Urinary Tract Infections / Cystitis

Symptoms, Causes & Treatment

A urinary tract infection refers to a bacterial infection that affects part of the urinary tract. An infection of the bladder is known as cystitis, an infection of the urethra is known as urethritis, and infection of the kidney is known as pyelonephritis.

Urinary tract infections are more common in women than men and recurrences are common.

Causes of Urinary Tract Infections

• Cystitis: nearly 85% is due to infection with Escherischia coli, although other agents may rarely be involved.  Along with EColi, We commonly find various Citrobacter species in clients stool samples that have been having recurrent UTI’s that improve dramatically after treatment
• Kidney infections usually result from poorly managed bladder infections, but may also result from a blood-borne infection

Risk factors

• Female anatomy: proximity of urethra to anus and vagina; short length of urethra
• Poor personal hygiene
• Pregnancy
• Post-menopausal women: due to estrogen deficiency and thinning of urethral mucosa. Estrogen normally maintains vaginal flora – low estrogen dramatically changes the microflora from one dominated by Lactobacillus species to one dominated by E.coli.
• Sexual intercourse (‘honeymoon cystitis’) or unprotected sex
• Use of a diaphragm
• Systemic disorders e.g. diabetes, gut infections, compromised immune systems
• Structural abnormalities
• Antibiotic and OCP use
• Inadequate fluids
• urine stasis
• Mechanical trauma e.g. catheterisation
• Use of irritant chemicals or contraceptive devices
• History of Chlamydia (urethritis)

Signs & symptoms of Urinary Tract Infections & Cystitis

• Painful burning urination
• Frequent urge to urinate
• Urgent desire to empty bladder
• Cloudy, foul-smelling or dark urine
• Pain / tenderness above pubic bone or lower back
• Fever and flank pain (in kidney infection)
• Rarely, blood or pus in the urine
• In males, purulent discharge from penis in urethritis

Low-grade, chronic UTI’s may also be asymptomatic or present simply as frequent urination. Older women with frequent urination should be assessed for an underlying UTI.

TREATMENT STRATEGY FOR URINARY TRACT INFECTIONS

*Note* – UTI’s increase the risk of kidney infection – if kidney infection is suspected, patient needs to seek acute medical care.  Symptoms include fever, pain in back, side or groin and frequent urination.

• Provide antimicrobials and bacterial anti-adhesives
• Support immune system
• Soothe / heal mucous membranes
• Restore urinary tract microflora balance
• Encourage diuresis
• Relieve symptoms
• Prevent recurrent UTI’s

Diet plan guidelines for Urinary Tract Infections & Cystitis

• Fresh, whole food diet high in fibre and low in sugars, refined carbohydrates and alcohol, all of which suppress immune function
• Probiotic-rich diet: studies show that diets that favour a healthy microflora reduce the incidence of UTI. Diets should include fermented dairy products (yoghurt, kefir) and other fermented foods (miso, sauerkraut, kim chee, kombucha, etc.)
• Cranberry juice (unsweetened) 300mL daily: decreases bacterial adhesion to walls of UT and inhibits growth of E. coli.
• Garlic: broad-spectrum antibiotic. Include 1-2 fresh cloves garlic daily
• Increase fluid intake to at least one glass every hour: to promote diuresis. Fluids may be taken in the form of herbal teas (dandelion leaf tea is an effective diuretic) and fresh vegetable juices (including celery, watermelon and parsley which all have a diuretic effect).
• Avoid caffeine: causes contraction of bladder sphincter
• The consumption of non-organic chicken and pork have been associated with UTIs due to the presence of E.coli in these foods.

Supplements that support Urinary Tract Infections & Cystitis

• Zinc – immune support
• Garlic capsules – antimicrobial and immune support
• Probiotics: specific strains have been shown to prevent recurrence of UTIs, in particular Lactobacillus rhamnosus, Lactobacillus reuteri, Lactobacillus casei Shirota and Lactobacillus crispatus. Probiotic supplements may be used both orally and/or intra-vaginally.
• Cranberry supplements: may provide anti-adhesion activity against E. coli.
• D-mannose: may provide anti-adhesion activity against E. coli.

Herbal medicine treatment that supports UTI’s & Cystitis

Hot teas are the best form of herbs to use for UTIs

• Urinary antiseptics /antimicrobials: cranberry, garlic, goldenseal, buchu, uva ursi, juniper berry (contra-indicated in kidney disease), sandalwood, thyme
• Support immune system: Echinacea, andrographis, baptisia
• Urinary demulcents: couch grass, corn silk, licorice, marshmallow
• Urinary astringents: horsetail, plaintain, cleavers
• Diuretics: dandelion leaf, celery, corn silk, couch grass, birch leaf

FUNCTIONAL MEDICINE TREATMENT OF UTI’s & CYSTITIS

The above nutritional and herbal considerations will assist in supporting someone suffering from a Urinary Tract Infection.  Recurrent low grade chronic UTI’s require investigation into why reinfection is reoccurring and what body systems are contributing to the cause of the condition.

At Advanced Functional Medicine, we commonly find contributing factors in patients gut microflora and immune deficiencies.  This imbalances can greatly affect urinary tract infections.   Gut pathogens such as Klebsiella and Citrobacter are commonly associated with recurrent UTI’s.

If you or a family member are suffering from chronic urinary tract infections or other bladder or kidney complications we would love to hear from you, What is your best remedy for clearing up UTI’s?  Have you uncovered your reason why they continue to reoccur?  Please write a comment below.

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