Health Topics > Immune system > urinarytractinfections

URINARY TRACT INFECTIONS

What is it?

Cystitis means inflammation of the bladder and may be sudden in onset (acute) or chronic (longstanding). Inflammation and infection can travel upwards from the bladder and eventually affect the kidneys, which is called pyelonephritis. It is important to get bladder infections under control quickly, as continued episodes increase the likelihood of infection involving the upper urinary tract and the kidneys, which can result in permanent scarring of the kidneys.
Women are far more susceptible than men. 

Urinary tract infections (UTIs) are very common.  Approximately 250,000 Australians are affected every year.

What causes it?

  • Infection with bacteria, which often originate from bacteria in the bowel or vagina. This can be aggravated by poor personal hygiene, and mechanical problems such as urinary reflux from the bladder or prolapse of the vagina or bowel.
  • Urinary tract infections are mainly caused by organisms from the bowel which colonise the skin in the genital area and gain entry to the bladder via the urethra to cause cystitis. From the bladder the infection may sometimes extend up the ureters to the kidneys causing pyelonephritis. 
  • Infection of the urinary tract may also occasionally occur via the bloodstream.
    Because the urethra is so close to the vagina, in many women infection is precipitated by sexual intercourse, which can force micro-organisms up into the bladder. This is sometimes called "honeymoon cystitis".
  • Inadequate hydration can cause stagnation of urine. Stagnant urine becomes infected more easily.
  • A poor diet, which is lacking in raw foods and antioxidants.
  • Hormonal deficiencies of oestrogen and testosterone, which are common in menopausal women. These deficiencies result in thinning (atrophy) of the tissues of the vagina and bladder thus making them more fragile and vulnerable to infection.
  • Immune dysfunction, which can result in autoimmune diseases such as nephritis (inflammation of the kidney). Immune dysfunction can also result in chronic inflammation of the entire bladder wall and this painful condition is known as chronic interstitial cystitis.
  • Stones forming in the bladder, ureters and kidneys, which obstruct the free flow of urine, thus increasing the risk of infection.

What are the symptoms?

The symptoms of acute cystitis include pain or burning on urination and urinary frequency, and the urine may have an offensive smell. Chronic or recurrent cystitis may not produce the typical symptoms and regular urine tests may be required to pick up the infection. Pyelonephritis is characterised by loin pain, fever, rigors, nausea and sometimes vomiting.
 
Many patients with recurrent cystitis symptoms do not actually have a urinary tract infection, having no bacteria in their urine showing up on testing. In this situation, other causes to be considered include vaginitis, chlamydia infection, prostatitis and interstitial cystitis. Interstitial cystitis is a distressing complaint which may not be as uncommon as the medical community seems to believe. It presents with urinary frequency (sometimes up to 60 times a day!), burning or discomfort with urination and often intense pain in the pelvis, bladder and vagina, frequently resulting in painful intercourse. It most often affects women over 40 years of age, though 25 percent of patients are under 30. The cause is unclear and there is frequently a long delay before the correct diagnosis is made. This is largely because many doctors know very little about the condition and there has been inadequate research. Urine cultures are clear; the typical signs are small pinpoint haemorrhages on the bladder wall seen on cystoscopy (examination of the bladder via a special telescope). Usually the bladder must be stretched and filled with water before these haemorrhages are visible.
 

Treatment and general recommendations

  • Urinate regularly; do not delay going to the toilet. Try to empty your bladder completely each time. 
  • After opening your bowels gently wipe from front to back, not towards the urethra. 
  • Urinating before and after intercourse is important for prevention in women.
  • Recurrent sufferers of cystitis who use a diaphragm, which may put pressure on the bladder, may need to consider a different form of contraception.
  • Avoid smoking, which can irritate the bladder's mucosal lining.

