Two views: How to treat bladder infections

TRADITIONAL: Dr. Lynn Stothers, director of research at the University of British Columbia Bladder Care Centre

If a woman is suffering from a urinary tract infection (UTI), I prescribe antibiotics for one to three days. That cures the infection 90 percent of the time. (In some cases, a longer run of antibiotics may be necessary.) UTIs are caused by an invasion of bacteria, most commonly E. coli.

Antibiotics reduce bacteria, relieving painful symptoms, often within hours, and ultimately curing the infection. For prevention, I probably think like a naturopath. Women should maintain good hygiene by showering daily, avoiding irritating chemicals and urinating before and after intercourse to flush out bacteria.

Drinking pure cranberry juice may also aid prevention; the juice contains high levels of a compound called anthocyanin. In a study I did in 2002, published in the Canadian Journal of Urology, 150 women drank 250 mL of juice three times a day or took cranberry tablets twice a day, which reduced the frequency of UTIs by a third. I’m currently involved in a long-term study for the U.S. National Institutes of Health to figure out how much cranberry juice women should drink to prevent UTIs. In other studies, patients who drank between 59 and 240 mL of juice once or twice a day were generally successful at preventing UTIs.

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ALTERNATIVE: Patricia J. Wales, naturopath in Calgary

For 25 years, I recommended an alkaline wash of the urinary tract: Drink a teaspoon of baking soda sweetened with apple juice, followed by two cups of water every 20 minutes for an hour. Repeat three or four times. The alkalinity and volume of the water helps flush bacteria from the bladder and urinary tract and stem bacteria growth.

Recently, I’ve recommended adding a teaspoon of a sugar called mannose, available at health-food stores, to water and drinking every three or four hours. If a patient doesn’t feel better within 24 hours, she should try antibiotics; some infections are too advanced to treat any other way.

But if you could avoid antibiotics, why wouldn’t you? They depopulate the gut of good bacteria and can cause gas, diarrhea and poor digestion. Once the infection is gone, it’s time to consider why you got it. If you routinely have UTIs, avoid perfumed soap, wear cotton underwear and pee after sex, to get rid of bacteria that may have been pushed up there. Don’t wear tight jeans or pantyhose. Many women don’t go to the bathroom enough, but we should be urinating every two to three hours. Drinking cranberry juice can also be preventive. Choose unsweetened brands or those sweetened with apple juice instead of with extra sugar.