UTI - Cystitis

Self-Management of Cystitis and Urinary Tract Infections (UTIs)

What is Cystitis and a what is a  UTI?

• Cystitis refers to inflammation of the bladder, which is often caused by a urinary tract infection (UTI).
• UTIs can affect any part of the urinary system, but the lower urinary tract (bladder and urethra) is most commonly involved.
• Symptoms of a UTI or cystitis include:
   
  • A frequent urge to urinate
  • A burning or stinging sensation when urinating
  • Cloudy, dark, or strong-smelling urine
  • Pelvic discomfort or lower abdominal pain
  • Feeling tired or generally unwell

Can UTIs be treated without antibiotics?

In many cases, mild UTIs and cystitis can be managed without antibiotics. This is especially true for non-complicated UTIs in otherwise healthy individuals. The following self-care strategies can help alleviate symptoms and promote recovery.

1. Hydration:

• Drink plenty of fluids—aim for 6-8 glasses of water per day. This helps flush bacteria out of your urinary system.
• Cranberry products (juice or tablets) may help in some cases, though evidence is mixed. They may be beneficial for recurrent UTIs but aren't a cure for acute infection.
• Avoid caffeine, alcohol, and acidic drinks like citrus juices, as they can irritate the bladder.

2. Pain Relief:

• Over-the-counter pain relievers like paracetamol or ibuprofen can help manage pain and discomfort.
• Urinary alkalinisers (like sodium bicarbonate sachets) may also help by neutralising the acidity of your urine, reducing irritation.
• Heat packs or warm baths may provide relief from pelvic or lower abdominal pain.

3. Rest and Hygiene:

• Rest to help your body fight the infection.
• Maintain good hygiene, but avoid using harsh soaps or douches, as these can irritate the urethra and bladder.
• After urination, wipe front to back to avoid bacteria from the anal area reaching the urethra.

4. Probiotics:

• Taking probiotics (e.g., lactobacillus) may help restore healthy bacteria in the urinary tract and vagina, especially if you’ve recently used antibiotics or had recurrent UTIs.

5. Avoid Irritants:

• Avoid using scented feminine products or sprays, which can irritate the urinary tract.
• If you’re sexually active, urinate after intercourse to flush out any bacteria that may have entered the urethra.

When to Seek Further Help:

1. Severe Symptoms or No Improvement:

• If your symptoms are severe (e.g., high fever, chills, severe pelvic pain, or blood in the urine), or if they don't improve within 2-3 days of self-care, seek medical advice.

2. Frequent Recurrences:

• If you experience frequent UTIs or cystitis, it’s important to consult with a healthcare professional to discuss preventive strategies.

3. Risk Groups:

• Pregnant women, people with diabetes, those with weakened immune systems, or individuals who have a history of recurrent UTIs should see a GP or nurse for proper diagnosis and management, as UTIs can cause more complications in these groups.

4. Systemic Symptoms:

• If you develop fever, nausea, vomiting, or back pain, it could be a sign that the infection has spread to the kidneys (pyelonephritis), which requires urgent medical attention.

NHS Pharmacy First Scheme (England)

Who can use the NHS Pharmacy First scheme? If you're experiencing symptoms of a UTI or cystitis, you may be able to seek help from a local NHS pharmacy first—this is part of the NHS Pharmacy First scheme. Under this scheme, certain groups of patients can access faster advice and treatment directly from a pharmacist without needing to see a GP.

Who is eligible?

• Women aged 16-65 with symptoms of cystitis or a lower UTI can approach an NHS pharmacy for advice, and if appropriate, the pharmacist may recommend over-the-counter treatments or prescribe antibiotics (if needed).

What to expect when using the scheme:

• The pharmacist will assess your symptoms and provide advice. If your symptoms suggest a straightforward UTI, they may recommend a course of treatment.
• They will also advise you on lifestyle changes and over-the-counter remedies that can help.
• If your symptoms are severe, or if there are concerns about complications, the pharmacist will refer you to a GP or other healthcare provider.

Please Note: The Pharmacy First scheme may not apply to men or women with complicated UTIs (e.g., pregnant women or those with underlying health conditions). In such cases, a GP consultation is required.

When to Contact Your GP or Seek Medical Care:

• If you're unsure whether you're eligible for the Pharmacy First scheme or if your symptoms are not improving with self-care, don’t hesitate to contact your GP for advice.
• If you experience fever, chills, flank pain, or blood in your urine, or if you feel very unwell, you should contact your GP or seek urgent medical attention, as these could be signs of a more serious infection like pyelonephritis (kidney infection).

Summary:

• Self-care: Stay hydrated, use over-the-counter pain relief, and rest. Probiotics and urinary alkalinisers may also be helpful but please check with a pharmacist to ensure these are safe for you to use.
• When to seek help: If symptoms are severe or not improving, or if you're in a high-risk group (e.g., pregnant women, elderly, or those with chronic health conditions), seek medical advice.
• Pharmacy First: Women aged 16-65 with uncomplicated cystitis can approach a pharmacy for faster treatment.

Always listen to your body. If you’re unsure about your symptoms or treatment, reaching out for professional advice is the best way to ensure proper care.