Natural Treatments for Bladder Infection
• Urinary Tract Infection
Bladder infections are a common problem for women, accounting for more than 6 million office visits each year. Men, because of the greater distance between their bladder and urethral opening, only rarely develop bladder infections.
The primary symptoms of a bladder infection are burning during urination, frequency of urination, and urgency to urinate, possibly accompanied by pain in the lower abdomen and cloudy or bloody urine. Occasionally, the infection spreads upward into the kidneys, producing symptoms such as intense back pain, high fever, chills, nausea, and diarrhea.
Conventional treatment for bladder infections consists of appropriate antibiotic treatment guided by urine culture. Women with frequent bladder infections may keep on hand a prescription for antibiotics to be used when symptoms arise. Some women may choose to take antibiotics continuously to prevent infection. Certain hygiene habits, such as showering before or urinating after oral sex or intercourse, are commonly said to be helpful, although this has not been proven.
Principal Proposed Natural Treatments
Women who do not want to use antibiotics may be able to find some help through the use of herbs. However, if symptoms do not improve or signs of a kidney infection develop, medical attention is essential to prevent serious complications.
Cranberry juice is commonly used to prevent bladder infections as well as to overcome low-level chronic infections. The cranberry plant is a close relative of the common blueberry. Native Americans used it both as food and as a treatment for bladder and kidney diseases. The Pilgrims learned about cranberry from local tribes and quickly adopted it for their own use. Subsequent physicians used it for bladder infections, for "bladder gravel," and to remove "blood toxins."
In the 1920s, researchers observed that drinking cranberry juice makes the urine more acidic. Because common urine infection bacteria, such as E. coli , dislike acidic surroundings, physicians concluded that they had discovered a scientific explanation for the traditional uses of cranberry. This discovery led to widespread medical use of cranberry juice for bladder infections. Cranberry fell out of favor after World War II, only to return in the 1960s as a self-treatment for bladder infections.
More recent research has revised the conclusions reached by scientists in the 1920s. It appears that cranberry's acidification of the urine is not likely to play an important role in the treatment of bladder infections; current research has instead focused on cranberry's apparent ability to interfere with the bacteria establishing a foothold on the bladder wall. 1-7,30
The best evidence for the use of cranberry juice for preventing bladder infections comes from a 1-year,
A double-blind study of 376 hospitalized seniors attempted to determine whether a low dose of cranberry juice cocktail would help prevent acute infections.
Another double-blind study evaluated cranberry juice cocktail for treatment of chronic bladder infections.
In addition, a year-long
A review of 10 studies investigated the benefits of cranberry juice or tablets compared to a placebo control in patients susceptible to urinary tract infections. Among 1,049 participants, the researchers found the cranberry products reduced the incidence of urinary tract infections by 35%, a statistically significant amount, over a 12-month period. The effect was most notable in those with recurrent infections. However, many subjects dropped out of the studies early, suggesting that continuous consumption of cranberries is not well tolerated.
On the negative side, three double-blind, placebo-controlled studies failed to find cranberry extract helpful for preventing bladder infection in people with bladder paralysis (neurogenic bladder).
Uva ursi has a long history of use for urinary conditions in both America and Europe. Until the development of sulfa antibiotics, its principal active component, arbutin, was frequently prescribed by physicians as a treatment for bladder and kidney infections. It appears that the arbutin contained in uva ursi leaves is broken down in the intestine to another chemical, hydroquinone. This is altered a bit by the liver and then sent to the kidneys for excretion.
The European Scientific Cooperative on Phytotherapy (ESCOP) is a scientific organization assigned the task of harmonizing herb policy among European countries. ESCOP recommends uva ursi for "uncomplicated infections of the urinary tract such as cystitis when antibiotic treatment is not considered essential."
Despite this recommendation, surprisingly little research has been done on uva ursi.
Two studies evaluated the antibacterial power of the urine of people who were taking uva ursi and found activity against most major bacteria that infect the urinary tract.
One study did evaluate uva ursi for prevention of bladder infections. This double-blind trial followed 57 women for 1 year.
As noted above, hydroquinone is toxic, and for this reason most experts recommend that uva ursi should not be used for more than a couple of weeks.
For more information, including dosage and safety issues, see the full
Other Proposed Natural Treatments
A preliminary double-blind, placebo-controlled study published in 2007 tested a standardized combination of nasturtium and
Many nutritionally oriented physicians believe that regularly taking
This topic is also discussed in the
3. Zafriri D, Ofek I, Adar R, et al. Inhibitory activity of cranberry juice on adherence of type 1 and type P fimbriated Escherichia coli to eucaryotic cells. Antimicrob Agents Chemother. 1989;33:92-98.
4. Howell AB, Vorsa N, Marderosian AD, et al. Inhibition of the adherence of p-fimbriated Escherichia coli to uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries [letter]. N Engl J Med. 1998;339:1085-1086.
6. Howell AB, Vorsa N, Der Marderosian A, et al. Inhibition of the adherence of P-fimbriated Escherichia coli to uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries [letter]. N Engl J Med. 1998;339:1085-1086.
7. Habash MB, Van der Mei HC, Busscher HJ, et al. The effect of water, ascorbic acid, and cranberry derived supplementation on human urine and uropathogen adhesion to silicone rubber. Can J Microbiol. 1999;45:691-694.
9. Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol. 2002;9:1558-1562.
12. Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1-5.
29. Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1-5.
30. Di Martino P, Agniel R, David K et al. Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial. World J Urol. 2006 Jan 6. [Epub ahead of print]
31. McMurdo ME, Bissett LY, Price RJ, et al. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing. 2005;34:256-261.
32. Waites KB, Canupp KC, Armstrong S, et al. Effect of cranberry extract on bacteriuria and pyuria in persons with neurogenic bladder secondary to spinal cord injury. J Spinal Cord Med. 2004;27:35-40.
33. Linsenmeyer TA, Harrison B, Oakley A, et al. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospective, double-blinded, placebo-controlled, crossover study. SCI Nurs. 2005;22:20-25.
34. Bauer HW, Alloussi S, Egger G, et al. A Long-Term, Multicenter, Double-Blind Study of an Escherichia Coli Extract (OM-89) in Female Patients with Recurrent Urinary Tract Infections. Eur Urol. 2005;47:542-548.
35. Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, et al. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand. 2007;86:783-787.
36. Albrecht U, Goos KH, Schneider B. A randomised, double-blind, placebo-controlled trial of a herbal medicinal product containing Tropaeoli majoris herba (nasturtium) and Armoraciae rusticanae radix (horseradish) for the prophylactic treatment of patients with chronically recurrent lower urinary tract infections. Curr Med Res Opin. 2007 Aug 24. [Epub ahead of print]
39. Hess MJ, Hess PE, Sullivan MR, et al. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder. Spinal Cord. 2008 Apr 8.
Last reviewed April 2009 by EBSCO CAM Review Board
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