This article discusses various natural alternatives,
such as cranberries, blueberries, and the sugar D-mannose,
that fight urinary tract infections (UTI) and, by so doing, help
preserve the future effectiveness of life-saving antibiotics.
UTIs can be an aggravating, recurring health
problem for individuals with spinal cord injury (SCI) and dysfunction
(SCD).
According to the Agency for Health Care Policy and Resear
ch, 80% of
those with spinal cord injury will experience UTIs within 16
years of injury; UTIs are the most frequent secondary medical
complication during acute care and rehabilitation; and urinary-system
disorders are the fifth most common primary or secondary cause of death.
Seventy to ninety percent of persons with multiple
sclerosis (MS) eventually develop bladder dysfunction, and, as a result,
a predisposition to UTIs. For
MS patients over age 65, these infections are the primary or secondary
diagnosis for nearly one-third of hospitalizations.
In the general population, about 90% of UTIs are
caused by E. coli bacteria, which although a normal part of our
intestinal miroflora, do not belong in our urinary system.
In the case of SCD, a diversity of bacteria in addition to E.
Coli can cause UTIs.
Antibiotics
– A Double-edged Sword?
For more than a half-century, people with spinal
cord injury and dysfunction have
relied on antibiotics to control UTIs. The development of these drugs
stems back to 1928 when British microbiologist and eventual Nobel
Laureate Alexander Fleming observed that bacterial growth was inhibited
by a penicillin-producing mold. Although infection-fighting molds have
been a part of mankind’s healing armamentarium since antiquity and
noted by scientists before Fleming, penicillin became the first
antibiotic isolated from one. The exigencies of World War II resulted in
penicillin’s production in sufficient quantities for general use,
including the treatment of the Paralyzed Veterans of America’s
founders.
Since then, scientists have developed a multitude
of potent antibiotics. In my case, as a graduate student, I help
elucidate the molecular mechanism of vancomycin, now an antibiotic of
last resort in resistant infections.
Although antibiotics have greatly increased the
life expectancy of people with spinal cord injury and dysfunction, reliance on them has ominous future
implications given the growth of antibiotic-resistant bacteria. For
example, every year, 2 million hospital patients acquire infections that
that they did not have when they entered the hospital; of these, 80,000
die. Statistics such as these are especially relevant to infection- and
hospitalization-prone individuals with paralysis and clearly indicate the need
to maintain antibiotic effectiveness.
In spite of their clear importance, every time you
use antibiotics you short-circuit your body’s inherent healing
potential, cumulatively compromising your long-term health. You may be
winning the immediate health-care battle, but you are setting yourself
up to lose the war.
Furthermore, in spite of commonly held assumptions
that bacteria are the “bad guys,” optimal health requires that we
maintain a symbiotic, health-enhancing partnership with them. For example, many different bacteria that live within our
digestive system are essential for proper digestion and chronic health.
Every time we use an antibiotic, we undercut this bacterial
partnership. By killing off the ”good guys,” we create a void that
may be filled by health-compromising pathogens or antibiotic-resistant
bacteria that now have no competition for growth.
This theme was emphasized in a March 28, 2003
Science magazine article (Gilmore & Ferretti), which stated that
"Not only does the highly evolved gut flora community extend the
processing of undigested food to the benefit of the host, but it also
contributes to host defense by limiting colonization of the
gastrointestinal tract by pathogens." The article notes that at least
500 different microbes live in the gut.
Unfortunately, we also face a huge exposure to
antibiotic residues through meat and poultry consumption. In this
country annually, 25-million pounds of antibiotics (8X human medicine
use) are fed to livestock and poultry, not for therapeutic reasons but
to promote economic-efficient growth.
By fostering development of resistant bacteria, this practice may
ultimately render useless the antibiotics that have been a cornerstone
of SCD healthcare.
To reduce your vulnerability to the seemingly
inevitable erosion of antibiotic power, use when feasible and prudent
various alternatives for enhancing urinary-tract health and attempt to
hold in reserve the heavy-duty antibiotic artillery for major medical
crises. For most of these innocuous alternatives, there is little to
lose and potentially much to gain.
