Overview
With a lifetime prevalence rate of 53% among women1, discussion about urinary tract infections (UTIs) seems a necessary one.
UTI’s are an infection in which bacteria have colonized in the bladder1 or in the tract from the urethra to the bladder. This can be caused by candida, or E. coli, most commonly1 attributing to 80% of infections.1,2 While the majority of infections are simple cystitis from these common causes, some complicated infections might hint at underlying disease states such as diabetes, or structural of the organ and system.1 It commonly presents as frequent urination, urgency, and frequency. One should be aware of symptoms such as fever, myalgia, or low back pain and seek prompt medical assistance, as delayed identification and treatment can progress to the kidneys and are common following UTIs.1
Contributing factors to the condition include catheterization, history of UTIs, age, spinal injury, use of condoms, particularly with spermicide, infrequent voiding, tight clothing, tampon use, even soaps.1 Some hormonal changes that come with changing sexual partners and pregnancy can also be a factor behind UTIs.1 For men the risks are less and include anal intercourse, renal stones, a female partner that has a current UTI, and circumcision.1,3
Biochemically, an acidic body due to poor diet, infrequent voiding or deficient water intake can alter the pH acidity of the body and increase prevalence of infections.1 Deficiencies of antioxidants, vitamin c, vitamin D can contribute to the condition as well as some medications an environmental toxins. 1
Therapeutic Foods
An alkalizing diet that supports the high intake of fruits and vegetables as well as whole grains, limited animal proteins and low in carbohydrates and sugars could be supportive in prevention of UTIs and tissue damage.4 Caffeine, starch, tobacco, alcohol and food additives are also acidic culprits that an alkaline diet avoids.1 An alkaline diet decreases potential renal acid burden among other health benefits. 4
Alkaline diets result in a more alkaline urine pH and may result in reduced calcium in the urine, consequently providing protection against kidney stones.4 More research is needed to identify length of time and possible reduction of occurrence of UTIs, but the current research is promising. 4 Since antibiotics are common protocol with UTIs, alkaline diets that can help rebuild a healthy microbiome should be considered.
Possible difficulty with the alkaline diet might arise during social situations in which fast food, alcohol, fried foods, excessive carbohydrate and omega 6 fats are consumed. One possible solution might be to eat ahead of time and allow a reduced consumption of one favorite social food.
Specific Therapeutic Foods to Include
Garlic contains allicin, a sulfur containing compound that shows in studies to decrease bacteria and prevent kidney tissue destruction from infection.1,5,6 Studies have identified effectiveness against a broad range of microorganisms including viral, fungal, bacterial, and parasitic origins.1,6 One clove eaten daily is sufficient for prevention; One clove three times a day for an acute infection.7
Cranberries and tart cranberry juice are an effective treatment for UTIs and is presumed that compounds within the cranberry inhibit bacteria from adhering to the lining of the bladder wall.1,8,9 Studies have shown that daily intake of 72mg of the proanthocyanins found in cranberries offered prophylactic protection of bacterial adhesion and a resulting UTI.8 Another 2015 study backed up these findings stating that phenolics from cranberries seemed to have a correlation to the reduction of bacterial colonization and a progression to a UTI9, however, the optimal dose for the treatment is currently unknown.1
Supplements to Consider
Uva Ursi
Uva ursi is an herb otherwise known as bearberry, of anti- inflammatory, antimicrobial astringent action.7 In one preliminary trial, women took the extract for one month and then were followed along for a year. Of those women, 18% who got the placebo and 0% who received the herb developed a UTI.1,10
The recommended effective dose is 3g of dried herb daily1 used for a week at a time, not to exceed five courses a year.1 Due to the potential toxicity to the liver, uva ursi is not recommended for use long term, thus making it unsuitable in prophylaxis.1 It is contraindicated in children and pregnant or lactating women.1,7
Dandelion
When used alongside uva ursi, dandelion has been known to be part of another effective treatment.10 In this case, the roots and leaves are used and serve as a nutritive, a bitter, and a diuretic. Those with gallstones, liver obstruction, or renal disorders should not use.7 Those that are allergic to plants in the Asteraceae family should not use, also those with flatulence, diarrhea or dyspepsia should use with caution. Four to ten grams of the dried herb can be used three times a day7, though it’s effectiveness at which dose and timing in treatment of UTIs is yet unclear.
Collaborative Therapies
In cases of recurrence, it is beneficial to coordinate a team of professionals to work together. One potential partner could be an acupuncturist. Acupuncture has proven to be worthy of consideration in reducing occurrence of UTI in those with a history of recurrences.1 In a 2002 random control trial of 100 women with a history of recurrent UTIs, a 50% decline in recurrence was observed in comparison to the non-treatment control group. The women who received treatment participated in biweekly sessions of acupuncture for 4 weeks and then observation for 6 months.11
Conclusion
In conclusion, urinary tract infections can be a common problem for many, with recurrence after an initial infection making the malady a frequent reason for a medical visit. However, proper hygiene, an alkalizing diet, and preventative strategies, give rise to hope for those who suffer.
References
- Rakel D. Integrative Medicine. In: Integrative Medicine. 4th ed. Elsevier; 2018:320-333.
- Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002;113 Suppl 1A(1 SUPPL. 1):14-19. doi:10.1016/S0002-9343(02)01055-0
- Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am. 1997;11(3):551-581. doi:10.1016/S0891-5520(05)70373-1
- Schwalfenberg GK. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? J Environ Public Health. 2012;2012. doi:10.1155/2012/727630
- Harjai K, Kumar R, Singh S. Garlic blocks quorum sensing and attenuates the virulence of Pseudomonas aeruginosa. FEMS Immunol Med Microbiol. 2010;58(2):161-168. doi:10.1111/J.1574-695X.2009.00614.X
- Fujisawa H, Watanabe K, Suma K, et al. Antibacterial potential of garlic-derived allicin and its cancellation by sulfhydryl compounds. Biosci Biotechnol Biochem. 2009;73(9):1948-1955. doi:10.1271/BBB.90096
- Marciano M, Vizniak N. Botanical Medicine. ProHealthSys
- Howell AB, Botto H, Combescure C, et al. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis. 2010;10. doi:10.1186/1471-2334-10-94
- De Llano DG, Esteban-Fernández A, Sánchez-Patán F, Martín-Álvarez PJ, Moreno-Arribas MV, Bartolomé B. Anti-Adhesive Activity of Cranberry Phenolic Compounds and Their Microbial-Derived Metabolites against Uropathogenic Escherichia coli in Bladder Epithelial Cell Cultures. Int J Mol Sci. 2015;16(6):12119-12130. doi:10.3390/IJMS160612119
- Uva Ursi. LiverTox Clin Res Inf Drug-Induced Liver Inj. Published online March 28, 2020. Accessed January 8, 2022. https://www.ncbi.nlm.nih.gov/books/NBK556475/
- Alraek T, Soedal LIF, Fagerheim SU, Digranes A, Baerheim A. Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women. Am J Public Health. 2002;92(10):1609-1611. doi:10.2105/AJPH.92.10.1609