bladderBLADDER PROBLEMS – Dying to Go

by Lynn Hinderliter CN, LDN

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.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.

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.

  • Diet and allergies (see details below) together or separately can provide a common causative effect for any bladder problem.

  • 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.

  • 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. 

  • 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.

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:

  • coffee, tea, alcohol, citrus fruit and juice, tomatoes, and spicy foods.
  • Other less common irritants are eggs, pork, onions, wheat, corn and milk.
  • Diet sodas are considered a factor in bladder urgency and UTIs.  http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1646695
  • Diets high in protein, or protein for people who have problems digesting it, can also be problematic.
  • 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!.  http://www.emediawire.com/releases/2004/11/emw182586.htm

 If you have a personal intolerance it may affect you in this way, even though it is not on my list.

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. 

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.

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.

 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.  http://www.hypnosisnetwork.com/testimonials/Sammy-the-Elephant-and-Mr-Camel

 

 

 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 IntercourseHow 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

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. 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.

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.

 

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.

 

 

 

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. Smoking is a factor in approximately half of deaths from bladder cancer among men and about a third of bladder cancer deaths among women.

Find the recommended supplements here

The Krisiloff Diet for Prostatitis, Urinary Incontinence and bed-wetting – http://www.krisiloffdiet.com/about_diet.html

D-Mannose research

An Overview of Interstitial Cystitis – http://kidney.niddk.nih.gov/kudiseases/pubs/uti_ez/index.htm

Help Children Overcome Bedwetting While Discovering Self-Appreciation – http://www.hypnosisnetwork.com/hypnosis/bedwetting.php

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