Conditions, Cystitis

UTI First Aid: Flushing and Alkalizing, does it make sense?

Pharmacies usually sell ‘cystitis relief’ products designed to serve as a first aid for urinary tract infections. These preparations are designed to alkalize the urine.

Moreover, flushing through increased fluid intake is usually recommended.

I have previously recommended doing this as it is the common advice for cystitis relief before taking antibiotics.

Some people may well have success with this approach but is it scientifically validated?




Ingredients of Common Cystitis Relief ‘Medication’

There are several preparations available over the counter at pharmacies.

Common ingredients are:

  • Sodium Citrate Dihydrate
  • Sucrose

Sodium citrate is the active ingredient that is an alkali and therefore can have an alkalizing effect on urine.

Sucrose is simply table sugar. But here’s the catch: bacteria feed on sugar and especially simple sugars are a preferred food for pathogenic bacteria.

Therefore, having sugar in an anti-cystitis preparation makes no sense!

The Idea behind Cystitis Relief Recommendations

The idea behind this method is that urinary pathogens thrive in a more acidic environment and that therefore alkalizing (or raising the pH of) the urine with alkali such as sodium citrate or bicarbonate of soda can hinder the pathogens from growing.

Increased intake of fluids could then ‘flush out’ the bacteria.

Moreover, alkalizing the urine could help to relief the burning sensation usually associated with urinary tract infections (this claim is probably validated).

However, I could find no support for these recommendations in the scientific literature.

About Urinary pH

Urinary pH can vary from 4.5 – 8, depending on an individual diet. Generally, normal urinary pH is slightly acidic at around 5.5 to 6.5 [1].

According to some people, urinary pathogens thrive in an alkaline environment. However, that is not true.

In the gut or vagina for example, it is well established that acid-forming bacteria are ‘friendly’ (such as Lactobacilli). This is why fermented foods such as yoghurt turn sour and also why vinegar is used for pickling – acidity makes it impossible for pathogens to survive, keeping food preserved for longer periods of time.

In urine, the presence of pathogens raises the pH to a more alkaline value. Urinary pathogens have also been shown to produce more biofilms in a more alkaline pH [2, 3, 4].

Therefore, alkalizing the urine doesn’t really make any sense and could theoretically even make it easier for the pathogens to form biofilms and survive in the bladder.

What about flushing the bacteria out of the bladder?

Pathogens are glued to the calls of the bladder wall and cannot be washed away (unless their adherence is inhibited).

Moreover, urine contains natural anti-infection chemicals that will be diluted. Any antibiotic taken will also be diluted [5, 6].

Tests may be negative after following a ‘flushing regime’ but this is only because they are even less likely to pick up the now diluted pathogens.

Therefore, trying to flush away an infection with increased fluid intake does not make much sense and may even be counterproductive.

Conclusion

I’d be vary of these recommendations as they do not make sense. But I am open to hearing otherwise. I know some people have had relief with them and some ‘experts’ highly recommend this ‘first aid’ procedure.

In my opinion however, it could increase the risk of chronic infections by allowing bacteria to stay and take hold in the bladder.

Instead, infections should be erased promptly, whether in an orthodox or more natural way.

I have no personal experience with this method therefore I’d be interested in hearing others!

Please let me know your opinions and experiences in the comments!



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Sources

Boots CanesOasis Cystitis Relief Cranberry Flavour Oral Solution – 6 Sachets http://www.boots.com/canesoasis-cystitis-relief-cranberry-flavour-oral-solution-6-sachets-10181666

Boots Boots Pharmaceuticals Cystitis Relief Cranberry Flavour- 6 Sachets http://www.boots.com/boots-pharmaceuticals-cystitis-relief-cranberry-flavour-6-sachets

  1. Jeff A. Simerville, John J. Pahira Urinalysis: a comprehensive review March 15, 2005 http://www.drplace.com/Urinalysis_a_comprehensive_review.16.30279.htm
  2. HEDELIN, H., BRATT, C.-G., ECKERDAL, G. and LINCOLN, K. (1991), Relationship between Urease-producing Bacteria, Urinary pH and Encrustation on Indwelling Urinary Catheters. British Journal of Urology, 67: 527–531.
  3. Goodson, M. and Rowbury, R.J. (1989), Habituation to normally lethal acidity by prior growth of Escherichia coli at a sub-lethal acid pH value. Letters in Applied Microbiology, 8: 77–79
  4. Choong et al Catheter associated urinary tract infection and encrustation International Journal of Antimicrobial Agents Volume 17, Issue 4, April 2001, Pages 305-310
  5. Bladder Action UK How cUTI Forms 2007 http://www.bladderaction.org/about-cuti/how-cuti-forms/
  6. Malone-Lee, James. “How poor NHS testing and antibiotic use is creating super-strength cystitis.” Podiatry Review, vol. 73, no. 6, 2016, p. 26+. Academic OneFile, Accessed 24 Aug. 2017.

 

6 Comments

  • Reply

    Laura

    September 4, 2017

    You’ve said what doesn’t work but what does work??

    • Reply

      Layla

      September 7, 2017

      Good point! Fortunately I don’t suffer from UTIs anymore so it’s not something I can or have tested on myself. However, it would make sense to me to use a natural antimicrobial such as Lauricidin, plus something that prevents pathogens from adhering in the bladder (such as cranberry PACs or D-Mannose) and the n friendly bacteria to help balance the urinary microbiome (I have posts on all of these).

  • Reply

    Laura

    September 7, 2017

    Hi again, Layla! I tried “alkalinizing” my urine with different products and this never worked. As I said in an earlier email, it was getting hormones balanced that did the trick, most likely adding DHEA supplements. I take 10 mg daily now and can now tolerate all citrus (including lemons and limes), tomatoes, and vinegar. Before, just a little bit of any of these would usually have me urinating every 2 hours during the night. I am delighted to be free of the pain and frequency of urination. I enjoy your posts!

    • Reply

      Layla

      September 8, 2017

      Thanks for sharing, Laura! I’ll have to dig in deeper into DHEA. I think I have it listed as a supplement for IC but I’d be interested to know more details.

  • Reply

    Sheryl Chan

    September 8, 2017

    This is interesting. I read that cranberry pills help, but only before and not after you’ve already contracted a UTI, due to the adherence on cell walls as you mentioned. I personally found it did nothing for me regardless. I suppose the alkalising just helps with the pain while taking antibiotics (cos nothing else eases the acute pain when in the midst of a UTI for me!).

    • Reply

      Layla

      September 8, 2017

      You’re right (I do have an article on cranberry as well). I believe cranberry has mainly been found to be helpful for E. Coli infections so if a different bacteria is causing the trouble it may not do much at all. Interesting to hear that the alkalizing helps your pain, I guess the acid urine can be quite irritating if there’s inflammation present.

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