Cystitis
WHAT IS CYSTITIS?
Cystitis is a urinary tract infection (UTI) that causes inflammation of the bladder. You can get cystitis when bacteria gets into your bladder through your urethra, which is the tube connecting to the bladder that carries urine out of your body. It's a common type of UTI, particularly in women, and although it can be painful, is usually not a cause for serious concern.
Mild cases will often get better by themselves within a few days. However, some people experience episodes of cystitis frequently and may need regular or long-term treatment. There's also a chance that cystitis could lead to a more serious kidney infection in some cases, so it's important to seek professional advice if your symptoms don't improve.
NOTE: This article/page uses the terms ‘male/man/men’ and/or ‘female/woman/women’. Please note, this is in reference to the sex assigned at birth.
TYPES OF CYSTITIS
Cystitis is inflammation of the bladder, usually caused by an infection. It's a common type of urinary tract infection. Find out more about the symptoms, causes and ways to treat cystitis.
The symptoms of cystitis can come on suddenly and include:
- A stinging pain or burning when you pee, often with a need to pee more urgently and frequently.
- You may also notice that your urine is darker in colour, cloudy and can have a strong smell.
- In some cases, cystitis may also cause pain low down in your tummy and make you feel generally unwell and tired.
In older people or those with conditions causing cognitive impairment (such as dementia) and people with a urinary catheter, symptoms may also include:
• changes in behaviour, such as acting confused or agitated (delirium)
• wetting themselves more than usual
• shivering or shaking (rigors)
In adults, cystitis does not usually cause a high temperature. If you do experience a high temperature (38°C or higher) alongside symptoms of cystitis and pain in your lower back and sides, it could be a sign of a kidney infection.
Cystitis isn't usually a cause for serious concern, but the symptoms can be similar to several other conditions, so it's important to get a proper diagnosis. Mild cases will often clear up on their own within a few days and can be managed with self-care measures such as painkillers, rest and plenty of fluids. Products containing sodium citrate can often relieve mild cystitis symptoms by making urine less acidic.
You can speak to a pharmacist or your GP if you need any advice about treating cystitis or if you are over 18 and have been experiencing symptoms for two days you can access Boots Online Doctor Cystitis treatment2 to access prescription-only cystitis treatment in-store without visiting your GP. You should always see your GP if your symptoms are severe or don't start to get better in a few days, you get cystitis frequently, or you're pregnant.
If you have a fever, shakes, severe back pain or are vomiting, this service is not suitable for you, please get in touch with your GP, NHS 111 or in an emergency 999 for help.
Possible symptoms in young children include a high temperature (fever) of 38C (100.4F) or above, weakness, irritability, reduced appetite and vomiting. Children and men should always be seen by a GP if they have symptoms of cystitis, as the condition is less common and could be more serious in these groups.
While it's uncommon, mainly due to the anatomy of the male reproductive system, men can get cystitis.
Men develop cystitis due to;
- sexual activity
- using urinary catheters
- having an enlarged prostate
- having health conditions that weaken the immune system (i.e. HIV or diabetes)
- holding urine for long periods of time
- bladder stones
Cystitis symptoms are very similar between sexes.
Some of the symptoms noticed may be:
- a frequent urge to urinate and often only passing a small amount
- a feeling of tingling or burning while urinating
- experiencing pain in the bladder
- identifying traces of blood in urine, or urine which is dark, cloudy or strong smelling
- feeling unwell, weak or feverish
Cystitis in men is diagnosed through urinalysis, where doctors will send a sample of urine to identify the presence of infectious bacteria, cystoscopy, which is an imaging test made available by inserting a urinary catheter into the urethra and at times through imaging such as ultrasounds or X-rays.
It can be difficult to tell whether a child has cystitis, because the symptoms can be similar to lots of other conditions and young children cannot easily communicate how they feel.
Symptoms of cystitis in young children may include:
• a high temperature (fever) of 38C (100.4F) or above
• weakness and tiredness
• irritability
• reduced appetite
• vomiting
• peeing more frequently or deliberately holding in their pee
• a change in their normal toilet habits, such as wetting themselves or wetting the bed
• pain in their tummy (abdomen), side or lower back
Children should always be seen by a GP if they have symptoms of cystitis, as the condition is less common and could be more serious.
