Cranberry, bladder tea, vitamins: What helps with cystitis?

It starts with a pulling sensation in the abdomen, a supposedly full bladder, a constant urge to urinate, pain on the toilet: urinary tract infections. Both sexes can get it, but it tends to be a woman's disease: almost one in two women suffers from it at least once in her life, one in ten even once a year. A bladder infection can affect the bladder or the urethra - in which case it is a lower urinary tract infection, i.e. an inflammation of the bladder or urethra. If, on the other hand, the kidney or urethra are infected, it is an upper urinary tract infection. . But how does the troublesome infection in the urogenital area come about? Why are women affected more often than men and what home remedies really help with uncomplicated courses? Dr Dara Lazar, a urology specialist in her practice in Vienna and the Privatklinik Döbling, asked me about the causes of the disease - and about effective remedies you can use yourself in mild cases.

Wet bikini and cold feet: What triggers cystitis?

There are folk sayings that women hear from an early age: Child, don't sit on cold ground for so long, don't leave your wet bikini on, and don't walk around barefoot outside in months that contain an "R". What's true about that: Yes, once you've got a bladder infection, cold is not good for you. But the illness is not triggered by the cold itself, but by bacteria from the intestinal tract. "Germs like Escherichia coli, enterococci and other intestinal germs rise up into the bladder and trigger inflammation and discomfort there," says urologist Lazar.

However, grandma's recommendations cannot be completely dismissed, says the specialist. The cold provides ideal conditions for bacteria to spread in the bladder: "The cold causes our blood vessels to constrict and the cold is conducted from the feet towards the abdomen. In addition, the cold lowers our immune system, which makes it easier for the infection to take hold."

The cold becomes particularly relevant for stubborn germs like the E-coli bacterium. Once it has made it into the urogenital area, it is often very difficult to get rid of the germ. "Escherichia coli can hide in the epithelial cells of the urethra and bladder and thus survive antibiotic treatment." Certain triggers - such as the cold stimulus - can cause the germ to come back again and again and cause symptoms. .

Bladder infections: Women are affected more often than men - why?

Urinary tract infections are indeed considered a women's problem. The fact that they suffer from it more often is due to their anatomy: a woman's urethra is 14 centimetres shorter than a man's, and the urinary outlet and anus are also closer together. Bacteria from the intestinal tract therefore have an altogether shorter path to the bladder.

When having sex, bacteria get into the bladder.

During sex, bacteria from the intestines enter the urethra particularly easily and cause an infection there. This risk is particularly high for women with changing partners. According to the German Society of Urology, the rate of infections can increase 60-fold with the rate of genital contact. This refers to changing genital contacts; the society does not provide any information on the risk in monogamous partnerships. However, the risk could be significantly reduced by the use of condoms.

In general, the following applies: The use of condoms is recommended.

The general rule is: "Drinking enough before sex and going to the toilet afterwards helps to flush out E-coli bacteria directly before they can settle in the bladder and urethra," says the expert.

What can be an additional risk factor for women is hormonal contraception. The reason: the weakened intestinal and vaginal flora, in which bacteria can spread more easily. Around 60 per cent of Dr Lazar's young female patients come to the practice because of a bladder infection caused by hormonal contraception. "Nobody looks at the contraceptive method. Women are often left there alone with their pain and turned away by doctors."

Painkillers instead of antibiotics?

Speaking of pain: because urinary tract infections are so unpleasant, they often tempt people to take a drug to relieve the pain. The good news is: a study in the medical journal BMJ concludes: painkillers are almost as effective against bladder infections as antibiotics. For example, 70 percent of women were free of symptoms after taking ibuprofen and 80 percent after taking antibiotics after one week.

Lazar, a urologist, is sceptical about this: many painkillers are broken down via the kidneys, which is why this form of treatment should be used with caution. "My experience is that painkillers are not enough to get rid of an infection. They do a good job of combating the symptoms, but I think it is unlikely that they will eliminate the germs in the long term."

