No.

116 November 2003

Effective Treatment of Urinary Tract Infections Using Herbal

Medicines
by Rose Cornelissen-Mok
Urinary tract infections or UTIs are very common, only
respiratory infections occur more often in practice.1 Herbal
medicine is very effective at quickly alleviating the
symptoms and treating the cause.
There are three categories of infection:

Urethritis: Inflammation of the urethra. The urethra is

the canal that transports urine from the bladder. In
males this canal also serves as the genital tract.

Cystitis: Bacterial infection of the urinary bladder.

Pyelonephritis: This is the most serious of the three

categories, where bacteria in the bladder migrate to
the kidneys and cause infection.
About 80% of UTIs are caused by the Gram-negative
bacterium Escherichia coli (E. coli, a useful organism in the
large intestine). Other microorganisms called Chlamydia
trachomatis and Mycoplasma hominis can also cause
infection and tend to remain limited to the urethra and
reproductive system. Unlike E.coli, these bacteria are
sexually transmitted, therefore both partners need to be
treated.
In males the prostate gland plays a role in producing
secretions that slow down bacterial growth, also the male
urethra is considerably long and has 'bends' that prevent
bacteria from reaching the bladder.
In females, the urethra is short and straight and the
perineum, which is somewhat of a protective barrier, can
become damaged or irritated. This, along with ready
contamination from the bowel bacteria, means UTIs are
more commonly found in females.
In both males and females the immune defenses also
prevent infection. When an infection does occur, the
bacteria colonise and spread to the bladder causing
infectious processes which start destroying the superficial
lining of the urinary tract and bladder and if progressed,
will affect the kidneys.
Symptoms: sudden onset, urinary frequency that is burning
or irritating and a persistent urge to urinate even when the
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bladder is empty. Urine may be cloudy and have an odour

and lower abdominal cramping and pressure is present
above the pubis in females and in men, fullness in the
rectum. In more progressed cases there is fever, chills, low
back pain, blood in the urine, nausea, vomiting and
diarrhoea.
In small children the signs and symptoms may not be
clear, there may be a high or low-grade fever, irritability
and lack of appetite, with or without the typical adult
symptoms.
Differential diagnosis is important as the cause of infection
may be due to an enlarged prostate, abnormal masses,
obstruction, calculi, diabetes, changes to the bladder,
pregnancy, chlamydia, viruses such as herpes simplex or
fungal infection. In children UTIs may be caused by a
neurogenic bladder (due to spinal cord injury or
myelomeningocele). UTIs are less common in boys and
need to be investigated further for functional problems.
Recurrent problems in girls i.e. more than three episodes,
also suggests the need for further investigation.
Interstitial cystitis (IC), a chronic inflammation of the
bladder, presents with many of the symptoms of UTI and
will be covered in a future article.

Underlying Issues
UTIs are often caused by contamination of E.coli from the
bowel with failure to wipe from front to back after
defecation (in females). "Honeymoon syndrome" is a
common condition where acidity is decreased in the
female urethra by alkaline semen. The alkaline condition is
more favourable to bacterial growth. Women who are
susceptible to UTIs should cleanse before sexual
intercourse and urinate afterwards. In menopause, the
urethral tissue thinning due to decreasing oestrogen
increases susceptibility to local trauma and infection.
Chronic constipation, oral contraceptive use, an acidic
and/or high sugar diet and parasitic infections may also
trigger a susceptible individual and reduce the body's
natural defense against the Gram-negative bacteria.
1

Treatment

Antibiotics such as the combination drug

trimethoprim/sulfamethoxazole, trimethoprim, amoxicillin,
nitrofurantoin, ampicillin and the quinolone class of drugs
are generally used to treat routine uncomplicated UTIs.

For uncomplicated cystitis, urethritis and related

conditions:
Immediately start to alkalinise the body and urinary
system with a 1/2 teaspoon of bicarbonate of soda
(sodium bicarbonate or baking soda) in water every 34 hours.
With acute conditions, fluids are important but flushing
is contraindicated as it may increase tissue irritation.
(Flushing is more useful in chronic cattarhal conditions
as a result of chronic longstanding UTIs. Here diuretics
such as horsetail are also more useful.)

Herb
Cranberry (Vaccinium
macrocarpon)
Crataeva (Crataeva

nurvala)
Buchu (Agathosma
betulina)

Bearberry
(Arctostaphylos uvaursi)

Horsetail (Equisetum

arvense)
Juniper (Juniperus
communis)

Golden Seal
(Hydrastis
canadensis)

Marshmallow Root
(Althaea officinalis)

Corn Silk (Zea mays)

and Couch Grass
(Agropyron repens)

Herbal infusions based on the herbs mentioned below

are excellent, however avoid decocting, as the volatile
oil content is especially high in some herbs e.g. buchu.
Reduce dietary sugars, alcohol, coffee, fats and acidforming foods such as commercial fruit juice and
tomato puree.
Address recurrent or chronic infections and the role of
allergies as a trigger.
Examine other triggers such as hormonal changes,
stress, digestive disturbances, diet and personal
practices.
In cases of male urethritis of viral origin e.g. herpes, St
John's wort is of great value in conjunction with
immune supporting herbs.
Immune support to stabilise the body's natural
defense against bacterial infection in the form of
Echinacea and/or Andrographis is essential. In fact,
immune support is the most important part of the
treatment of UTIs.

