Also indexed as: Bladder Infection, Cystitis, Honeymoon
Cystitis, UTI
Urgency? Frequency? Could be a UTI. Triggered by bacteria, UTI,
or urinary tract infection, can occur in the kidneys, bladder, or urethra. According to
research or other evidence, the following self-care steps may be helpful:
- Check out cranberry
- To treat and to prevent recurrences, drink 4 to 10 ounces (114 to
296 ml) of cranberry juice a day or take 400 mg of powdered cranberry concentrate twice a
day
- Try an enzyme preparation
- To enhance antibiotic effectiveness, take 400 mg a day of
proteolytic enzymes, such as bromelain and trypsin
- Avoid allergic foods
- Work with a knowledgeable health practitioner to find out if you
have allergies to foods that increase your susceptibility to urinary tract infections
- Aim for a strong immune system with a multivitamin
- Take one a day to avoid vitamin and mineral deficiencies and to
better resist infections
- If you have a UTI, see a healthcare provider
- Existing infections may require treatment with antibiotics
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full urinary tract infection
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About UTIs
Urinary tract infections (UTIs) are
infections of the kidney, bladder, and urethra.
UTIs are generally triggered by bacteria and are more common when there is partial blockage
of the urinary tract. In some people, UTIs tend to recur.
Product ratings for a
urinary tract infection
What are the symptoms?
Symptoms of a UTI usually begin suddenly and include frequent urination that is irritating
or burning, a persistent urge to urinate even after the bladder has been emptied, and cramping
or pressure in the lower abdomen. The urine often has a strong or unusual smell and may appear
cloudy. In more serious infections, fever,
chills, pain in the back below the ribs,
nausea, vomiting, and diarrhea may also be
present.
Medical options
Over the counter products containing
phenazopyridine (Azo-Standard®, Prodium®) may be used to relieve pain, burning,
and urgency, but they do not treat the infection.
Oral antibiotics are typically used to
treat uncomplicated infections; the most
commonly prescribed are the combination drug
trimethoprim/sulfamethoxazole (Bactrim®, Septra®) and the fluoroquinolones, such
as levofloxacin (Levaquin®), ciprofloxacin (Cipro®), and ofloxacin (Floxin®). One of the third-generation
cephalosporins, cefixime (Suprax®) and
the tetracyclinedoxycycline (Vibramycin®) may be used as
well.
Intravenous antibiotics, such as the aminoglycosides gentamicin (Garamycin®) and tobramycin (Nebicin®, Tobrex®), may be used
for more serious infections.
Dietary changes that may be helpful
When healthy volunteers consumed a large amount (100 grams) of refined sugar, the ability of their white blood cells
to destroy bacteria was impaired for at least five hours.1 Consumption of excessive
amounts of alcohol has also been shown to suppress immune function.2 Reduced intake of dietary
fat has been shown to stimulate
immunity.3 For these reasons, many doctors recommend a reduced intake of sugar, alcohol, and fat during an acute infection and for prevention of recurrences.
People who have recurrent or chronic infections should discuss the possible role of allergies with a doctor, since chronic infections
have been linked to allergies in many reports.4 5 6
7 Identifying and eliminating foods that trigger problems may help reduce the number of
infections.
Vitamins that may be helpful
The proteolytic enzymes, bromelain (from pineapple) and trypsin may enhance the effectiveness
of antibiotics in people with a UTI. In a
double-blind trial, people with UTIs received antibiotics plus either bromelain/trypsin in
combination (400 mg per day for two days) or a placebo. One hundred percent of those who
received the enzymes had a resolution of their
infection, compared with only 46% of those given the placebo.8 This study used
enteric-coated tablets. Enteric-coating prevents stomach acid from partially destroying the
bromelain. Most commercially available bromelain products today are not enteric-coated, and it
is not known if non-enteric coated preparations would be as effective.
Some bacteria that typically cause urinary tract infections can attach themselves to the
lining of the urinary tract by binding to molecules of mannose that naturally occur there.9
Theoretically, if enough D-mannose is present in the urine, it would bind to the bacteria and
prevent them from attaching to the urinary tract lining.10 One animal study has
demonstrated this protective effect,11 but whether it would occur in humans is
unknown, and no human research has investigated the effectiveness of oral D-mannose for the
prevention or treatment of urinary tract infections.
Many doctors recommend 5,000 mg or more of
vitamin C per day for an acute UTI, as well as long-term supplementation for people who
are prone to recurrent UTIs. Although no controlled clinical trials have demonstrated the
effectiveness of vitamin C for this purpose, vitamin C has been shown to inhibit the growth of
E. coli, the most common bacterial cause of UTIs.12 In addition,
supplementation with 4,000 mg or more of vitamin C per day, results in a slight increase in
the acidity of the urine,13 creating an “unfriendly” environment for
some infection-causing bacteria.
