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If you are one of the millions of women who have suffered from a painful urinary tract infection, a common cause of cystitis, make sure you have green tea in your kitchen cabinet. Science has yielded proof that this delicious drink can help you heal faster and ensure that the antibiotics are effective
A frequently prescribed antibiotic combination, trimethoprim-sulfamethoxazole, is used to treat many types of infection, including bronchitis, middle ear infections and cystitis, a common infection of the bladder.[i] Sold under the brand names Bactrim®, Bactrim BS® and Sulfatrim Pediatric®, these antibiotics, jointly called co-trimoxazole, have proven effective against E. coli, the bacteria responsible for up to 95% of cystitis infections.[ii]
But the overuse of antibiotics worldwide has caused many bacterial strains, including E. coli, to become increasingly drug-resistant, prompting scientists to explore the use of anti-microbial herbs in combination with antibiotics in order to boost their efficacy.
Study Offers Hope in Green Tea as Aid to Cystitis Sufferers
These synergistic effects were explored by researchers at Kerman University of Medical Sciences in Kerman, Iran, in a pioneering clinical trial investigating green tea as an adjunct therapy for treatment of cystitis in women.
In this triple-blind, randomized trial, researchers selected 35 patients from a sample group of healthy, premenopausal, non-pregnant adult women between 18 and 50 years of age with acute uncomplicated cystitis.
Women with complicating factors such as diabetes, discharge or vaginitis, as well as regular green tea drinkers were excluded from consideration. Researchers hypothesized that the response rate to co-trimoxazole would be around 50%, and that this rate would rise to around 80% by adding green tea to patients' daily intake.
To test their hypothesis, 107 patients were allocated into one of two groups, experimental or placebo (control). Participants were assigned to receive four 500-milligram (mg) capsules of green tea in the experimental group, while the control group received the same number of starch-only capsules with identical shape, color and packaging.
Both groups were dosed daily for a period of three days, while also receiving the standard course of antibiotic treatment: two 480-mg tablets of co-trimoxazole twice daily for three days.
Green Tea Has Powerful Antimicrobial Effects
Green tea is known for powerful healing properties, including the ability to fight viral infections and prevent periodontal disease. In prior studies on the antimicrobial effect of green tea for UTIs, it has been noted that effectiveness is enhanced when green tea is administered before bed due to the retention of therapeutic catechins in the bladder overnight.[iv]
Study authors noted that more than 90% of the antimicrobial agents in green tea are excreted in the first eight hours after ingestion, therefore the patients received their capsules in the evening during the study period.[v]
The presence of acute uncomplicated cystitis symptoms was recorded via urinalysis at baseline and also on the fourth day at the end of the study period. Patients were screened for symptoms during the three-day trial via phone consultation.
Patients whose symptoms were not resolved on the fourth day were referred to physicians for further treatment, and patients were asked to return to the clinic at two, four and six weeks post-commencement for physician assessment of the symptoms of recurrent uncomplicated cystitis.
Green Tea Helps Women Treat Uncomplicated Cystitis
Of the 107 eligible participants, 70 women completed the trial. Women in the green tea group showed a statistically significant decrease in the prevalence of cystitis symptoms at each time point after initiating treatment in comparison with the placebo group.
Meanwhile, the addition of the green tea resulted in a statistically significant improvement in urinalysis results (abnormal urine color, the presence of pus and bacteria in the urine), with the exception of blood in the urine (hematuria), after three days of treatment.
Regarding side effects of treatment, seven patients in the placebo group and six in the green tea group reported mild nausea that was resolved within two days. There was no statistically significant difference in the incidence of nausea between the two groups. No other significant side effects were reported.
In the placebo group, 63% of the patients remained symptomatic, 37.1% had bacteriuria and 57.1% had pyuria on urinalysis after three days of co-trimoxazole therapy, suggesting that there is a high prevalence of co-trimoxazole resistance among E. coli strains in the urinary tract for individuals in this geographic region (Kerman, Iran).
Previous in vitro studies in Iran have reported that more than 47% of the E. coli isolates from patients with UTIs were resistant to cotrimoxazole.[vi], [vii] However, in the green tea group, almost all the patients responded to the treatment.
