inflammation of the urinary bladder

There are around 150 million cases of cystitis worldwide every year. 25-30% of women have at least one bout of cystitis in their lifetime. The infection is mainly caused by coli bacteria (Escheria coli), which are transmitted via the intestines.

Women are at higher risk due to their shorter urinary tract. If the mucous membranes of the vaginal opening are colonized by intestinal coli bacteria, the risk is particularly high.

Many women get urinary tract infections after menopause because their mucous membranes dry out as a result of reduced estrogen levels.

E. coli bacteria are a natural part of the natural microflora in the intestines, but not in the bladder. When E. coli bacteria enter the urinary tract and bladder, the white blood cells of the immune system are attracted and symptoms of cystitis appear.
If the infection is not treated, in about 5% of cases the bacteria penetrate the renal pelvis via the urethra and cause pyelonephritis.

Although antibiotics are generally effective in treating bladder infections, they have some side effects and there is a risk that resistance will develop. In addition, antibiotics do not treat the underlying cause, such as a weak immune system.

The great advantage of naturopathic approaches is that, when used consistently, they are at least as effective as antibiotics. The main difference is that they have no negative side effects, but at the same time strengthen the immune system and thus contribute to causal rather than just symptomatic treatment. A new infection is therefore much less likely to occur. After antibiotic therapy, however, there is a risk that the immune system will be weakened due to the intestinal flora now being affected, often leading to fungal infections (intestinal fungus and/or vaginal fungus) and, not infrequently, the next bladder infection will occur very soon.

Study situation on the use of micronutrients as an alternative to antibiotic therapy

D-mannose can help with urinary tract infections and bladder infections and often replace antibiotics with side effects. D-mannose is a type of sugar that is related to glucose, but is hardly metabolized in the body. D-mannose is instead excreted in the urine. On its way through the bladder, D-mannose binds to the bacteria that cause urinary tract infections and bladder infections. Bound to D-mannose, the bacteria can no longer cling to the bladder wall (cf. Hung, Chia-Suei, et al. "Structural basis of tropism of Escherichia coli to the bladder during urinary tract infection." Molecular microbiology 44.4 (2002): 903-915).

The preventive effect of D-mannose was confirmed in a clinical study in Croatia (see Kranjčec Bojana, Dino Pape, and Silvio Altarac. "D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial." World journal of urology 32.1 (2014): 79-84): 308 women with acute cystitis who had also suffered from urinary tract infections in the past were divided into three groups after the usual treatment with antibiotics:

For six months, group 1 received 2 grams of D-mannose daily, group 2 received 50 mg of the antibiotic nitrofurantoin daily during the same period, and group 3 underwent no prophylactic measures and thus served as a control group.A total of 98 of the women suffered from a bladder infection again during the study period, 62 of whom belonged to the control group. 21 women in the antibiotic group suffered from a bladder infection again, and only 15 women in the D-mannose group. The researchers concluded their study by saying that D-mannose is very good for preventing urinary tract infections and bladder infections - especially for people who suffer from constantly recurring bladder infections.

On behalf of the Institute for Quality and Efficiency in Health Care  (IQWiG) investigated whether herbal remedies help with recurrent cystitis. The scientists’ conclusion: The preventive use of cranberry-Preparations can be useful for women with uncomplicated recurrent cystitis. In comparison with placebo treatment, several randomized controlled studies indicate that the infection does not recur or only recurs later.

To answer the question of whether herbal remedies help with recurrent uncomplicated cystitis, the  IQWiG  The scientific team commissioned by the company selected 15 suitable studies. Most of the studies included examined preparations containing cranberry. This shows an indication of a To use of cranberry compared to placebo – both in terms of the recurrence rate of the urinary tract infection and the time until the first recurrence (relapse). In terms of preventing recurrences, in addition to cranberry preparations, there is evidence for a preparation made from lovage root, rosemary leaves and centaury. additional benefit, thus an added value, compared to treatment with antibiotics alone.

Various observational studies and one clinical study each  prove that the vegetable mustard oils from nasturtium and horseradish are effective and well tolerated in uncomplicated respiratory infections and cystitis and can even reduce the relapse rate of urinary and respiratory tract infections when taken long-term.

Numerous studies show that the mustard oils contained  antibacterial, anti-inflammatory and antiviral  It was shown, among other things, that only the combination of the mustard oils from both plants achieves a particularly strong effect against many different types of bacteria. In addition to a direct growth-inhibiting and germicidal effect  The mustard oils also have an effect on bacterial biofilm formation and the penetration of bacteria into the cells of the inner bladder wall (internalization). According to current knowledge, these are essential mechanisms, especially with regard to recurrent bladder infections. In addition, the mustard oils intervene in the signaling pathways relevant to inflammation and thus help to alleviate the often very painful symptoms of a bladder infection.

