Cystitis treatment

Cystitis is a common inflammation of the bladder, most often caused by a urinary tract infection (UTI). It’s especially common in women because they have a shorter tube, called a urethra, that carries urine (pee) out of the body. This makes it easier for bacteria to enter the bladder and cause an infection. Between 75 and 95% of cystitis infections are caused by Escherichia coli (E. coli).

Because bacteria are naturally found around the vagina and the anus, which are both close to the opening of the urethra, UTI-causing bacteria can easily be transferred from stools or during sex.

The symptoms of cystitis are:

• pain, burning, or stinging sensation when going for a pee
• dark, cloudy, or strong-smelling urine
• needing to pee more often and urgently than usual
• lower abdominal pain

Sometimes cystitis will go away on its own within a few days, but in some cases, you may need antibiotics. The main treatment for cystitis caused by a UTI is a course of antibiotics, but there are also several things you can do at home to help manage your symptoms.

Antibiotics to treat cystitis

The first-line treatment for lower UTIs (infections that affect the bladder and urethra) in non-pregnant women is nitrofurantoin or trimethoprim. If these do not work or are not suitable for you, fosfomycin or pivmecillinam can be given as alternatives. At Asda Online Doctor, our doctors can prescribe nitrofurantoin or fosfomycin. Men and pregnant women should speak to a healthcare professional.

Nitrofurantoin

Nitrofurantoin is a broad-spectrum antibiotic, which means it’s effective on a wide range of bacteria. It works by entering the bacterial cells and damaging their genetic material, preventing them from multiplying and causing cystitis symptoms. Clinical trials have shown that nitrofurantoin has cure rates between 79 and 92%. Nitrofurantoin is the first antibiotic treatment recommended for cystitis caused by a UTI.

The usual UTI treatment dose is one 100mg capsule twice a day for 3 days. You should leave 12 hours between doses and try to take it with food to help prevent side effects. Most people will feel better within a few days of taking nitrofurantoin for cystitis caused by a UTI.

Fosfomycin

Fosfomycin is also a broad-spectrum antibiotic that’s usually offered if you cannot take nitrofurantoin, such as if it’s ineffective or unsuitable. It works by killing bacteria, like E. coli, that cause cystitis by interfering with their cell wall, preventing them from growing and surviving. Research shows that 1 month after treatment 98% of people treated with fosfomycin had no cystitis-causing bacteria in their pee compared to 95% who were given cephalexin.

Fosfomycin is given in 3g sachets, which need to be mixed with water and swallowed. The usual dose is one 3g sachet. Most people notice their UTI symptoms get better within 2 to 3 days of taking fosfomycin.

Treating cystitis at home

Cystitis symptoms can also be managed at home, with or without antibiotics, by:

• taking paracetamol up to 4 times a day to manage pain
• drinking plenty of clear fluids throughout the day
• holding a hot compress or hot water bottle over your stomach if you are getting pain
• peeing often and avoiding holding it in
• avoiding drinks that may irritate your bladder, such as coffee or alcohol
• avoiding sex until the infection has passed
• trying over-the-counter cystitis sachets or drinking cranberry juice may help manage cystitis, although the scientific evidence is limited and not conclusive once the infection has started

Like all medications, cystitis treatments can cause side effects, but not everyone will get them. The most common side effects are usually gastrointestinal, such as feeling or being sick. However, some people find that taking their medication with food can help with this.

Common side effects

The most common nitrofurantoin side effects are:

• feeling sick (nausea)
• being sick (vomiting)
• diarrhoea
• loss of appetite
• headaches
• dizziness or sleepiness

The most common side effects of fosfomycin are:

• headache
• dizziness
• diarrhoea
• feeling sick (nausea)
• indigestion
• abdominal pain
• vaginal infections or inflammation

How to manage the side effects

Most of the side effects of cystitis treatment are mild and go away on their own once your body gets used to the medication, or you stop taking it. There are things you can do to help manage them at home, such as:

• headaches – get plenty of rest, drink fluids frequently, and take over-the-counter painkillers, like paracetamol or ibuprofen
• feeling sick – try taking your medication with food and avoid spicy, rich, or greasy foods
• being sick – take frequent sips of water to prevent dehydration, get plenty of rest, and try to eat plain foods, like toast or crackers
• diarrhoea – drink plenty of fluids and speak to a pharmacist about anti-diarrhoea medication
• loss of appetite – try to eat when you would usually be hungry, and it may help to eat smaller, more frequent meals
• dizziness – avoid driving or operating machinery while you feel dizzy, it can also help to lie down until it passes and then get up slowly

Although it is possible to manage side effects at home, if you’re worried or concerned about any you have, including those not listed in the patient information, speak to your doctor or pharmacist for more advice.

