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20% of American women suffer from the
uncomfortable, painful and activity restricting attacks known as
UTIs, or Urinary Tract Infections, many of them over and over
again to the point where the condition develops into Interstitial
Cystitis, an even more painful and debilitating problem. The
number of people affected by overactive bladder is even
greater - estimated at somewhere between 17 and 53 million
Americans.
The two leading prescription drugs for the condition- Detrol LA and Ditropan XL- have sales over the past 12 months of
over $700 million dollars- and they estimate they have hit less than
15% of the market. However, when one considers the possible side
effects (liver and kidney function, warnings for glaucoma, digestive
problems ) I know that most thinking people will be happy to know
there are natural alternatives. Above all, it is important to know
that overactive bladder is not a normal part of aging and you do not
have to accept it as a way of life.
An over-active bladder is one of
the 10 most common chronic conditions in the US. Traditional
medicine doesn't hold out much (safe) hope for sufferers, but there
are some strategies, natural help for bladder infections, that can restore your quality of life.
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Diet and allergies
(see details below) together or separately can provide a common
causative effect for any bladder problem.
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Exercise - practice Kegels,
the control measure which involves identifying the pelvic muscles
that control the bladder, and then conscientiously contracting and
relaxing them daily, 10 counts of contracting and holding for 10
seconds, and 10 counts of contracting and relaxing in quick
succession 10 times. You will be amazed at how quickly you will
see a difference in your control. I simply do this as I walk
the dogs each morning, counting a contraction for each step.
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Herbs - Urologist Dr. Lonny
Green and colleagues have compounded certain formulas for each
bladder problem. He has formulated one specifically for the
over-active bladder called Bladder-Control.
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Collagen - low collagen
levels have been identified as a possible culprit, since collagen
is the glue that holds body tissues together. Mainstream
medicine suggests infusions of collagen, but I see no reason
not to try supplementing with some formulas high in
hyaluronic
acid.
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Many people are made profoundly
uncomfortable by the
acid in foods
and while some have
immediate digestive reactions, others, unfortunately for them, have
more deep-seated reactions which they may not connect to the food,
as is the case with the bladder.
The bladder is accessed by a narrow
channel, and my theory is that reactions to food which cause
inflammation, make narrow channels swell (technical jargon, you
see!), with resulting pain and proliferation of bacteria.
The
most common culprits for bladder irritation are:
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coffee, tea,
alcohol, citrus fruit and juice, tomatoes, and spicy foods.
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Other less common irritants
are eggs, pork, onions, wheat, corn and milk.
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Diet sodas are considered a
factor in bladder urgency and
UTIs.
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Diets high in protein, or protein for
people who have problems digesting it, can also be problematic.
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Choosing a diet which will alkalize
your body's pH can go a long way towards helping you overcome this
condition.
Read my article on pH
Realizing that Stress affects pH
negatively is important.
This article lays it on the line for the Stress/Cystitis/Holiday
connection!.
If you have a personal
intolerance it
may affect you in this way, even though it is not on my list.
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Therefore identifying and eliminating
allergens from your diet and making sure you are avoiding
acidifying foods and
maintaining neutral pH
in your body is an excellent first step in controlling
bladder problems.
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If you are overweight, it may
interest you to know that a 2002 study at the department of
obstetrics, gynecology and reproductive sciences at the University
of California, San Francisco found that weight loss reduces episodes
of urine loss, according to the head of the study group, Dr. Leslee
Subak.
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Let us also look at some of the
possible causes of UTIs, of which perhaps the most common is sexual
activity - which is why UTIs are often known as "Honeymoon
Cystitis". If this is the cause of the infections, the problem
can sometimes be traced to the position used, which irritates the
urethra: a simple variation in angle can make all the difference!
Another strategy which can make a difference is to empty your
bladder both before and after intercourse.
The causative effect doubles if a
diaphragm is used. All too often, diaphragms are fitted too
large, constricting the neck of the bladder, and therefore the
strategy I recommend to avoid UTIs, voiding immediately after
intercourse, is performed inefficiently, and some urine remains in
the bladder as a breeding ground for bacteria. If you are aware of
the presence of your diaphragm when you have it in place, it may be
too large.
