Urinary tract Infection treatment with herbs, vitamins, natural products, natural remedy and prevention with supplements by Ray Sahelian, M.D.
April 10 2018

Urinary tract infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. The urinary tract includes the kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), bladder, and the tube that carries urine from the bladder (urethra). The special connection of the ureters at the bladder help prevent urine from backing up into the kidneys, and the flow of urine through the urethra helps to eliminate bacteria. Men, women, and children develop urinary tract infection.

Natural supplements used to treat or prevent urinary tract infections
There are many herbs and natural substances that have been tested, but research is still early. Therefore, no firm guidelines can be given at this time. I provide info on some of the natural substances that have been tested. Consult with your doctor before using any of these supplements if you have a urinary tract infection.

Cranberry juice or cranberry extracts is probably the most widely known natural substance used to prevent urinary tract infections.
Crit Rev Food Sci Nutr. 2014. Cranberry and recurrent cystitis: more than marketing? Cranberry is a traditional folk remedy for cystitis and, which, in the form of a variety of products and formulations has over several decades undergone extensive evaluation for the management of urinary tract infections (UTI). The aim of this retrospective study is to summarize and review the most relevant and recent preclinical and clinical studies on cranberries for the treatment of UTIs. The scientific literature selected for this review was identified by searches of Medline via PubMed. A variety of recent experimental evidence has shed light on the mechanism underlying the anti-adhesive properties of proanthrocyanidins, their structure-activity relationships, and pharmacokinetics. Analysis of clinical studies and evaluation of the cranberry efficacy/safety ratio in the prevention of UTIs strongly support the use of cranberry in the prophylaxis of recurrent UTIs in young and middle-aged women.

Ann Pharmacother. 2015. Cranberry Products for the Prophylaxis of Urinary Tract Infections in Pediatric Patients. Cranberry appears effective for the prevention of UTIs in otherwise healthy children and is at least as effective as antibiotics in children with underlying urogenital abnormalities.

J. Nutr. 2017. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis.
 

D Mannose pills may be helpful in preventing UTIs.

Garlic is claimed to help, but I have not seen good human studies.

Probiotics are also claimed to be of benefit but the results of studies have not been consistent. Since probiotics have multiple health benefits, they are worth taking as supplements.

Uva ursi is known as bearberry and has long been popular for fighting urinary tract infections.

I get UTIs all the time, no one has been able to tell me why. My problem is that I am allergic to Cipro, Macrobids, Bactrim, Omnicef, Kelfex, Septra, Penicillin, Augmentin, have even taken Benadryl along with most of them and ER here I come again. Is there any natural cures for UTIs urinary tract infections that anyone knows about?
   One has to have a full evaluation by a urologist to determine that there are no anatomical reasons for abnormal kidney or bladder problems that are causing the frequent UTIs. Cranberry juice, taking cranberry supplements, d-mannose, or bearberry (uva ursi) herb may be helpful in some patients, along with plenty of water.

Case Rep Med. 2014. Efficient and cost-effective alternative treatment for recurrent urinary tract infections and interstitial cystitis in women: a two-case report. Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance.

Causes

The most common cause are bacteria from the bowel that live on the skin near the rectum or in the vagina which can spread and enter the urinary tract through the urethra. Once these bacteria enter the urethra they travel upwards causing infection in the bladder and sometimes other parts of the urinary tract. Sexual intercourse is a common cause of urinary tract infections because the female anatomy can make women more prone to urinary tract infections. During sexual intercourse bacteria in the vaginal area is sometimes massaged into the urethra by the motion of the penis. Women who change sexual partners or begin having sexual intercourse more frequently may experience bladder or urinary tract infections more often than women in monogamous relationships. Although it is rare, some women get a urinary tract infection almost every time they have sex. Another cause of urinary tract infection is waiting too long to urinate. The bladder is a muscle that stretches to hold urine and contracts when the urine is released. Waiting very long past the time you first feel the need to urinate causes the bladder to stretch beyond its capacity which over time can weaken the bladder muscle. When the bladder is weakened it may not empty completely and some urine is left in the bladder which may increase the risk of urinary tract infection or bladder infection. Other factors may also increase a woman's risk of developing urinary tract infection including pregnancy, having urinary tract infections or bladder infections as a child, having past menopause, and diabetes.

Pets as cause of urinary tract infection
Getting an E. coli bug from your pet might lead to a urinary tract infection. Transferring or sharing of E. coli strains among humans and pets within a household, including strains that can cause urinary tract infections, appears to be quite common.

Symptoms, what you may notice
Signs and symptoms include a burning sensation when urinating, frequency, feeling like you need to urinate more often than usual, urgency, feeling the urge to urinate but not being able to; leaking a little urine; urine that smells bad; and cloudy, dark or bloody urine.

