce the likelihood of recurrent cystitis. You could also try taking tablets which contain a cranberry extract. Some research has shown that cranberry products could help to prevent bacteria from growing. However, don’t take cranberry products if you’re taking warfarin (a blood-thinning medicine).
  • Wear underwear that is made of natural materials, such as cotton or linen – don’t wear thongs.
  • After using the toilet, make sure you wipe from front to back.
  • After a bowel movement, wash the area around your anus.
  • Go to the toilet as soon as you feel the urge.
  • It may be useful to wash your genital area before having sexual intercourse. Try to urinate shortly after having sex to help flush away any bacteria.
  • If you have been through the menopause, using an oestrogen replacement treatment might help to prevent cystitis. This can be a cream or pessary (a small tablet that you insert into your vagina).
  • If you’re a women, using a spermicidal product for contraception can increase your risk. This is because it can destroy good bacteria called, lactobacilli. Talk to your GP or family planning adviser about changing your method of contraception if necessary.

Prevention of reoccurring cystitis

If you get cystitis frequently, your GP may prescribe you a low-dose antibiotic to keep at home. You can take this if your cystitis comes back again.

Your GP will advise you on how often to take them depending on what type of antibiotic you’re prescribed. You may be prescribed trimethoprim, which you can take daily. Another medicine used to treat reoccurring cystitis is called nitrofurantoin. You take this immediately after having sex. If you get reoccurring cystitis, it’s likely that your GP will refer you to a urologist. This is a doctor who specialises in identifying and treating conditions that affect the urinary system. He or she may offer you some further tests.


Reviewed by Hemali Parekh, Bupa Health Information Team, December 2013.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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