Despite the fact that the efficacy of many herbal remedies in the treatment and prevention of disease has not yet been demonstrated scientifically, herbal medicine continues to gain adherents among both consumers and health care providers, and some major insurance companies now cover the cost of herbs recommended by licensed health practitioners. Although they can be purchased without prescription, herbal remedies may be contraindicated for a variety of reasons; therefore, before initiating any complementary herbal therapy, patients should discuss their intention to do so---as they would any change in their medical regimen---with their primary care providers. For more information on herbal medicine, visit the National Center for complementary and Alternative Medicine online at http://www.nlm.nih.gov/medlineplus/herbalmedicine.html .

The herbs listed below have been used for the prevention and complementary treatment of urinary tract infection (UTI). These remedies are relatively free of side effects: however, as pertains to any treatment, nurses should read the most recent relevant research and be familiar with proper applications and dosages as well as any possible side effects and necessary precautions before they recommend or administer them.

German Chamomile Used topically, preparations made from this common plant are said to have natural anti-inflammatory and antibiotic effects that promote tissue healing. The main active compounds are flavonoids and volatile oils. Ointments and gels are available: it may also be use in poultice form to treat anogenital tissue inflamed by UTI.

Cranberry Juice The Cochrane Database System Review examined all randomized and quasi-randomized studies on the efficacy of cranberry juice in preventing UTI in susceptible men, women, and children and found a “small number of poor quality trials.” The authors said that there is no conclusive evidence for recommending cranberry juice for preventing UTI.

Other studies have shown that cranberries contain compounds that prevent Escherichia coli from adhering to uroepithelia cells, causing the bacteria to be flushed and preventing their colonization. Substances in cranberry juice may also weaken the attachment of E. coli to urinary catheters. Another potential benefit may be a reduction in the need for antibiotic therapy. Cranberry is also available as an extract, in tablets and capsules. In one study reported by the Journal of the American Medical Association, 72 postmenopausal women who drank 10 oz. of cranberry juice a day for six months were 58% less likely to develop UTI than were women who drank a placebo with the same amount of vitamin C.

Bearberry Leaf Commonly called uva-ursi, this herb is available in powder or dried extract from for infusions or cold macerations and as extracts and in solid forms for oral administration. Its disinfectant properties work systemically to decrease inflammation and irritation of the urinary tract. It works best in an alkaline environment and should not be used in combination with acidic foods such as cranberry juice or medications that increase uric acid levels in the bladder.

Echinacea Purpurea There are several varieties of Echinacea, each with its own medicinal properties. Little is known about the mechanism of action of the various compounds that have been identified in the plant, although it appears that they primarily affect the phagocytic immune system, not the acquired immune system. The fresh, above-ground parts of Echinacea purpurea, harvested at flowering, are known as Echinacea purpurea herb and are used internally as complementary therapy for lower urinary infections as well as for colds and chronic respiratory infections. When taken orally or parenterally, it acts as an immunostimulant; hence its beneficial effects in the treatment of infections. Some of the effects include an increase of the number of white blood cells and spleen cells, activation of the capacity for phagocytosis by human granulocytes, elevations in body temperature, reproduction of T-helper cells and the production of cytokines such as interleukin-1. Until recently, most of the studies on Echinacea had been conducted in Germany; the plant is now being studied intensively in the United States.

Herb manufacturers, unlike drug companies, are not required to conduct controlled studies to prove the safety and effectiveness of their products. The result, unfortunately, is a great deal of promotion of herbal products that is unfounded and misleading. In the absence of general standards of quality, herbal preparations should be obtained only from well know suppliers.

Toni Gilbert, Transpersonal Counselor and holistic nurse, Jefferson, OR

References

1. Medical Economics Company. PDR for Herbal Medicines. Montvale (NJ); Medical Economics; 1998.
2. Jepson, RG, et al. Cranberries for preventing urinary tract infections. Cochrane Database Syst. Rev 2001; 3: CD001321.
3. Robbers JE, Tyler VE. Tyler’s herbs of choice: the therapeutic use of phytomedicinals. New York: Haworth Herbal Press; 2000.
4. Menopause: its not just hot flashes. Dr. Andrew Weil’s self-healing 2001 Sep: 4-5.
5. Percival SS. Use of Echinacea in medicine. Biochem Pharmacol 2000; 60 (2): 155-8.