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Cystitis: What to Try First and When to Get Medical Advice
Cystitis can start with symptoms such as a burning or stinging feeling when you pee, needing to go more often, or suddenly feeling an urgent need to use the toilet. Some mild UTIs can improve on their own, while others may need treatment.
Here’s what you can do to manage your symptoms, when a clinician or pharmacist may be able to help, and the signs that mean you should seek further medical advice.
3 Key Things to Know
Mild cystitis symptoms can sometimes improve with self-care
A clinician or pharmacist can assess whether antibiotics may be appropriate
Certain symptoms, including fever, back pain or blood in your urine, need prompt medical advice
Educational Guide
What can help with cystitis symptoms?
If your symptoms are mild, there are some simple things you can do while monitoring how you feel:
Drink enough water to stay well hydrated and pass pale urine regularly
Take paracetamol for pain or discomfort, if it is suitable for you
Rest and give your body time to recover
Avoid drinks that may irritate your bladder, such as coffee and alcohol
Cystitis sachets and cranberry products are also widely available, but there is currently limited evidence that they help treat a UTI once an infection has started.
If your symptoms are getting worse or are not improving within 48 hours, speak to a clinician or pharmacist.
Can a pharmacist help without a GP appointment?
In England, women aged 16 to 64 with symptoms of an uncomplicated UTI may be able to receive an assessment through the NHS Pharmacy First service without needing to see their GP first.
A pharmacist will ask questions about your symptoms, medical history and any factors that could make the infection more complicated.
Following the assessment, they may provide:
Self-care advice
Advice on managing your symptoms
Antibiotic treatment where clinically appropriate
Referral to another healthcare service if further assessment is needed
The Pharmacy First UTI pathway is not suitable for everyone. If you are pregnant or breastfeeding, male, aged under 16 or 65 and over, or have certain other risk factors, you may need assessment through your GP or NHS 111 instead.
Expert Advice
Most UTIs are straightforward to treat, but symptoms that are getting worse or not improving should be assessed. Fever, back pain or feeling very unwell can be signs that you need more urgent medical attention.
When should you seek medical advice?
Contact your GP or NHS 111 promptly if:
Your symptoms are getting worse quickly
Your symptoms have not improved within 48 hours of self-care or treatment
You have blood in your urine
You have a high or very low temperature, or feel hot, cold or shivery
You have pain in your lower tummy, back or side, particularly just under the ribs
You feel or are being sick
You are pregnant
You are male
You are aged 65 or over
You have diabetes or a weakened immune system
You have had 2 UTIs within 6 months or 3 within 12 months
Back or side pain, fever, shivering or feeling very unwell can sometimes indicate that the infection has spread to the kidneys and should be assessed promptly.
Call 999 or go to A&E if you become confused, very drowsy or have difficulty speaking.
Educational Guide
What to Have Ready for Your Consultation
It may help to have the following information ready:
When your symptoms started
The symptoms you are experiencing
Any medicines you currently take
Any allergies you have
Whether you have had a UTI recently
Whether you are pregnant or breastfeeding
Details of any previous UTI treatment
Your Consultation: 4 Common Questions
1. Can cranberry juice or tablets treat cystitis?
There is currently no good evidence that cranberry products treat a UTI once symptoms have started. Some people use cranberry products to help prevent recurrent UTIs, but they should not be relied on to treat an active infection.
2. Will I need to provide a urine sample?
Not always. An uncomplicated UTI can sometimes be assessed based on your symptoms and medical history. A urine sample may be needed if your symptoms are unusual, keep returning or there are other factors that need further investigation.
3. Can men use the same pharmacy service for a UTI?
The NHS Pharmacy First uncomplicated UTI pathway is for women aged 16 to 64. Men with symptoms of a UTI should seek medical advice from their GP or NHS 111, as further assessment may be needed.
4. What if my UTIs keep coming back?
If you have had 2 UTIs within 6 months or 3 within 12 months, this is considered recurrent UTI. Speak to your GP, as they may want to investigate why the infections are returning and discuss treatment or prevention options.
