History

Urinary tract infections have been described since ancient times with the first documented description in the Ebers Papyrus dated to circa 1550 BC. It was described by the Egyptians as "sending forth heat from the bladder". Effective treatment did not occur until the development and availability of antibiotics in the 1930s before which time herbs, bloodletting and rest were recommended.

In pregnancy

Urinary tract infections are more concerning in pregnancy due to the increased risk of kidney infections. During pregnancy, high progesterone levels elevate the risk of decreased muscle tone of the ureters and bladder, which leads to a greater likelihood of reflux, where urine flows back up the ureters and towards the kidneys. While pregnant women do not have an increased risk of asymptomatic bacteriuria, if bacteriuria is present they do have a 25-40% risk of a kidney infection. Thus if urine testing shows signs of an infection—even in the absence of symptoms—treatment is recommended. Cephalexin or nitrofurantoin are typically used because they are generally considered safe in pregnancy. A kidney infection during pregnancy may result in premature birth or pre-eclampsia (a state of high blood pressure and kidney dysfunction during pregnancy that can lead to seizures).

Urinary tract infection in women

Introduction:

Urinary tract infections (UTIs) are caused by bacteria and are 10 times more common among women than men. More than 50% of women will have at least one UTI during their lifetime; for most of these infections, patients need to see a doctor and be treated with antibiotics. About 30 - 40% of UTIs recur within 6 months after the initial episode. When UTIs do recur, it is often because the treatments used to suppress bacteria seem to work at first, but do not produce a lasting cure. UTIs can also recur when a woman is infected again by different bacteria.

Signs and Symptoms:

• Pain or burning during urination

• The need to urinate more often than usual

• A feeling of urgency during urination

• Blood or pus in the urine

• Cramps or pain in the lower abdomen

• Chills or fever (fever may be the only symptom in infants and children)

• Strong smelling urine

• Pain during sexual intercourse

• Nausea, vomiting, and malaise

What Causes It?:

Risk factors include:

• A new sex partner or multiple partners

• More frequent or intense intercourse

• Diabetes

• Pregnancy

• Escherichia coli (E. coli)

• Staphylococcus saprophyticus

• Use of irritating products, such as harsh skin cleansers

• Use of irritating contraceptives, such as diaphragms and spermicides

• Use of birth control pills

• Heavy use of antibiotics

• A blockage in the urinary tract (benign masses or tumors)

• A history of UTIs, especially if the infections were less than 6 months apart

What to Expect at Your Provider's Office:

Your health care provider will feel your abdomen and kidneys for changes and use laboratory tests, such as a urine culture, to find out if you have a UTI. If the usual treatments do not work, your provider will explore the possibility that you have some other condition. Other illnesses can cause symptoms that mimic a UTI, such as sexually transmitted diseases.

Treatment Options:

Drug Therapies

Several antibiotics and other drugs may treat UTIs. The course for most antibiotics is 7 - 10 days. Shorter courses of treatment are available, and your health care provider may prescribe an antibiotic that you take for 1 - 3 days.

Complementary and Alternative Therapies

Always tell your health care provider about the herbs and supplements you are using.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Drink a lot of fluids, such as herbal teas and water. Avoid sweetened fruit juices and other sweetened drinks.

• Cranberries and blueberries contain substances that inhibit the binding of bacteria to bladder tissue. Drinking unsweetened cranberry juice regularly helps lower the risk of UTIs.

• Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.If you are susceptible to UTIs, drinking cranberry juice or taking cranberry pills may help prevent recurrence.

• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).

• Eat more high fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.

• Avoid refined foods such as white breads, pastas, and especially sugar.

• Eat fewer red meats and more lean meats, cold water fish, tofu (soy, if no allergy is present) or beans for protein.

• Use healthy cooking oils, such as olive oil or vegetable oil.

• Reduce or eliminate trans fatty acids, found in commercially baked goods, such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.

• Avoid coffee and other stimulants, alcohol, and tobacco.

• Drink 6 - 8 glasses of filtered water daily.

• Exercise at least 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.

• Vitamin C, 500 - 1,000 mg 1 - 2 times daily, as an antioxidant and for immune support.

• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil 1 - 2 times daily, to help decrease inflammation and promote general health. Cold water fish, such as salmon or halibut, are good sources. Fish oil supplements can increase the effects of certain blood thinning medications.

• IP-6 (Inositol hexophosphonate), 1 - 8 grams daily on an empty stomach, for kidney health. Check with your health care provider for proper dosing.

• L-glutamine, 500 - 1,000 mg 3 times daily, for support of gastrointestinal health and immunity.

• Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. There is strong scientific evidence to support the use of probiotics for urological conditions. Refrigerate probiotic supplements for best results.

• Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) 3 times daily, for antibacterial, antifungal, and antiviral activity.

Natural hormone replacement therapy may help prevent UTIs. Ask your health care provider about this treatment.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted. Many herbs interact with medications, so you should always tell your doctor about any herbal therapies you are using or considering using. The following herbs may be useful for short term treatment of a urinary tract infection.

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer and immune effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.

• Cat's claw (Uncaria tomentosa) standardized extract, 20 mg 3 times a day, for anticancer, immune and antibacterial or antifungal activity. Cat's claw can interact with many different medications. Speak to your health care provider. Do not take cat's claw if you have Leukemia.

• Reishi mushroom (Ganoderma lucidum) standardized extract, 150 - 300 mg 2 - 3 times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops 2 - 3 times a day. High doses of Reishi may have a blood thinning effect, so speak to your doctor if you are on blood thinning medications.

• Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg 2 - 3 times daily, for detoxification support.

• Uva-ursi (Arctostaphylos uva-ursi) standardized extract, 250 - 500 mg 3 times daily for no more than 4 days. You may also prepare teas from the leaf of this herb.

• Buchu (Barosma betulina) 200 mg 1 - 3 times daily for antibacterial effects. Buchu can interact with Lithium and with blood thinning medications.