The Independent Pharmacy

Cystitis (UTI)

Suffering from cystitis, a common urinary tract infection (UTI), can be quite painful, often causing a stinging or burning sensation when you pee. You might feel the need to go more urgently and frequently, and your wee may appear cloudy or even bloodstained. While it can be agonising each time you visit the toilet, you can often get through mild bouts by drinking plenty of fluids, taking painkillers to ease discomfort and avoiding sex. Let’s find the right treatment to relieve your symptoms and keep you feeling comfortable and healthy.

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Advice for Cystitis (UTI)

What is Cystitis and what causes it?

Cystitis is an infection of the urinary tract or bladder causing pain and inflammation. It is also commonly known as a water infection, bladder infection or urinary tract infection (UTI). It is caused by bacteria, usually from the anus, entering the urinary tract (urethra) and moving up to the bladder, causing infection.

The most common causes of cystitis are bacterial infection - most commonly by caused the bacterium, E.Coli. The bacteria are more likely to enter the urethra during sex if you wipe from back to front after using the toilet when inserting a tampon or a contraceptive diaphragm. Bacteria in your bladder are more likely to cause an infection if there is a blockage in, or there has been damage or irritation to, your urinary system.

Cystitis is most common in women, it is estimated almost all women will experience cystitis at least once in their life. Around 1 in 5 of those that experience cystitis will suffer from it more than once, known as recurrent cystitis. Cystitis is more common in women due to their shorter urethra, allowing bacteria to reach the bladder more easily. It is most common in women who:

  • Are pregnant
  • Are sexually active
  • Have been through the menopause
  • Are diabetic
  • Use a catheter
  • Have kidney problems

What are the symptoms of Cystitis?

The most common symptoms of cystitis are:

  • Burning, stinging or pain when you urinate
  • Feeling the need to urinate frequently
  • Only being able to produce small amounts of urine
  • Some pain behind the pubic bone or in the lower back

Other symptoms that may be present and indicate a more serious infection are:

  • Severe pain behind the pubic bone or in the lower back
  • Pain in the flanks (the sides of your lower back – where your kidney are located)
  • Nausea and vomiting
  • Fever (temperature over 38°C)
  • Blood in the urine

If any of the above symptoms are present you should consult a doctor as your infection may have moved up your urinary tract to your kidneys (called pyelonephritis) and require more serious treatment.

Urinary tract infections in children, men and the elderly should always be treated by their GP. In children sometimes the only symptom present may be fever, although they can also include not feeding/eating, sickness, increased sleep or incontinence (weak bladder). Symptoms may also be absent in the elderly but are more likely to include incontinence, confusion or fatigue.

It is important to know the difference between cystitis and thrush, two conditions that are often confused and mistreated by people who are self-medicating.

How is Cystitis diagnosed?

Women who have had cystitis before that has been diagnosed and investigated by their GP, can self-diagnose their symptoms if they are similar to those previously and there are none of the warnings symptoms present.

It is very important that women who experience cystitis for the first time, as well as men and children, always consult their GP – it should not be self-treated.

Additionally, women should visit their GP if they:

  • Experience cystitis more than 3 times in a year for an investigation into the cause of recurrent cystitis.
  • Are pregnant or suspect they may be pregnant
  • Have a catheter inserted
  • Are experiencing any other symptoms listed above that indicate their infection may be more severe including nausea, severe pain, fever or blood in the urine.
  • Are diabetic

Your GP can make an accurate diagnosis of your condition based on your current symptoms and medical history. If necessary they will be able to take a urine sample and perform tests to aid a correct diagnosis. Cystitis can have similar symptoms to vaginal thrush and some sexually transmitted infections so a correct diagnosis is vital to successful treatment.

How do I treat Cystitis?

Women who are able to self-diagnose their cystitis are able to purchase treatment without the need to visit their GP. The following treatment options are available:

  • Urine alkalizing sachets (cystitis sachets) – this help to make the urine less acidic reducing the stinging sensation when urinating. Examples include Cymalon and Cystopurin.
  • Over-the-counter painkillers – normal painkillers such as paracetamol or ibuprofen can be used to reduce discomfort.
  • Antibiotics - Nitrofurantoin (Macrobid) and Trimethoprim are available to purchase from our Online Pharmacy for women who have previously been diagnosed with cystitis by their GP. Macrobid is the first-line antibiotic for the treatment of simple cases of cystitis in women. It is taken twice daily in a short course of 3 days to clear up most simple cases of cystitis. Antibiotics will normally improve the symptoms of cystitis within 24 hours and cure the condition within 72 hours. If the condition has not fully resolved once the 3-day course of cystitis is complete, or your symptoms have worsened, you should see your GP for further treatment and advice.

Women with cystitis should also adopt the lifestyle changes listed below in ‘Prevention’ to reduce symptoms and speed up recovery.

