Cystitis and urinary tract infections are not only acutely painful, they can also become chronic. Antibiotics are usually prescribed – with the result that the bladder infection clears up quickly, but often recurs just as quickly or is replaced by side effects. Therefore, the natural approach, which addresses the causes of cystitis, is much more effective in many cases.
Cystitis affects all genders
More than 50 percent of all women suffer from cystitis at least once in their lives. Women between the ages of 14 and 24 are particularly affected, and again after the age of 65.
Men are rarely affected in their younger years. However, as they reach their sixties, they also suffer from urinary tract infections more frequently.
More than 4 million patients in the EU develop a urinary tract infection each year simply because they wear a catheter, either short-term or long-term. 20 to 30 percent of these infections are preventable (5), for example by early removal of the catheter or better hygiene.
The symptoms of cystitis
With a bladder infection, urine may take on a reddish hue due to blood. The typical symptom, however, is an extremely annoying urge to urinate, even after just going to the bathroom. Urine comes out in small drops and is accompanied by a painful burning sensation.
If cystitis becomes more severe, burning and pain may persist even after using the toilet. Nausea and cramping abdominal pain may also occur. Therefore, it’s almost impossible to leave the house when you have an inflammation of the bladder.
Conventional medical therapy
In order to get you back to work as quickly as possible and because it is stated in medical guidelines, most doctors prescribe antibiotics immediately for a urinary tract infection.
As many as 15 percent of all antibiotic prescriptions concern urinary tract infections (1). These medications generally provide rapid relief; within just a few hours, the medication overpowers the causative bacteria, and improvement occurs. In rare cases, fungi can also cause a urinary tract infection. In this case, antibiotics would obviously not help.
How cystitis develops
The bacteria or fungi that can cause cystitis usually come from the body’s own intestinal or vaginal flora, enter the urethra and migrate this way into the bladder.
Of course, a healthy body has protective mechanisms to prevent problematic germs from entering the urinary tract or the bladder. And even if they do get there, a healthy immune system eliminates them.
Only when the body’s own protective mechanisms are disrupted can the unwanted bacteria colonize the mucous membranes of the urethra and bladder. The problem is therefore rarely the bacteria themselves, but rather the body’s weakened defenses. In the fight against the bacteria, the bladder wall swells, becomes inflamed, and causes the typical symptoms.
As inflammation worsens, the bladder lining becomes increasingly fragile, raising the risk of bleeding — which can cause the urine to appear red. Therefore, if you want to avoid bladder infections in the future, you should definitely strengthen your immune system as much as possible.
The possible complications
If a cystitis is not treated carefully, it can become chronic and lead to further complications. These include, for example, the death of bladder tissue, which can then lead to bladder shrinkage. If the urethra is particularly affected, it can narrow over time due to chronic inflammation.
If the bacteria move beyond the bladder and ascend through the ureters to colonize the renal pelvis, it can lead to pyelonephritis — a kidney infection that may cause a pulling sensation or pain in the kidney area.
Now we speak of an upper urinary tract infection, while a cystitis or urethritis belong to the lower urinary tract infections.
In upper urinary tract infections, there is a risk that the bacteria will spread throughout the body via the bloodstream. This, in turn, can lead to sepsis (commonly known as “blood poisoning”) with fever and, in extreme cases, organ failure with potentially fatal consequences.
It is this horror vision that makes every doctor immediately rush to the antibiotic cabinet when a patient reports the typical burning sensation when urinating or even just a tugging sensation in the bladder region.
If the patient is skeptical or even dares to ask about alternatives, the risks mentioned are described to him in the darkest terms, so that without antibiotics he already finds himself on the waiting list for a donor kidney.
Therefore, hardly any patient dares to leave the practice without antibiotics for a bladder infection. If, contrary to expectations, the antibiotic doesn’t help, a different antibiotic must be tried, as in this case the bacteria are resistant to the first one prescribed.
Cystitis from the hospital
Such antibiotic resistance is becoming increasingly common, particularly in two groups of people: those who took antibiotics shortly before the onset of cystitis (e.g. because of another infection) and those who acquired the infection during a hospital stay (usually due to a bladder catheter).
