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Cystitis

Expert reviewer Professor Raj Persad Consultant Urological Surgeon
Next review due June 2021

Cystitis is inflammation of your bladder that is usually caused by a bacterial infection. It’s most likely to affect women, but men and children can get it too.


An image showing a woman in a coffee shop

About cystitis

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.


An image showing the location of the bladder and surrounding structures


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.

Frequently asked questions

  • 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.

  • 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.


    A food and symptoms diary from Bupa UK
  • 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.


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  • 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



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