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Urinary tract infection in women

Also listed as: UTI

• Signs and Symptoms
• What Causes It?
• What to Expect at Your Provider's Office
• Treatment Options
• Following Up
• Special Considerations
• Supporting Research

Urinary tract infections (UTIs) are caused by bacteria and are 10 times more common among women than men. About 30% of UTIs go away and do not recur. When UTIs do recur, it is often because the treatments used to suppress bacteria seem to work at first but do not produce a lasting cure. UTIs can also recur when a woman is infected again by a different kind of bacterium.

Signs and Symptoms

• Pain or burning when urinating
• The need to urinate more often than usual
• A feeling of urgency when you urinate
• Blood or pus in the urine
• Cramps or pain in the lower abdomen
• Chills or fever (fever may be the only symptom in infants and children)
• Strong-smelling urine
• Pain during sexual intercourse

What Causes It?

Some risk factors include the following.

• A new sex partner or multiple partners
• More frequent or intense intercourse
• Diabetes
• Pregnancy
• Use of irritating products such as harsh skin cleansers
• Use of irritating contraceptives such as diaphragms and spermicides
• Use of birth control pills
• Heavy use of antibiotics
• A blockage in the urinary tract (benign masses or tumors)
• A history of UTIs, especially if the infections were less than 6 months apart

What to Expect at Your Provider's Office

Your health care provider will feel your abdomen and kidneys for changes and use laboratory tests, such as a urine culture, to find out if you have a UTI. If the usual treatments do not work, your provider will explore the possibility that you have some other condition. Other illnesses can cause symptoms that mimic a UTI, such as sexually transmitted diseases.

Treatment Options

Drug Therapies

Several antibiotics and other drugs may treat UTIs. The most effective antibiotics are usually taken for 7 - 10 days. Shorter courses of treatment are available, and your health care provider may prescribe an antibiotic that you take for 1 - 3 days.

Complementary and Alternative Therapies

Always tell your health care provider about the herbs and supplements you are using.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Drink a lot of fluids, such as herbal teas and water. Avoid sweetened fruit juices and other sweetened drinks.
• Cranberries and blueberries contain substances that inhibit the binding of bacteria to bladder tissue. Drinking unsweetened cranberry juice regularly seems to help lower the risk of UTIs.
• Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
• Eat more high fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.
• Avoid refined foods such as white breads, pastas, and especially sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 - 8 glasses of filtered water daily.
• Exercise at least 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals such as magnesium, calcium, zinc and selenium.
• Vitamin C, 500 - 1000 mg one to two times daily, as an antioxidant and for immune support.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and help in general health. Cold-water fish, such as salmon or halibut, are good sources.
• IP-6 (Inositol hexophosphonate), 1 - 8 grams daily on an empty stomach, for kidney health. Check with your health care provider for proper dosing.
• L-glutamine, 500 - 1000 mg three times daily, for support of gastrointestinal health and immunity.
• Probiotic supplement (containing Lactobacillus acidophilus ), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
• Grapefruit seed extract ( Citrus paradisi ), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial, antifungal, and antiviral activity.

Natural hormone replacement therapy may help prevent UTIs. Ask your health care provider about this treatment.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea ( Camellia sinensis ) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer and immune effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.
• Cat's claw ( Uncaria tomentosa ) standardized extract, 20 mg three times a day, for anticancer, immune and antibacterial or antifungal activity.
• Reishi mushroom ( Ganoderma lucidum ) standardized extract, 150 - 300 mg two to three times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
• Milk thistle ( Silybum marianum ) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
• Relora, 250 mg 1 - 3 times a day, for stress and related adrenal insufficiency.
• Uva-ursi ( Arctostaphylos uva-ursi ) standardized extract, 250 - 500 mg three times daily for no more than 4 days. You may also prepare teas from the leaf of this herb.

Homeopathy

There have been few studies examining the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for UTI based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Apis mellifica -- for stinging or burning pains that tend to worsen at night and from warmth. People for whom this remedy is appropriate feel an intense urge to urinate, yet can only do so in drops
• Aconitum -- for early symptoms of UTI, particularly with extremely painful urination that is often described as a hot sensation
• Berberis -- for UTIs with burning or shooting pain during urination that may radiate to the pelvis or back. When not urinating, an aching sensation is present in the bladder that worsens with movement. Pains may also extend to legs and abdomen
• Cantharis -- this is the most common and considered the most effective homeopathic remedy for UTI. This remedy is most appropriate for people who are restless, experience a burning sensation and decreased urine flow (despite a strong desire to urinate), and have increased sexual desire despite symptoms
• Mercurius -- for burning urination and a strong urge to urinate. Symptoms worsen at night and tend to be accompanied by chills and sweating. Urine is dark and only small amounts pass. Burning sensation is often worse when the individual is not urinating
• Nux vomica -- for people who have a constant urge to urinate. Pain is described as needle-like. The urge to have a bowel movement may accompany urinary urgency. Mild, temporary relief may be experienced from urination and warm baths. Symptoms may begin following ingestion of alcohol, coffee, drugs or overeating
• Pulsatilla -- for bladder inflammation that begins after an individual develops a sudden chill in hot weather. This remedy is most appropriate for people with an urgent desire to urinate who may be emotional, crave attention, and dribble urine after laughing, coughing, sneezing, or being surprised
• Sarsaparilla -- for women who experience severe pain at the end of urination and who, occasionally, may feel compelled to stand to urinate
• Staphysagria -- for UTIs usually associated with sexual intercourse or following extreme embarrassment or humiliation, particularly from sexual abuse. This remedy is most appropriate for those who have an urgent desire to urinate and have the sensation that a single drop of urine is still present even following urination

Following Up

Preventive measures you can follow:

• Urinate both before and after intercourse.
• Have your health care provider recheck the fit of your diaphragm if you use one.
• Avoid sex while you are being treated for a UTI.

Special Considerations

If you are pregnant, you are more at risk for developing a UTI.

Supporting Research

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Chan WK, Lam DT, Law HK, et al. Ganoderma lucidum mycelium and spore extracts as natural adjuvants for immunotherapy. J Altern Complement Med . 2005;11(6):1047-57.

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• Review Date: 8/11/2006
• Reviewed By: Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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