Bladder Infections & Cystitis
The goal of this page is to give you information about infections and irritation in the urinary system and to help you understand the things you can do to help with treatment. Also I want to give you clues about how to lower the risk so that you will have fewer of these infections.
One of the important questions is to determine if your pain is from infection (cystitis or kidney infection), or from irritation (interstitial cystitis). You will want to avoid useless and potentially troubling use of an antibiotic if it won`t help.
In either case, reducing the heating aspects of your diet will likely help. Please see the information below on cooling diet and daikon tea.
Infection or Irritation?
Heralded by the urge to urinate frequently, increased urinary frequency, lower abdominal discomfort, low back pain, these are the usual symptoms that we think of as those of a urinary tract infection. But these can be the same with irritation.
Additional symptoms which are almost always those of infection include fever, fatigue, generalized abdominal pain, upper back pain (in the region of the kidneys), and nausea.
Pain in the upper back accompanied by fever and a positive finding of white and red blood cells in the urine almost always points to a kidney infection - a more serious situation.
One of the diagnostic dilemmas is to discover if these symptoms are due to infection, or irritation (without infection). If the pain is from irritation and not infection, it will not respond to an antibiotic.
Infection = Bladder Infection (UTI) and Kidney Infection
Bladder infections are almost always caused by bacteria. These bacteria travel along the surface of the moist skin from the anus to the opening of the urethra. A number of situations may lead to them ascending the urethra (shorter in women than in men) and multiplying in the bladder, when they begin to make their presence known.
Kidney infections may be caused by bacteria which go up the ureters into the kidneys. In these cases, kidney stones may be the cause. There are likely other possibilities including a generalized illness when bacteria travel through the blood and settle in the kidneys. The pain from a kidney infection is almost always only one one side of the back. There is almost always fever, chills, sweats, abdominal pain, loss of appetite, and nausea.
Irritation = Interstitial Cystitis (IC)
Symptoms of interstitial cystitis overlap those of infections but if the urine is cultured, no bacteria grow. People with bladder irritation almost always think that they have an infection.
When the urine of the patient with IC is checked with a dipstick in the doctor's office, it may show blood or white blood cells but usually not both. You will not have a fever with IC unless there is another reason for it, i.e. a viral infection. If you have IC, an antibiotic will not make you better. I often see women who come to the clinic with bladder symptoms who have been on an antibiotic and are not better. Their urine often shows a few white blood cells (leukocytes). They have no fever, but have pain and urgency.
On examination these women may have a vaginal infection, possibly yeast (Candida) or another infection which had been there when the problem started and which was not improved by the antibiotic. Usually a vaginal infection will be accompanied by a discharge: cottage cheese with yeast, watery and possibly yellowish with other bacteria, Trichomas or Gardnerella. These all require different therapy.
How do you avoid frequent UTI`s
Here are some tips to reduce the frequency of UTI`s.
- urinate as soon after sexual intercourse as possible - it washes bacteria out of the urethra
- no sex that first involves the anus and then moves to the vagina
- no sexual marathons - you may have heard the term honeymoon cystitis
- wash you bottom (with soap if you choose) after a bowel movement and after a heavy workout if you`re sweaty
- don`t use anything in your vagina except water - no perfumed products or wipes as these remove the natural protection
- don`t shave or remove the hair on your labia - it is part of the natural barrier and removing it often leads to infection
- stay out of hot tubs and especially no sex if you`re in one anyway
- take Acidophilus every day - it`s been proven to reduce the frequency of UTI`s
- don`t wear a thong - some experts feel that it may aid in the transport of fecal material toward the urethra and thus increase infection rates
- don`t try to hold your urine for long periods of time
- don`t sit around cold i.e. in a wet bathing suit
- reduce or don't consume food or drinks which have been heated in a microwave - one hidden source of microwaved foods is in quick service restaurants where the food has been previously frozen, then microwaved for quick heating. Please see the page on Electro-Smog for more information on this.
- spermacidal contraceptives increase the likelihood of a UTI. They cause an increase of harmful bacteria in the labial area and in the vagina.
- after menopause when the estrogen levels are low, the tissues in the vaginal area can dry out, crack, or become easily irritated, and lead to an increase in bacterial invasion. (Please see below for suggestions).
Antibiotics and UTI`s
Most physicians try to use the antibiotic which has the lowest risk of adverse effects and will do the job. In most situations this will be Macrobid™. It kills E. coli, the most frequent cause of UTI`s without creating too many other problems. When you take any antibiotic, please consider taking a probiotic to protect you. During the antibiotic this is Saccharomyces boulardii (Florastor)™ or another similar product.
After your antibiotic is finished...
At the end of the course of antibiotics, adding 2 or 3 capsules of Acidophilus daily will help to change the bacteria in the colon from trouble making ones, to those of lesser virulence.
In my experience, people who have a diet heavy in meat and sugar have more UTI`s, and those eating more vegetables have fewer.
Heating (an Oriental medical term) can lead to bladder irritation.
Practitioners of oriental medicine have long observed tiny red dots of the tip of the tongue and connected it with an overheated condition. This they find in all infections, and so too, in bladder infections. There are herbal therapies for this but there are also some things you can do at home.
Reduce your use of foods heated in the microwave. These foods seem to transfer heat to your body and seem to result in inflammation and infection in sensitive people.
Reduce foods which create heat; fried and baked food, hot, spicy food.
Choose foods which are cooling; cucumber, cauliflower, leafy green vegetables, rice etc. The best of these home remedies is to make a tea out of a vegetable, widely available in food stores which cater to Oriental customers. This white radish is called Lo bok in Chinese, daikon in Japanese.
Other Complementary Approaches
- Bluegreen algae is cooling and taking this as a supplement may promote healing especially if you have interstitial cystitis.
- D-mannose, a non metabolized sugar goes via urine to the bladder and helps to block the bacteria from adhering to the bladder walls. it may work as well as antibiotics in the early phase of infection. Obtain from health food stores. Take 1 g. two to three times daily. D-mannose works in the same way as cranberry is supposed to but much better. Cranberry juice alone is intolerably sour. Most cranberry juice is mostly apple, and is high in sugar (promotes infection). D-mannose is no problem for diabetics.
- Post Menopausal Women often have so little estrogen in their system that the tissues around the urethra become dried out and crack. This allows bacteria easy access. I often prescribe estrogen in the form of estriol, 1 mg. per dose to be used as needed to strengthen the tissues around the urethra, which a compounding pharmacy will prepare, on prescription.
- Conjugated estrogens like Premarin™ may also be used, but in my experience, they may cause unwanted breast stimulation, which does not seem to happen with the use of estriol.
Change the acid balance (pH) of the urine
In the case of IC, the bladder is often irritated by acidic urine. A very quick way to change this is by consuming a drink of baking soda which is alkalinizing.
- mix 1 heaping teaspoon of baking soda in 4 ounces of warm water and drink every 2 hours. If this approach helps with your symptoms it may mean there are no bacteria present. Taper off as soon as possible. Please see your health care provider to get urine tested for infection.
- a slower and more reliable way to make the urine more alkaline is to change the balance of the diet. This means reducing the acid forming foods like meat, grains like wheat, coffee, and refined sugars. Vegetables and a limited number of fruits can make the urine more alkaline.
- urine dip sticks to check urine pH can be purchased in pharmacies and some natural food stores.
WGP™Betaglucan, in my experience, if used regularly, will strengthen your immunity, and seems to be helpful in reducing the frequency of UTIs.