Cystitis infections are mainly thought to occur when bacteria from the bowel or on the skin get into the bladder through the urethra and causes a bladder infection. However, it can sometimes happen when the bladder is irritated for another reason.
Cystitis can be caused by:
• bacteria getting into your bladder during sex
• wiping your bottom after going to the toilet – particularly if you wipe from back to front
• having a catheter (a thin tube inserted into the urethra to drain the bladder)
• using a diaphragm for contraception or spermicide
• not emptying your bladder fully after peeing
• during pregnancy, the growing uterus can press against the bladder and prevent it from emptying fully
• an enlarged prostate gland can also sometimes prevent the bladder from emptying fully
• low oestrogen during menopause can make the walls of the urethra thinner and more prone to cystitis
• having diabetes: high sugar levels in your urine can provide a good environment for bacteria to multiply.
Cystitis can also be caused by damage or irritation to the urethra and bladder.
This can be the result of the following:
• friction during sex
• chemical irritants, such as those in perfumed soap or bubble bath
• damage caused by a catheter or surgery on your bladder
• radiotherapy to your pelvis or treatment with certain chemotherapy medicines
There are lots of ways you can help to relieve the symptoms of a UTI, such as:
• consider taking over-the-counter medicines, such as paracetamol or ibuprofen if suitable
• drink enough fluids to stop you from feeling thirsty. Aim to drink six to eight glasses a day, including water, decaffeinated and sugar-free drinks
• soothe your discomfort with a hot water bottle
• avoid having sex until you're feeling better as it may make the condition worse
• avoid alcohol, fruit juice and caffeine
You can speak to a pharmacist or your GP if you need any advice about treating cystitis. In some cases, your GP may prescribe a course of antibiotics which should start to relieve symptoms within a few days.
If you are over 18 and have been experiencing symptoms for two days you can access Boots Online Doctor Cystitis Treatment2 to access prescription-only cystitis treatment in-store without visiting your GP. You should always see your GP if your symptoms are severe or don't start to get better in a few days, you get cystitis frequently, or you're pregnant.
If you have a fever, shakes, severe back pain or are vomiting, this service is not suitable for you, please get in touch with your GP, NHS 111 or in an emergency 999 for help.
If you get cystitis frequently, there are some things you can try to help prevent it from returning:
- make sure that you wee as soon as possible after sex
- when using the toilet, wipe from front to back
- keep well hydrated by drinking plenty of fluids, especially water
- don’t use scented products such as shower gels and soaps around your vagina
- keep the genital area clean and dry
- make sure that you do not hold in your pee and empty your bladder fully when you do pee
Read more about advice and tips to help prevent cystitis.
Most cases of mild cystitis can resolve with a bit of self-care and painkillers to help relieve discomfort. However, you should see your GP if you:
• Have severe symptoms, like blood in your urine
• Think your child might have cystitis
• Are pregnant
• Get cystitis frequently
• Don't feel your symptoms have improved within three days
• Are unsure if it is cystitis or something else
It’s important to note that UTIs in general are often divided into two categories and each requires different medical care: complicated and uncomplicated. An uncomplicated UTI typically occurs in people who:
• Are female
• Are healthy
• Are not pregnant
• Are premenopausal
• Have a functionally normal urinary tract and kidney function
A complicated UTI has an increased likelihood of complications such as a persistent infection. They can by default occur in a male or in a female who:
• Is postmenopausal
• Is pregnant
• Has a foreign body in their urinary tract, such as a catheter
• Has more than one illness or disease occurring at the same time, such as diabetes
• Has a functionally abnormal tract and kidney function
Under the new NHS service, Pharmacy First,32 our pharmacists are now equipped to provide even more support for women aged 16 to 64 experiencing symptoms of uncomplicated UTI (Urinary Tract Infection).
If you’re experiencing a UTI and have at least one of the following symptoms for more than 48 hours:
• Burning or stinging during urination
• Dark, cloudy, or strong-smelling urine
Speak to one of our pharmacists before heading to your GP.
No appointment is needed, and we can offer advice and treatment, including prescription medicines where appropriate. It’s a convenient option to address minor health concerns without the need for a GP visit.
