Natural Ways to Avoid Urinary Tract Infections

A urinary tract infection (UTI) is an infection which occurs within the urinary system - the kidneys, bladder, urethra, ureters and prostate (in men). The majority of UTIs occur in the lower urinary tract - the bladder - and are often called cystitis. Around 50% of women and 5% of men will experience at least one UTI in their lifetime.

Antibiotics are typically prescribed for UTIs; however, a significant number of women suffer from recurrent UTIs following antibiotic treatment. There is also a growing concern about bacterial resistance as a consequence of antibiotic overuse which has created a need for safe and effective non-antibiotic prevention strategies for recurrent urinary tract infections (UTIs).

Symptoms of urinary tract infection

Lower UTIs typically manifest with increased urinary frequency, urgency, and painful urination. However, patients with infections in the upper urinary tract that reach the kidney may suffer from chills, fever, nausea and vomiting.

Causes of urinary tract infections

The vast majority of UTIs are caused by E. coli bacteria, a type of bacteria that usually live in the digestive tracts of humans and animals. If the bacteria invade the urinary tract, it can attach to the lining of the bladder and lead to inflammation. However, sometimes other organisms can cause UTIs.

Who is at risk?

• Women have a shorter urethra than men, which allows bacteria to travel more easily into the bladder. The female urethra is also situated closer to the rectum, making it easier for bacteria from the rectal area to reach the urethral area. 
• Women at a higher risk for UTIs include those who are sexually active, use diaphragms or spermicide for birth control, are postmenopausal, or have a strong family history of recurrent UTIs (2 or more family members).
• Elderly people people are more vulnerable to UTIs for several reasons, including incomplete bladder emptying, incontinence, and overall susceptibility to infections due to aging.
• People with blockage in the urinary tract. An enlarged prostate gland or kidney stones can obstruct the flow of urine, increasing the risk of UTIs.
• People with urinary catheters. Most hospital-acquired UTIs are associated with the use of catheters.
• Patients with spinal cord injury. Inability to empty the bladder may allow bacteria to grow in the urine.
• People with diabetes. High glucose in the urine and impaired immune system predispose to infection.
• Babies born with urinary tract abnormalities.

Diet can influence a healthy urinary tract

Plant based diets

The kidneys play a vital role in filtering toxins out of the blood via the urine. Maintaining healthy kidneys reduces the risk of a UTI reaching the kidneys, and prevent formation of kidney stones. Researchers found that people eating plant-base diets appear to have superior kidney function! 

Reduce your sugar intake

A diet high in sugar from food and drinks may impair the immune system and reduce its ability to fight bacterial infections. Excess glucose in the urine provides a favorable environment for bacteria to multiply.

Drink cranberry juice

Perhaps the most well known natural remedy for UTIs, cranberries are loaded with vitamin C, which enhances immune function. It is thought that components called proanthocyanidins in cranberries interfere with the ability of bacteria to adhere to the lining of the bladder. 

Studies suggest that drinking between 240 ml to 300 ml cranberry juice per day may help prevent the recurrence of UTIs. 

Look for juice that is not artificially sweetened to avoid added sugar. (Note that cranberry juice can interact with the blood thinning medication).

Green tea

Among its many health benefits, green tea contains compounds called polyphenols that have been shown to have antimicrobial effects on E. coli bacteria, which commonly are the cause  ofUTIs.

Keep up with fluids

Restricting your fluid intake may increase your urine concentration and may irritate your bladder, resulting in UTIs. Water helps to keep the urine diluted and stimulates you to urinate more, flushing the bacteria from your urinary tract.

Cinnamon

This well known spice commonly used in Southeast Asia is not only a potent antioxidant, but also has antibacterial properties. Researchers found that when trans-cinnamaldehyde, a compound in cinnamon, was applied as a coating to urinary catheters, it prevented the growth of E coli, the bacteria responsible for the majority of UTIs. Add to diet. 

Add naturally fermented foods to your diet

Plain yoghurt with bacterial cultures, kefir, sauerkraut, kimchi, and kombucha, are rich with beneficial bacteria. A Finnish Study found that women consuming fermented dairy products containing probiotic bacteria 3 times a week reduced their risk of UTI recurrence by 80%.

Keep your bladder healthy

Some foods and beverages are known to be bladder irritants, and can increase your risk of UTIs. Restrict your caffeine intake to 1 cup of coffee per day, or replace with a decaf alternative; reduce or eliminate alcohol, carbonated drinks, spicy foods, and citrus fruits.

Nutritional Supplements

Cranberry capsules. Taking cranberry capsules may prove more effective than drinking cranberry juice due to higher concentration of cranberry. Women who took cranberry capsules lowered their risk of UTIs by 50%. Recommended dose: 400 mg twice daily.

Probiotics. Probiotics inhibit the growth of pathogenic bacteria that are likely to cause UTIs; replenish normal flora; and stimulate your immune function. Preliminary studies using probiotics supplements containing lactobacillus species show promise for prevention and treatment of UTIs.

D-mannose. This is a naturally occurring sugar that is found in some fruits - including apples, blueberries, currants, and cranberries. Just like cranberries, it can stop E. coli bacteria from adhering to the walls of the bladder. In one study D-mannose significantly reduced the risk of UTIs in women with history of recurrent UTIs.