Urinary tract infections account for more than 30 percent of so-called nosocomial infections (hospital-acquired infections). These are infections that one would never have experienced without a hospital stay. These include, in particular, pneumonia, postoperative wound infections, and the aforementioned urinary tract infections.
It is even known that 15 percent of all hospital patients with urinary catheters develop a urinary tract infection. Of these 15 percent, 50,000 people die each year in the USA alone because cystitis escalates into sepsis, which can no longer be treated due to resistant hospital-acquired bacteria (2).
Recurrent cystitis
Back to the initially uncomplicated cystitis, which the family doctor treats with antibiotics. The symptoms disappear, and everything could be fine – if the unpleasant burning, the urge to urinate, and the pain didn’t return after just a few weeks.
If this occurs twice within six months or three times within a year, it is referred to as recurrent urinary tract infections. This is by no means an uncommon occurrence. As many as 50 percent of patients with urinary tract infections experience another bout of cystitis within the same year.
Chronic cystitis
It’s not always “just” two or three bouts of bladder infection per year. Many patients suffer from urinary tract infections much more frequently—about every six weeks or even more frequently. This is referred to as chronic cystitis.
Of course, these patients also receive antibiotics for every bladder infection to prevent pyelonephritis (inflammation of the kidneys). (Incidentally, 30 percent of all bladder infections are caused by pyelonephritis, but in the vast majority of cases, it goes unnoticed because it is asymptomatic and heals without consequences.)
Another option is long-term prophylactic therapy. In this treatment, the patient, or usually the female patient (who is prone to recurring cystitis), takes an antibiotic DAILY before bedtime for six months, two years, or even five years – despite the fact that antibiotics are known to have significant side effects and, from a naturopathic perspective, are also one of the most important risk factors for the development of cystitis.
Antibiotics not only kill unwanted bacteria in the urinary tract, but also impair the vaginal and intestinal flora. However, an intact intestinal flora is a prerequisite for a functioning immune system. And this is precisely where the problem lies for people with frequent bladder infections: their immune system is weakened.
Cystitis goes, fungal infection comes
Another disadvantage of antibiotic therapy for bladder inflammation or other infections is that quite a few patients immediately develop a yeast infection, usually in the form of a vaginal yeast infection. This is because if the medication damages and reduces the number of bacteria in the intestinal and vaginal flora, the fungi, which are always present in small numbers, can suddenly spread.
Doctors now offer other medications to combat the fungi. Hardly anyone thinks about restoring the intestinal flora, or even the vaginal flora.
Risk factor diabetes
Diabetics are more frequently affected by cystitis than healthy people – probably because in diabetics various parameters of the immune system are impaired, because their metabolism is disturbed in some respects and, in the case of existing neurological problems of the bladder, they can no longer empty it completely (3).
Therefore, if you have diabetes, holistic measures (diet, exercise, supplements, etc.) can not only help you better control your diabetes but also reduce your risk of urinary tract infections.
Cystitis after sex
There is often a striking correlation between the occurrence of cystitis and sexual intercourse – regardless of whether condoms are used or not. The risk of a urinary tract infection is said to be 60 times higher in the first 48 hours after sex.
The main reason for this is that sexual activity makes it much easier for bacteria from the intestines or vagina to enter the urethra, where—if the right conditions are met—they can cause inflammation. This is even more likely to happen the drier the vaginal mucosa is, so natural lubricants can help protect the mucosa from being so vulnerable.
Some practices can promote the migration of intestinal bacteria into the urethra, which is why anal penetration should not be followed by vaginal penetration – at least not without taking appropriate hygiene measures in between.
It has also been shown that spermicides (chemical sperm-killing gels, suppositories or creams used for contraception) can increase the risk of cystitis in susceptible women.
If you tend to get bladder infections after sex, drink plenty of water before sex and go to the bathroom immediately afterward. While this may not sound overly romantic, it will significantly reduce your risk of developing a bladder infection.
The vaccination against cystitis
A vaccine against recurrent cystitis (StroVac® from Strathmann) has been on the market for many years. It consists of three injections given one to two weeks apart. This is intended to provide protection for approximately one year. However, the package insert cautions that “a protective immune response, clinically manifested by an improvement in symptoms or freedom from symptoms for a certain period, may not be induced in every vaccinated person.”
