Though I wouldn’t wish it on anyone, I feel quite fortunate to have once suffered a bad UTI (urinary tract infection) because I’ll never forget the excruciating pain. Remember Tom Hanks’ description at the beginning of The Green Mile? It’s like pissing razors…

Also called bladder infections or cystitis, the symptoms usually include urinary urgency, where you feel like you have to go right now, but then not much comes out, and what does really burns. And a few minutes later it happens again. You may also have lower abdominal pain, fever, chills or visible drops of blood in your urine. This is more prevalent in women than men, is caused, in over 90% of cases, by the Escherichia coli (E. coli for short) bug, a certain number of which are necessary in our intestines for proper digestion. However, E. coli doesn’t ever belong in the urethra or the bladder. Normally, the bug lives at the end of the digestive tract, which we politely call the anus, and can get easily swiped forward to the opening of the urethra, which is the tube up to the bladder. In women, this tube is much shorter, and closer to the rectum.

(An interesting aside: the E. coli responsible for fast-food related deaths in recent years is suspected to be a mutant of the normal gut E. coli caused by antibiotics in animal feed, causing resistant super bugs.)

While inadequate sexual hygiene is responsible for many UTIs, women who suffer from recurrent bladder infections need to be evaluated for the presence of other bugs, especially Chlamydia trachomatis, a sexually transmitted disease which is typically symptomless in men.

As always, disease prevention is the best approach to your health management (Please read the post How A Man Can Help Their Female Partner Who Has A Bladder Infection for more information). Since many UTIs flare up after sex, especially with a new partner, basic sexual hygiene is the mandatory first step in prevention. Ladies, you definitely do not want poop anywhere near your vagina or urethra. Don’t use fancy perfumed soaps or lotions in the genital area because these may irritate the skin and make you more susceptible to infection. Make sure everybody has clean hands, fingernails, mouths, and private parts before engaging in sexual activity. Try to pee before sex and again right after, as soon as possible, to mechanically wash any critters away from the bladder. Drink plenty of fluids, especially pure water, to encourage frequent urination, to dilute the urine which makes it less tasty to bacteria, and to keep the mucous membranes (which includes the bladder) moist and healthy. Try to drink a cup (8 ounces) of water for every 25 pounds of body weight daily, ideally between meals so as to not dilute digestive enzymes.

Cranberry juice is a well-known preventive and even curative agent to combat UTIs because it renders the urine more acidic, thus less hospitable to the E. coli. Some women find cranberry juice too irritating, in which case stick with water. Pineapple juice, diluted, is another good beverage in UTIs because the enzymes (especially bromelain) provide an anti-inflammatory effect. Please note: one of my colleagues has noticed repeatedly that chronic UTIs often respond to complete avoidance of all fruits. Apparently, the fructose is irritating to the urinary tracts of certain people. So don’t assume that fruit juice alone can cure a bladder infection — it may worsen the symptoms. Herbal teas that can help cleanse the urinary tract include Dandelion (Taraxacum officinale), Bearberry (Uva ursi; use very cautiously if you have kidney problems) and Goldenseal (quite bitter). Take 1 cup of strongly steeped tea (about 1 tablespoon herb per 1 cup near-boiling water) 2-3 times daily. If the Goldenseal (Hydrastis canadensis) is in powdered form, only 1/4 tsp per cup water will suffice.

Many cases of children’s bed wetting are due to food-induced bladder irritation. Common culprits, as usual, include wheat, dairy, soy, corn (especially high fructose corn syrup), citrus fruits or even eggs. Be alert to this possibility, especially if sexual activity doesn’t explain the infection. Another common irritant is synthetic estrogen, in the form of birth control pills or post-menopausal hormone support. If you are on the pill and suffer from UTIs, try a progesterone-only pill or another form of birth control.

Wear loose clothing that doesn’t bind the genital area, and choose 100% cotton underpants, or at least lingerie with cotton crotches. Don’t torture yourself with clothing that’s tricky to remove when you need to urinate.

If you think you may have a UTI, you may be able to avoid doctors’ fees through home urinalysis, which works well for detecting the most common E. coli bladder infection. Check your local drugstore for a dipstick test, which usually costs under a dollar. Women with frequent UTIs may need a more complex test, called a “culture and sensitivity” which determines which antibiotics will be effective. Antibiotics, however, should be a last resort after the treatment suggestions below.

Goldenseal (Hydrastis canadensis) is also effective, whether taken as tea, capsules (2 caps 4 times daily for 24 hours beyond resolution of symptoms), or tincture (3-4 dropperfuls 4 times daily also for 24 hours beyond symptom resolution). You can also use a Goldenseal tea topically, to wash the labia and urethra twice daily. This tea can be used preventively before and after sex by women prone to bladder infections. Goldenseal is very specific for healing mucous membranes which is why it also helps travelers’ diarrhea, sore throat, stuffy nose, sinus infections and eye infections. Do not use Goldenseal heavily for more than a week without consulting a knowledgeable medical professional or trained herbalist. Avoid during pregnancy, especially the first trimester. It is strong medicine!

If you suspect a bladder infection, intensify sexual hygiene practices or, ideally, avoid sex as soon as symptoms are present. UTIs usually come on suddenly.  If lots of water and cranberry juice doesn’t seem to help within 24 hours, try strictly avoiding fruit, especially if you have chronic UTIs. Ask yourself honestly whether you are frustrated or angry about your current love life. Past or present sexual abuse can manifest as chronic bladder infections. There is always a better option to staying in an abusive relationship, even if it seems terrifying to make a change.

The crown jewel of this article, saved for the end of course, is an effective, naturally occurring nutrient that will relieve most common UTIs quickly without side effects. It is a simple sugar called D-Mannose, quite similar in structure to glucose. How does it work? In a nutshell, D-mannose has tiny thin “fingers” which bind to the E. coli even more tenaciously than the E. coli sticks to the bladder wall. The result is that simply by urinating, the E. coli/D-Mannose complex gets mechanically flushed out. No killing bugs with antibiotics, no killing friendly gut bacteria (D-mannose is absorbed high up in the intestinal tract), no expensive prescription drugs. Hopefully, health food stores and pharmacies will start carrying D-Mannose consistently. If you can’t find it, you can order from Bio Tech Pharmacal (1-800-345-1199). The dose is 1/4-1/2 tsp (depending on your weight) every 2 to 4 hours while awake, stirred into a cup of water. It tastes nice. The lower dose at less frequent intervals is appropriate for a child. You should get relief within 12 hours and complete resolution within 48 hours. If not, please see a doctor because you definitely want to avoid this infection progressing upwards and attacking the kidneys.

Bibliography

• Murray M, Pizzorno J. Encyclopedia of Natural Medicine. Prima Publishing, Rocklin, CA
• Martin L. Health Care of Women. JB Lippincott, Philadelphia, PA
• Lapides J. “The Key to Urinary Infections” The Female Patient, 5:11-14. August 1980
• Sabath LD, Charles D. “UTIs in the Female,” Obstetrics and Gynecology, 55 (5-supplement):162S-170S. May 1980
• Wright J. “D-Mannose for Bladder and Kidney Infections” Townsend Letter for Doctors and Patients, pp 96-98. July 1999