SUFFERING FROM A
URINARY TRACT INFECTION?
If you’re a sufferer of cystitis or other urinary tract infection (usually abbreviated to UTI), you’re not alone. It's been estimated that more than 50% of women will suffer with some kind of bladder infection at some time during their life. Sadly, many will experience repeated attacks. UTIs are an incredibly common type of infection. Put
simply, a urinary tract infection happens when harmful bugs get into the
urethra (that's the 'peeing' pipe which connects the bladder to the outside world).
UTIs can occur in anyone at any age but women tend to be more prone than men. The reason? Anatomy. Not only is the female urethra shorter than in the male, the closeness of the urinary opening to the vaginal and anal exits gives bacteria easier and faster access to the bladder and, in the worse case scenario, onwards and upwards via the ureter tubes to the kidneys. Others at risk include diabetics, men with prostate problems, the elderly, people with poor (as well as over-zealous) genital hygiene and those who don’t drink enough fluids.
UTIs can occur in anyone at any age but women tend to be more prone than men. The reason? Anatomy. Not only is the female urethra shorter than in the male, the closeness of the urinary opening to the vaginal and anal exits gives bacteria easier and faster access to the bladder and, in the worse case scenario, onwards and upwards via the ureter tubes to the kidneys. Others at risk include diabetics, men with prostate problems, the elderly, people with poor (as well as over-zealous) genital hygiene and those who don’t drink enough fluids.
What causes UTIs?First and foremost, bacteria. Anything that disturbs the natural bacterial balance (think antibiotics and other medicines such as steroids, anti-ulcer drugs and spermicides, having not-so-good health, horrible hormones, excessive stress) can also make picking up a water infection all too easy. And they can be a real nuisance to those with nervous system disorders, and anyone with restricted movement such as someone confined to a wheelchair or long term bed rest.
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IMPORTANT NOTEIn elderly people who suffer UTIs, problems with balance and unsteadiness on the feet are common. This is worth knowing because it’s a symptom often missed or simply associated with ageing. Given that there has long been concern about the repeated or excessive use of antibiotics in older people, it’s just as well to wait for test results before resorting to these drugs. If tests show that medical treatment is not necessary but symptoms still persist, then it's a good idea to check fluid intake which, in the elderly, is often found to be far too low.
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ANTIBIOTIC OVERKILL?
It used to be the case that most urinary tract infections could be dispatched relatively quickly and effectively with a course of antibiotics. Unfortunately, now that antibiotic resistance has become such a feature of our lives, standard treatment can sometimes be counter-productive, often requiring two different types of antibiotic at one time or several courses of antibiotics instead of one, as well as increasing the risk of another side effect - thrush. And even then, they might not work.
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WHEN TO SEEK HELP
When you go to your GP, which you really should do if you have any of the symptoms listed in this article, then it's very likely that you’ll be given a prescription for antibiotics. If you have a serious infection, this can sometimes be the only way to go. However, I always advise caution if the doctor is suggesting you take antibiotics BEFORE you have the results of a urine sample. This is because it is possible to get the same symptoms as those of a bladder infection but without any bacteria being present. This is sometimes referred to as non-bacterial cystitis. The big disadvantage with antibiotic treatment is that most of them are what we call broad-spectrum, in other words, they aren’t choosy about what they destroy, splatting every bit of bacteria including the good stuff that you want to keep. That's if they work. A bigger problem is the now very real danger of antibiotic resistance and the risk of picking up superbugs. Unfortunately, it's the over-use of antibiotics - originally the magic bullet designed to kill bacteria and therefore eradicate infection - which has allowed bacteria such as E.coli, Klebsiella and Proteus to become resistant, stronger if you like, and to mutate, and therefore able to survive standard medical treatment. There's more in my book Good Gut Bugs on this subject. In the meantime, my article on this website Why We Need Good Gut Bugs and the pages on Probiotics may be helpful.
ALTERNATIVES?