The so-called booster vaccine (Booster-StroVac) is administered after one year. The package insert also states that “no long-term clinical studies have been conducted”.
Therefore, only those side effects that may occur immediately after vaccination are listed.
- Swelling at the injection site
- Arms or buttocks that are so sore that the arm cannot be used or sitting is impossible
- flu-like symptoms with nausea, fever and chills
Apart from the fact that the vaccine contains mercury (thimerosal) and aluminum, substances that have long been removed from many other vaccines because of their health risks, the vaccination cannot, of course, solve the underlying problem (a weak immune system, disturbed intestinal and vaginal flora, etc.) and therefore the common cause of cystitis.
A well-thought-out therapy for cystitis
An acute bladder infection is, of course, extremely unpleasant – no question about it. Given the potential risks, it shouldn’t be taken lightly. Therefore, a well-thought-out treatment is ALWAYS necessary.
Whether antibiotics should be part of such a treatment (to relieve very severe acute symptoms) is a case-by-case decision. However, it can be stated quite clearly that antibiotics can NEVER be used as the sole treatment for cystitis in the long term.
In the case of uncomplicated urinary tract infections, half of them could theoretically heal without medical treatment. However, this would mean, firstly, that the patient would have to endure the annoying symptoms for longer (which not everyone is willing to do), and secondly, of course, they would also be away from work for longer, which is undesirable.
However, it would be better to take two weeks off work to cure the cystitis than to have to take sick leave every few weeks due to recurring urinary tract infections.
Home remedies for cystitis
Naturopathic and holistic therapy for bladder inflammation and urinary tract infections can include the following measures, the three most important of which are: drink plenty of fluids, keep warm, and avoid eating sugar!
1. Drink plenty of fluids when you have a bladder infection – water and bladder-kidney tea
At the very first sign of a bladder infection, you should drink plenty of water—about 3 liters per day. This will help flush the bacteria out of the bladder quickly and prevent them from adhering to the bladder wall as easily. The burning sensation will also significantly reduce.
You can replace part of the water, say 1 liter, with bladder tea. Bladder teas are made from medicinal plants that have a flushing and antibacterial effect, such as horsetail, birch leaves, nettles, or goldenrod. If you are pregnant, ask your pharmacist beforehand which tea is suitable for you.
2. Keep your feet warm if you have a bladder infection
Also, keep yourself warm. Avoid cold feet. You can take hot foot baths or place a hot water bottle on your abdomen, but don’t let it get too hot.
3. Avoid sugar if you have cystitis
If you have a sweet tooth or enjoy sweetened drinks, try not to consume sugar when you have a bladder infection.
Firstly, sugary and therefore acidic foods are rarely high-quality foods; secondly, they cause blood sugar fluctuations that can weaken the immune system; and thirdly, they seem to actually feed bacteria. Therefore, experience shows that cutting out sugar for once increases the likelihood of your cystitis healing faster.
4. Restore your intestinal flora
Every dose of antibiotics damages the intestinal and vaginal flora and thus the mucous membranes. Since both the intestinal and vaginal flora and the intestinal mucosa are part of the immune system, it becomes clear why the immune system becomes increasingly weaker the more frequently antibiotics are prescribed.
However, the weaker the immune system becomes, the more likely it is for recurring urinary tract infections or other infections to occur. As mentioned above, for some people, a single course of antibiotics is enough to cause a fungal infection, for which more antifungal medications are prescribed.
Soon there seems to be no escape from the vicious circle of cystitis – antibiotics – fungal infection – antimycotics – cystitis – antibiotics etc.
While yeast infections are clearly noticeable in the vagina, when they affect the intestines, the symptoms are much more diffuse and not so easily attributed to the intestines, such as fatigue, difficulty concentrating, cravings for sweets, and skin problems.
In general, the intestinal flora should be rebuilt after every course of antibiotic therapy, as well as when frequent infections or other health problems occur. You can find out more information: How does intestinal cleansing work?
Pregnant people can take probiotics (which positively support the intestinal flora), but should not perform a complete colon cleanse – more on this video: Can you have colonics during pregnancy?