A urinary tract infection (UTI) occurs when bacteria become excessive in the bladder, kidneys or elsewhere in the urinary tract.
Symptoms of UTI may include:
A burning sensation during urination.
The frequent need to urinate, though often passing little urine.
Pain in the side below the ribs or in the back.
Bloody or cloudy urine that may have a bad odor.
Chills or fever.

Cost effective approach
The duration and symptom severity of urinary tract infection (UTI) don't seem to depend on whether antibiotics are given immediately or delayed, or which tests are used for diagnosis. Most cost-effective, however, are a dipstick-based diagnosis plus immediate treatment strategy. Dr. Paul Little at the University of Southampton, UK, compared the effectiveness of five different approaches to managing suspected UTIs in 309 non-pregnant women, 18 to 70 years of age. The five approaches were immediate empiric antibiotics, delayed empiric antibiotics (48 hours after presentation), antibiotics given if two or more symptoms are present (urine cloudiness, urine smell, nocturia, dysuria), antibiotics given if dipstick shows nitrites or both leukocytes and blood, and antibiotics given with positive midstream urine analysis. The duration and severity of symptoms did not differ significantly by treatment approach. Patients in any group who waited 48 hours or longer to receive antibiotics had fewer repeat consultations than those who received immediate antibiotics. However, their symptoms lasted 37% longer, on average, than those of immediately treated patients. Dr. Paul Little at the University of Southampton, UK, calculates that dipstick testing with immediate antibiotics is the most cost effective approach. Many women are open to a delayed treatment approach and feel reassured by the availability of a "just in case" prescription. BMJ 2010.
 

Urinary tract Infection treatment

Oral therapy with an antibiotic effective against gram-negative aerobic coliform bacteria, such as E coli, is the principal treatment intervention in patients with urinary tract infection. The patient with an uncomplicated presumed lower urinary tract infection or simple cystitis who has symptoms of less than 48 hours' duration may be treated with one of the following agents for a total of 3 days:

Co-trimoxazole DS (double strength) (eg, Bactrim, Septra)
Ciprofloxacin or similar fluoroquinolone: Reserving the use of fluoroquinolones for complicated infections or cases with documented drug resistance may help decrease the incidence of bacterial resistance to drugs in the fluoroquinolone class. These drugs must be avoided in pregnancy.
Nitrofurantoin macrocrystals (eg, Macrodantin)
Amoxicillin/clavulanate (eg, Augmentin)
Estrogen treatment delivered vaginally may help prevent repeat urinary tract infections in postmenopausal women.

Antibiotic resistance in general is on the rise worldwide, but one especially troubling example is the rise in resistant strains of E coli, the bacteria that cause more than 80% of UTIs.

Urinary tract infection in children
Urinary tract infections are relatively common in children and are a common cause of fever with absence of other urinary symptoms. It is prudent that pediatricians and urologists perform a correct diagnosis to prevent long-term complications of urinary tract infections, particularly renal scaring. Treatment strategies depend on various factors particularly the child's age and severity of illness. Specifications of antibiotics to be used also depend on the age of the patient and the spectrum of the antibiotic, based on the prevalence of organisms at certain ages and in certain situations. Low dose antibiotic prophylaxis, an important aspect of therapy for urinary tract infections in childhood, may be needed in chronic urinary tract infections. The goal of therapy should always be directed to prevention of renal scaring and its complications including hypertension and renal functional deterioration.

Young children treated for urinary tract infections are not likely to benefit from continued antibiotic treatment after the infection clears. The use of prophylactic antibiotics, which involves daily administration of antibiotics to children after an initial urinary tract infection, or UTI, does not prevent recurrence, and it increases the risk of infection caused by antibiotic-resistant bugs. Journal of the American Medical Association, July 11, 2007.
 

Additional herbs that have been tested
Pak J Biol Sci. 2013. In vitro antibacterial activity and stability of Avicennia marina against urinary tract infection pathogens at different parameters.

Emails
Is there a scientific proof that banaba leaves can cure urinary tract infection? bcos i was once diagnosed with UTI and as a Filipino culture where traditional medicines are still preferred to use, neighbors and aunts told me to drink the water from banaba boiled leaves. and i would like to ask also if i can have my American diabetic husband drink the water from banaba boiled leaves.
   Many cultures used herbs for various medical conditions. Sometimes they are effective, other times they are old wives' tales. In the case of banaba, we are not closely familiar with the native usage of this herb in the Philippines. As of 2011, I could not find human studies in the west regarding the use of banaba leaves for UTI treatment.

The daughter of our house helper had at the age of 7 several times urinary tract infections. With fever and other symptoms and missed classes repeatedly. At the school clinic she was given antibiotics which did not prevent the recurrence. I then finally made her to take cranberry capsules which the girl took religiously daily may for 3 months. The UTI stopped dead and never came back.