Natural approaches to prevention and treatment of infections of the lower urinary tract
Infections of the lower urinary tract are common occurrences in young women, during pregnancy, and in peri- and postmenopausal women. Because of the chronic nature of urinary tract infections (UTIs) and the potential for antibiotic resistance, a natural approach to prevention and treatment is desirable. Clinical research suggests the best natural options for long-term prevention include cranberry, mannose, and probiotics. Botanicals that can be effective at the first sign of an infection and for short-term prophylaxis include berberine and uva ursi. Estriol cream and vitamins A and C have also been shown to prevent UTIs, while potassium salts can alkalinize the urine and reduce dysuria. (Altern Med Rev 2008;13(3):227-244)
Urinary tract infections (UTIs) account for 8.3 million doctor visits yearly in the United States and are the second-most common site for infection. Infections of the lower urinary tract (urethra and bladder) are common among women--affecting as many as one in five women at some time during their lifetime. Although UTIs are not as common in men, they can indicate an obstruction such as a stone or enlarged prostate; thus, they are uncommon in men under age 50. (1) The term UTI in this article refers to infections of the lower urinary tract--the bladder and urethra.
UTIs can chronically recur--20 percent of women who have one infection will have a recurrence. Of this group, 30 percent will have a third occurrence, and of this group, 80 percent have additional recurrences. In other words, the more infections one has had, the more likely another will occur. (1) Many women with chronic UTIs are on antibiotics more than off, running the risk of developing dysbiosis and antibiotic resistance.
Although UTIs can be asymptomatic, they commonly present with distressing symptoms, including frequent urge to urinate, pain on urination, pressure or pain above the pubic bone in the bladder even when not urinating, difficulty passing urine, and general symptoms of fatigue. In addition to painful urination and pyuria (white blood cells in the urine), men may experience a full sensation in the rectum. Children with UTIs can often be asymptomatic or present with less specific symptoms, such as irritability, incontinence, diarrhea, poor appetite, and fever. Signs include cloudy or milky urine that can be pink or reddish tinged if significant blood is present. A fever, flank pain, nausea, and vomiting are usually signs the infection has reached the kidneys, causing acute pyelonephritis. (1,2)
Risk factors for UTI include female gender, sexual activity, mode of birth control, menopause, diabetes, catheter use, and urinary tract obstruction (stone, tumor, strictures, or enlarged prostate). Voiding before and after intercourse, use of cotton underwear, and avoidance of feminine hygiene deodorants and scented toilet paper may decrease risk.
In college-age women, frequent sexual intercourse is a risk factor. In addition, it is not uncommon for a woman to have a UTI after her first sexual encounter ("honeymoon cystitis"). A case-control study compared 43 college-age women with UTIs to college-age controls--149 women with upper respiratory...