Mode of Action and Dosage

May prevent E.coli from attaching to the walls of the bladder where they colonise and cause infection. Cranberry is also
useful for patients who have difficulty emptying their bladder and therefore have a tendency to infection.
Dose: juice concentrate equivalent to fresh fruit. Subacute: 7.510 g per day. Acute: 1520 g per day.
Inhibits acute and chronic inflammation. Decreases bladder stone formation and calcium oxalate kidney stones. Improves
bladder tone and therefore bladder emptying (e.g. in males, hypotonic bladder due to BPH).
Dose: Decoction of dried bark or root bark: 1525 g per day. 1:2 liquid extract: 614 mL per day, 40100 mL per week.
Strongly disinfects the urinary tract and acts as a mild diuretic. Traditionally used to treat chronic genitourinary tract
conditions such as recurrent cystitis, abnormally acidic urine, increased desire to urinate with little relief after micturition
and incontinence associated with a diseased prostate.
Dose: Dried leaf: 36 g per day as an infusion. Buchu essential oil: 3696 mg per day. 1:2 liquid extract: 24.5 mL per day,
1530 mL per week.
Excellent in acute cattarhal cystitis and dysuria via its antibacterial, astringent and anti-inflammatory actions on the
genitourinary system. Strengthens and tones.
Dose: Dried leaf: up to 12 g per day (equivalent to 400800 mg arbutin) prepared as a cold infusion or macerate. 1:2 liquid
extract: 4.58.5 mL of per day, 3060 mL per week.
Contraindications: Pregnancy, lactation.
Reduces swelling and inflammation, haemostatic and generally increases the health of the surface of the urinary tract. A
'knitting herb' for increased connective tissue resistance.
Dose: 1:2 liquid extract: 26 mL per day, 1540 mL per week.
Useful for diuretic, anti-inflammatory and antiseptic properties. Preferably used where there is a mild state of UTI present
such as prior to menses and where hormonal imbalance is being addressed also.
Dose: 1:2 liquid extract: 1.53 mL per day, 1020 mL per week.
Contraindications: Pregnancy, kidney disease.
A trophorestorative to the mucous membranes especially where there are catarrhal states and inflammation. Though
golden seal is primarily known for its gut activity it is also traditionally used in cystitis.
Dose: Dried rhizome/root: 0.72 g per day. 1:3 tincture: 24.5 mL per day, 1530 ml per week. 1:5 tincture: 3.57 mL per
day, 2550 mL per week. Higher doses may be used in acute conditions.
Contraindications: Pregnancy, jaundiced neonates.
Some practitioners recommend taking this separately as a drink for maximum effect. Highly demulcent and soothing and
beneficial to mucous membrane surfaces. A supportive herb.
Dose: Dried root: 1 teaspoon as a decoction, three times per day. 1:5 tincture or glycetract: 36 mL per day, 2040 mL per
week.
Help alleviate any irritation of the urinary system and are soothing and toning. Reduce acidity and are mildly diuretic.
Dose: Corn Silk 1:1 liquid extract: 26 mL per day, 1540 mL per week. Couch Grass 1:1 liquid extract: 36 mL per day, 2040
mL per week.

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Combinations
Primary UTI combination: Cranberry, Crataeva, Buchu,
Bearberry must be used in conjunction with immune
supporting herbs.
The following, in conjunction with the above UTI herbs, are
examples of herbs to consider when indicators are present:
Echinacea angustifolia root, Echinacea purpurea root,
tablets containing Andrographis, holy basil, Echinacea
root (immune modulating)
Golden Seal (UTI)
St John's Wort (viral UTI)
Saw Palmetto liposterolic extract (UTI and BPH)
Tablets containing Stemona, black walnut, wormwood,
clove bud (UTI and parasitic triggers)
Tablets containing St John's wort, false unicorn, wild
yam, sage, Korean ginseng (UTI and menopause)
REFERENCES
1
Schappert SM. Ambulatory care visits to physician offices, hospital
outpatient departments, and emergency departments: United States,
1997. Vital Health Stat 13 1999; (143): i-iv, 1-39

Copyright 2003 MediHerb Pty Ltd.

Not for Public Distribution. For Education of Health Care Professionals Only.