LifeCare Chiropractic

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d-mannose

Dietary factors protecting women from urinary tract infection – (03-04-03)

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Dietary factors protecting women from urinary tract infection.

This article finds that dietary habits can have an impact on UTIs in women. Cranberry juice has been used for UTIs and it is believed that D-mannose, the sugar present in the juice, prevents bacteria such as E. coli from adhering to the wall of the urinary tract and bladder. Probiotic supplementation has also helped with many patients in my office. I usually recommend douches; however, patients have reported benefits even with oral use (it is believed to positively affect the flora of the GI tract and thus lower cross contamination). It is refreshing to see a study supporting something other than recurrent antibiotic scripts (leading to yeast infections and more scripts…). Which, if you think about it (and hopefully you will…) antibiotics kill off one of the substances that were shown to protect against UTIs. Hmmm…

AJCN — Abstracts: Kontiokari et al. 77 (3): 600

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Cranberry Juice and Adhesion of Antibiotic-Resistant Uropathogens – (07-01-02)

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Cranberry Juice and Adhesion of Antibiotic-Resistant Uropathogens

The results of this study are really quite amazing. Use of cranberry juice in this study changed anti-adherence of E. coli from 0% up to 80%. A quick comment, however…this article denotes that cranberry juice “cocktail” was used. This generally refers to the sugar-added version, not the natural stuff.

If this is the case in this study, it is likely that the actual juice may have been even more effective. Keep in mind that it is actually the D-mannose in the juice that is absorbed, passes through to the urine and binds the fimbrae on the pathogenic bacteria, thus preventing the bacteria from attaching to the cells of our urinary system. Couple this therapy with probiotic deuches and I’m sure that the use of antibiotics for UTIs would become a rare therapy.

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CRANBERRY VS ANTIBIOTICS FOR UTI

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Cranberries are one of those natural remedies that come to mind first thing when someone mentions urinary tract infections.  Usually, when a recommendation like cranberries for UTIs has passed the test of time, it’s because there is validity to the claim.

So, we can accept that cranberries are good for UTIs, but are they being used in the most effective manner?  This particular study put cranberry capsules head to head with an antibiotic regimen for a year in women who suffered with recurrent UTIs.

The results were that the antibiotics were more effective, but within a single month antibiotic resistance was beginning to develop.  Keep in mind that the cranberry was effective, just not quite as effective as the antibiotics by a few percentage points.

Now for the important things to consider.  First, I am not a fan of using supplements vs the actual juice.  Then, it needs to be the real stuff, not the cocktail, sugar laden junk that many buy thinking it’s going to help with their UTIs.  I will usually tell patients to down a jar in a day for the strongest effects.

Even better is a two step approach.  First, it is actually a non-metabolized sugar called d-mannose that is believed to do the work of the cranberries.  So our bodies absorb it, but most of the d-mannose shows up in the urine and has no effect on blood sugar. 

E. coli is the most common agent causing UTIs and creates problems when the pili attach to the lining of our urinary tract.   When d-mannose is present, however, the E. coli attach to the d-mannose instead of your urinary tract and subsequently gets washed away.  So using the d-mannose directly instead of the cranberry juice can be far more effective in managing chronic UTIs. 

The other step involves making sure that E. coli does not make it to the opening of the urinary tract (the urethra) in the first place.  In a normal female who has never been on antibiotics will have plenty of healthy bacterial flora present to constantly secrete low levels of lactic acid, thus keeping the E. coli from the urethra in the first place. 

Ironically, antibiotics may actually increase the risk for UTIs by destroying this normal flora, making it easier for E. coli to make it to the urethra.  So, the second step is actually using probiotic douches (preferably with distilled water, if not, then vinegar is ok) daily for a week.

The combination of the d-mannose and probiotic douches will be far more effective than the cranberry juice alone.  So, if this study finds that antibiotics are only a little better than cranberry juice, I’d love to see this 2 step approach go head to head with antibiotics.

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