Cystitis

Cystitis is inflammation of the bladder. It's usually caused by a urinary tract infection (UTI).

Cystitis is very common, especially in women and people with a female urinary system. It often gets better in a few days without treatment.

In some cases, your GP may prescribe antibiotics. If you get cystitis often, you may need regular or long-term treatment.

Symptoms of cystitis

Cystitis can cause:

• pain, burning or stinging when you pee
• a need to pee more often and urgently than normal
• pee that's dark, cloudy or strong-smelling
• feeling like you need to pee again soon after going to the toilet
• pain low down in your tummy
• feeling unwell, achy, sick and tired
• confusion in older people - especially people with cognitive problems such as dementia

Young children with cystitis may have other symptoms, such as:

• a high temperature (fever)
• weakness and tiredness
• irritability
• not eating as much as usual
• vomiting

Treatment from a GP

Your GP can diagnose cystitis by asking about your symptoms.

They may:

• tell you how to treat cystitis at home
• prescribe antibiotics - usually a tablet or capsule to take 2 to 4 times a day for 3 days
• test a sample of your pee for bacteria

Treating cystitis at home

You may not need to see a GP if you have:

• a female urinary system
• mild symptoms for less than 3 days

To help with cystitis, you can:

• ask your pharmacist for advice
• take paracetamol or ibuprofen
• drink plenty of water
• hold a hot water bottle on your tummy or between your thighs
• avoid having sex

Some people use cranberry juice or products that reduce the acidity of their pee. But it's not clear if these are effective.

If cystitis keeps coming back

You may need other treatment if you have a female urinary system and have cystitis:

• 2 or more times in 6 months
• 3 or more times in 12 months

Your GP may:

• prescribe antibiotics to use whenever you get symptoms (stand-by antibiotics)
• prescribe a low dose of antibiotics to take over several months (continuous antibiotics)
• refer you for tests such as an ultrasound of the urinary tract

Preventing cystitis

It is not always possible to prevent cystitis.

But if you get cystitis often, there are some things you can try.

Causes of cystitis

Cystitis is usually caused by a bacterial infection.

Bacteria in the bowel or on the skin can get into the bladder through the urethra. The urethra is the tube that removes urine from the bladder and out of the body.

The urethra is shorter in the female urinary system than the male urinary system. This means bacteria are more likely to reach the bladder and cause an infection.

Some things that can increase the risk of bacteria getting into your bladder include:

• having sex
• wiping your bottom from back to front after you go to the toilet
• inserting a tampon
• having a urinary catheter (a tube that empties the bladder)
• using a diaphragm for contraception
• experiencing the menopause - changes to your hormones and urethra can make it easier to get a UTI
• having diabetes - when the level of sugar in your pee becomes too high, bacteria can multiply
• using spermicide with contraception
• conditions that block the urinary tract, such as kidney stones
• being pregnant
• conditions that make it difficult to fully empty the bladder, such as an enlarged prostate gland in men
• having a weakened immune system

Less common causes of cystitis

Sometimes cystitis happens when the urethra or bladder is irritated or damaged.

This can be from:

• friction from sex
• chemical irritants, such as chemicals in perfumed soap or bubble bath
• a catheter or surgery on your bladder
• radiotherapy to your pelvis or treatment with certain chemotherapy medicines
• female genital mutilation (FGM) - an illegal practice of cutting a woman's genitals

Ketamine use

Regular use of ketamine can cause problems with your bladder and urinary system. This may be called ketamine bladder or ketamine-induced cystitis.

It's best to tell your GP or doctor if you use ketamine. It will help them to recommend the right treatment for you.

Regular ketamine use damages the lining of the bladder and affects the urinary system. It's important to get help early if you use ketamine and have bladder problems.

Interstitial cystitis

Interstitial cystitis is a rare and long-term pain condition. It's sometimes called painful bladder syndrome (PBS).

Symptoms of interstitial cystitis can be similar to cystitis. They include frequent pelvic pain and problems peeing. But there is no obvious bladder infection and antibiotics do not help.

If you think you have interstitial cystitis, talk to your GP. They can tell you about ways to reduce your symptoms.

Interstitial cystitis is not well understood and difficult to diagnose. You may need to have several tests to exclude other causes of your symptoms.

Treatment for interstitial cystitis

You may need to try several treatments to find one that works for you.

Treatments include:

• lifestyle changes - for example, exercise and avoiding certain foods such as coffee
• medicines
• physiotherapy
• surgery or procedures, if other treatments do not work