BE WELL INFORMED
If you suspect either a urinary (or vaginal infection), especially if you have pain, discharge or a repeatedly urgent need to empty the bladder, then please see your doctor or practice nurse as soon as possible. Don’t ignore symptoms. Untreated urine infections can lead to kidney damage and untreated Bacterial Vaginosis (BV) could increase the risk of more serious conditions such as pelvic inflammatory disease. But don’t accept antibiotics without vaginal swabs and/or urine tests being taken, otherwise you could end up with the wrong diagnosis and the wrong medication. There are several symptoms that can mimic infection but that don’t require antibiotics. Vaginal discharge might, indeed, mean BV which is an infection but it could also suggest thrush, which isn’t. Anti-fungal treatments don’t work against BV just as antibiotics don’t work to clear vaginal candida (thrush). Likewise, symptoms identical to those of a water infection might, as suggested above, be non-bacterial trigonitis, interstitial cystitis or an STD. A negative result may also indicate a viral condition or the presence of some kind of rarely seen bacteria. So it’s important to be sure that you don’t make matters worse by taking wrong or unnecessary prescription or over-the-counter drugs.
MOST LIKELY SYMPTOMS?
SYMPTOMS OF A URINARY TRACT INFECTION CAN INCLUDE:
Discoloured, dark, cloudy or foul-smelling urine (could be pink or red if there is blood in the urine) Pain in the groin or region of the pubic bone A feeling of heaviness or pressure in the lower abdomen The persistent sensation of needing to empty the bladder accompanied by pain and/or burning during urination Sweating and shivering Disturbed sleep; General lethargy and tiredness |
SYMPTOMS OF A KIDNEY INFECTION CAN INCLUDE:
Any or all of the symptoms relating to uncomplicated UTIs Back pain around about waistband level Pain in the side, the ribcage or in the lower abdomen Extreme tiredness High fever Nausea or vomiting Night sweats Under the circumstances of what we would call an uncomplicated UTI where the bacteria are only being troublesome in the bladder, there would not normally be any sign of fever. If there is fever, it can indicate that the infection has reached either the kidneys or, in men, the prostate. A fever may mean the infection has travelled as far as the kidneys or has penetrated the prostate. In any case, professional medical advice should be sought without delay. |
COULD IT BE KIDNEY STONES?
KIDNEY STONES are formed from crystals – most usually made up of calcium and another substance called oxalate – that build up in the urine. Small crystals may be passed unnoticed but, sometimes, they accumulate into one or more larger pieces which can not only irritate the kidneys but may also cause infection, damage or blockage. To give you some idea of how immobilising this can be, the pain caused by a kidney stone, especially if it's on the move, has very often been described as being akin to that of childbirth. Although larger stones will almost inevitably require some kind of surgical intervention, small ones may work their way out of the body without major incident. The best case scenario is to take preventive action to stop them occurring in the first place. For example, avoiding foods that are high in oxalate, such as spinach, rhubarb and wheat bran cereals, and drinking more fluid which dilutes the urine and reduces the risk of particles accumulating. There is also evidence that probiotic therapy can help against stone formation.
It's been discovered that people prone to calcium oxalate kidney stones tend to have lower levels of a particularly helpful bacteria called Oxalobacter formigenes which is involved in making an enzyme that breaks down the oxalates. Replacing O.formigenes isn't an option because it's not available as a supplement. However, other familiar and easily obtained probiotics, Bifidobacterium infantis, Bifidobacterium lactis and Lactobacillus acidophilus, could ride to the rescue because they, too, are able to manufacture the missing enzyme.
It's been discovered that people prone to calcium oxalate kidney stones tend to have lower levels of a particularly helpful bacteria called Oxalobacter formigenes which is involved in making an enzyme that breaks down the oxalates. Replacing O.formigenes isn't an option because it's not available as a supplement. However, other familiar and easily obtained probiotics, Bifidobacterium infantis, Bifidobacterium lactis and Lactobacillus acidophilus, could ride to the rescue because they, too, are able to manufacture the missing enzyme.