5. Probiotics prevent urinary tract infections
A colon cleanse always includes probiotic preparations containing lactic acid bacteria (Lactobacillus). If you don’t want to do a complete colon cleanse, which is primarily a preventative measure anyway, you can also take probiotics alone or use probiotic vaginal suppositories for acute cystitis (but also for prevention).
A 2013 study by researchers at the University of Michigan School of Public Health (4) states : 100 women participated in a randomized, controlled, double-blind trial of vaginal suppositories (containing Lactobacillus crispatus) for the prevention of recurrent cystitis. In the placebo group, 27 percent of women experienced a urinary tract infection over the course of eight weeks. In contrast, only 15 percent of women in the suppository group developed a bladder infection.
In the Dutch double-blind study, 252 menopausal women received either probiotic capsules, vaginal capsules, or an antibiotic. They all suffered from recurrent urinary tract infections. The probiotic preparations contained Lactobacillus rhamnosus and Lactobacillus reuteri.
In the probiotic group, 3.3 percent of women developed a cystitis, compared to only 2.9 percent in the antibiotic group. However, antibiotic resistance of E. coli (the most common UTI pathogen) quadrupled over the course of just four weeks in the women treated with antibiotics, which was not the case in the women receiving probiotics.
The researchers wrote: While probiotics do not appear to be quite as effective as antibiotics in treating urinary tract infections, this slightly reduced effect is readily accepted in exchange for avoiding antibiotic resistance. Probiotics should therefore be part of the treatment of urinary tract infections and can also be used during pregnancy—preferably in consultation with a physician.
*Build better gut health with P3 Probiotics
6. Nutrient-rich and alkaline diet
Of course, an immune system can only be successful and effective if the diet is designed to be free of problematic substances (preservatives, thickeners, flavorings, flavor enhancers, etc.) and, at the same time, rich in natural antioxidants and vital substances. Here you can find a 7-day alkaline diet plan.
7. Colloidal silver for cystitis?
If you have colloidal silver at home, you can also use it for a bladder infection. Laboratory tests have shown that colloidal silver can also combat Escherichia coli. Colloidal silver is not recommended during pregnancy due to the lack of appropriate safety studies.
If you make your own colloidal silver with a silver generator, which is very easy and inexpensive, then choose a fairly high concentration of 25 to 50 ppm and take one teaspoon of it two to three times a day – always at least one hour apart from meals.
Leave the silver in your mouth for as long as possible so it can be absorbed through the oral mucosa, and wait 10 to 20 minutes before drinking anything else. You should not take it for longer than 7 to 10 days.
8. D-Mannose prevents cystitis
D-mannose can be incorporated into therapy or taken preventively (including during pregnancy). D-mannose is a type of sugar. However, unlike table sugar or glucose, it is not metabolized; instead, it is excreted largely unchanged in the urine. In the bladder, D-mannose binds to the bacteria responsible for the cystitis and ensures that they can now be flushed out of the body with urine.
Unlike conventional antibiotic therapies, taking D-mannose has no side effects, does not impair the intestinal flora, and therefore does not promote fungal infections following antibiotic therapy. Read more about D-mannose and its effects on cystitis.
There, we describe a study that showed that D-mannose protects against urinary tract infections better than antibiotics, and of course, it’s better than doing nothing at all. If you want to try D-mannose, take at least 2 g daily for six months. Most supplements already contain the correct daily dose which also contain cranberry extract—which brings us to our next tip.
* D-Mannose can be found here at this link.
8. Cranberry juice and extract
If you have a bladder infection, you can also drink about 300 ml of lingonberry or cranberry juice daily (diluted with enough water to allow you to drink the juice). Alternatively, you can also take cranberries in the form of cranberry extract.
Cranberries, also called lingonberries, contain substances (proanthocyanidins) that smooth and soften the inner lining of the bladder, making it harder for harmful bacteria to take hold.
A study published in the British Medical Journal in June 2001 found that only 16 percent of women who drank 50 ml of cranberry juice daily for 6 months suffered from a recurrence of cystitis within the following months (5).
In the control group, there were twice as many women. Since other foods, such as blueberries, are also rich in proanthocyanidins, they may have a similar effect.
Proanthocyanidins can also be taken in the form of OPC as a dietary supplement, e.g.