Vitamin A deficiency increases the risk of
many infections. Although much of the promising research with vitamin A supplements and
infections has focused on measles,14 vitamin A is also thought to be helpful in
other infections. Some doctors recommend that people with urinary tract infections take
vitamin A. A typical amount recommended to correct a deficiency is 10,000 to 25,000 IU per
day.
Since the immune system requires many
nutrients in order to function properly, many people take a multivitamin-mineral supplement for
“insurance.” In one double-blind trial, healthy elderly people who used such a
supplement for one year showed improvements in immune function, as well as a significant
reduction in the total number of infections (including non-urinary-tract
infections).15
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Modern research has suggested that
cranberry may prevent urinary tract infections. In a double-blind trial, elderly women who
drank 10 ounces (300 ml) of cranberry juice per day had a decrease in the amount of bacteria
in their urine.16 In another study, elderly residents of a nursing home consumed
either four ounces (120 ml) of cranberry juice or six capsules containing concentrated
cranberry daily for 13 months. During that time, the number of UTIs decreased by
25%.17 A small preliminary trial found that supplementation with encapsulated
cranberry concentrate (400 mg twice per day for three months) significantly reduced the
recurrence of UTIs in women (aged 18–45) with a history of recurrent
infections.18
Research has suggested cranberry may be effective against UTIs because it prevents E.
coli, the bacteria that causes most urinary tract infections, from attaching to the walls of the
bladder.19 Cranberry is not, however, a substitute for antibiotics in the treatment of acute UTIs. Moreover,
in children whose UTIs are due to “neurogenic bladder” (a condition caused by
spinal cord injury or myelomeningocele), cranberry juice supplementation did not reduce the
rate of infection.20 Drinking 10–16 ounces (300–500 ml) of unsweetened
or lightly sweetened cranberry juice is recommended by many doctors for prevention, and as
part of the treatment of UTIs. Alternatively, 400 mg of concentrated cranberry extracts twice
per day can be used.
Blueberry contains similar constituents as
cranberry, and might also prevent bacteria from attaching to the lining of the urinary
bladder.21 However, studies have not yet been done to determine if blueberry can
help prevent bladder infections.
Asparagus (Asparagus officinalis), birch (Betula spp.), couch grass
(Agropyron repens), goldenrod (Solidago virgaurea),horsetail, Java tea (Orthosiphon stamineus),
lovage (Levisticum officinale), parsley (Petroselinum crispum), spiny
restharrow (Ononis spinosa), and
nettle are approved in Germany as part of the therapy of people with UTIs. These herbs
appear to work by increasing urinary volume and supposedly helping to flush bacteria out of
the urinary tract.22 Juniper is
used in a similar fashion by many doctors. Generally, these plants are taken as tea.
Buchu leaf preparations have a history of
use in traditional herbal medicine as a urinary tract disinfectant and diuretic.23
However, the German Commission E monograph on buchu concludes that insufficient evidence
supports the modern use of buchu for the treatment of UTIs or inflammation.24
The volatile oil of horseradish has been
shown to kill bacteria that can cause urinary tract infections.25 The concentration
that is required to kill these bacteria can be attained in human urine after oral ingestion of
the oil. One early study found that horseradish extract may help people with urinary tract
infections.26 Further studies are necessary to confirm the safety and effectiveness
of horseradish in treating urinary tract infections.
Goldenseal is reputed to help treat many
types of infections. It contains berberine, an
alkaloid that may prevent UTIs by inhibiting bacteria from adhering to the wall of the urinary
bladder.27 Goldenseal and other plants containing berberine (such as Oregon grape) may help in the treatment of UTIs. These
herbs have not, however, been studied for the treatment of UTIs in humans.
Because of the anti-inflammatory effects of
plantain, it may be beneficial in some people with UTIs. However, human trials have not
been done to confirm this possibility or to confirm the traditional belief that plantain is
diuretic.28
An extract of uva ursi is used in Europe
and in traditional herbal medicine in North America, as a treatment for UTI.29 This
herb is approved in Germany for treatment of bladder infections.30 The active
constituent in uva ursi is arbutin. In the alkaline environment of the urine, arbutin is
converted into another chemical, called hydroquinone, which kills bacteria. A generally useful
amount of uva ursi tincture is 3–5 ml three times per day. Otherwise, 100–250 mg
of arbutin in herbal extract capsules or tablets three times per day can be used. Uva ursi
should only be used to treat a UTI under the close supervision of a physician.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
Acupuncture might be of some benefit for
women with recurrent UTIs. A controlled study compared acupuncture to sham
(“fake”) acupuncture or no treatment in a group of women with recurrent UTIs.
After six months, the women receiving real acupuncture had half as many UTI episodes as the
sham group and only one-third as many as the untreated group, a significant
difference.31
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enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind
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