The urinary tract includes the kidneys, bladder, ureters (the tubes that connect the kidney to the bladder), and urethra (the tube that leads from the bladder to the outside).  Urinary tract infections (UTI's) are caused by bacteria which usually originate in the urethra before moving backward into the bladder where they can then grow and flourish.  The main symptoms of UTI’s are urinary urgings, frequent urination, pain or burning during urination, and cloudiness or blood in the urine.  Some patients may experience low back pain (often radiating upward), dizziness, and nausea. 

Urinary tract infections occur more frequently in women than in men.  The infections can be divided into three categories/types. 

• Urethritis is an infection of the urethra.  This is a viral infection usually transmitted during intercourse. 

• Cystitis is infection of the urinary bladder. 

• Pyelonephritis, or kidney infection, occurs when the bacteria in the bladder migrate to the kidneys, and is much more serious than the other two types of UTI.  In these cases it is important to see a doctor or medically trained herbalist immediately.
 
To prevent UTI's, women should wash the perineal area daily with a mild unscented soap, and change tampons and sanitary napkins frequently.  After using the toilet, wipe from front to back to keep bacteria away from the urethra.  In addition, wash the hands and genitals before and after sexual intercourse, and use lubricants to avoid bruising the urethra.  Avoid wearing tight clothing, which can increase heat.  Drink plenty of pure water each day.

I also advise patients who suffer from frequent UTI's to make a solution of 5 drops of grapefruit seed extract (not grapeseed extract) in 4-6 ounces of water, with which both partners should wash their genitals before and after sexual intercourse.  Regular use of probiotics containing L.  acidophilus may also be a valuable preventive measure.  With any infections that occur from the mouth all the way down to the colon and urinary system, it is important to reduce intake of sugars so the bacteria don’t decide to have a party and invite their friends.

As far back as the early 1800's, Europeans noticed that drinking cranberry juice was beneficial for preventing and treating UTI's.  Scientists have recently identified the source of this benefit.  Cranberries contain a natural chemical that weakens the ability of the bacteria to attach to the urinary tract (Avorn et al., 1994).  However, it requires a very high level of this chemical to obtain a strong beneficial effect, so it is usually best to buy the concentrated pills now available in health food stores.  Interestingly, TCM doctors often add talcum to their formulas as well because it is slippery and reduces heat.  One might wonder if the heat is reduced because the infectious organisms also find it slippery.

We treat UTI's in our clinic with a combination of the following two strategies.  (We always administer the herbal treatments as teas or tinctures.)

1. Choose three or four strong anti-inflammatory and antiseptic herbs to reduce heat and infection, especially those with diuretic properties, such as guduchi stem, phellodendron root, dandelion leaf, yin chen hao (Artemisia capillaris), varuna (Crataeva species), buchu leaf (Barosma betulina), uva ursi leaf (Arctostaphylos uva-ursi), and cleavers herb (Galium aparine).  This should comprise about 70% of your formula.

2. Use herbs that soothe and coat the urinary tract, such as talcum, slippery elm bark, and marshmallow root.  This should comprise the remaining 30% of your formula, or can be administered separately as powders or cold water infusions.

Research Highlights

A clinical trial in India looked at the Ayurvedic herb varuna as a UTI treatment.  Of the 84 cases studied, patients with urinary tract infections accompanied by painful, burning urination experienced a cure rate of 55%, along with 40% improvement and 5% failure rates (Pramod, 1982).  An additional study resulted in an 85% improvement rate (Deshpande et al., 1982).  This herb also increases bladder tone (Bone, 1996). More on Ayurvedic treatment of urinary disorders.