This same chain of events can be set
up by using tampons that are extremely large and
super-absorbent. If your infections tend to occur around the time of
your period, tampons are a possible culprit. The answer is simple:
remove the tampon when you have to void.
Dr. Foxman at the University of
Michigan (Ann Arbor) has determined that using condoms with
nonoxynol-9 triples a woman's chance of getting UTIs. This is
because the spermicidal also destroys the good bacteria
responsible for maintaining the acidity of the vagina enabling the
Escherichia Coli bacteria to enter and thrive. This is a real
"Catch-22"!
Do you have back-pain? Another
possible cause of UTIs is constriction of the vertebrae in your back
where certain nerves to the bladder originate. This problem can be
caused by trauma, wearing high heels, weight- lifting, or
degeneration. It can be addressed sometimes by medication, sometimes
by exercise such as yoga or swimming, and sometimes by chiropractic
manipulation.
More detailed information can be found in Dr.Larrian
Gillespie, M.D.'s excellent book, You Don't Have to Live With
Cystitis.
| Children are very
susceptible to bladder infections, and they can be very uncomfortable
for the child and frustrating for the parent , as they are frequently accompanied by bed-wetting
episodes. Determining the cause is
once again the most important step, since otherwise the
usual debilitating cycle of infection and antibiotics will
be set in train with the consequences for the digestive
and immune systems.
Once one has ruled out the possibility
of abuse, which unfortunately has to be considered,
then the most common reasons are:
Not going to the bathroom
frequently enough, often seen in little shy or
self-conscious children once they start going to school.
It is very important to enlist your child's help in
making sure they go to the bathroom regularly.
Perhaps even put a little note in the lunch box to
remind them to go at that inconspicuous time, whether
they feel like it at that moment or not!
Wiping incorrectly from back to
front in little girls can be a cause of infection, as
bacteria are transferred from one passage to another.
Tight fitting underwear, or
perhaps wearing a favorite pair for too long - this also
needs to be checked.
Constipation, where the stool
impacts in the colon and prevents complete draining of
the bladder, can be another cause.
Bubble baths, and irritant soap
should be suspect as possible causes of bladder
infections
For some children, excess sugar
and food allergies can be part of the problem.
Candida needs to be ruled out, and if the child
has had frequent courses of antibiotics, even in the
absence of Candida, a possible imbalance of the friendly
flora should be suspected and corrected with
probiotics.
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If your child is experiencing problems with
bed-wetting, I highly recommend this charming and
unconventional approach, which helps your child overcome
bedwetting and learn self-control, simply by relaxing with a
delightful bedtime story.
Read
some testimonials here.
If you know the causative reason for your problem, it
makes it easier to avoid: recurring bouts of cystitis can lead to a
far more serious problem called Interstitial Cystitis.
For
some unfortunate people, it may be that a natural defense mechanism
is absent: a glycoprotein called Tamm-Horsfall which blocks the
attachment of bacteria . Also a factor to consider is the presence of probiotics in
the vaginal tract, which help protect against infection. It is
increasingly recognized that intestinal and urogenital
microflora are critical for the health and well-being of humans,
and therefore replenishing these flora with probiotic
organisms seems to be an option that has a growing scientific
basis.
Stress, faulty diet, and antibiotics are some of the things
that reduce the availability of these friendly bacteria.
The following information about
Interstitial Cystitis is
quoted directly from Urologist Dr. Lonny Green, co-formulator
of The Natural Bladder supplements and a Board Certified
Urologist.
Interstitial Cystitis (IC) is a condition causing
discomfort and pain in the bladder and surrounding pelvic
region. Interstitial cystitis is a challenging disease that
is difficult to define, since a general consensus has not
been reached as to how it is to be diagnosed. The National
Institute of Arthritis, Diabetes, Digestive and Kidney
Diseases (NIADDK) established criteria for diagnosis in 1987
but they were not meant to define the disease, but rather to
ensure that groups of patients studied would be relatively
comparable. There is no agreed upon pathologic finding with
which to diagnosis a person as having IC.
