The Natural Path to Chronic Urinary Tract Infections (UTIs)

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If you’re a woman, your chance of getting a urinary tract infection is extremely high and many can lead into chronic infections that are recurrent, sometimes for years. There are two types are UTIs, bladder infections (BIs) and kidney infections (KIs). I will be specifically chatting about BIs, since KIs should be treated promptly with antibiotics.

UTIs are bacterial infections that are not to be taken lightly. If you have had the joy of experiencing one…you know how incredibly debilitating they are. Common symptoms of a UTI are:

Frequent and/or intense urge to urinate
Burning sensation when urinating
Pain or pressure in the lower back or abdomen
Cloudy, dark, bloody, or strange-smelling urine
Symptoms of shaky or feeling tired
Fever or chills, nausea and vomiting (likely a sign that the infection has gone to the kidneys)

If you suspect you have a UTI, it is imperative that you head to the medical doctor to get a urine sample to confirm. In younger, sexually active women, sudden onset of painful urination can also be due to chlamydia infection or gonorrhea (rarely), so getting a urine culture as well is beneficial. The majority of UTIs are bacterial in origin so medical doctor’s prescribe antibiotics during an acute episode. Some women who have chronic BIs are given long-term antibiotics for preventative measures. However, frequent antibiotic use, especially in women with chronic BIs, has been shown to alter intestinal and vaginal flora and increase the rate of antibiotic resistance.

Naturopathic approaches should be strongly considered in cases where chronic BIs are still a problem. Naturopathic doctors can treat acute, single episodes of BIs, but you want to be under the supervision of a doctor since these infections can quickly develop into kidney infections, which are very dangerous and can only be treated with antibiotics.

Housekeeping Rules for your lady parts:

If you were ever told to wipe from front to back after using the washroom, listen! This is a key factor in preventing recurrent BIs. Since the urethra (where you pee) is located close to the anus in women, bacteria from the large intestine are in perfect position to escape the anus and invade the urethra. Some women have shorter urethras allowing bacteria to ascend more easily to the bladder, making them more prone to BIs.
Another housekeeping tip is to urinate after sex. Having sex can introduce bacteria into the urinary tract, again causing an infection in the urethra.
Avoid vaginal hygiene products (ie. douches), which can be irritating to the urethral area and alter the vaginal flora.
Research has shown that wearing cotton underwear can reduce the chance of UTIs since it is more breathable.

Dietary recommendations:

Increase your intake of water to ensure you are peeing regularly to flush out bacteria and prevent their adherence to the urethra.
Add in some UNSWEETENED PURE cranberry juice (not the Welch’s cranberry or any “cranberry cocktail” drinks). It is a known anti-adhesion agent, meaning it can prevent the bacteria from setting up shop in your urethra. It can be found in different forms: juice, tablets or capsules. You want to be drinking about 250-300ml/day, which you can dilute in some water since the pure cranberry juice can be quite tart. Cranberry juice is also safe and effective for the prevention of UTI’s in pregnancy, which is important since they tend to be more common.
Your GUT and VAGINAL flora are key players in preventing recurrent BIs, therefore keep your diet low in sugar and high in fiber, specifically from dark leafy greens.
To reduce the susceptibility to bladder infections it may be necessary to address and remove food sensitivities.

Supplement Recommendations:

Probiotics: can help keep the vaginal and gut flora balanced. You want to make sure the probiotics specifically contain the Lactobacillus species. One of my favorites is the UltraFlora’s Women’s by Metagenics that contains a 50:50 blend of Lactobacillus rhamnosus and Lactobacillus reuteri, once/day. This targets healthy vaginal flora by increasing the number of beneficial lactobacilli. Lactobacillus generates an acidic vaginal pH and interferes with the adhesion of common urinary bacteria. Vaginal probiotic suppositories have been used weekly and shown to reduce the incidence of UTIs after 12 months.
D-Mannose: a simple sugar that acts similarly to cranberry in that is prevents the adherence of bacteria. It can be used for treating acute BIs and for prophylaxis in women prone to recurrent infections. It has been shown to be more or just as effective as antibiotics when used for chronic BIs but with a much lower incidence of side effects. A general dose is around 2 grams of powder/day during an acute infection.
A healthy immune system can help the body resist infections. Specific vitamins I recommend are Vitamin C. Studies have shown that it increases the release of nitric oxide in the urine, which acts as a bacterial killing agent against the most common bacteria that causes UTIs, E.Coli. General dose is around 1-2grams/day. Vitamin A and Zinc are other common recommendations for supporting the immune system.

Herbal Recommendations:

For acute bladder infections, berberine extracts (found in various plants – Hydrastis Canadensis and Berberis vulgaris) have significant antimicrobial activity. It inhibits the growth of several bacteria, including resistant E.Coli (common in chronic BI patients). Berberine can also act as an antimicrobial to treat dysbiosis (altered bacterial flora in the gut), which can indirectly reduce the occurrence of BIs since dysbiosis can increase the incidence of BIs.
Other great anti-septics used in acute cases are: Uva Ursi and Yarrow. Can be done as an infusion/tea so they can be flushed through the urinary tract. The addition of marshmallow root can be added if symptoms of burning are present. These preparations can also be taken in capsule form.
If stress is associated with your chronic BI, it is beneficial to incorporate herbs that specifically work at supporting your stress response while ensuring your immune system stays in check.
Just a note: recurrent bladder infections are common in postmenopausal women due to the decrease in estrogen and its role in maintaining healthy vaginal flora and mucosa. There are many herbal recommendations that can help support this hormone imbalance and important to address these changes to reduce the reoccurrence of UTIs.

This information given is not to discourage antibiotic use, since in some cases it is absolutely necessary. It is to provide you with more preventative strategies and other naturopathic alternatives for treating chronic UTIs, all of which have much lower side effects compared to long-term antibiotics.

If you have any questions or would like to schedule an appointment at Whole Family Health, please contact us today!