The amino acid L-methionine has a  Urine acidifying effect: The body needs about 0.5 g of methionine per day to maintain muscle. If you take in more than 1.5 g per day, the body has to break down the excess. This breakdown produces sulfate, which is excreted via the kidneys. Protons are secreted into the urine, which becomes acidic.

This effect is seen in the  treatment of urinary tract diseases  in which an acidic pH value in the urine inhibits the adhesion of bacteria to the urothelial cells and inhibits bacterial growth.In addition  inhibits  methionine  formation of kidney stones,  improves stone solubility  and  supports the effect of certain antibiotics.

The effect of pumpkin was first described in the 16th century in connection with the urinary tract. Today we know that the active ingredients in its seeds, i.e. the pumpkin seeds, can be found. Their positive effect on the bladder has been scientifically studied many times. It is noteworthy that these active ingredients are not contained in the popular pumpkin seed oil, as is often assumed, but only in the shell of the pumpkin seeds.

Pumpkin seeds are indicated for strengthening and strengthening bladder function and for treating irritable bladder and urination problems in BPH. Phytosterols isolated from pumpkin seeds have been shown to have anti-inflammatory, antimicrobial, prostatotropic and urodynamic effects. In addition to the specific phytosterols, non-specific ingredients such as unsaturated fatty acids, certain amino acids, vitamins, minerals and trace elements can also be involved in the therapeutic effect of pumpkin seeds.

The calming and regulating effect of pumpkin seeds on the bladder ("bladder tonic") was already described in reports from the 1960s. Later, an open study tested the effect of 6 g of pumpkin seeds daily on 101 patients with irritable bladder. During the treatment, the symptoms and the micturition index (daily urine volume/number of micturitions) improved: after eight weeks of treatment, the average amount of urine per micturition had increased by almost 60%. Too frequent and painful urination had noticeably decreased. Over 80% of the patients reported a subjective improvement.

In addition to its wound-healing properties, goldenrod Centuries ago, goldenrod was already known to have another therapeutic property: its diuretic effect. This has been confirmed by modern phytotherapy. Goldenrod is now indicated for flushing therapy in inflammatory diseases of the urinary tract and for the preventive treatment of kidney stones and kidney gravel. Flavonoids, saponins and phenol glycosides are considered to be effective ingredients. In addition to its diuretic effect, goldenrod has also been shown to have anti-inflammatory, analgesic and slightly spasmolytic properties. These are beneficial for urinary tract infections, such as cystitis.

The rosemary The ingredients include essential oils, tannins, flavonoids, bitter substances and resins. In folk medicine, rosemary is used primarily to stimulate the flow of bile and urine, for wounds and eczema, and for gastrointestinal complaints.

lovage Lovage root is also one of the tried and tested medicinal plants when it comes to natural treatment of bladder infections, kidney problems and urinary stones. For example, the essential oils contained in lovage promote the excretion of urine via the kidneys - they have a diuretic effect, as the technical jargon goes. The urinary tract is thus flushed out more thoroughly. This indirectly makes it more difficult for bacteria to attach themselves to the mucous membrane and they are flushed out with the urine.

A clinical study (cf. Wagenlehner, FM et al.: Urol Int 2018; 101:327-336) with over 600 patients from 2018 compared a combination of rosemary, lovage and centaury with the most commonly prescribed antibiotic therapy for acute, uncomplicated cystitis.The result: 84% of the women in the herbal preparation group did not require any additional antibiotics. In terms of the time until the effect took effect and the reduction in symptoms, both treatment strategies were equivalent. And compared to antibiotic therapy, fewer gastrointestinal complaints were observed with the three-drug herbal combination.

zinc Contributes to the maintenance of a normal immune system: White blood cells such as macrophages use zinc as a toxic weapon to fight bacterial infections.

vitamin D increases the production of cathelicidin, an antimicrobial peptide that may be able to reduce the penetration of infectious microorganisms into the bladder mucosa by binding to the adhesive particles of pathogens such as E. coli (a mechanism similar to that of D-mannose) and stimulating the immune response. This is confirmed by a study of postmenopausal women, which found that women deficient in this vitamin were more likely to suffer from urinary tract infections. The study compared the vitamin D levels of women with recurrent infections with those of women who did not experience such episodes, and found significantly lower vitamin D levels in the former group (9.8 ng/ml compared to an average of 23 ng/ml).

vitamin A contributes to the normal function of the (bladder) mucosa.