Myths:
Only medications can help eliminate urinary tract infections.
Facts:
Specific dietary considerations and selected nutrients can help resolve and prevent urinary tract infections.
Overview:
Urinary tract infections (UTIs) are infections of the bladder, urethra, and sometimes the kidney. They are generally triggered by bacteria and are more common with any partial blockage of the urinary tract. In some people, UTIs tend to recur.
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.
Conventional Treatment:
Oral antibiotics are typically used for uncomplicated infections. Intravenous antibiotics may be used for more serious infections. Among the many antibiotics commonly prescribed for UTIs are the combination drug sulfamethoxazole-trimethoprim (Bactrim®, Septra®), fluoroquinolones (e.g., levofloxacin [Levaquin™], ciprofloxacin [Cipro®, Cilaxan®]), aminoglycosides (e.g., gentamicin [Garamycin®], tobramycin [Nebicin®, Tobrex®]), and third-generation cephalosporins (e.g., cefixime [Suprax®]).
Complementary Treatment:Shopping TipsEssential: Cranberry NS 500 mg 180 vcaps (CRA13) -
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Bromelain Capsules for the digestive system. Recommended Vitamins, Supplements, Herbs & Other Nutritional Products
Nutritional supplements that may be helpful
- Bromelain (enteric-coated tablets, 400 mg per day for two days): The enzyme bromelain (from pineapple) appears to enhance the effectiveness of antibiotics in people with UTIs. In a double-blind study, 28 individuals with a UTI received antibiotics plus either bromelain or a placebo. Signs of infection resolved in all of those who received bromelain, compared with only 46% of those given placebo.
Herbs that may be helpful
- Cranberry (Vaccinium macrocarpon) (drink 300-500 ml [10-16 oz] of unsweetened or lightly sweetened cranberry juice per day; or take 400 mg of concentrated cranberry extracts twice per day): Modern research has confirmed the benefits of cranberry for the prevention of urinary tract infections. Note: cranberry is not a substitute for antibiotics in the treatment of acute UTIs.
Dietary changes that may be helpful
- Avoid sugar: When healthy volunteers ingested 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.
- Avoid alcohol: Ingestion of excessive amounts of alcohol has also been shown to suppress the immune system.
- Reduce dietary fat: Reducing the intake of dietary fat stimulates immunity.
- Allergies: People who have recurrent or chronic infections should discuss with a doctor the possible role of allergies. Chronic infections have been linked to allergies in many reports. Identifying and eliminating the foods that trigger problems may help reduce the number of infections.
Acupuncture
Acupuncture might be of some benefit for women with recurrent UTIs. A controlled study compared acupuncture to sham 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.
Discussion of Herbs & Nutrition
Bromelain
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. 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.
Cranberry
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. 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%. A small preliminary trial found that supplementation with encapsulated cranberry concentrate (400 mg BID for three months) significantly reduced the recurrence of UTIs in women (aged 18-45) with a history of recurrent infections.
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. 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. 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 BID can be used.
Vitamin C
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. 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, creating an "unfriendly" environment for some infection-causing bacteria.
Vitamin A
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, 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.
Multivitamins
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).
Other Herbs & Foods
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