If the response rates were related to the synergistic effects of green tea catechins, it suggests that adding green tea to co-trimoxazole therapy could be a way to decrease and control the rates of co-trimoxazole resistance among uropathogenic E. coli strains.[viii]
In their final analysis, researchers concluded that green tea was an effective adjunct to trimethoprim-sulfamethoxazole therapy for treating acute uncomplicated cystitis in women. They concluded that this result could be related to antibacterial effects of green tea catechins and its synergistic effects when taken in conjunction with standard antibiotic treatment.[ix]
Cystitis: A Common Infection for Women
Common or "uncomplicated" cystitis is a bacterial infection of the bladder that is the most prevalent type of urinary tract infection (UTI) in women,[x] spurring more than 6 million trips to the doctor every year in the U.S.[xi]
Cystitis is typically caused when E. coli bacteria enter the bladder through the urethra, although other types of bacteria can also cause cystitis.[xii] Cystitis can occur as a reaction to certain drugs or radiation treatment, or in response to irritants such as feminine hygiene sprays and spermicides.[xiii]
Health factors like having a blocked bladder or loss of bowel control create conditions where bacteria are more prevalent around the urethra. These bacteria move up the urethra and into the bladder causing cystitis, which is why illnesses requiring the use of a urinary catheter increase the likelihood of developing a UTI.[xiv]
Women generally become more susceptible to cystitis if they are older, pregnant, diabetic or confined to bed rest for long periods of time.[xv]
Signs You May Have Cystitis
Discomfort while urinating is typically the first sign of a cystitis infection. The sensation of painful, urgent or more frequent urination may accompany a sensation of bladder fullness or lower abdominal discomfort. The region around the pubic bones may become more sensitive. You may also have a low-grade fever and may even detect blood in your urine.
During the more than 6 million visits to physicians that women make each year seeking treatment for UTI, diagnostic measures generally include asking the patient to urinate into a cup for a leukocyte esterase dipstick urinalysis, aimed at detecting white blood cells in the urine, showing that infection is present. Doctors may also take a bacterial culture. Diagnostic imaging is not indicated in the diagnosis of cystitis.[xvi]
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[i] Drugs.com, Treatment options, Urinary tract infection, https://www.drugs.com/mtm/sulfamethoxazole-and-trimethoprim.html
[ii] Uncomplicated Urinary Tract Infection, Hooton, Thomas M., N Engl J Med 2012; 366:1028-1037, DOI: 10.1056/NEJMcp1104429, https://www.nejm.org/doi/full/10.1056/NEJMcp1104429
[iii] Green tea as an adjunctive therapy for treatment of acute uncomplicated cystitis in women: A randomized clinical trial. Kheirabadi Z, Mehrabani M, Sarafzadeh F, Dabaghzadeh F, Ahmadinia N. Complement Ther Clin Pract. 2019 Feb;34:13-16. doi: 10.1016/j.ctcp.2018.10.018. PMID: 30712716
[v] Green tea as an adjunctive therapy for treatment of acute uncomplicated cystitis in women: A randomized clinical trial. Kheirabadi Z, Mehrabani M, Sarafzadeh F, Dabaghzadeh F, Ahmadinia N. Complement Ther Clin Pract. 2019 Feb;34:13-16. doi: 10.1016/j.ctcp.2018.10.018. PMID: 30712716
[viii] Green tea as an adjunctive therapy for treatment of acute uncomplicated cystitis in women: A randomized clinical trial. Kheirabadi Z, Mehrabani M, Sarafzadeh F, Dabaghzadeh F, Ahmadinia N. Complement Ther Clin Pract. 2019 Feb;34:13-16. doi: 10.1016/j.ctcp.2018.10.018. PMID: 30712716
[ix] Green tea as an adjunctive therapy for treatment of acute uncomplicated cystitis in women: A randomized clinical trial. Kheirabadi Z, Mehrabani M, Sarafzadeh F, Dabaghzadeh F, Ahmadinia N. Complement Ther Clin Pract. 2019 Feb;34:13-16. doi: 10.1016/j.ctcp.2018.10.018. PMID: 30712716
[x] University of Rochester Medical Center, Urology, Adult Patients, Interstitial Cystitis, https://www.urmc.rochester.edu/urology/adult-patients/interstitial-cystitis.aspx
[xi] Medscape, Drugs & Diseases, Infections Diseases, Urinary Tract Infection (UTI) and Cystitis (Bladder Infection) in Females, https://emedicine.medscape.com/article/233101-overview
[xiii] Mayo Clinic, Patient Care & Health Information, Diseases & Conditions, Cystitis, https://www.mayoclinic.org/diseases-conditions/cystitis/symptoms-causes/syc-20371306
[xvi] Medscape, Drugs & Diseases, Infectious Diseases, Urinary Tract Infection (UTI) and Cystitis (Bladder Infection) in Females, https://emedicine.medscape.com/article/233101-overview