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Cystitis

Expert reviewer, Professor Raj Persad, Urologist
Next review due December 2023

Cystitis is inflammation of your bladder that’s usually caused by a bacterial infection. It can cause pain when you pee and make you pee more often.


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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 enter 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. You’re less likely to get cystitis if you’re male. This is because when you have a longer urethra, bacteria have further to travel to reach your bladder. Older men are more likely to get cystitis than younger men.

Sometimes you can have symptoms of cystitis without any signs of a bacterial infection. This may be because normal tests haven’t picked up the infection. Or you may have a condition called interstitial cystitis, or painful bladder syndrome, instead. See our FAQ What is interstitial cystitis?

Symptoms of cystitis

You don’t always get symptoms with cystitis. But if you do, these may include:

  • burning or stinging when you pee
  • needing to pee regularly, but passing only a little or no urine
  • cloudy, dark or strong-smelling urine
  • blood in your urine – you may not be able to see the blood but it can be picked up in urine tests
  • pain in your lower tummy
  • a strong urge to pee, which can cause incontinence (peeing without meaning to)
  • tiredness or feeling generally unwell
  • a high temperature (fever)
  • feeling confused (especially in older people)

Sometimes cystitis symptoms come on very suddenly. They may be so bad that you find it hard to do your usual activities.

Some of these symptoms can also be caused by other things, particularly in those who are older or smoke. So, if they don’t get better after a few days, or if you can see blood in your pee, contact your GP.

Cystitis symptoms in children

Babies and children can get cystitis. They may have problems peeing or may have more general symptoms, such as a high temperature, not feeling hungry and feeling (or being) sick.

Cystitis in children can be caused by a problem with their bladder or kidneys, or they may have constipation. If you think your child may have cystitis, it’s very important that you contact your GP. If cystitis in children isn’t treated, it can damage their kidneys.

Diagnosis of cystitis

Cystitis often clears up on its own after a few days, so you may not need to see your GP. But it’s important that you see your doctor if:

  • you can see blood in your urine
  • your symptoms get worse or don’t get any better on their own
  • you‘re male and you have any urinary symptoms

If you think your baby or child may have cystitis, it’s important that they are seen by a GP too.

Your GP will ask about your symptoms and examine you. They may also ask about your medical history. They 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, or you might need to have a scan of your bladder.

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 get complications.

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Self-help measures for cystitis

  • Mild cystitis usually clears up by itself after a few days without any specific treatment. There are lots of things you can do to try to ease your symptoms. Take over-the-counter painkillers, such as paracetamol and ibuprofen.
  • 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.

You can buy cystitis remedies over the counter from a pharmacy. These remedies contain citric acid with potassium citrate or sodium bicarbonate, which make urine less acidic. Some people find using these remedies eases burning or discomfort when they pee. But doctors still don’t know how well these products work. 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 to clear up the infection.

Some pharmacies in the UK can test you for cystitis and prescribe antibiotics if you have a bacterial infection. This means you don’t need to see your GP first.

You usually take antibiotics for cystitis 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 male, are pregnant, have diabetes or are prone to cystitis. Sometimes your GP may prescribe you more than one type of antibiotic.

If you’re taking antibiotics, your symptoms should start to ease after a couple of days. 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. They may then prescribe a different antibiotic.

It’s important to take the whole 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. Sometimes your doctor might ask you to take different types of antibiotics at different times.

If your cystitis comes back, or the antibiotics still aren’t working, 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 at all, something else may be causing your symptoms. You may have a condition called interstitial cystitis. This causes ongoing inflammation in your bladder and cystitis-like symptoms. It isn’t caused by bacteria so can’t be treated with antibiotics. Interstitial cystitis is difficult to diagnose and treat, so your GP may refer you to a urologist. For more information, see our FAQ What is interstitial cystitis?

Causes of cystitis

Cystitis is caused by a bacterial infection. Over eight in every 10 cases of cystitis are caused by the bacterium 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.

  • During sex. Bacteria may get into your bladder when you have sex.
  • Poor hygiene. Bacteria can pass from your anus to your urethra, especially if you have bowel incontinence.
  • Dehydration. Not drinking enough fluids may mean you don’t need to pee much, so urine sits in your bladder for longer and bacteria grow there.
  • Pregnancy. Your growing uterus may press against your bladder, stopping it from emptying completely. This may make bacteria more likely to grow in your bladder.
  • Diabetes. If your urine contains more sugar than usual, this can boost the growth of bacteria in your bladder and urethra.
  • Menopause. Low oestrogen levels can make your urethra wall thinner and your urine more acidic. This can make you more prone to cystitis.
  • Having a catheter (a tube that’s put into your urethra to drain urine out of your bladder).
  • Contraception. Using a diaphragm or spermicide-coated condoms may make you more likely to get cystitis. Diaphragms can stop your bladder from emptying properly, which may mean more bacteria grow.
  • Stones (calculi) in your urinary system, such as kidney stones or bladder stones. These can get stuck, so your pee builds up in your bladder.
  • An enlarged prostate. This can block your bladder, which means you pee less often.
  • Conditions that affect the structure of your urinary tract.