*California Gold’s OPC (Vitaflavan®) provides about 75 mg of OPCs per daily dose.
9. Bearberry leaves as a tea for cystitis
Bearberry leaf tea has an antibacterial effect on the urinary tract and can prevent a bladder infection from occurring if consumed at the first sign. (It is not suitable for pregnant people, however.) Bearberry leaf tea, or rather the active ingredient arbutin, is said to work best when the urine is alkaline.
Therefore, if you want to use bearberry leaf tea, you should not take any measures that acidify the urine (e.g., do not take methionine, which is sometimes also recommended as a measure for urinary tract infections).
Bearberry leaf tea should not be consumed for longer than one week. Drink three to four cups daily, each from a tea bag.
10. Herbal medicine for cystitis
In herbal medicine, various other medicinal plants have already proven their effectiveness in treating cystitis in studies, such as the combination of centaury, rosemary and lovage.
In a study of over 600 women suffering from cystitis, half received the herbs and the other half an antibiotic (fosfomycin trometamol). The herbal remedy was found to be as effective as the antibiotic (6).
Another combination consists of horseradish and nasturtium. Both medicinal plants work through their mustard oils, among other things. These prevent Escherichia coli from penetrating the cells of the bladder wall.
In this way, the bacteria protect themselves from antibiotics. Rather than simply attaching themselves to the outside of the bladder wall, they hide inside the bladder wall cells (7), where antibiotics cannot or hardly can reach. This is one reason why bladder infections can recur.
Of course, you can also consume horseradish and nasturtiums in other ways, for example, adding nasturtiums to salads. The plant is very easy to grow in the garden or on the balcony and grows quickly, so you’ll have plenty of it throughout the spring and summer. And you can easily make your own “penicillin” from horseradish. You can find the recipe in our recipe section: Penicillin from Horseradish.
Willow bark can also be used for cystitis (preferably not during pregnancy) because its main active ingredient, salicin, has pain-relieving and anti-inflammatory effects. A 2018 study combined willow bark extract with D-mannose and a probiotic from Lactobacillus acidophilus to develop a new treatment concept for recurring cystitis.
Participants included 68 women and 17 men. They received 1000 mg of D-mannose and 200 mg of willow bark extract three times daily for five days. This was followed by maintenance therapy, in which they took 700 mg of D-mannose and 50 mg of the probiotic twice daily. Over the next two months, they repeated the maintenance therapy every two weeks – with the result that their symptoms improved significantly (8).
Other medicinal herbs that can be helpful for cystitis and can also be regularly included in your diet as a preventative measure are oregano and thyme. Both herbs are safe to consume in small amounts during pregnancy, but should not be taken in capsule form.
11. Check vitamin D
If you or your children are prone to frequent bladder infections, have your vitamin D levels checked. A 2019 study, for example, showed that people with low vitamin D levels are more likely to develop bladder infections than those with high vitamin D stores (9). If you are diagnosed with a deficiency, take vitamin D. We describe how to do this in our article on the correct intake of vitamin D.
12. Balance hormone levels
In menopausal women, estrogen and/or progesterone deficiency often leads to susceptibility to cystitis, so even the use of hormone-containing vaginal gels can provide excellent results. You can have your doctor check your blood hormone levels and prescribe bioidentical hormone preparations (capsules, gel, or cream) as needed. Not every doctor is familiar with this, so be sure to clarify this before your appointment.
13. Acupuncture can help with cystitis
A 2020 meta-analysis examined the effectiveness of acupuncture therapy in preventing recurrent cystitis. The researchers concluded that increasing antibiotic resistance necessitates alternative approaches. Five randomized controlled trials with a total of 341 participants were ultimately evaluated. It showed that acupuncture can improve the treatment of urinary tract infections and that the risk of recurrent cystitis can be reduced by acupuncture (10).
In a 2002 study, for example, nearly 100 participants received acupuncture twice a week for four weeks. Over the next six months, 73 percent of women in the acupuncture group were free of UTIs, compared to only 52 percent in the control group. The acupuncture group experienced only half as many UTIs per month as the control group (11).
Acupuncture can also be used during pregnancy, but it must be tailored to the pregnancy. It may even be possible to perform acupuncture in such a way that the treatment also has a positive effect on the pregnancy.
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