YOUR URINE TEST WAS NEGATIVE?Sometimes, you might go down with one or more of the symptoms in the lists above and yet find that your urine test came back negative (showing no bacteria present). If that happens, it could indicate:
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DON'T IGNORE THE SYMPTOMSUntreated bladder and urethra infections can progress to kidney infection such as polynephritis which is not only more difficult to eradicate but can also lead to kidney damage. Infection of the kidneys may also be the result of bacteria passing through the kidneys from the bloodstream or could be the result of kidney stones.
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DIET ACTION PLAN
- Incorporate probiotics drinks into your daily food plan (check the label for words such as Lactobacillus and Bifidus).
- Go for Fresh, unsweetened, plain bio-yoghurt every day. Better still, try Kefir. Avoid low fat yoghurt and any with added fruit flavourings, sugar and/or sweeteners.
- Make soup everyday by cooking a variety of vegetables and then pulping them in a blender. If cooking truly isn’t your thing, go for organic soups, available from most good supermarkets.
- Find out about fermented foods such as sauerkraut, kombucha, kefir, fermented bean curd, fermented bean paste, tempeh, kimchee and all kinds of fermented vegetables. Fermented foods are not only rich in those all important good gut bugs I’m always talking about but they are also brilliant immune system boosters, fab for the digestion and helpful in detoxing. In addition, there's really good evidence available that fermented foods are valuable in the prevention and treatment of infections and yeast overgroth. Not generally found in regular supermarkets but widely available in specialist shops. If you want to have a go at home, sidestep to this link for a really useful demo on how to prep your own fermented veggies: http://www.youtube.com/embed/05lVOmj1Pqg
- Add garlic to your cooking, grate it raw into salads and also take a top quality garlic supplement such as Biocare Garlic Plus. The active ingredients in raw garlic are proven to be anti-bacterial, anti-viral, anti-parasitic and anti-fungal. It is especially active in killing Escherichia coli (E.coli), the most common bacteria involved in UTIs.
- Avoid packaged fruit juices until the infection has cleared up and when you go back to them, choose those that are truly fresh, sugar, sweetener and additive-free. Better still, juice your own fruit.
- Avoid cow’s milk, beef and pork. Stick to organic chicken and turkey, fresh fish and vegetarian proteins.
- Eat stacks of fresh vegetables of all kinds and colours. See my article Colour Your Way to a Healthier Diet for lots of ideas. In particular, include as many red and purple fruits and vegetables in the diet as possible. They are rich in nutrient substances known as proanthocyanadins which may help to prevent the bacteria sticking to the bladder lining.
- Drink plenty of fluid but avoid alcohol, coffee and (temporarily) shop bought juices, all of which can irritate the bladder lining.
CONSIDER THESE SUPPLEMENTS
If you’re plagued on a regular basis with UTIs or vaginal thrush, invest in the best probiotic you can afford, stay on it at least until symptoms are eradicated and then, as a maintenance dose, for a month every couple of months. Whilst there have been a handful of studies showing no benefit to using probiotic bacteria in the treatment of UTIs, the majority are extremely positive. I can certainly confirm excellent results in clinical practice with patients who had previously suffered from repeat infections and are now infection-free. Other research does seem to substantiate that when good gut bugs are in short supply, then the risk of urinary tract infections is higher. I usually recommend Bionutri Ecodophilus, Sweet Cures Probiotic therapy, or one of the excellent probiotics supplements from Viridian or Biocare.
Check out my article on Probiotics for more info.
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PREGNANT OR BREAST-FEEDING?
PROBIOTICS Urinary tract infections are incredibly common during pregnancy. Consider a course of probiotics if you’re pregnant or breast-feeding. Studies show that breastfeeding can reduce the risk of UTIs in babies and may confer greater protection in later life against this condition. In addition, certain Lactobacillus strains such as Lactobacilli rhamnosus and Lactobacilli reuteri have been shown to be helpful to pregnant women suffering from bacterial vaginosis and could even be more effective than antibiotics. According to Gregor Reid, Professor of Microbiology & Immunology at The University of Western Ontario, a course of supplements could have the desired effect in three to five days and, encouragingly, that suppositories (if and when available) could work even more quickly. No-one wants to take medication during pregnancy unless it's absolutely necessary and that goes for antibiotics too.
