Cystitis: an approach to urinary symptoms

Cystitis means inflammation of the bladder; a common cause is a bacterial urinary tract infection. Burning, frequent or urgent urination, small amounts of urine and lower abdominal discomfort may occur. Dark colour or odour alone does not prove infection. Symptoms are nothing to be ashamed of and are not a judgement on personal cleanliness.

The clinician considers symptoms, previous infections, possible pregnancy and medicines. Urinalysis and culture, which help identify a germ and suitable treatment, may be requested; not everyone needs the same test. Recurrent or persistent symptoms warrant consideration of other causes and further investigations.

When bacterial infection is suspected, antibiotic choice and duration are individual. Do not take leftover antibiotics or someone else’s prescription; follow the prescribed dose and course. Seek review if symptoms do not start improving within 48 hours of treatment or worsen at any time. Herbal remedies and cranberry products do not replace treatment of an existing infection.

Fever, chills, back or flank pain, nausea or vomiting may suggest kidney infection; seek same-day assessment. Seek early advice for urinary symptoms in children, pregnancy, men, older adults, diabetes or a weakened immune system; report blood in urine promptly too. Call 112 for new confusion, marked drowsiness, difficulty speaking or severe deterioration.