Cystitis is a common type of lower urinary tract infection (UTI). Your urinary tract is made up of your kidneys, ureters (the tubes that connect each kidney to your bladder), your bladder and your urethra. You get cystitis when bacteria get into your bladder through your urethra, the tube that carries urine out of your body.
Around half of women will get a urinary tract infection such as cystitis at some point in their lifetime. Men are less likely to get cystitis than women. This is because they have longer urethras, so bacteria have further to travel to reach their bladder. However, older men are more likely to get cystitis than younger men.
Sometimes women have symptoms of cystitis without an apparent bacterial infection. This may be because the infection hasn’t been detected by the normal tests or, in a small number of cases, due to a condition called interstitial cystitis or painful bladder syndrome. See Antibiotics for cystitis below and our FAQ on Can interstitial cystitis be treated? for more information.
Symptoms of cystitis
Not everyone with cystitis notices any symptoms. But if you have cystitis, your symptoms may include:
- pain or discomfort when you wee
- a frequent, urgent need to wee, but you only pass small amounts or no urine
- cloudy, dark or strong-smelling urine
- blood in your urine – you may not always be able to see the blood but it can be found in tests
- pain in your lower tummy
- tiredness or feeling generally unwell
- a fever
- feeling confused (especially in older people)
Sometimes cystitis symptoms come on very suddenly. You may notice a burning or stinging sensation when you wee. This can be very mild or so bad that it affects your daily activities.
Urinary symptoms can also be caused by conditions other than cystitis, particularly in those who are older or smoke. So, if your symptoms don’t get better after a few days, or you can see blood in your urine, contact your GP.
Cystitis symptoms in children
Urinary tract infections such as cystitis affect children, especially those under two years. As well as the above symptoms, children may also have a fever, lose their appetite and feel (or be) sick.
If you think your child may have cystitis, contact your GP for advice. It’s important to seek medical help as soon as you can, because these symptoms may be due to other, more serious conditions. Cystitis in children may be a sign that there’s a more serious problem with their bladder, ureter or kidneys, which could lead to complications if not treated.
Diagnosis of cystitis
Cystitis often clears up on its own, so you may not need to see your GP. But if your symptoms get worse or don’t get any better on their own, contact your GP for advice. Your GP will be able to rule out any otherconditions that could be causing your symptoms. If men or children have any urinary symptoms, it’s a good idea to contact your GP too as it may be more serious.
Your GP will ask about your symptoms and examine you. They may also ask you about your medical history. Your GP can often diagnose cystitis from your symptoms without doing any tests. But they may ask for a sample of your urine to check for signs of a bacterial infection. Depending on the results, they may send the sample to a laboratory for further tests.
You can have cystitis without any symptoms, especially if you’re over 65. If so, your cystitis may only be discovered when you have a urine test for other reasons, or if you develop complications.
Self-help measures for cystitis
Mild cystitis usually clears up by itself after four or five days without any specific treatment. There are several things you can try to ease your symptoms.
- Take over-the-counter painkillers, such as paracetamol and ibuprofen, to help ease your pain.
- Drink more fluids, such as water, to help flush out the infection.
- Put a warm hot water bottle on your lower tummy to help ease any discomfort.
- Try to rest as much as possible.
- Have warm baths, but don’t use any soap or perfumed products as these can irritate your bladder.
You can buy cystitis remedies over the counter from a pharmacy, but we don’t know how well they work to ease your symptoms. These remedies contain citric acid with potassium citrate or sodium bicarbonate, which make urine less acidic. Some people find using these cystitis remedies makes them less likely to feel pain or discomfort when they wee. If you do decide to use these products, you can only use them for a short time. This is because they contain lots of potassium or salt. You may not be able to use them if you’re pregnant, on a low-salt diet or have heart, liver or kidney problems, so speak to a pharmacist or your GP first.
Antibiotics for cystitis
If your symptoms aren’t getting any better after two or three days, or seem to be getting worse, speak to your GP. Your GP may prescribe antibiotics, such as trimethoprim and nitrofurantoin, to clear up the infection.
Some pharmacies in the UK provide ‘minor ailment services’. This means they can give you treatments for uncomplicated problems such as cystitis, without you having to see your GP. For more information, speak to your pharmacist.
You usually take these antibiotics for three days, but sometimes antibiotics are prescribed for seven days or longer. You’re more likely to have a longer course of antibiotics if you’re a man, are pregnant, have diabetes or are prone to cystitis.
