Natural treatments for bladder infection
Natural treatments for bladder infections focus on alternative remedies that individuals may consider to alleviate symptoms and prevent recurrence, especially for those looking to avoid antibiotics. Cranberry is one of the most well-known natural options, historically used by Indigenous peoples and later adopted by Western medicine; it may help prevent bacteria from adhering to the bladder wall. Another herb, uva ursi, has antiseptic properties and has been used traditionally for urinary conditions, though caution is advised due to potential toxicity and side effects with prolonged use.
Other suggested natural treatments include probiotics, particularly a harmless strain of E. coli that has shown promise in reducing urinary tract infections, and vitamin C, which might help lower infection rates by acidifying urine. Some practitioners recommend a low-sugar diet and supplements like zinc and d-mannose, which may help improve immune function and create a protective lining in the bladder, respectively. Additional herbs like goldenseal and buchu are also mentioned for their potential benefits, although evidence supporting their effectiveness varies.
Lifestyle changes, such as increased water intake and proper hygiene practices, can further support bladder health and help in preventing infections. It is essential for individuals experiencing severe symptoms or recurrent infections to seek medical advice, as natural remedies may not be sufficient in all cases.
Natural treatments for bladder infection
- DEFINITION: Treatment of infections of the bladder.
- PRINCIPAL PROPOSED NATURAL TREATMENTS: Cranberry, uva ursi
- OTHER PROPOSED NATURAL TREATMENTS: Buchu, cleavers, goldenseal, goldenrod, horseradish with nasturtium, juniper, lapacho, low-sugar diet, mannose, methionine, probiotics, sandalwood, vitamin C, zinc
Introduction
Bladder infections are a common problem for women, accounting for millions of office visits each year. It is among the most common outpatient infections. Men, because of the greater distance between their bladder and urethral opening, 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. This can be life-threatening.
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 continuously take low-dose prophylaxis antibiotics to prevent infection, but these are special cases. To prevent antibiotic resistance, continuous antibiotic use is generally a last resort. 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 wish to avoid antibiotics may find some herbs and supplements helpful. However, if symptoms do not improve or signs of a kidney infection develop, medical attention is essential to prevent serious complications.
Cranberry. Cranberry juice is commonly used to prevent bladder infections and to overcome low-level chronic infections. The cranberry plant is a close relative of the common blueberry. American Indians used it both as food and as a treatment for bladder and kidney diseases. The pilgrims learned about cranberry from local Indigenous peoples 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 made the urine more acidic. Because common urine-infection bacteria, such as Escherichia 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.
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; later research has instead focused on cranberry’s apparent ability to interfere with the bacteria, establishing a foothold on the bladder wall. If the bacteria cannot “hold on,” they will be washed out with the stream of urine. Studies suggest that in women who frequently develop bladder infections, bacteria have an especially easy time holding on to the bladder wall. Thus, when taken regularly, cranberry juice might break the cycle of repeated infection.
The best evidence for the use of cranberry juice for preventing bladder infections comes from a one-year, double-blind, placebo-controlled study of 150 sexually active women that compared placebo with both cranberry juice (eight ounces three times daily) and cranberry tablets. The results showed that both forms of cranberry significantly reduced the number of episodes of bladder infections.
A double-blind study of 376 hospitalized elderly adults attempted to determine whether a low dose of cranberry juice cocktail would help prevent acute infections. It failed to find benefit, most likely because of the minimal dosage of cranberry: only ten ounces daily of cranberry juice cocktail. Furthermore, because of the low rate of infections, it would have been more difficult for this study to produce statistically significant results.
Another double-blind study evaluated cranberry juice cocktail to treat chronic bladder infections. This trial followed 153 women with an average age of 78.5 years for six months. Many women of this age group develop chronic asymptomatic bladder infections—signs of bacteria in the urine without any symptoms. One-half of the participants were given ten ounces per day of a standard commercial cranberry cocktail drink, and the other was a placebo drink prepared to look and taste the same. Both treatments contained the same amount of vitamin C to eliminate the possible effect of that supplement. Despite the weak preparation of cranberry used, the results showed that the treatment significantly reduced bacteria and white blood cells in the urine.