Interstitial cystitis is a different condition. It isn’t caused by a bacterial infection. Doctors don’t know why some people have interstitial cystitis and others don’t. But it may be caused by a problem with your bladder or immune system or changes to your nervous system.

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 get an infection called pyelonephritis. This can cause pain in your side and back and a high temperature (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.

Cystitis in men can lead to an infection of the prostate gland (prostatitis). This can cause pain, especially at the bottom of your penis and around your anus (back passage). You may not be able to pee when you go to the loo. Prostatitis is treated with a long 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.

  • There are lots of things you can do to help prevent cystitis. Drink plenty of fluids every day, including water and diluted squash, but limit caffeinated drinks, such as tea and coffee.
  • Wear underwear that’s made from natural materials, such as cotton or linen – don’t wear thongs.
  • After you pee, wipe from front to back.
  • Keep your perineum (skin between your anus and vulva) clean and dry, especially after doing a poo.
  • Always pee as soon as you feel you need to go – don’t put it off.
  • If you’ve been through the menopause, use oestrogen replacement vaginal creams and gels.
  • If you can, use a non-barrier contraceptive (such as the contraceptive pill) that doesn’t use spermicide. If you need to change your contraception, talk to your GP or family planning adviser.

If you get cystitis after having sex, there are lots of things you can do to limit this. See our FAQ on Is cystitis a sexually transmitted infection?

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.

Your GP may refer you to a urologist (a doctor who specialises in the urinary system). They may offer you some further tests. Some people find that drinking cranberry juice, taking tablets containing cranberry extracts or D-mannose can help to prevent cystitis if they’re prone to it. But there’s not a lot of evidence that these help. You may not be able to use these products if you’re pregnant, so speak to a pharmacist or your GP first .

Frequently asked questions

  • Cystitis isn’t a sexually transmitted infection (STI), but the bacteria that cause it can get into your bladder when you have sex.

    • There are some things you can do to make this less likely to happen. Pee before having sex.
    • Pee after sex (within 15 minutes) to help flush away any bacteria.
    • Wash your genital area (and hands) with water before you have sex.
    • Use a lubricant gel during sex.
    • If you use a diaphragm for contraception, make sure it’s fitted properly. Using a diaphragm that’s not the right size or shape for you may make you more likely to get cystitis.
    • Try not to use spermicide-coated condoms, as these may increase your chances of getting cystitis. Use a different form of contraception instead, and 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.

    • Changing what you eat and drink may ease your cystitis and stop it coming back. Drink plenty of fluids (ideally water-based drinks) 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 make your symptoms worse.
    • Some foods, such as tomatoes, spices and chocolate, can make cystitis symptoms worse.
    • Some people say that drinking cranberry juice or taking tablets containing cranberry extracts eases their symptoms. But there’s no clear evidence this helps.

    You could keep a food diary, making a note of your symptoms and what you eat and drink every day to see if there’s a pattern. If you think some foods and drinks may be making your cystitis worse, try cutting them out to see if this helps. But if you’re thinking about making any drastic changes to your diet, have a chat with your GP or dietitian first.


    A food and symptoms diary from Bupa UK
  • Interstitial cystitis (painful bladder syndrome) is a long-term condition that causes inflammation in your bladder. You may have cystitis symptoms as well as lower tummy or pelvic pain or pressure when your bladder is full. It isn’t caused by bacteria, so you can’t treat it with antibiotics.

    • Several treatments are available, but they don’t work for everyone. 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.
    • Changing your diet – see our FAQ on Can changing my diet help cystitis?
    • Pelvic floor exercises or bladder retraining may help your symptoms.
    • Antispasmodic medicines (which stop contractions of your bladder) may help to control any bladder pain.
    • Antidepressant medicines, such as amitriptyline, may 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 Victoria Goldman, Freelance Health Editor and Abbey Stanford, Specialist Health Editor, Bupa Health Content Team, December 2020
    Expert reviewer, Professor Raj Persad, Urologist
    Next review due December 2023

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