You’ll usually begin to feel better within a few days of starting antibiotics. If the antibiotics aren’t working, your GP may send a sample of your urine to a laboratory to check which bacteria are causing your symptoms. Your GP may then prescribe a different antibiotic. It’s important to complete the full course of antibiotics, even if your symptoms seem to have cleared up. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.
If your cystitis comes back, see your GP. They may refer you to a urologist (a doctor who specialises in the urinary system) for more tests.
If antibiotics don’t help your symptoms at all, something else may be causing your symptoms. You may even have a different type of cystitis, called interstitial cystitis. This is a long-term condition that causes ongoing inflammation in your bladder and cystitis-like symptoms. Interstitial cystitis isn’t caused by bacteria so can’t be treated with antibiotics. It’s difficult to diagnose and treat, so your GP may refer you to a urologist. For more information, see our FAQ: Can interstitial cystitis be treated?
Causes of cystitis
Cystitis is caused by a bacterial infection. Over eight in every 10 cases of cystitis are caused by a bacterium called Escherichia coli (E.coli), which usually lives harmlessly in your bowel.
Bacteria can get into your urinary tract in lots of ways to cause an infection.
- Sex. When you’re having sex, bacteria can pass into your bladder.
- Poor hygiene. Bowel incontinence can cause cystitis, especially in older women. Women have shorter urethras than men, so bacteria don’t have so far to travel to reach their bladder. In women, the urethra is also closer to the back passage (anus), which makes it easier for bacteria to pass from their anus into their urethra.
- Pregnancy. If you’re pregnant, your growing uterus may press against your bladder, stopping it from emptying completely. Holding small amounts of urine in your bladder could encourage bacteria to grow.
- Diabetes. If you have diabetes, your urine may contain more sugar than usual. This can boost the growth of bacteria in your bladder and urethra.
- Menopause. After the menopause, the types of bacteria that usually live harmlessly in your vagina may change, increasing your risk of getting cystitis.
- Having a catheter (a tube that’s put into your urethra to drain urine out of your bladder). Bacteria could get into your bladder if you have a catheter. Your bladder and urethra could be injured when your catheter is inserted, which may make you more likely to get a bacterial infection.
- Contraception. Using a diaphragm or spermicide-coated condoms may make you more prone to cystitis. Diaphragms can prevent your bladder from emptying properly, which can mean more bacteria grow.
- Stones (calculi) in your urinary system, such as kidney stones or bladder stones. These can get lodged and cause urine to accumulate, which can mean more bacteria grow.
- An enlarged prostate. If your prostate is bigger than usual, it can block your bladder, which means you wee less often.
- Abnormalities of your urinary tract. If you have a condition that affects the structure of your urinary tract, this can make you more prone to cystitis.
Interstitial cystitis isn’t caused by a bacterial infection. Why some women have interstitial cystitis and others don’t isn’t clear. But it may be caused by a problem with your bladder, changes to your nervous system, something in your urine or an allergy.
Complications of cystitis
Cystitis is often mild and clears up on its own. But in some people, the infection can cause complications if it isn’t treated.
If bacteria in your bladder reach your kidneys, you may develop an infection called pyelonephritis. This can cause pain in your side and back and a high fever. You may feel sick (or be sick) too. Pyelonephritis can be treated with antibiotics. If it isn’t treated, it may damage your kidneys.
In men, cystitis can lead to prostatitis. This infection of the prostate gland can cause pain, especially at the bottom of your penis and around your anus (back passage). You may not be able to wee when you go to the loo. Prostatitis is treated with an extended course of antibiotics.
Cystitis and pregnancy
If you get cystitis when you’re pregnant, you may develop a kidney infection (pyelonephritis). You could also give birth early and have a low birth weight baby if your cystitis isn’t treated.
You’ll be screened for cystitis at your early antenatal appointments. If you have cystitis, you’ll be treated quickly with antibiotics that are safe to take during pregnancy. If you’re pregnant and think you may have cystitis, speak to your GP or midwife.
Prevention of cystitis
There are lots of things you can do to help prevent cystitis.
- Drink lots of fluids, including water and diluted squash, but fewer caffeinated drinks, such as tea and coffee.
- Wear underwear that’s made of natural materials, such as cotton or linen – don’t wear thongs.
- After you go to the toilet, wipe from front to back.
- Don’t use perfumed products on your genital area, as these can irritate your bladder.
- Have showers rather than baths.
- Keep your perineum (skin between your anus and vulva) clean and dry, especially after a bowel movement.
- Go to the toilet as soon as you feel you need to go – don’t put it off.
- Wash your genital area before you have sex.