Under the Pharmacy First scheme, women aged 16 to 64 years living in England can access advice and care for uncomplicated UTIs such as cystitis at our pharmacies. However, this service excludes pregnant women, those with a urinary catheter or those who experience recurrent UTIs (2 in 6 months or 3 in 12 months).
If our pharmacist believes your symptoms require further attention, they may refer you to another healthcare professional, such as your GP.
Interstitial cystitis is a chronic condition different to cystitis and is often called Bladder Pain Syndrome (BPS). Whilst it isn’t caused by a bacterial infection, it is a poorly understood condition and there is no single test that can diagnose interstitial cystitis. The exact causes of interstitial cystitis are not well understood but could include damage to the bladder lining or poorly functioning pelvic floor muscles.
Interstitial cystitis or BPS may also be associated with chronic conditions such as fibromyalgia, myalgia encephalomyelitis or chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS). Although interstitial cystitis or BPS can affect people of all ages, it's much more common in women than men, usually over the age of 30. The symptoms will often come and go over time. There may be times lasting days, weeks or months when your symptoms improve, followed by flare-ups when they're worse. Symptoms can include:
- pelvic pain and pressure particularly in your lower tummy and bladder area
- frequent urges to pee
- pain during sex
- you may see blood in your urine which is called haematuria
You may experience a flare up after a period of no symptoms. Interstitial cystitis or BPS has a big impact on your everyday life, including work, mental health and relationships. But when a diagnosis is confirmed there are different treatments that can help.
These symptoms can sometimes be caused by other conditions, such as cancer of the bladder. This is why you'll need a range of tests to rule out other possible causes before BPS (interstitial cystitis) can be diagnosed.
You can find out more from the NHS Interstitial Cystitis Support page
Your urinary tract includes your bladder, urethra and kidneys. Kidneys filter your blood and control blood pressure and the amount of fluid in the body. Most people with cystitis will not get a kidney infection, but occasionally the bacteria can travel up from the bladder into one or both kidneys causing an infection.
Other factors can also put you more at risk of developing a kidney infection including kidney stones, having diabetes or a weakened immune system. Symptoms of a kidney infection can quickly come on and include a high temperature (38°C or higher), shivery/chills, and pain localised to your lower side or back. You may also be experiencing the symptoms of cystitis. Older people may experience confusion.
If you are experiencing any of these symptoms or symptoms of a UTI that have not improved after a few days, you should visit a GP as soon as possible. A GP may do a urine test to see whether you have a urinary tract infection. If you cannot get a GP appointment and need urgent medical attention, go to your nearest urgent care centre or A&E.
Most kidney infections need prompt treatment with antibiotics to stop the infection from damaging the kidneys or spreading to the bloodstream (Sepsis). You may also need an over the counter pain relief product such as paracetamol. However, anti-inflammatory painkillers (NSAIDs) such as ibuprofen are not generally recommended for a kidney infection – they may increase the risk of further kidney problems so should not be taken unless advised by a doctor. With antibiotics, you should start to feel better within two weeks.
Sepsis (or blood poisoning) is very serious and can be hard to spot. Sepsis happens when the body’s immune system overreacts to an infection causing damage to the organs and tissues in the body.
Anyone with an infection can get sepsis but there are some people who are more likely to get an infection that could lead to sepsis, including:
• babies under 1, particularly if they're born early (premature) or their mother had an infection while pregnant
• people over 75 years old
• people with diabetes
• people with a weakened immune system, such as those having chemotherapy treatment or who recently had an organ transplant
• people who have recently had surgery or a serious illness
• women who have just given birth, had a miscarriage or had an abortion
Symptoms of Sepsis in adults or older children include:
• slurring of speech and acting confused
• skin may appear mottled or discoloured, pale and blotchy
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast
If you are not sure if it is Sepsis, you should call 111.
Sepsis needs treatment in the hospital straight away because it can get worse quickly. It would be best if you got antibiotics as soon as possible. Find your nearest NHS A&E. If sepsis is not treated early, it can turn into septic shock and cause your organs to fail.
LEARN MORE ABOUT CYSTITIS
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