Cystitis treatments are available over-the-counter at pharmacies or with a prescription, depending on the type of treatment you choose. Typically, prescription-only treatments are antibiotics that work by killing the bacteria responsible for an infection that’s causing cystitis. While over-the-counter options, like cystitis sachets, lower the acidity of your urine, making it less uncomfortable to go for a pee.

Can you buy antibiotics for cystitis online?

Yes, you can request antibiotics for cystitis caused by a UTI online from trusted online services, like Asda Online Doctor, but you will still need a doctor’s permission to get them. To get cystitis treatments from us, you will need to:

1. Complete a short online health questionnaire.
2. One of our doctors will review your answers to check if the medication is safe and suitable for you.
3. If approved, your medication will be delivered to your address, or you can collect it from your nearest Asda Pharmacy.

Our service allows you to get prescribed and approved treatment quickly and easily, with next-day delivery.

Is cystitis treatment available over the counter?

Yes, cystitis treatments are available over-the-counter, but they will only help you manage the symptoms and not cure any underlying infection. Over-the-counter products include sachets that contain potassium or sodium citrate to reduce the pain or burning sensation you may get by lowering the acidity of your urine. Antibiotics for cystitis, on the other hand, are only available with a prescription from a doctor.

If your symptoms have not improved after 48 hours or are getting worse, you should consider taking an antibiotic for a UTI. A doctor may provide you with a prescription but advise you to wait 48 hours to see if your symptoms clear up on their own.

If you experience any of the following or your symptoms get worse, speak to a doctor urgently, as this could be a sign of a kidney infection:

• fever
• back pain
• feeling sick (nausea)

There are several home remedies you can try to relieve cystitis symptoms, such as pain or burning when you pee. However, these will not treat the source of any infection, and instead, will just make the pain and discomfort more manageable.

Bicarbonate of soda

Changing the acidity of your urine can help reduce the pain and discomfort you may feel when going for a pee. Mixing bicarbonate of soda with water to make an alkaline solution (lowers acidity) may help with this. Try mixing half to 1 teaspoon of bicarbonate of soda in half a glass of water and drinking it fully. You should aim to do this 2 to 3 times a day.

However, there is limited scientific evidence to support the effectiveness of this method, and it should not replace medical treatment.

Cranberry juice

Some people drink cranberry juice when they have cystitis or a UTI. However, there is little evidence to suggest that cranberry juice or cranberry products can effectively treat cystitis. It’s still important to stay hydrated, but remember that cranberry juice also contains a lot of sugar.

Lemon barley water

Some people find that diluted lemon barley water can help ease cystitis symptoms and make going for a pee more comfortable. This is similar to bicarbonate of soda because it's alkaline, so it can lower the acidity of your urine. However, there is not any strong scientific evidence.

Stay hydrated

Hydration is really important for preventing and managing cystitis. Aiming to drink between 1.5 and 2 litres of water per day will help to dilute your urine and cause more bacteria to be flushed out of the urinary tract. Research suggests that encouraging premenopausal women who have a low fluid intake to drink at least 1.5 litres per day reduces the frequency of UTIs like cystitis.

The most common cause of cystitis is a bacterial infection. Bacteria from poo can enter the urethra, causing an infection. It’s more common in women than in men because women have a shorter urethra.

Some of the things that increase the chance of cystitis are:

• wiping from front to back when going to the toilet
• sex
• using spermicide
• urinary catheters
• pregnancy
• menopause
• diabetes
• a weakened immune system
• conditions that block the urinary tract, such as kidney stones

There are several things you can do to help prevent cystitis, such as:

Yes, cystitis can come back, and it’s common to get recurrent UTIs. More than 47% of people with a previous history of a UTI get a recurrent infection. If you keep getting recurrent cystitis, a doctor may recommend more long-term treatments, such as low-dose antibiotics to stop the infection from returning or may investigate other causes.

You may keep getting cystitis for several reasons, including wiping incorrectly when going to the toilet, using certain types of contraception, or having sex. You may also just be more at risk of getting them, such as if you have a weakened immune system.

Cystitis is not always caused by an infection, so it’s important to seek medical advice if you keep getting it. Understanding some of the common triggers can help you prevent further infections in the future. They include:

• wiping from back to front when using the toilet
• not emptying your bladder fully
• not peeing after sex
• using perfumed soaps and shampoos
• using spermicide with diaphragms or condoms
• not finishing a course of antibiotics for a previous UTI