IC can have a devastating effect upon a person's life. It
has been reported that using well-developed quality of life
indicators, IC patients scored extremely low- in fact, even
lower than a sample of patients with chronic renal failure
undergoing dialysis.
What are some of the symptoms of IC?
The symptoms of IC vary from person to person and even over
time in the same individual. People suffering from IC often
experience flare-ups and remissions. Symptoms include the
following:
Severe Bladder Pain or Pressure
Intense Pelvic and/or Lower Abdominal Pain
Excessive Frequency of Urination
Urgency of Urination
Reduced Bladder Capacity
Tenderness in Pelvic / Genital Area
Painful Intercourse
How Common Is Interstitial Cystitis?
A mentioned above, there is no agreed upon pathologic
finding with which to diagnosis a person as having IC.
Accordingly, the true prevalence of IC is hard to determine.
Patients presenting to physicians with the symptoms
mentioned are often given a different diagnosis, such as a
urinary tract infection or prostatitis. It is felt that at
least 700,000 people in the United States have IC. IC
affects people of all races and ages, and is more common in
women than in men.
What Causes IC?
Despite ongoing research into Interstitial Cystitis, the
cause remains unknown. Different theories exist as to the
origin of the disease. No bacteria, fungi, viruses or other
pathogens have been definitively linked to IC, but some
investigators still believe it is caused by an organism we
have not yet been able to isolate and identify. Others feel
that toxic substances in the urine may be responsible, while
some feel it may be a type of auto-immune disease. Evidence
has been presented that the protective lining of the
bladder-known as the GAG (glycosaminoglycan) layer- is
deficient in patients with IC, leading to the symptoms seen
in the disease.
How Do I Know if I Have IC?
Since the symptoms of IC are similar to those of other
disorders of the urinary tract, and since there is no
definitive test to check for IC, physicians must first be
sure other conditions do not exist before considering a
diagnosis of IC. These conditions include urinary tract
infections, pelvic infections, sexually transmitted
diseases, bladder cancer, kidney stones, and vaginal
infections in women and prostate infections in men.
Physicians will typically look in the bladder with a small
telescope, a procedure known as cystoscopy. When done under
anesthesia, the bladder will be distended and the bladder
wall will be examined for ulcers or a blood vessel pattern
known as glomerulations. A biopsy may also be obtained. As
mentioned, there is no one single definitive test for IC,
but these examinations can provide clues as well as
excluding other diseases.
What Treatments are Available?
Unfortunately, we do not yet have a cure for Interstitial
Cystitis. Because we do not know the cause of the disease,
treatments are aimed at relieving the symptoms. Numerous
treatment regimens are in use, including:
Bladder Stretching Under Anesthesia
Instillation of Various Solutions Into the Bladder
Prescription Drugs
Surgery
Transcutaneous Electrical Nerve Stimulation
Implantable Electrical Nerve Stimulation
Bladder Training
Physical Therapy / Myofascial Techniques
Visualization Techniques
Dietary Modification
Herbal Therapy
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Dr. Green, together with the Natural
Bladder's scientific advisory board , has formulated
Bladder-Q
to address Interstitial Cystitis. Click on the name for
details of the formula.
What to do about UTIs once you
have one? The conventional approach is with antibiotics, but as
most of us who have used them for this problem know, that usually
ends in vaginitis and yeast infections, not to mention a repeat of
the UTI. Nowadays, instead of a ten day cycle of antibiotics, most
doctors recommend a short, sharp 3 day burst, and this helps. But it
is definitely a good idea to couple the antibiotics with
acidophilus capsules. Some worrying research results from a 5
years study in Seattle (1999) found that more than 20% of the most
common bacteria causing infections are now resistant to antibiotics,
which makes it more important than ever to find out WHY you are
getting the infections and addressing the cause.
