Cystitis is inflammation of the bladder, usually caused by a bladder infection.
It’s a common type of urinary tract infection (UTI), particularly in women, and is usually more of a nuisance than a cause for serious concern.
Mild cases will often get better by themselves within a few days. But some people experience episodes of cystitis frequently and may need regular or long-term treatment.
There’s also a chance that cystitis could lead to a more serious kidney infection in some cases, so it’s important to seek medical advice if your symptoms don’t improve.
Signs and symptoms of cystitis
pain, burning or stinging when you pee
needing to pee more often and urgently than normal
urine that’s dark, cloudy or strong smelling
pain low down in your tummy
feeling generally unwell, achy, sick and tired
See a GP if:
you’re not sure whether you have cystitis
your symptoms don’t start to improve within 3 days
you get cystitis frequently
you have severe symptoms, such as blood in your urine, a fever or pain in your side
you’re pregnant and have symptoms of cystitis
you’re a man and have symptoms of cystitis
your child has symptoms of cystitis
A GP should be able to diagnose cystitis by asking about your symptoms.
They may test a sample of your urine for bacteria to help confirm the diagnosis.
What causes cystitis?
Most cases are thought to occur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (the tube that carries urine out of your body).
It’s not always clear how this happens.
But some things can increase your risk of getting it, including:
wiping your bottom from back to front after going to the toilet
having a urinary catheter (a thin tube inserted into the urethra to drain the bladder)
being younger than 1 or older than 75
using a diaphragm for contraception
having a weakened immune system
Women may get cystitis more often than men because their anus (back passage) is closer to their urethra and their urethra is much shorter, which means bacteria may be able to get into the bladder more easily.
Treatments for cystitis
If you have been having mild symptoms for less than 3 days or you have had cystitis before and don’t feel you need to see a GP, you may want to treat your symptoms at home or ask a pharmacist for advice.
Until you’re feeling better, it may help to:
take paracetamol or ibuprofen
drink plenty of water
hold a hot water bottle on your tummy or between your thighs
avoid having sex
wipe from front to back when you go to the toilet
gently wash around your genitals with a skin-sensitive soap
Some people believe that cranberry drinks and products that reduce the acidity of their urine (such as sodium bicarbonate or potassium citrate) will help.
If you see a GP and they diagnose you with cystitis, you’ll usually be prescribed a course of antibiotics to treat the infection. These should start to have an effect within a day or 2.
Nitrofurantoin (the active substance in MacroBID) is an antibiotic.
It is used to prevent and treat infections of the bladder, kidney and other parts of the urinary tract.
When you take nitrofurantoin, your body quickly filters it out of your blood and into your pee. This is useful if you have a urinary tract infection because it means the medicine is concentrated at the site of infection. But it means nitrofurantoin won’t work for any other types of infection.
MacroBID is a prolonged release capsule, which should be taken for the full 3 day course, to prevent antibiotic resistance.
The most common side effect of nitrofurantoin is an upset stomach. Taking this medicine with or straight after food will help prevent a stomach upset.
You can drink alcohol while taking nitrofurantoin.
Nitrofurantoin may turn pee dark yellow or brown. This is quite normal. Pee will return to normal after you finish taking the medicine.
DO NOT TAKE MacroBID
• if you are allergic to Nitrofurantoin, other medicines containing nitrofurantoin or any of the other ingredients of this medicine (listed
in section 6)
• if you have a disease of the kidneys which is severely affecting the way they work (ask your doctor if you are not sure)
• if you are in the final stages of pregnancy (labour or delivery) as there is a risk that it might affect the baby
• if you have porphyria (blood disorder)
• if in patients with G6PD (glucose-6-phosphate dehydrogenase) deficiency
• if in infants under three months of age
• if you are breast feeding a baby with suspected or known deficiency in an enzyme called G6PD (glucose-6-phosphate dehydrogenase).
HOW TO TAKE MacroBID
The usual dose of nitrofurantoin to treat a urinary tract infection is 100mg taken twice a day for three days.Taken this with or straight after food will help prevent a stomach upset.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Most of them are mild and disappear when
you stop taking MacroBID. If you experience any of the side effects detailed below or any other side effects, stop taking MacroBID and
consult your doctor.
All medicines can cause allergic reactions although serious allergic reactions are rare. If you notice any sudden wheeziness, difficulty in
breathing, swelling of the eyelids, face or lips, rash or itching (especially affecting your whole body) STOP TAKING your medicine and
go to a doctor immediately.
Please note that while taking MacroBID your urine may become coloured dark yellow or brown. This is quite normal and not a reason
to stop taking the medicine.
If you notice any of the following side effects consult your doctor immediately:
• Your lungs may react to MacroBID. This may develop quickly, within a week of starting treatment or very slowly, especially in
elderly patients. This may produce fever, chills, cough and shortness of breath
• MacroBID may cause the liver to become inflamed, producing jaundice (yellowing of the skin or whites of the eyes)
• Severe reduction in blood cells which can cause weakness, bruising or make infections more likely
• Blue or purple coloration of the skin due to low oxygen levels. A condition known as cyanosis.
• Symptoms of fever, flu, abdominal pain, diarrhea, blood in your stool and weakness. These could be signs of a condition known as
• Symptoms of fatigue, abdominal pain, joint pain and swelling. These could be signs of a condition known as hepatitis.
For a full list of side effects please see patient information leaflet.