 Urinary tract infections (UTI) are a surprisingly common health problem and may be caused by bacteria, viruses, fungi or parasites. The bacteria E.coli causes over 80% of all UTI’s. E coli is a normal resident of the intestinal flora that can pass through the peritoneum into the urinary tract and bladder. Urine found in the bladder should be sterile. UTIs are more common in women with 1 to 3 % prevalence in non-pregnant women. Prevalence increases with age and in the elderly yearly infections are not uncommon. Infections are more common in women because of anatomical differences. In women, the urethra is shorter
and is less resistant to bacterial infection; the urethral opening is also much closer to the anus, which increases the likelihood of contamination and infection. Diabetics are also much more likely to suffer from UTIs as the presence of glucose in the urine constitutes a good growth medium for bacteria. Common findings with UTIs include urinary frequency, urgency, painful urination, incontinence, low back pain, cloudy urine and blood in the urine. The conventional treatment for UTIs is antibiotic therapy. As for all bacterial infections, antibiotic resistance is becoming a concern in the treatment of UTIs. With the overuse of antibiotics, organisms once sensitive to a certain treatment are increasingly more resistant, making treatment more difficult and more dangerous. Furthermore, many women have recurring UTI without having any of the predisposing factors. In repeating infections, bacteria can be identified but it is not always understood why the infection recurs.
Urinary tract infection prevention
Those suffering from chronic recurring UTIs can take precautions to reduce the frequency of infections. Proper hydration is essential because fluids dilute the bacteria in the urine. Probiotics are also helpful as they promote the presence of healthy bacteria in the intestines, where most UTI bacteria originate. Also, because most UTI are treated with antibiotics, which destroy the intestinal flora, replenishing intestinal bacteria may help to prevent recurrence. Irritants to the bladder such as caffeine, alcohol, and spices should be avoided.
In recent years cranberries have received much attention because of their beneficial properties with respect to urinary tract health. Research supports their use in the treatment of bacterial infections caused by E. coli, the organism behind most urinary infections.
Characteristics of cranberries
Cranberries are a favorite food of cranes, hence their name. Native Americans were the first to use the berries as a food source. They have been used in the treatment of UTI for many years and are now regarded as a non-pharmaceutical approach for the treatment and prevention of simple UTI infections. Cranberries are effective in the treatment of the majority of UTI, however, not all UTIs are caused by E.coli, the bacteria against which cranberries have demonstrated efficacy.
Cranberries have many other health benefits. Like other berries, cranberries contain an abundance of antioxidants and were shown to be extremely helpful at reducing oxidative stress.
Pharmacology
• The consumption of cranberries acidifies the urine, which reduces bacterial growth.
• Cranberries also contain certain tannins, more specifically proanthocyanidins that have been shown to reduce bacterial adherence to the urinary tract wall. 3 hours after taking cranberry, molecular changes in the adhesion apparatus used by bacteria to attach themselves to the urinary tract wall have been found. This is a significant benefit in the treatment of UTIs as adherence is essential for infection.
• The proanthocyanidins found in cranberries might have anticarcinogenic activity
Research summary
If bacteria cannot attach themselves to the urinary tract wall, they cannot cause an infection. However, once attached to the urinary tract wall, bacteria cannot be removed by the body’s normal clearing mechanisms. Studies have documented that drinking eight glasses of cranberry juice twice a day can eradicate most UTIs. If consumption is maintained, infection is unlikely to recur; a Harvard study has demonstrated that regular use of cranberry juice reduced bacterial growth in the urinary tract. Studies have demonstrated that infections can be reduced by over 50% in elderly women drinking 300 ml of cranberry juice per day.
Consumption of cranberry juice reduces urinary wall problems in patients with severe problems. Elderly hospitalized patients had significantly fewer E. coli urinary tract infections if they were given cranberry juice as a prophylactic. Cranberry can also potentially be used to treat recurrent kidney stones because supplementation reduces ionized calcium in the urine.
Cranberries contain antioxidants and 100g of cranberry has the same ability as 1000mg of vitamin C and 3700 mg of vitamin E at preventing the oxidation of LDL cholesterol. Cranberries also increase the clearance of LDL cholesterol by the liver reducing circulating oxidized LDL levels.
Indications
The importance of antioxidants in health promotion is well established. Berries typically have a high concentration of antioxidants and cranberries are no exception. Where cranberries stand apart is in their ability at preventing the adhesion of pathological bacteria to the urinary tract wall. This is particular helpful for the prevention and treatment of urinary tract infections.
Why Cran-UTI?
The benefits of cranberries for the treatment and prevention of urinary tract infections have been demonstrated. Drinking 8-16 ounces of cranberry juice per day is unrealistic for most. Self-medication with cranberry juice cocktail is common in the treatment of UTIs, unfortunately cranberry cocktails contain a lot of sugar and only 23% juice. They are not a good choice for the therapeutic use of cranberries and should not be used by diabetics because of the high sugar content. Also, cranberry tablets are more cost effective than cranberry juice in the treatment and prevention of UTI. Cran-UTI is a concentrated extract containing 630 mg of cranberry, the equivalent to roughly 1 1/2 cups of cranberries.
References
• Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA 1994 Mar 9; 271(10): 751-4.
• Zafriri D, Ofek I, Adar R, Pocino M, Sharon N. Inhibitory activity of cranberry juice on adherence of type 1 and type P fimbriated Escherichia coli to eucaryotic cells. Antimicrob Agents Chemother 1989 Jan; 33(1): 92-8.
• Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol 2002 Jun; 9(3): 1558-62.
• Howell AB. Cranberry proanthocyanidins and the maintenance of urinary tract health. Crit Rev Food Sci Nutr 2002; 42(3 Suppl): 273-8.
• Howell AB, Foxman B. Cranberry juice and adhesion of antibiotic-resistant uropathogens. JAMA. 2002 Jun 19; 287(23): 3082-3.
|