Herbal Remedies

Garlic (Allium Sativum). Garlic is a culinary herb known for its powerful antibacterial properties. Use freshly crushed garlic or supplement to get its most potent antibacterial properties.

Uva-Ursi (Bearberry). Has been used traditionally as herbal remedy for mild cystitis, possibly for its antimicrobial and diuretic properties. (Note this herb should only be used short term).

Goldenseal (Hydrastis canadensis). Often used in treatment for upper respiratory infections, this herb has antibacterial properties that may help fight UTIs.

Echinacea. Although not traditionally used for UTIs, this common immune-stimulating herb may enhance immunity to fight bacterial infections.

Kidney and Bladder Teas. Some herbal teas are used to increase urine output in order to prevent recurring UTIs. These include asparagus root, java, lovage, and stinging nettle. (Note that these herbs may irritate the urinary tract mucosa so do not drink them while having an acute UTI; use as prevention only).

Lifestyle Interventions

The following tips may help reduce your risk of recurring UTIs:

• Do not hold urine. Urinate when you feel the need
• Wipe from front to back to prevent bacteria from spreading into the urethra
• Empty the bladder shortly after intercourse
• Take showers instead of tub baths and avoid hot tubs/Jacuzzis
• Avoid using scented feminine products that can irritate the urethra
• Avoid using diaphragms or spermicides. Discuss alternate birth control methods with health-care provider.
• Choose cotton underwear over synthetic material

Acupuncture. This ancient Chinese practice has been shown to reduce the recurrence rate of UTIs by 50%!

References 

1. Alraek, T., Soedal, L. I. F., Fagerheim, S. U., et al. (2002). Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women. American Journal of Public Health, 92(10), 1609–11. http://www.ncbi.nlm.nih.gov/pubmed/12356607
2. Amalaradjou, M. A. R., Narayanan, A., Baskaran, S. A., et al. (2010). Antibiofilm effect of trans-cinnamaldehyde on uropathogenic Escherichia coli. The Journal of Urology, 184(1), 358–63.
3. http://doi.org/10.1016/j.juro.2010.03.006 Barsotti, G., Morelli, E., Cupisti, A., et al. (1996).
4. A low-nitrogen low-phosphorus Vegan diet for patients with chronic renal failure. Nephron, 74(2), 390–4. http://www.ncbi.nlm.nih.gov/pubmed/8893161 Foxman, B., & Buxton, M. (2013).
5. Alternative approaches to conventional treatment of acute uncomplicated urinary tract infection in women. Current Infectious Disease Reports, 15(2), 124–9. http://doi.org/10.1007/s11908-013-0317-5 Foxman, B., W Cronenwett, A. E., Spino, C., Berger, M. B., & Morgan, D. M. (2015).
6. Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. The American Journal of Obstetrics & Gynecology, 213, 194–196. http://doi.org/10.1016/j.ajog.2015.04.003 Hisano, M., Bruschini, H., Nicodemo, A. C., et al. (2012).
7. Cranberries and lower urinary tract infection prevention. Clinics. http://doi.org/10.6061/clinics/2012(06)18 Kontiokari, T., Laitinen, J., Järvi, L., et al. (2003).
8. Dietary factors protecting women from urinary tract infection. The American Journal of Clinical Nutrition, 77(3), 600–4. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12600849 Kranjčec, B., Papeš, D., & Altarac, S. (2014).
9. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World Journal of Urology, 32(1), 79–84. http://doi.org/10.1007/s00345-013-1091-6
10. Kidney Health Australia. Urinary tract infections (2016). http://kidney.org.au/your-kidneys/detect/urinary-tract-infections Maki, K. C., Kaspar, K. L., Khoo, C., et al. (2016).
11. Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection. The American Journal of Clinical Nutrition. http://doi.org/10.3945/ajcn.116.130542
12. Mayo Clinic. Diseases and Conditions: Urinary tract infection (UTI) (2015). http://www.mayoclinic.org/diseases-conditions/urinary-tract-infection
13. National Institute of Diabetes and Digestive and Kidney Diseases. (NIDDK). Urinary Tract Infection In Adults. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-tract-infections-in-adults/Pages/facts.aspx Natural Medicines - Clinical Management Series: Natural Medicines in the Clinical Management of Urinary Tract Infections (2016).
14. http://naturaldatabase.therapeuticresearch.com Reygaert, W., & Jusufi, I. (2013).
15. Green tea as an effective antimicrobial for urinary tract infections caused by Escherichia coli. Frontiers in Microbiology, 4, 162. http://doi.org/10.3389/fmicb.2013.00162 Shields-Cutler, R. R., Crowley, J. R., Hung, C. S., et al. (2015).
16. Human Urinary Composition Controls Antibacterial Activity of Siderocalin. The Journal of Biological Chemistry, 290(26), 15949–60. http://doi.org/10.1074/jbc.M115.645812 Wyman, J. F., Burgio, K. L., & Newman, D. K. (2009).
17. Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. International Journal of Clinical Practice, 63(8), 1177–91. http://doi.org/10.1111/j.1742-1241.2009.02078.x