- Go to the toilet soon after you have sex if you can, to help flush away any bacteria.
- If you’ve been through the menopause, use oestrogen replacement creams and gels, as these may help to prevent cystitis.
- If you can, use a non-barrier contraceptive (such as the contraceptive pill) that doesn’t need spermicide. Using a lubricant during sex may help too. Talk to your GP or family planning adviser about changing your form of contraception if necessary.
Some people find that drinking cranberry juice or taking tablets containing cranberry extracts can help to prevent cystitis, if they’re prone to the infection. But there’s no clear evidence that cranberry helps.
Prevention of regular cystitis infections
If you get cystitis a lot, your GP may prescribe a low-dose antibiotic for you to keep at home. You can take this if your cystitis comes back again. You may be prescribed trimethoprim or nitrofurantoin. Your GP will let you know how often to take your medicine.
If you get cystitis regularly, it’s important to see your GP. They’ll probably refer you to a urologist (a doctor who specialises in the urinary system). They may offer you some further tests.
FAQ: Is cystitis a sexually transmitted infection?
Cystitis isn’t a sexually transmitted infection (STI), but the bacteria that cause cystitis can get into your bladder when you have sex.
There are some things you can do to make this less likely to happen.
- Wee before having sex.
- Wee after sex (within 15 minutes) to help flush away any bacteria.
- Wash your genital area (and hands) before you have sex.
- If you use a diaphragm for contraception, make sure it’s fitted properly. If you’re prone to cystitis, try a smaller size or a coil spring diaphragm. Diaphragms can stop your bladder from emptying properly, which means bacteria are more likely to grow inside, so switch to another form of contraception if you keep getting cystitis.
- Try not to use spermicide-coated condoms (use a different form of contraception instead), as these may increase your risk of getting cystitis. But make sure you protect yourself from STIs – ask your GP for advice.
Some sexually transmitted infections, such as chlamydia, can cause similar symptoms to cystitis. So, it’s important to get bad or ongoing symptoms checked out at a sexual health clinic or by your GP.
If you keep getting cystitis after having sex, see your GP. They may prescribe antibiotics to keep at home and take straight after you have sex. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.
FAQ: Can some foods and drinks prevent cystitis?
Making some general changes to your diet may ease your cystitis and stop it coming back.
- Drink plenty of fluids (water-based drinks, ideally) to help flush out any bacteria.
- Don’t drink too much caffeine (eg in tea and coffee), alcohol or acidic drinks (eg fruit juices), as these may irritate your bladder.
- Some people find that drinking cranberry juice or taking tablets containing cranberry extracts may help their symptoms. But this doesn’t work for everyone and there’s no clear evidence that cranberry helps.
You may find certain foods or drinks trigger your cystitis. Tomatoes, spices and chocolate can irritate your bladder and may even cause inflammation. Try to keep a diary of your symptoms and what you eat and drink every day to see if there’s a pattern. If you notice one, try to cut any triggers out of your diet or have fewer of them. Have a chat with your GP or dietitian if you’re thinking about making any changes to your diet.
FAQ: Can interstitial cystitis be treated?
Interstitial cystitis (painful bladder syndrome) is a long-term condition that causes inflammation in your bladder. It causes symptoms of cystitis as well as bladder, vaginal or lower tummy pain when your bladder is full. It isn’t caused by bacteria, so you can’t treat it with antibiotics.
Several other treatments are available for interstitial cystitis, but they don’t work for everyone. So, you may have to try lots of different things before you find the right one for you.
- Over-the-counter anti-inflammatory medicines, such as aspirin or ibuprofen, may help to ease pain. Your GP may prescribe you other, stronger anti-inflammatory medicines if your pain is really bad.
- Antispasmodic medicines (which stop contractions of your bladder) may help to control any bladder pain.
- Antidepressant medicines, such as amitriptyline, can reduce your pain.
Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.
