Many women seem to suffer with recurrent urinary tract infections (UTI), usually cystitis.  This is a painful condition that occurs when the lining of the bladder becomes inflamed, making urination painful.  I was shocked to learn that one in five women suffers from a UTI at least once per year.  Some women suffer from [...]]]>

Many women seem to suffer with recurrent urinary tract infections (UTI), usually cystitis.  This is a painful condition that occurs when the lining of the bladder becomes inflamed, making urination painful.  I was shocked to learn that one in five women suffers from a UTI at least once per year.  Some women suffer from recurrent attacks.  If cystitis occurs treatment needs to be prompt and antibiotics may well be necessary, this is because recurring UTI’s may lead to kidney infections which can be serious.  The key to UTI’s seems to be prevention.

Cystitis tends to occur as a result of a bacterial infection.  Urine is normally free of bacteria when stored in the bladder but sometimes bacteria in the urinary tract can overwhelm the immune system and multiply, causing infection.  Ignoring the urge to urinate can increase the likelihood of UTI since urine remains in the bladder for increased periods allowing bacteria to multiply.  Personal hygiene is important since bacteria from the anal area may enter the urinary tract during sex or when wiping after a bowel movement (this is why women are always taught to wipe from front to back).

The problem with treating recurrent bouts of UTI with antibiotics is that, over time, it can exacerbate the issue.  The bacteria may become resistant to the antibiotics.  Antibiotic use is also associated with increased risk of recurrent thrush infections, which can also lead to UTI.  Trying to prevent an infection in the first instance seems to be the answer. 

Today I want to look at cranberry juice and cranberry supplements as a way of preventing UTI in women.  Traditionally cranberry has been used by women to treat and prevent cystitis.  It was thought that cranberry worked by making the urine acidic and therefore causing the bladder not to be an environment where bacteria can colonise and multiply.  Cranberry does acidify the urine and this is certainly one of its benefits.  However, it has been shown more recently that cranberry actually provides major benefit through other means.  It appears to prevent bacteria from adhering, or clinging, to the lining of the bladder and urinary tract.  The specific agent within cranberries that seems to be useful here are pro-anthocyanidins, natural biologically active plant compounds.  If bacteria cannot cling to the urinary tract they will be washed out of the body with the urine.

Scientific research is beginning to accumulate for the usefulness of cranberry juice, supplements and other products in the treatment and prevention of UTI. 

Recently a study tested the effectiveness of cranberry against an antibiotic called trimethoprin in the prevention of UTIs in women who suffered from recurrent attacks (1).  137 women were involved and they were given the antibiotic or 500mg cranberry extract per day for six months.  It was found that the cranberry extract was as good as the antibiotic in preventing UTI.  The antibiotic produced more side effects.  The authors of the study note that cranberry extract is a cheap and useful alternative to antibiotics and as a natural product does not carry the risk of causing antibiotic resistance or further infections with thrush causing bacteria and yeasts.

Another very recent and well designed study(2) looked at the effectiveness of cranberry supplements for the prevention of UTIs in a particularly susceptible group of individuals (those with spinal cord injuries affecting the bladder).  The study lasted six months and the participants received a cranberry extract supplement or a placebo (non active tablet).  There was a reduction in the likelihood of UTI and UTI symptoms when taking the cranberry supplement and the frequency of UTI was reduced in the cranberry group compared to placebo.  The authors of the study suggest that cranberry extract supplements should be seriously considered for the prevention of UTI.

In 2007(4) a study was conducted in women who were between the ages of 25 and 70 years old.  These women had a history of suffering with a MINIMUM of 6 UTI in the proceeding year.   The participants took one high-dose cranberry capsule twice daily for 12 weeks containing 200 mg of a concentrated cranberry extract standardized to 30% pro-anthocianidins.  The participants were then followed up once per month for 4 months and then after 2 years.  During the study none of the women suffered a UTI and two years later those who continued with a supplement continued to be free of UTI.  The study was small and preliminary and needs further follow up with placebo-controlled trial but the results are very encouraging indeed.

Cranberry juice has also been widely tested and a review of the available evidence (3) suggests that cranberry juice may decrease the number of symptomatic UTIs over a 12-month period, particularly in women who suffer with recurrent UTIs.

Most women would probably prefer not to take continued and repeat doses of antibiotics in order to prevent the occurrence of cystitis or other urinary tract infections.  Cranberry really does seem like a viable alternative.  If you want to try drinking cranberry juice for prevention then 2-3 250ml glasses a day are recommended, but be wary and check the label of the juice – many varieties are loaded with sugar and/or artificial sweetners and only contain 5% pure fruit!!  Look for juices providing 100% pure fruit juice, these tend to be cranberry mixed with another juice (pure cranberry would be very bitter).  Taking a cranberry supplement is another option, these are usually standardised to contain 10% pro-anthocyanidins and 800-1000mg a day is usually recommended. 

If you have received intensive antibiotic treatment in the past you may wish to take probiotic and/or a prebiotic supplement to help the body re-colonise with ’friendly’ beneficial bacteria.

(1)McMurdo ME et al.  2008. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women.  J Antimicron Chemother.  28 November [Epub ahead of print]
(2) Hess MJ et al.  2008.  Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder.  Spinal Cord.  46(9):622-6.
(3) Jepson RG & Craig JC.  2007.  A systematic review of the evidence for cranberries and blueberries in UTI prevention.  Mol Nutr Food Res.  51(6):738-45.
(4) Bailey DT et al.  2007.  Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study.  Phytomedicine.  14(4):237-41

Written by Ani Kowal

Related posts:

1. Cranberries may help men with urinary tract symptoms
2. Probiotics for the prevention of cystitis
3. Probiotic pessaries: a new natural way to tackle chronic UTIs