D-MANNOSE The supplement Waterfall D-mannose is a natural and very effective alternative to antibiotics. Check out the information on their excellent website and talk to your health care provider about using D-mannose during pregnancy.
D-MANNOSE The supplement Waterfall D-mannose is a natural and very effective alternative to antibiotics. Check out the information on their excellent website and talk to your health care provider about using D-mannose during pregnancy.
SOMETHING TO SOOTHE
In addition to any other treatment you may be using to treat bladder or vaginal infections, you might also try mixing a couple of tablespoons of live yogurt (plain, no sugar or additives) with the contents of a probiotic capsule or single serving of probiotic powder (ideally one that includes Lactobacillus acidophilus). Slap it on to your bits after washing and then protect your underwear with a panty pad. I have heard of some practitioners recommending that sufferers might saturate a tampon with a probiotic mixture but my own clinic experience suggests that tampons are best avoided where there is any kind of urinary or vaginal infection. Or if your prefer, slosh the mixture into a bidet or bowl of tepid water and use it as a daily douche. But don’t get carried away with the idea that vaginal and urine infections can be cured by excessive cleanliness. Whilst good hygiene is a given, over-douching can make matters worse by washing out any good bacteria. And don’t forget that everyone carries some E. coli and some yeast organisms. They live naturally within us so it isn’t realistic to try to totally eradicate them. The key to comfort is control.
OTHER TIPS & TREATMENTS
Talk to your pharmacist. There are several products available over-the-counter which can help reduce symptoms. Some are designed to lower the pH of the vagina (which makes life uncomfortable for bad bacteria); others are naturally anti-bacterial and/or anti-fungal. There are also plenty of cranberry-based powders and drinks (avoid any which contain sugar), vaginal applicators containing healthy flora, helpful nutritional sugars (see below) and, of course, probiotic supplements.
If you are plagued with repeated attacks and nothing that you do seems to have a lasting effect, ask your GP about what new treatments might be available. For example, a recent study has shown that injecting hyaluronic acid and chondroitin sulphate into the wall of the bladder may help. And check out the section later on in this article on a special helper called D-mannose.
If you are plagued with repeated attacks and nothing that you do seems to have a lasting effect, ask your GP about what new treatments might be available. For example, a recent study has shown that injecting hyaluronic acid and chondroitin sulphate into the wall of the bladder may help. And check out the section later on in this article on a special helper called D-mannose.
GIRLS, DON'T WEAR THONGS: they’re notorious for triggering uro-genital problems because of the irritation caused by fabric chafing. For the same reason, it's best to get used to life without tight jeans. And avoid underwear made from non-breathable fibres.
DRINK
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I make no apologies for repeating and repeating, "Drink more water". Low intake of fluid definitely increases the risk of infection because it concentrates the urine. Increasing intake throughout the day is obvious common sense but drinking an additional glass of water first thing in the morning before breakfast may be especially helpful.
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HYGIENE
Pay sensible attention to genital/anal hygiene especially after a bowel movement and before and after sexual intercourse. Emptying your bladder after sex is especially important. Even if all you really want to do is to roll over and go to sleep, making the effort to go to the bathroom means that you help flush accumulated bacteria away rather than leaving it there to multiply. Washing thoroughly around the opening to the vagina and urethra has been shown to reduce the risk of infection occurring but don't get carried away with excess douching or the use of highly antiseptic vaginal products. If you need to pee, don’t hang on and put it off. Urinate when the body demands it. When you’re done, always wipe from front to back.
OTHER REMEDIES WORTH CONSIDERING
ACUPUNCTURE is said to be helpful in the treatment of recurrent urinary infections. There are a handful of studies showing good results and, in addition, patient feedback is positive. Certainly worth a go, especially if you’re at the end of your tether and nothing else is working.