Alternatives

Non-Prescription Alternatives

Effective relief from the symptoms of cystitis, Cymalon Sachets is one of the most popular cystitis remedies in the UK. Cymalon sachets contain sodium citrate which helps to neutralise urine acidity during an attack of cystitis, providing welcome relief from the burning pain and irritation. Keep them in the bathroom for easy access when the first symptoms show.

Cystitis (UTI) FAQs

  • Cystitis is the inflammation of the bladder wall. This can be caused by a bacterial infection (usually by E. coli which lives harmlessly in the intestine) or from physical irritation or bruising during sexual intercourse. The bacteria move upwards via the urethra (the tube that connects the bladder to the outside world) and attaches to the bladder wall causing the pain, frequency and discomfort associated with cystitis.

  • No – cystitis, a bladder infection or a urinary tract infection (UTI) are all different terms for the same condition that can be used interchangeably.

  • Cystitis is an infection, however it cannot be transmitted like the common cold. Cystitis is not contagious; you do not need to worry about passing it on to others.

  • There are a number of different treatments for cystitis.

    You can use simple sachets that make the urine less acidic and stop the burning sensation e.g Cystopurin, Cymalon, Potassium Citrate Mixture & Canesten Oasis.

    As cystitis is a bacterial infection it can also be treated using antibiotics; Trimethoprim is the most common. It is eliminated from the body in the urine, therefore it occurs in high concentrations exactly where it is needed for effective treatment. Trimethoprim is available to treat cystitis in women through our Online Pharmacy. Other antibiotics can be used to treat cystitis if Trimethoprim is not suitable, these can be prescribed by your GP.

  • If you have had a urinary tract infection before you may recognise the symptoms. These can include:

    • a burning or stinging sensation when you pass urine.
    • the urgency and increased frequency of passing water.
    • only being able to produce small amounts of urine.

    See the 'Symptoms' section above for a detailed overview of the symptoms of cystitis.

  • The urethra is longer in men than women, this makes it harder for bacteria to travel up to the bladder. Men can also get cystitis but this is far less common and they must see their GP to rule out other serious conditions like urinary obstruction, enlarged prostate or tumours.

  • No, you should ask your GP to perform one for you. They will require you provide them with a fresh urine sample which can be sent to a lab for analysis. This will allow them to confirm if a bacterial infection is present and also to check which antibiotic treatment will be most effective.

  • The burning sensation, frequency of and the urgency of passing urine can start to subside in as little as a few hours but will usually resolve after a day of starting antibiotic treatment. After the initial symptoms have resolved you maybe left with a few days of irritation. You should never stop your antibiotic treatment early, even if you begin to feel better.

  • Over-the-counter painkillers, like ibuprofen, aspirin and paracetamol, are fine for treating the pain of cystitis. These can be taken with trimethoprim but always check with your pharmacist or GP if you are on any other medicines.

  • Trimethoprim is eliminated from the body in the urine, this means it is present in large concentrations exactly where it is needed. It is normally prescribed straight away, without sending a sample off for analysis because it works so quickly.

    If you have not seen an improvement in your symptoms within 48 hours you need to see your doctor face to face. Your infection may be resistant to the first line treatment of trimethoprim and they can send a fresh urine sample off for analysis to identify the bacterial cause of your infection. Your cystitis can then be accurately treated with a different antibiotic to which there is no resistance.

  • The antibiotics that interact with contraceptive tablets are rifampicin and rifabutin (used to treat tuberculosis and meningitis). Other antibiotics, including those used to treat cystitis, do not interact with the contraceptive pill.

  • No, trimethoprim does not interact with alcohol. You can drink in moderation whilst taking trimethoprim, however alcohol can worsen the symptoms of cystitis so it is not normally recommended.

  • Thrush is caused when the naturally occurring yeast, Candida Albicans, overgrows in the vagina. This usually happens after a course of antibiotics because they reduce bacteria in the vagina that regulate the yeast. As the candida over grows the symptoms of thrush develop. This is completely normal and is easy to treat with a Fluconazole 150mg Capsule.

  • Washing the vaginal area with soap can increase irritation and decrease good bacteria and natural lubricants making your symptoms worse and prolonging your suffering. It can also make you more prone to getting vaginal thrush.

  • Cranberry juice does not cure or treat the symptoms of cystitis but it is thought to stop the bacteria from attaching to the wall of the bladder and urethra. This makes is more useful for prevention rather than cure.

    The evidence for this is limited with some studies showing that it does work and others showing it had little effect.

  • It is important to finish the course of antibiotics even if you feel better to ensure all the bacteria have been killed off. If the bacteria are not completely eradicated then these is chance your cystitis infection could return. In this case, the bacteria may become resistant to antibiotics and be harder to treat in the future.

Guides for Cystitis (UTI)

Andy Boysan

Authored by

Andy Boysan
Andy Boysan
BPharm
2047716
Director & Superintendent Pharmacist

Andy is a co-founder and the Superintendent Pharmacist and Director at The Independent Pharmacy.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.

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