Inflammation of the bladder

Worldwide, there are approximately 150 million cases of cystitis each year. 25-30% of women experience at least one cystitis in their lifetime. The infection is primarily caused by E. coli bacteria (Escheria coli), which are transmitted through the intestines.

Due to their shorter urinary tract, women are at higher risk. If the mucous membranes of the vaginal opening are colonized by coliform 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, they attract the immune system's white blood cells, and symptoms of cystitis occur.
If the infection is not treated, in about 5% of cases the bacteria penetrate the renal pelvis via the urethra and cause pyelonephritis.

Antibiotics are effective in the treatment of inflammation of the bladder i.d.R. effective, but have some side effects and there is v.a. the risk of developing resistance. Furthermore, antibiotics do not treat the underlying cause, such as a weak immune system.

The great advantage of naturopathic approaches is that, when implemented consistently, they are at least as effective as antibiotics. The key difference is that they have no negative side effects and simultaneously strengthen the immune system, thus contributing to causal rather than merely symptomatic treatment. Re-infection is therefore significantly less likely to occur. However, after antibiotic therapy, there is a risk that the now-affected intestinal flora will weaken the immune system, often leading to fungal infections (intestinal thrush and/or vaginal yeast infection) and, not infrequently, to another bladder infection very soon afterward.

Studies on the use of micronutrients as an alternative to antibiotic therapy

D-Mannose Can help with urinary tract infections and cystitis and often replaces antibiotics with frequent side effects. D-mannose is a type of sugar related to glucose, but is barely metabolized in the body. Instead, D-mannose is excreted in the urine. On its way through the bladder, D-mannose binds to the bacteria that cause urinary tract infections and cystitis. Bound to D-mannose, the bacteria can no longer adhere to the bladder wall (see 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 recurrent urinary tract infections in the past were divided into three groups after standard antibiotic treatment:

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 did not take any prophylactic measures and thus served as the control group.A total of 98 of the women experienced a recurrence of cystitis during the study period, 62 of whom were in the control group. 21 women in the antibiotic group experienced a recurrence of cystitis, compared to only 15 in the D-mannose group. The researchers concluded their study by stating that D-mannose is very effective in preventing urinary tract infections and cystitis – especially for people who suffer from recurring cystitis.

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

To answer the question of whether herbal remedies help with recurring uncomplicated cystitis, the IQWiG The scientific team commissioned by the company selected 15 suitable studies. Most of the included studies 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 urinary tract infections and the time until the first recurrence (relapse). In terms of preventing recurrences, there is evidence for a preparation containing lovage root, rosemary leaves, and centaury, in addition to cranberry preparations. Additional benefits, 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 tract 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 This showed u.a., that only the combination of the mustard oils of both plants achieves a particularly strong effect against many different types of bacteria. In addition to a direct growth-inhibiting and germicidal effect Mustard oils also have an effect on bacterial biofilm formation and the penetration of bacteria into the cells of the bladder lining (internalization). According to current knowledge, these are essential mechanisms, especially with regard to recurrent cystitis. Furthermore, mustard oils interfere with the signaling pathways relevant to inflammation, thus contributing to the relief of the often very painful symptoms of cystitis.

The amino acid L-Methionine has a Urine acidifying effect: The body needs approximately 0.5 g of methionine per day to maintain muscle mass. If you consume more than 1.5 g per day, the body must break down the excess. This breakdown produces sulfate, which is excreted via the kidneys. Protons are secreted into the urine, thus acidifying it.

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 bacterial growth.In addition inhibits Methionine the 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, as is often assumed, found in the popular pumpkin seed oil, but rather exclusively in the shell of the pumpkin seeds.

Pumpkin seeds are indicated for strengthening and toning bladder function, as well as for the treatment of 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 specific phytosterols, nonspecific components such as unsaturated fatty acids, certain amino acids, vitamins, minerals, and trace elements may also contribute to the therapeutic effects of pumpkin seeds.

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

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

The rosemary ingredients contained are u.a. essential oils, tannins, flavonoids, bitter substances, and resins. In folk medicine, rosemary is used primarily to stimulate bile and urine flow, 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 treatments for cystitis, kidney problems, and urinary stones. For example, the essential oils contained in lovage promote u.a. the excretion of urine via the kidneys – they have a diuretic effect, as the medical term is. This means that the urinary tract is flushed more thoroughly. This indirectly makes it more difficult for bacteria to adhere to the mucous membranes and they are flushed out with the urine.

A clinical study (cf. Wagenlehner, F.M. 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 women in the herbal preparation group did not require additional antibiotics. In terms of time to onset and symptom reduction, both treatment strategies were equivalent. And compared to antibiotic therapy, fewer gastrointestinal complaints were observed with the triple 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 similar mechanism to that of D-mannose) and stimulating the immune response. This is confirmed by a study in postmenopausal women, which found that women deficient in this vitamin suffer more frequently 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.