Antibiotics for urinary tract infections: as often as necessary, as rarely as possible

The fact is: there is no way around an antibiotic after a certain point in the urinary tract infection. These alarm signals are: Blood in the urine, flank pain and fever. "If you don't go to the doctor, you risk kidney pelvic inflammation and, in the worst case, urosepsis with kidney failure," warns the urologist.

But antibiotics should not become the standard treatment for a pinching bladder. Antibiotic resistance can already be observed here. A team of researchers from the University of Washington School of Medicine published their study results in the journal Clinical Infectious Diseases and came to the conclusion that a relatively large number of women already have antibiotic-resistant Escherichia coli bacteria in their intestines.

In a [study conducted by a team of researchers from the University of Washington School of Medicine, antibiotic-resistant Escherichia coli bacteria are already present in the intestines. A [review article](https://www.ncbi.nlm.nih.gov/books/NBK279402/) on the scientific platform PubMed therefore advises against treating uncomplicated courses of the disease with antibiotics for the time being, without any previous illnesses or other risks. This means that for initial symptoms such as a burning sensation when urinating and uncomplicated courses, one should first resort to home remedies .

Preparations from cranberries for cystitis: studies disagree

[Cranberry or cranberry granules](https://www.galaxus.ch/search?filter=t_pt%3D3567%7C3536%7C382&q=cranberry) are probably at the top of the list of home remedies for bladder infections. A meta-analysis by an Austrian research team under the leadership of [Gesundheit Österreich GmbH](https://www.iqwig.de/presse/pressemitteilungen/pressemitteilungen-detailseite_63296.html) gives us hope, because: According to this, preparations made from cranberries can actually prevent recurrent bladder infections or delay their occurrence. . A [comparative study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370320/) published in the Clinics Journal also looked at the effect of cranberries and compared the results of several studies: The authors of the study confirmed its preventive effect, but there was no evidence for its effectiveness in acute urinary tract infections. However, cranberry granules are an effective alternative for patients with antibiotic resistance, as the risk of recurrent bladder infections can be reduced if they are taken regularly. The authors of the study confirm their preventive effect, but there is no evidence that they are effective for acute urinary tract infections. Specialist doctor Lazar also puts the effect of cranberries into perspective, at least when it comes to acute infections: although the arbutin contained in cranberries is supposed to hinder the adhesion of E-coli bacteria in the bladder. However, her observation shows: "Most of the time it is not enough to get rid of an infection only with cranberry preparations. But you can definitely try the cranberry juice as an additional therapy." Say: If you feel a slight burning sensation in the bladder when you urinate, you can take cranberry granules in combination with plenty of fluids. And if you are prone to recurrent urinary tract infections, you can try a daily glass of cranberry and cranberry juice (50 millilitres a day, according to the study) for a while. However, if the symptoms persist or worsen, you should not wait any longer and consult a doctor.

Nasturtium and horseradish: mustard oils are said to help

Talking about natural remedies: one plant substance that is currently being researched a lot is mustard oils, which are contained in nasturtiums and horseradish and can also be taken in tablet form or as a tea. According to a recent study in ["Der Urologe"](https://link.springer.com/article/10.1007/s00120-020-01289-4), their anti-inflammatory and antibacterial effect has been proven. This also covers numerous clinically relevant germs, including multi-resistant ones. The authors write: "The efficacy and tolerability of the therapy of uncomplicated infections of the urinary and respiratory tract with the ITC-containing plants nasturtium and horseradish has been proven in clinical studies." The effect against antibacterial and anti-inflammatory germs has also been proven in clinical studies. The effect against antibiotic-resistant germs has also been proven in other [studies](https://link.springer.com/article/10.1007/BF03370054). "Mustard oils are antibacteriostatic," confirms Dr Lazar. "They prevent bacterial growth and can even kill the bacteria in some cases." For the latter effect, however, you need a very high dose.](https://academic.oup.com/cid/article/70/5/937/5528138?login=false)

Vitamin C: Biting into the sour lemon

. Also vitamin C should be part of every medicine cabinet: it is often a first approach to solving an incipient bladder infection. The ascorbic acid in vitamin C has an antibacterial effect and inhibits bacterial growth, confirms the urologist. Furthermore, vitamin C helps to strengthen the immune system, making it easier to fight infections.