CRANBERRY JUICE? I have to be upfront and say I'm not a big fan. It's way too acidic for me which is probably why it made me feel worse when I did try it (see further down this page). In fact, I've tried juice, concentrate and capsules and got nowhere until I used D-mannose (more on this later). You may be one who swears by cranberry juice and if it works for you then that’s great. Unfortunately, some cartons or bottles of cranberry may have added sugar which can increase the risk of thrush and others may contain sweeteners; neither creates the right environment to deal with an overgrowth of bacteria. And cranberry juice products can vary significantly in their quality and ingredients. Although some cranberry can certainly produce an initial improvement in symptoms for some people AND it has been highly publicised as being beneficial in the treatment of UTIs, there is also concern that some can actually increase the chances of an infection recurring over time. The EFSA (European Food Safety Authority) for one, is not convinced by the health claims made for cranberry juice in the treatment of UTIs. One of the problems seems to be this: E.coli (Escherichia Coli), the most common bacteria found in UTIs, is what is known as acid adaptive; in other words it gets its nutrition, what it needs to feed on, from the acids in its local environment. Cranberry, being highly acidic (it produces hippuric acid in the urine), makes for perfect conditions for E.coli and other gram negative bacteria to run amok. Acidic forms of Vitamin C can create similar conditions (see my note about this further down the column). Ergo, consuming cranberry juice where there is a definite and diagnosed urinary infection can increase the risk not only of that infection becoming more severe and harder to get rid of but also of it recurring. So, if you're a cranberry addict and have found it's the treatment of choice for you, then go for a quality cranberry extract or capsules rather than juice. And buy the best that you can afford, checking the label to make sure it's free of sugar and additives. Whatever you choose to do, I'd suggest taking any treatment in conjunction with a probiotic. And please also read my comments under the heading D-Mannose below. NOTE ABOUT VITAMIN C: Decent daily doses of Vitamin C Complex (quality buffered formulae such as Viridian, Biocare or Bionutri, not the plain ascorbic acid tablets - usually cheap - and especially not those that you dissolve in water) are an excellent addition to any treatment programme. I usually recommend 2 grams three times daily during an attack and 1 to 2 grams daily as a maintenance dose.
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ECHINAFORCE:
Herbal remedies can provide valuable support. I would always consider Dr Vogel’s Echinaforce as a number one helper. Use the tincture rather than the tablets. I find it works more quickly and because it’s a liquid that you need to take with water, it helps you to increase that all important fluid intake. Also useful is the herb Uva-ursi which has antiseptic and anti-inflammatory properties. If you’re a person who is plagued by repeated attacks of cystitis, then these two plant remedies are worth using regularly as prevention. The Vogel company has a really good Uva-ursi/Echinacea combination product. MOLKOSAN: The whey drink Molkosan has a natural antibiotic action and is prebiotic so it encourages repopulation of healthy bacteria in the urinary tract. It’s also soothing for that sharp pain associated with urinary infection and is an excellent therapy for dealing with thrush. Before embarking on cranberry treatment, you might also find the following links to be helpful: http://www.efsa.europa.eu/en/efsajournal/pub/943.htm http://www.ncbi.nlm.nih.gov/pubmed/22777630 http://advances.nutrition.org/content/4/6/618.full http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370320 http://www.waterfall-d-mannose.com/ecoli-metabolises-cranberry.html |
DO THE D-MANNOSE TREATMENT
Another way of knocking urinary tract infections on the head is by using something called glyco-nutrients also sometimes known as nutritional sugars. If you suffer repeatedly from cystitis, then this is a very worthwhile treatment, especially if you’ve reached the stage where you think nothing is ever going to work or you’re battling with the misery of repeated infections which haven’t responded to antibiotics. While we usually think of sugar, such as sucrose, as being damaging to the body (ordinary table sugar is sucrose), some types are actually beneficial. One that most people are familiar with is glucosamine, used to help ease the pain and stiffness of arthritic joints. Others such as xylose, ribose and mannose are less well known. When it comes to treating intractable urinary infections, I have seen excellent results for Waterfall D-mannose and rate this product very highly indeed. One of my TOP TEN. This is because it works so well in the majority of cases.
