Patient information from BMJ

Cystitis

Last published:Mar 27, 2023

If you get a burning pain when you pass urine, you might have cystitis. Cystitis can clear up on its own in a few days. But many people need treatment. If you get a lot of infections, your doctor may recommend treatments to prevent them.

What happens?

Cystitis happens when germs (bacteria) grow in your bladder. This causes inflammation. Both men and women can get cystitis. But cystitis is rare in men. This information is about cystitis in women and what to do about frequent infections.

Urine doesn't usually contain enough bacteria to cause infections. But sometimes bacteria from around your anus can spread to your urethra (the tube that carries urine from your bladder to outside your body).

From here, the bacteria can travel to your bladder and cause an infection.

Having sex is a common cause of cystitis. Other things that can make it more likely include:

• using a vaginal spermicide cream or gel

• having diabetes

• having a tube to drain urine from your bladder (this is called a catheter)

• being older

• reaching the menopause

• being pregnant.

Some women get cystitis again and again. If it happens more than three times a year, doctors call this recurrent cystitis.

What are the symptoms?

The main symptoms of cystitis are:

• a burning pain when you pass urine, and

• feeling the need to pass urine often.

You might also have:

• urine that's cloudy and smells bad

• blood in your urine, and

• pain in your abdomen.

If your symptoms are very bad, or get worse, you should see your doctor.

Your doctor or nurse can test your urine for infection, to check whether you have cystitis. You may need further urine tests if your doctor wants to know which bacteria are causing your infection.

Sometimes cystitis can spread to your kidneys. This can be more serious.

You should see a doctor straight away if you have signs of a kidney infection. These include:

• fever

• pain in your side

• nausea, and

• vomiting.

What treatments work?

Cystitis often goes away on its own in about three days. But if your symptoms don't clear up in a few days, or if they are severe, you should see a doctor.

Your doctor will probably prescribe antibiotic tablets to clear the infection. You should take them exactly as your doctor prescribes, until you finish the course.

There are also things that you can do to help prevent another attack. If you get frequent infections, there are medicines that may help.

What to do during an attack

Some doctors recommend that you should drink more fluids (preferably water), to try to 'flush out' the bacteria. But it may be best to avoid acidic drinks like fruit juice, and drinks that may irritate your bladder, like coffee.

You can take paracetamol to relieve your pain. Holding a hot water bottle over your abdomen may be comforting.

Things you can do yourself to prevent more attacks

You might have heard that drinking cranberry juice or taking cranberry capsules can help prevent cystitis. There isn't enough evidence to say for sure whether it will work. But it won't do you any harm in moderate amounts.

Many women say that passing urine straight after sex stops them getting cystitis.

If you get recurrent cystitis your doctor might recommend that you take regular antibiotics, either daily, or after you have sex.

If you get cystitis when pregnant, you can still have antibiotics, but they will be different ones than for women who are not pregnant. This is because some antibiotics are not safe to take during pregnancy.

What will happen to me?

Cystitis can clear up by itself in about three days without any treatment. But if it doesn't, taking antibiotics for a few days will probably work.

If you have more than two infections a year for a few years in a row, you’ll probably keep getting infections unless you have treatment.