High doses of vitamin C should be taken with caution, however. According to the Deutsche Ärzteblatt, it can lead to liver insufficiency in rare cases - therefore, an excessively high dosage of vitamin C should be taken mainly to alleviate symptoms, but not preventively and permanently. In general, it is also advisable to consult a doctor in advance.

Bladder tea: What are the benefits of the product from the pharmacy?

The classic bladder remedy is probably bladder tea, which is available in every pharmacy. It contains many herbs that inhibit bacterial growth, the urologist explains. "We know that goldenrod works directly against the E coli germ, as does berry berry."

Tea

Morga Bladder tea

71 g

1

Tea

Morga Bladder tea

71 g

1

But because the berry leaves in particular can cause liver damage if taken long-term, bladder tea should not be taken for more than five weeks a year. "Bladder tea is a therapeutic remedy and should not be used preventively or in the long term," says the specialist. It is also very unlikely that a urinary tract infection will disappear with bladder tea alone. But: "It is certainly an additional slap in the face."

D-Mannose: A good sugar for bladder infections

. D-mannose, for example taken as a capsule, is a type of sugar that is hardly metabolised by our bodies, but is passed out through the urine. On its way out, D-mannose binds bacteria responsible for bladder infections and urinary tract infections . A study published in the World Journal of Urology confirms its effectiveness. According to the study, it can be assumed that D-mannose successfully prevents urinary tract infections. The Deutsche Ärzteblatt also confirms the effect: "By using 2 grams of D-mannose a day, the UTI rate was statistically significantly reduced compared to placebo in an [...] open study." . Dr Lazar explains: "D-mannose has an osmotic effect in the body and is very diuretic. This flushes out intestinal bacteria that have settled in the bladder."

The expert therefore advises: if you drink water before sex anyway to avoid a bladder infection, you can take a little D-mannose with it. This increases the chance of successfully flushing out all bacteria afterwards.

A sugar-free diet for urinary tract infections?

But be careful: not all sugar is the same. Unlike D-mannose, glucose is metabolised by the body, providing an ideal breeding ground for bacteria of all kinds. "Glucose in the urine nourishes and promotes urinary tract infections," confirms the specialist. However, there is no need to worry about glycose in the urine of healthy people. This only happens with pre-existing diseases like diabetes type 1 and type 2: Here, excess blood sugar is discharged through the urine, which is why patients often suffer from recurrent bladder infections. This is confirmed by the guideline of the German Society of Urology.

Without a pre-existing condition, however, there is no need to fear this, says Dr Lazar. "If you snack here and there as a healthy person, it has no effect at all on any urinary tract infections."

General recommendations for urinary tract infections

. Urinary tract infections can be managed well if they are uncomplicated. Those who suffer from them regularly can put together a promising medicine cabinet with natural herbal remedies for acute or preventive treatment

.

In general, however, a doctor's consultation is essential, says the expert. "There are so many factors to consider: Are there risk factors? What is the patient's previous medical history? How is contraception used? I therefore advise that even the use of herbal remedies be accompanied by a doctor."

And a pro-tip from Dr Lazar when the bladder pinches again? "Freshly squeezed, high doses of raw garlic juice. It kills E-coli bacteria quite reliably."

In rare cases, the inflammation of the urinary tract infection becomes chronic: it comes back again and again and can hardly be controlled by conventional therapies. In these cases, antibiotics are no longer helpful, as they should not be used as a permanent medication. For affected patients, vaccination in the form of an injection and immunotherapy in tablet form can help. The StroVac vaccination has been permitted since 2004 and provides basic immunisation that should last for a year and prevent bladder infections. However, there are no long-term studies on the effectiveness of the vaccine.