Nutritional Approaches:
Cranberries & Blueberries: Cranberry
products are a traditional UTI-fighting folk remedy that has been
embraced by the SCD community. In an article posted on http://carecure.rutgers.edu
(click on CareCure Community and scroll down to the “Cranberry and UTI”
article), Dr. Wise Young, one of the nation’s preeminent SCI
physicians (Piscataway, NJ), says that more than 40% of those with SCI
take cranberry concentrates. The article summarizes the results of more
than 40 scientific studies evaluating cranberries’ infection-fighting
properties.
In addition to acidifying urine, cranberries
contain substances that inhibit bacteria from attaching to the bladder
lining and, as such, promoting the flushing out of bacteria with the
urine stream. These anti-bacterial substances include tannin-like
compounds called proanthocyanidins and potentially the sugar D-mannose
(see below).
Cranberries’ UTI-fighting ability is supported by
an ever-growing body of scientific evidence Although more research is
needed on SCD-associated UTI’s, a recent pilot study (Reid, et al, Spinal
Cord, January 2001) indicated that drinking cranberry juice greatly
reduced bacterial attachment to cells lining the bladder in subjects
with SCI. Promisingly, this was a broad-spectrum, anti-bacterial effect
not limited to merely E. coli, the UTI-causing culprit in the general
population.
To avoid excess sugar, consume unsweetened - albeit
lip-puckering - cranberry juice, cranberry extract capsules, or
naturally sweet blueberries, which scientists have shown to
contain similar UTI-fighting substances.
D-mannose: Studies suggest
that D-mannose is 10 times more effective than cranberries in dislodging
E. coli bacteria from the bladder wall, and, as such, can ameliorate
more than 90% of UTIs in 24-48 hours.
In addition to reading many impressive testimonials
from able-bodied consumers whose recurring UTI’s have been
successfully treated with the product, I talked to several D-mannose
users with SCI:
Stephanie, an artist friend who has had recurring
UTI’s, says D-mannose was “a wonderful UTI product.”
She adds “ I take several glasses of water a day with a half
teaspoon of the powdered D-mannose. I am absolutely positive that it has
stabilized my bladder condition to the effect of better control, easier
to empty, and the discomfort “tightness” or burning is gone. U-tract is
a necessity in my daily life!!"
Richard also testified to D-mannose’s
effectiveness. A retired teacher and long-time member of the Paralyzed
Veterans of America, he told me
that his UTI frequency had greatly increased with age until he was
routinely afflicted with one that required antibiotic therapy every 40
days. About a year ago, he started prophylactically taking D-mannose and
feels that it has made a huge difference, noting that “most of the
time now, my urine is more clear and lacking of the characteristic UTI-associated
odor.” He says the product has greatly decreased his UTI incidence.
Another PVA member David stated that he is a
"D-mannose fan." He notes "I’ve had numerous urinary tract infections
for 25 years and was starting to run out of effective antibiotics. Since
I started taking it six months ago, I've not had a UTI."
Mechanism of Action: D-mannose is a
naturally occurring sugar similar in structure to but metabolized
differently from, glucose (a component of table sugar). Because the body
metabolizes only small amounts of D-mannose and excretes the rest in the
urine, it doesn’t interfere with blood-sugar regulation even in
diabetics.
The cell wall of the UTI-causing E. coli bacteria
has tiny finger-like projections that contain complex molecules called
lectins on their surfaces. These lectins are cellular glue that binds
the bacteria to the bladder wall so they cannot be readily rinsed out by
urination. However, because
D-mannose molecules will glom on to these lectins and fill up all of the
bacterial anchoring sites, the bacteria can no longer attach to the
bladder wall and are, therefore, flushed away. In other words, unlike
antibiotics, D-mannose does not kill any bacteria, whether they are good
or bad, but simply helps to displace them.
Visualize the bacteria as burrs sticking to the
lining of your clothes unless they are so covered with lint that they
fall away. Essentially, D-mannose represents the molecular lint that
makes the bacterial burrs fall away from your urinary-tract lining.
Conclusion:
To help preserve the future effectiveness of
life-saving antibiotics, consider using nutritional alternatives to
enhance urinary tract health, such as cranberries, blueberries, or
D-mannose. Who knows? You may lose your UTI chill on blueberry fill!
Adapted from article appearing in Paraplegia News, June, 2002 (For subscriptions,
go to www.pn-magazine.com).