In addition, a year-long open trial of 150 women found that regular use of a cranberry juice and lingonberry combination reduced the rate of urinary tract infection compared with a probiotic drink or no treatment. However, because this study was not double-blind, the results are unreliable.
A review of ten studies investigated the benefits of cranberry juice or tablets compared with a placebo control in persons susceptible to urinary tract infections. Among 1,049 participants, the researchers found that cranberry products reduced the incidence of urinary tract infections by 35 percent, a statistically significant amount, over twelve months. 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. Still, several reviews of cranberry juice studies have confirmed its efficacy in treating bladder infections in the early to mid-2020s.
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). However, a subsequent study of forty-seven persons with neurogenic bladder from spinal cord injuries found that the use of cranberry extract tablets over six months significantly reduced the risk of urinary tract infection.
Uva ursi. Uva ursi has a long history of use for urinary conditions in both the Americas and Europe. Until the development of sulfa antibiotics, uva ursi’s 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 chemical is altered by the liver and then sent to the kidneys for excretion. Hydroquinone then acts as an antiseptic in the bladder. (It is, however, potentially toxic.)
The European Scientific Cooperative on Phytotherapy (ESCOP) is an 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 taking uva ursi and found activity against most major bacteria that infect the urinary tract. However, a double-blind trial is needed to discover whether taking uva ursi helps people with urinary tract infections.
One double-blind study evaluated uva ursi to prevent bladder infections in fifty-seven women for one year. Half received a standardized dose of uva ursi (with dandelion leaf, intended to promote urine flow), while the others received a placebo. None of the women taking uva ursi during the study developed a bladder infection, whereas five untreated women did. However, long-term use of uva ursi is not recommended, so its preventative efficacy is irrelevant in a treatment setting. At high doses or if taken over a long period, uva ursi may cause thinning of the retina in the eye, liver, or kidney damage or potentially increase the chance of developing some cancers.
Other Proposed Natural Treatments
Probiotics (friendly bacteria) have shown some promise for preventing bladder infections. The best results have been seen with an unusual type of probiotic consisting of a harmless form of E. coli. This double-blind trial enrolled 453 women with an ongoing bladder infection at the beginning of the study. Participants received either the E. coli or placebo for ninety days, then went three months without treatment; they then received treatment again for the first ten days in months seven, eight, and nine. The results showed that compared with placebo, using the probiotic led to a 34 percent reduction in urinary tract infections. However, other studies have failed to find benefits with the use of the more common Lactobacillus probiotics.
A single-blind study found suggestive evidence that using vitamin C during pregnancy at a dose of 100 milligrams daily could reduce the incidence of bladder infections. A preliminary double-blind, placebo-controlled study published in 2007 tested a standardized combination of nasturtium and horseradish and found some evidence that it might help prevent new bladder infections among people with a history of frequently recurrent bladder infections. This study, however, had numerous problems in design and statistical analysis. Further lab research supported the use of vitamin C in preventing bladder infections, mostly in animal studies, but these were not replicated in large human trials. Still, its use is debated because it increases urine acidity.
Weak evidence has suggested that the use of the naturally occurring sugar d-mannose might help prevent or treat bladder infections. D-mannose may create a slippery lining on the bladder wall, preventing bacteria from infecting its cells. Studies have failed to conclusively support d-mannose's use for bladder infections using 200 milligrams, 2 grams, or 3 grams. The herb goldenseal, too, is widely recommended for bladder infections based on the antibiotic properties of its ingredient, berberine. However, it is unlikely that goldenseal taken by mouth provides enough berberine in the bladder wall to have any effect because it is poorly absorbed in the digestive tract.
Many nutritionally oriented physicians believe that regularly taking zinc supplements and decreasing sugar in the diet will help improve immunity against bladder infections. Herbs such as buchu, dandelion, goldenrod, juniper, cleavers, and sandalwood may increase urine flow, which could be helpful for increasing the speed of recovery from an infection that has already occurred. The herb lapacho and the supplement methionine are also sometimes recommended for bladder infections, but there is no real evidence that they work. Research also showed that supplementation with vitamin C could increase the acidity of the urine and prevent bacteria growth that could lead to bladder infections. Finally, lifestyle changes, such as drinking more water and eliminating more frequently, can also prevent bladder infections.
Bibliography
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