Diet

  • Drink plenty of fluids, that is, 8 to 12 glasses of water and two to three glasses of raw vegetable juices daily. 
  • Include often - garlic and onions, which have anti-bacterial activity, fresh fruits and vegetables, which alkalinise the urine. Thirty to forty percent of the diet should consist of raw fruits and vegetables. "The Liver Cleansing Diet" book and "The Healthy Liver and Bowel Book" have appropriate eating principles and recipes to follow as a way of life.
  • Cranberries are helpful to prevent and treat infections as they contain hippuric acid which inhibits the growth of bacteria in the bladder. You can obtain concentrated cranberry in capsule form.  Fresh cranberries can be blended and mixed into apple juice or yoghurt. 
  • Avoid - alcohol, white sugar, sugary drinks, drinks containing artificial sweeteners like diet colas, coffee and white flour products.

Raw Juicing

The recommended juice from "Raw Juices Can Save Your Life"  is:
• "Juice for the urinary tract" on page 74
 
The inclusion of cranberries in this juice can help to prevent bacteria from adhering to the lining of the bladder and urethra. If the bacteria cannot adhere to the mucosa, they are unable to cause infection. The garlic has antimicrobial activity against bacteria such as E.coli and Staphylococcus, which are associated with urinary tract infections.
 

NOTE:
It is vital that those with infections or diseases of the urinary tract increase their intake of water to 2 to 3 litres daily. Raw juicing is absolutely imperative and must become a way of life. Kidney disease is very common and is often present for years before being detected. This is unfortunate, as permanent damage to the kidneys may have already occurred which can be difficult to reverse. It is important to have your urine checked regularly if you have bladder or kidney problems. Indeed a mid-stream sample of urine can be checked every 3 months to detect problems at an early and treatable stage.

 

Recommended supplements:

Cranberry capsules

  • Take 1 capsule daily - Cranberry capsules are helpful for maintaining urinary health and the prevention of urinary tract infections, for both men and women. 

Vitamin C powder

  • Take 1 teaspoon daily of - Vitamin C with bioflavonoids.  The dose should be 2000 to 6000 mg daily, beta-carotene 20 mg daily.  This should be taken every day to keep the urine slightly acidic - you can experiment to find the most effective dose of vitamin C. You will need between 500 to 2000mg daily, which is best taken in 3 divided doses. Some people will find that ascorbic acid is too irritating, and may be better with the ascorbate or ester C forms of vitamin C.

Selenium tablets

  • Take 2 tablets twice daily to fight infection and boost immune function.

Magnesium tablets or powder

  • Take 2 tablets twice daily or 1 teaspoon daily in water or raw juice to assist in reducing muscle spasm of the bladder wall.

Olive leaf capsules

  • Take 2 capsules twice daily to help fight infection and boost immune function.  Olive leaf has been used as a natural antibiotic.  For acute infections it is necessary to increase the dose of Olive leaf to 1000mg three times daily. These supplements and raw juices can act as natural antibiotics which is important, as infecting bacteria often become resistant to antibiotic drugs which are used long term.

Hormones and cystitis

Hormone replacement therapy with natural oestrogen, progesterone and testosterone may enable urinary tract infections to be well controlled in peri-menopausal women. Creams containing combinations of these hormones can be applied to the vagina and vulval areas on a nightly basis. They are best used at night after sexual intercourse and after you have emptied your bladder and are ready to go to sleep.
 

Orthodox Medical Treatment

Urinary tract infections are treated with antibiotics such as trimethoprim, amoxycillin, cephalexin and norfloxacin. Severe cases of pyelonephritis may require hospital admission for intravenous antibiotic therapy. Patients with chronic or recurrent infections may be recommended to take antibiotics like nitrofurantoin or trimethoprim long term for six months or more. For women in whom cystitis follows sexual intercourse, a single dose of a pre-prescribed antibiotic immediately after sex can be very effective to thwart the infection.
 
Interstitial cystitis is difficult to treat and nutritional medicine may be your only hope. Thankfully, excellent results are achieved with the above nutritional recommendations. Otherwise, there are some medications which have been used with variable success. These include pentosan polysulfate sodium ("Elmiron"), prednisolone, an antidepressant medication and bladder instillation of sodium cromoglycate. Occasionally bladder stretching under anaesthesia may be performed.