- Bladder Health UK
0121 702 0820
- Urinary tract infection in adults. PatientPlus. www.patient.info, last checked March 2016
- Urinary tract infection (lower) – women. Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2015
- Acute cystitis. BMJ Best Practice. bestpractice.bmj.com, last updated March 2018
- Urinary tract infection (lower) – men. Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2014
- Bacterial urinary tract infections (UTI). The MSD Manuals. www.msdmanuals.com, last full review/revision May 2016
- Bacterial cystitis. Bladder Health UK. www.bladderhealthuk.org, accessed April 2018
- Urinary tract infection - children. Clinical Knowledge Summaries. cks.nice.org.uk, last updated November 2017
- Urinary tract infection in children. PatientPlus. www.patient.info, last checked March 2016
- Urinary tract infection (UTI) in children. The MSD Manuals. www.msdmanuals.com, last full review/revision January 2018
- Urinary tract infections in adults. National Institute for Health and Care Excellence (NICE) Quality Standard QS90. www.nice.org.uk, published June 2015, checked 2017
- Renal medicine. Oxford Handbook of Clinical Medicine (online). Oxford Medicine Online. oxfordmedicine.com, published online September 2017
- Nursing patients with renal and urological problems. Oxford Handbook of Adult Nursing (online). Oxford Medicine Online. oxfordmedicine.com, published online August 2010
- Self help. Bladder Health UK. www.bladderhealthuk.org, accessed April 2018
- Citric acid with potassium citrate. NICE British National Formulary. bnf.nice.org.uk, last updated April 2018
- Sodium bicarbonate. NICE British National Formulary. bnf.nice.org.uk, last updated April 2018
- Urinary tract infections. NICE British National Formulary. bnf.nice.org.uk, last updated April 2018
- Acute cystitis. BMJ Best Practice. bestpractice.bmj.com, last updated March 2018
- Recurrent urinary tract infection. PatientPlus. www.patient.info, last checked March 2016
- Interstitial cystitis/painful bladder syndrome. PatientPlus. www.patient.info, last checked August 2016
- Urinary tract infection in pregnancy. The MSD Manuals. www.msdmanuals.com, last full review/revision May 2016
- Acute cystitis. BMJ Best Practice. bestpractice.bmj.com, last updated March 2018
- Diabetes mellitus. PatientPlus. www.patient.info, last checked May 2016
- Infections in patients with diabetes mellitus. Medscape. emedicine.medscape.com, updated December 2015
- Menopause. Medscape. emedicine.medscape.com, updated August 2017
- Female barrier methods of contraception. PatientPlus. www.patient.info, last checked November 2015
- Pyelonephritis. PatientPlus. www.patient.info, last checked April 2016
- Prostatitis. PatientPlus. www.patient.info, last checked June 2015
- Lower urinary tract infections in women. PatientPlus. www.patient.info, last checked February 2016
- Preventative measures. Bladder Health UK. bladderhealthuk.org, accessed April 2018
- Renal medicine and urology. Oxford Handbook of General Practice (online). Oxford Medicine Online. oxfordmedicine.com, published online April 2014
- Trimethoprim. NICE British National Formulary. bnf.nice.org.uk, last updated April 2018
- Nitrofurantoin. NICE British National Formulary. bnf.nice.org.uk, last updated April 2018
- Interstitial cystitis. The MSD Manuals. www.msdmanuals.com, last full review/revision September 2016
- Philip Howard, Consultant Antimicrobial Pharmacist, Leeds Teaching Hospital NHS Trust, HCAI and AMR Project Lead, NHS England. Antimicrobial stewardship in community pharmacy – what do commissioners need to know? www.england.nhs.uk, accessed June 2018
- Achieving Excellence in Pharmaceutical Care: A Strategy for Scotland. Scottish Government. www.gov.scot, published August 2017
- Booth JL, Mullen AB, Thomson DAM, et al. Antibiotic treatment of urinary tract infection by community pharmacists: a cross-sectional study. Br J Gen Pract 2013; 63(609):e244–e49. doi: 10.3399/bjgp13X665206
- Bladder cancer. BMJ Best Practice. bestpractice.bmj,com, last reviewed June 2018
- Urinary calculi. MSD manuals. www.msdmanuals.com, last full review/revision March 2018
- Prostatitis - acute. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2014
- Urinary tract infection (UTI) in males. Medscape. emedicine.medscape.com, updated July 2018. https://emedicine.medscape.com/article/231574-overview
- Bladder Health UK
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form
Reviewed by Laura Blanks, Specialist Health Editor, Bupa Health Content Team, June 2018
Expert reviewer Professor Raj Persad Consultant Urological Surgeon
Next review due June 2021
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Meet the team
Head of Health Content
- Dylan Merkett – Lead Editor
- Graham Pembrey - Lead Editor
- Laura Blanks – Specialist Editor, Quality
- Michelle Harrison – Specialist Editor, Insights
- Natalie Heaton – Specialist Editor, User Experience
- Fay Jeffery – Web Editor
- Marcella McEvoy – Specialist Editor, Content Portfolio
- Alice Rossiter – Specialist Editor (on Maternity Leave)
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: email@example.com. Or you can write to us:
Health Content Team
Battle Bridge House
300 Grays Inn Road