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UTI

Does Cranberry Really Work for Urinary Tract Infections?

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cranberries and urinary tract infections
Photo courtesy of http://www.freeimages.com/profile/Keira

Pretty much everyone knows that you should drink cranberry juice for a urinary tract infection. But is this an old wives tale?

The quick answer is no—it is not an old wives tale. The research on the benefits of cranberry juice has been around for a long time. And actually, it is one of the sugars, D-mannose, that is present in cranberry juice, that does all the work.

A clarification is important here. We are talking about REAL cranberry juice, not the cocktail junk loaded with added sugars. If anything, this type of drink will promote urinary tract infections. In addition to helping with urinary tract infections, cranberries are loaded with antioxidants. Which brings us to this particular study. In it, researchers looked at the effects of a single dose of either a placebo drink, a cranberry leaf extract beverage (CLEB) or low calorie cranberry juice cocktail (LCJC). All participants were given one of the drinks one week apart. Here’s what they found:

  • The cranberry drink increase blood glutathione peroxidase activity (a marker of antioxidant protection).
  • The cranberry cocktail increased glutathione concentrations and superoxide dismutase activity (antioxidant activity).
  • Interestingly, within the first 3 hours of drinking either cranberry beverage there was a strong ability to block the attachment of the bacteria E. coli to the wall of the bladder.

Personally, I was surprised that the cranberry juice cocktail had similar protection as the real stuff, but it is what it is. Either way, I would still steer patients towards the use of the real stuff.

In case you’re not aware of what constitutes the “real stuff,” look for the most expensive cranberry juice you can find. And it’s going to be very, very sour. More than what the average person would enjoy drinking. This is why it is typically mixed with other juices or with added sugars.

In addition to cranberry juice (or the straight up D-mannose, which can be bought separately from places like Amazon), I also recommend probiotic douches, to make sure that the normal, protective bacterial flora is present in the vaginal vault to keep future infections at bay.

Lactulose may help prevent urinary tract infections – (11-01-01)

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Lactulose may help prevent urinary tract infections

This is an interesting editorial that really opens my eyes to something I’ve seen in practice. While I jump at the chance to recommend probiotics as a vaginal douche to help with UTIs or yeast infections, I have had patients whose irritation has resolved with oral probiotic use. This always surprised me; this article suggests that oral probiotics can lower the load of pathogenic bacteria reaching the stool and thereby lower risk of trans-location to the urinary tract. Interesting concept that may have answered this dilemma for me.

bmj.com Battle et al. 323 (7318): 936

Read entire article here

URINARY TRACT INFECTIONS CAN BE TREATED WITH DRUGS – (04-22-02)

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Lactobacillus Strains and Vaginal Ecology

Can’t help but to jump up and down over the common sense practicality of this research. Jane has normal flora in the vaginal vault that protect her from other bad infections. Jane takes antibiotics and kills off these protective bacteria. Jane now has yeast and E. coli that are no longer inhibited by the presence of the protective bacteria. Jane gets recurrent yeast infections and urinary tract infections treated with drugs. Jane could easily eliminate any future problem by reinnoculating herself with the protective bacteria. Sound simple?? Apparently not because this concept is virtually unheard of in OB/GYN and urologist circles.

Lactobacillus Strains and Vaginal Ecology –

Read entire article here

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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