On behalf of the Institute for Quality and Efficiency in Health Care (IQWiG), a scientific team under the leadership of “Gesundheit Österreich GmbH” in Vienna investigated the question of whether herbal remedies help with recurrent cystitis.
The results show that the preventive use of cranberry preparations can prevent or delay the recurrence of uncomplicated cystitis (recurrences).
To answer the question of whether herbal remedies help with recurrent uncomplicated cystitis, the scientific team commissioned by IQWiG identified 15 suitable studies, although their bias potential is mostly classified as high, In uncomplicated cystitis, the mucous membrane of the bladder becomes inflamed. The inflammation is usually caused by bacteria that ascend into the bladder via the urethra and multiply there. Urinary tract inflammation is much more common in women than in men. Typical symptoms include a painful, frequent or uncontrollable urge to urinate, pain when urinating and pain above the pubic bone. If there are two or more symptomatic episodes per six months or three or more episodes within a year, this is referred to as recurrent or “recurrent” cystitis. Treatment options for cystitis include both antibiotic and non-antibiotic therapies such as various herbal remedies. Antibiotics help with acute cystitis quite quickly and shorten the duration of the illness. However, they are not always necessary; uncomplicated cystitis heals within a week in 30 to 50 out of 100 women even without antibiotics. The herbal remedies used are made from cranberry, bearberry leaves, nasturtium herb or horseradish root, among others. They are said to have a germ-inhibiting, anti-inflammatory or diuretic effect and thus shorten the duration of acute cystitis or prevent its recurrence. Most of the included studies investigated preparations containing cranberry. There is an indication of a benefit of cranberry compared to placebo – both in terms of the recurrence rate of the urinary tract infection and the time until the first recurrence (relapse). “The HTA report comprehensively summarizes the results on the benefits of herbal preparations in the prevention and treatment of recurrent cystitis and shows that cranberry preparations in particular can play a role in the prevention of recurrence in women with uncomplicated recurrent cystitis,” IQWiG comments in the editorial comment on the report. “If the use of certain herbal preparations could also contribute to a reduced use of antibiotics – both in the treatment of acute cystitis and in prevention – and thus to a reduction in antibiotic resistance, this would be welcome.”