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Sharing & Information: UTI





Fast Facts:

  • Cranberry and Blueberry both contain compounds that prevent E.coli from sticking to the cells in the urinary tract. They also prevent biofilms in the mucosa that can be difficult to treat with antibiotics.

  • Cranberry may decrease the number of symptomatic UTI in women in a 12 month period.

  • Interaction with coumadin: cranberry affects how long coumadin is retained in the body and can lead to increased bruising and bleeding.

  • Cranberries also contain significant amounts of salicylic acid. Salicylic acid is similar to aspirin. Avoid drinking large quantities of cranberry juice if you are allergic to aspirin.

  • Cranberries contain oxalate,

  • a main component of kidney stones. Therapeutic doses can increase the oxalate in urine by 43% and is not advised for those with a history of kidney stones.

  • there is conflicting evidence/studies showing the safety of using cranberry with additional d-mannose during pregnancy. Consult with your healthcare provider before taking.¹

UTI, or urinary tract infection, refers to the presence of microbes anywhere in the urinary tract, distal urethra to kidney. UTI in the kidney is called pyelonephritis; in the bladder, cystitis; in the urethra, urethritis. UTI is caused by bacteria, commonly E.coli but may also be caused by other bacteria, viral, or fungal infections. The presence of bacteria in the urine is called bacteriuria and is not an indication for treatment in non-pregnant women. During pregnancy, bacteriuria is associated with increased risk of pyelonephritis as well as prematurity and other complications.


Risk factors

  • sexual activity with multiple partners, though urinating after sexual activity shows a decrease in the rate of UTI.

  • genetic factors can influence susceptibility to UTI. Maternal history is a factor.

  • the use of oral contraceptives doubles the risk of UTI compared to no birth control usage. Spermicides and diaphragm use also doubles the UTI rate.

  • Sexually transmitted infections (STI) and vaginitis show an increase in urethritis.

  • dehydration increases bacterial growth, leading to UTI.

  • history of antibiotic usage increases UTI instances.

  • use of menstrual pads vs tampons

  • wiping from back to front after a bowel movement

  • wearing non-absorbant. non-breathable underwear

  • bubble baths

Common symptoms

UTI is divided into Lower UTI (urethritis and cystitis) and Upper UTI (pyelonephritis), each with different symptoms and treatments.

Urethritis

  • gradual onset

  • urethral irritation and inflammation

  • changes in voiding patterns and dysuric symptoms

  • possible vaginal bleeding or discharge

Cystitis

  • sudden onset. *pregnant women may present contractions and supra-pubic pain and dsyuria possibly mistaken as polyuria

  • crampy, achy, 'just not feeling well' symptoms

  • frequent, painful urination

  • urgent need to urinate

  • supra-pubic pressure and malaise

  • 40% present blood in the urine (hematuria)

  • mild to moderate vaginal bleeding

Pyelonephritis

  • gradual onset (can be sudden if lower UTI present earlier

  • urinary symptoms may or may not present

  • fever, chills, nausea, malaise, and mild to extreme lower to middle back pain plus CVAT pain

  • greater risk to pregnancy that lower UTI

  • complications include acute papillary necrosis, septic shock, and perinephric abscess

  • chronic pyelonephritis may lead to scarring with diminished renal function

Additional Acute or Chronic Considerations

  • A-symptomatic bacteriuria

  • chancroid

  • constipation

  • diabetes

  • Dysfunctional uterine bleeding

  • Dysmenorrhea

  • Endometriosis

  • Gonorrhea

  • Interstitial Cystitis (IC)

  • Ovaria Cysts

  • Pelvic Inflammatory Disease (PID)

  • Pregnancy

  • Renal calculi

  • Sexual assault

  • Toxic Shock Syndrome (TSS)

  • Vaginitis

  • Vulvovaginitis

Traditional treatments

Oral antibiotics effective against E.coli is the primary treatment for UTI. Typically, a 3-day course is recommended for uncomplicated lower UTI within 48 hours of symptoms. Increased water intake is also suggested to promote diluted urine flow. Healthy pregnant women with no evidence of upper UTI may be treated with a 7-10 day course of ce[halosporin in the absence of upper UTI symptoms. Pregnant women are typically treated for all instances of bacteriuria regardless of symptoms.

Upper UTI requires antibiotic treatment and often hospitalization for IV therapy, 48-72 hours.

Commonplace antibiotic treatments have become less effective due to antibiotic overuse and resistance, and the use of antibiotics in pregnancy often leads to vaginal yeast infections requiring further treatment. Lifestyle changes are also recommended, such as voiding at first urging, voiding following sexual activity, increasing water intake, and avoiding the use of oral contraceptives, as well as risk factors shared above.