D-mannose is a still relatively unknown but extremely beneficial and safe treatment that works well in arresting persistent cases of urinary infection. One doctor I know says that she sees D-mannose as so effective in so many cases that she rates it as better than antibiotics and without the side effects. For those who are prone to repeated attack, it does need to be taken regularly. I would recommend that this is done alongside a good quality probiotic supplement and a buffered Vitamin C. As I mentioned earlier, please - not the kind of Vitamin C that comes in fizzy tablets from the chemist. This will nearly always be plain ascorbic acid with added flavourings and/or colourings. Apart from being cheap, it's not always helpful, creating an overly acidic environment that can cause certain types of bacteria to multiply. If that were not enough, this type of Vitamin C preparation can irritate the stomach and the bladder. My experience as a practitioner has been that, when used alongside a single two month course of high dose (20 billion+) probiotics plus good Vitamin C (Bionutri, Biocare, Viridian), the length of treatment with D-mannose tends to be shorter and doesn’t need to be repeated so often. Sometimes, a single course will eradicate a UTI in one go and that's that. Over and done with. But now I always suggest keeping Waterfall D-mannose in the first aid cabinet. I'm not prone to UTIs but I have suffered in the past from trigonitis. I was given antibiotics for this condition which didn't work (click here to read more). I also tried a cranberry/D-mannose combination product (can't remember the brand) which was recommended by my pharmacist but it didn't help either. Finally, I came to my senses and ordered up some Waterfall D-mannose, which I should have done in the first place. I had seen it work so well with patients and yet I never considered it for myself. Obviously my bladder condition was affecting the gears in my brain! Within only two days, I was feeling so much better and in 5 days, all symptoms were gone. I haven't had a problem since but I always keep the product on hand just in case.
The 'D' in D-mannose stands for 'dextra' (think dextrose) which indicates that it’s a sugar. D-mannose works like this: The way that bad bacteria actually set up an infection is first to get a grip onto the bladder wall. So whatever we can take that persuades them to 'unstick' themselves, known as the anti-adhesion capability, is going to help to get rid of the infection. When we take D-mannose as a supplement, the excess mannose washes through the bladder and the bad guys don’t like it. Suddenly unable to hang on any longer, undesirable bacteria, such as pathogenic E.coli, run for it, screaming in panic. Well no, not really screaming, but it's good to picture them rushing for the exit and then getting flushed out of the body when we urinate. So D-mannose doesn’t kill bacteria - it just prevents them from latching on to you. Because it also has anti-inflammatory properties, it’s extremely valuable in treating non-bacterial cystitis, painful bladder syndrome, interstitial cystitis and trigonitis.
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I always recommend taking Waterfall D-mannose
with a good quality probiotic such as Sweet-Cures Probiotic Blend or Bionutri Ecodophilus or one of the excellent probiotic products from Viridian or Biocare together with either Bionutri, Biocare or Viridian Vitamin C. My article on Probiotics may also be of help and interest. And you can read about Vitamin C by clicking this line. |
These websites may be helpful:
http://www.urologyadvice.com/
http://kidney.niddk.nih.gov/KUDiseases/pubs/utiadult/
http://www.askapatient.com/viewrating.asp?drug=19537&name=CIPRO
www.waterfall-d-mannose.com
More information on the conditions discussed in this section can be found in Good Gut Bugs by Kathryn Marsden (published by Piatkus Little Brown)
http://www.urologyadvice.com/
http://kidney.niddk.nih.gov/KUDiseases/pubs/utiadult/
http://www.askapatient.com/viewrating.asp?drug=19537&name=CIPRO
www.waterfall-d-mannose.com
More information on the conditions discussed in this section can be found in Good Gut Bugs by Kathryn Marsden (published by Piatkus Little Brown)