In 2001, a disturbing report showed
that there is a new
antibiotic-resistant strain of a common bacterium which is
contributing to an increase in relatively hard-to-treat bladder
infections in women in at least three U.S. cities. It appears to be
a strain of Escherichia
coli bacteria causing a substantial percentage of
drug-resistant urinary tract
infections among female university
students in Berkeley, Calif., Minneapolis and Ann Arbor, Mich.
Interestingly, the
microbes implicated in the Michigan and Minnesota infections were
almost identical to the California ones, which suggests the recent
arrival or emergence of a new drug-resistant strain that has spread
rapidly to different parts of the country.
"I think calling it an epidemic
is reasonable," said J. Glenn Morris, professor and chairman of the
department of epidemiology and preventive medicine at the University
of Maryland Medical School. "You probably do have
strains that are coming from a common
source and are responsible for an increase
above expected numbers" of drug-resistant infections.
This kind of thing makes preventative
action even more important, and because I believe myself to be
amongst those low in the natural protective factor mentioned above,
I use a Cranberry capsule formula with guaranteed "anti-adherence
factor": the formula prevents the bacteria from sticking to the
bladder wall. Personally, one capsule taken at night seems to do the
trick For an existing infection, Goldenseal extract, a blend of 2
herbs , Usnea & Uva Ursi, also Olive Leaf extract, and Oregano Oil,
are also helpful . Two homeopathics which control the discomfort and
pain almost immediately are Cantharis, and Berberis, both 6X.
Another simple method to control the pain is to take one teaspoon
(no more) of baking soda in a glass of water.
It is important to
know, however, that taking cranberry capsules once you have
an infection is usually not effective: using them on a daily
basis to PREVENT infection is the answer, and several studies
(in the Journal of the American Medical Association, Vol.
271, No. 10, March 1994 pp. 751-774, to name one; see below for
another) using cranberry juice, support this. We suggest the
capsules not only to avoid the juice's extra calories from sugar,
and the taste, but because the better companies standardize their
capsules to guarantee their anti-bacterial activity.
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Data from a new study confirm what many women think they already
know — drinking cranberry juice can reduce the risk of recurrent
urinary tract infection.
The finding suggests that this popular remedy could be a good way to
prevent recurrence of the painful infections and reduce the need for
antibiotics, Dr. Tero Kontiokari, of the University of Oulu in
Finland, and colleagues report in the June 30th issue of the British
Medical Journal.
In a randomized study of 150 women with a history of UTI, the
investigators asked one group to drink 50 mL of cranberry-lingonberry
juice daily, another to drink 100 mL of a lactobaccillus drink 5
days/week, and a third to drink neither beverage. In the cranberry
group, the number of episodes of UTI was reduced by about half at 6
months, while the lactobaccillus drink was ineffective.
Overall, 16% women in the cranberry group, 39% in the lactobacillus
group and 36% in a control group had at least one UTI during the
year-long study, Dr. Tero Kontiokari of the University of Oulu and
colleagues report.
"Since cranberry juice is a natural food product and readily
available, it seems a useful means for self administered prevention
of urinary tract infections," the authors conclude.
BMJ 2001:322;1571-1573.
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In an article by Naturopathic Doctor
Kathi Head (Let's Live Jul 2000),
I see that she recommends using Uva Ursi to fight an actual existing
infection, at a dosage of 250 to 500 mg (standardized to 20% Arbutin)
three times a day. She suggests discontinuing the use of cranberry
while using the Uva Ursi, since it works best in alkaline urine.
She points out that before the discovery of antibiotics, arbutin
(an active constituent of Uva Ursi) was the treatment of choice for
UTIs in both Europe and the US, and is still part of the drug
formularies in Europe. It has been shown to have anti-bacterial
effects on E. Coli and Staphylococcus , among others.
And a final note - remember that bladder cancer is
the fourth most common cancer among men, and the ninth most common
cancer among women. Promoting the health of your bladder with diet
and supplementation is helpful, BUT - smokers are
twice as likely to get bladder cancer as nonsmokers.
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Smoking is a factor in approximately
half of deaths from bladder cancer among men and about a third of
bladder cancer deaths among women.
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