Cystitis is a urinary tract infection (UTI) that affects the bladder. It's common, particularly in women. It often gets better by itself, but may sometimes be treated with antibiotics.

Some people get cystitis frequently and may need regular or long-term treatment.

Symptoms of cystitis include:

• pain, burning or stinging when you pee
• needing to pee more often and urgently than usual
• pee that's dark, cloudy or strong smelling
• pain low down in your tummy

Symptoms in young children may also include:

• a high temperature – they feel hotter than usual if you touch their neck, back or tummy
• wetting themselves
• reduced appetite and being sick
• weakness and irritability

In older, frail people with 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)

See a GP if:

Ask for an urgent GP appointment or get help from NHS 111 if:

If you have cystitis, a GP may:

• offer self-care advice and recommend taking a painkiller
• do a urine test, although this is not always needed
• give you a prescription for a 3-day course of antibiotics
• give you a prescription for antibiotics but suggest you wait for 48 hours before taking them, in case your symptoms go away on their own

Treatment for cystitis that keeps coming back

If you keep getting cystitis, a GP may prescribe:

• a single-dose antibiotic to take within 2 hours of having sex, if you've noticed sex triggers cystitis
• a low-dose antibiotic to take for up to 6 months
• a vaginal oestrogen cream, if you have gone through the menopause

In some women, antibiotics do not work or urine tests do not pick up an infection even though you have cystitis symptoms.

This may mean you have a long-term (chronic) bladder infection that is not picked up by current urine tests. Ask the GP for a referral to a specialist for further tests and treatment.

Long-term infections are linked to an increased risk of bladder cancer in people aged 60 and over.

If you have mild symptoms of cystitis, it can help to:

• take paracetamol up to 4 times a day to reduce pain
• give children paracetamol – follow the instructions on the bottle
• drink plenty of water
• hold a hot water bottle over your lower tummy
• avoid having sex
• avoid drinks that may irritate your bladder, like fruit juices, coffee and alcohol
• pee frequently

Some people take cystitis sachets or cranberry drinks and products every day to prevent cystitis from happening, which might help. However, there’s no evidence they help ease symptoms or treat cystitis if the infection has already started.

A pharmacist can help with cystitis

You can ask a pharmacist about treatments for cystitis. A pharmacist can:

• offer advice on things that can help you get better
• suggest the best painkiller to take
• tell you if you need to see a GP about your symptoms

Some pharmacies offer a cystitis management service. They may be able to give antibiotics if they're needed.

Find a pharmacy

Cystitis is usually caused by bacteria from poo getting into the tube that carries urine out of your body (urethra).

Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder and cause an infection.

Things that increase the chance of bacteria getting into the bladder include:

• having sex
• wiping your bottom from back to front after going to the toilet
• urinary catheters (a tube in your bladder used to drain urine)
• 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 been through the menopause
• having diabetes
• having a weakened immune system

If you get cystitis frequently, there are some things you can try to help prevent it returning.

If you keep getting cystitis, there is some evidence you may find it helpful to take:

• D-mannose – a sugar you can buy as a powder or tablets to take every day
• cranberry products – available as juice, tablets or capsules to take every day

Be aware that D-mannose and cranberry products can contain a lot of sugar. If you're taking warfarin, you should avoid cranberry products.