Botanical treatments

Botanical medicine offers an alternative to antibiotic use to reduce the duration and symptoms of lower UTI, aids in preventing progression to upper UTI, and aids in preventing a recurrence. Lower UTI in pregnant women is easily treated with a simple protocol.

Because of the risks associated with upper UTI and untreated and controlled pyelonephritis, pregnant women with upper UTI symptoms are strongly urged to refer to medical care and utilize botanical treatments only as complementary protocols.


Uncomplicated Cystitis treatments

Botanic treatment of lower UTI should blend the usage of urinary antiseptic and anti-microbial herbs with demulcent herbs. A diuretic may also be indicated to aid in increasing the flow of fluids through the bladder.

Calendula, thyme, and lavender are a triple threat to urethritis when used as a topical peri-cleanse. Calendula. thyme and lavender offer anti-inflammatory ad mild anti-microbial properties. In topical application, they help reduce the spread of rectal-to-urethra microbial properties. Topical usage is safe for pregnancy.

Herbal Peri-Cleanse for UTI
  • 7 g dried calendula blossoms

  • 4 g dried lavender blossoms

  • 3 g thyme leaf

Steep herbs in 1 liter of boiling water for 30 minutes, covered. Strain into peri bottle and add 1 tsp of sea salt. Rinse peri area after each urination and bowel movement (after wiping correctly) and gently pat dry. Can also be made by adding 1 TBS of Calendula tincture, 5 drops of lavender essential oil and 5 drops of thyme essential oil, blended into 1 cup of warm water with 1 tsp sea salt.

Infection-reducing herbs:

  • Yarrow (Achillea millefolium) *recommended as postpartum topical only

  • Uva Ursi (Arctostaphylos uva ursi) ²

  • Calendula (Calendula officinalis)

  • Echinacea (Echinacea spp.)

  • Lavender (Lavandula officinalis)

  • Thyme (Thymus vulgaris)

  • Cranberry (Vaccinium macrocarpon)

Spasm reduction in urinary tract smooth muscle:

  • Yarrow

  • Black cohosh (Actea racemosa) *some studies indicate a contradiction of use during pregnancy

  • Wild yam (Dioscorea villosa) *not appropriate at some stages of pregnancy

  • Kava kava (Piper methysticum)

  • Cramp bark (Viburnum opulus)

  • Black haw (Viburnum prunifolium)

Pain relief

  • Pulsatilla (Anemone pulsatilla)

  • Corydalis (Corydalis ambigua)

  • California poppy (Eschscholzia californica)

  • Kava kava (Piper methysticum)

  • Jamaican dogwood (Piscidea piscipula)

Sooth urinary tract irritation and inflammation

  • Marshmellow (Althea officinalis)

  • Goldenrod (Solidago virga urea)

When using cranberry to treat lower UTI, increase water intake to a minimum of 8 ounces of water every 2 hours, take a quality probiotic supplement, reduce or eliminate all sugar intake. urinate at 1st urging, and abstain from all sexual activity until UTI has cleared.

The author of this blog is not a licensed medical professional. The information in this post is presented for educational purposes only and does not constitute medical advice or consultation.

For more information, please consult the references cited below. If you know of other studies and research, please share the links in the comments section.

References:
Canadian College of Naturopathic Medicine, Safety and Efficacy of Cranberry during Pregnancy
Canadian Society for Clinical Pharmacology, Safety and Efficacy of Cranberry during Pregnancy and Lactation
German Commission E Monographs, expanded reference
Freinkel N, Lewis NJ, Akazawa S, Roth SI, Gorman L. The honeybee syndrome: implications of the teratogenicity of mannose in rat-embryo culture. New England Journal of Medicine, 1984;310:223-30. and Fuel-Mediated Teratogenesis study
¹ Natural D-Mannose is manufactured from birch/beech wood hydrolysate using a solvent-free separation process and is a white, crystalline powder. Natural D-Mannose is extremely safe, has no known side effects, and can be used by pregnant women and children. Synthetically produced D-Mannose requires potentially harmful chemicals for its manufacture. Contradictions: D-Mannose could potentially bind to sperm, preventing implantation. Those trying to conceive should not supplement with D-mannose.
² Uva Ursi principal use is as topical astringent applied for postpartum vulvovaginal healing. It is contradicted in cases involving children under 12 years old, people with a history of kidney disorders, and in those with inflamed or ulcerated GI conditions. Botanical Safety Handbook no longer contradicts usage in pregnancy as oxytoxic effect is based on a single, unreferenced report in Herb Contradictions and Drug Interactions, 1998. Not recommended for lactating women. Known drug interaction: possible potentiation of prednisone and related anti-inflammatory drugs by 50% methalonic extract.
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