Tips from doctors and specialists
Finally there is an effective agent to protect against burdensome bladder inflammation. Topwell-Pharmacist Samuel Knüsel on the subject of D-Mannose as a natural alternative to antibiotics.
He is a smart, highly educated, medically trained 27-year-old who maintains an open attitude to natural medicine and works as a Deputy Director in the Naturewell Pharmacy at Zurich Station on the newly opened Rail Link.
Urinary tract infections are a subject that the Topwell-Pharmacist Samuel Knüsel knows very well. «An acute, uncomplicated bladder inflammation affects every second woman over their lifetime. Around a third will experience a recurring infection within the next couple of months.» The symptoms are typical: frequent, painful urination, turbid, mostly foul-smelling urine without any itchiness or discharge.
What does the shrewd pharmacist advise in such situations? Watch and wait, drink tea or antibiotics? «Definitely not watch and wait, antibiotics only in restricted circumstances, though drinking tea is actually sensible», says Samuel Knüsel. «It is totally acceptable to take a non-prescription analgesic such as Ibuprofen, kidney- and bladder-dragées and D-Mannose in an uncomplicated urinary tract infection without involvement of the kidney, that is with no fever or flank pains.
The sooner the infection is treated, the greater is the likelihood of a rapid symptomatic improvement.» The simple sugar D-Mannose is particularly capable. It binds to the protein FimH on the fimbriae of the E. coli bacteria and inactivates them. Fimbriae are hair-like structures with which the bacteria bind to the bladder mucosa. In the first instance, however, D-Mannose is an excellent, natural and especially a gentle substance, which protects against burdensome bladder inflammation. «In one study, D-Mannose was investigated as a prophylactic against bladder inflammation», says Knüsel. «In comparison to antibiotics, the simple sugar proved to be just as good at protecting against bladder inflammation. However, it did so with significantly fewer side effects and without developing resistance as antibiotics can do.»
The experiences of customers as well as professional colleagues, including doctors, with D-Mannose are very good. The preparation helped many women, who until then had tried everything to get rid of their burdensome bladder inflammation. Mannose is therefore worth trying in every case, particularly since most people nowadays are aware of the issues with resistance formation due to antibiotic use. «A woman generally knows her body very well. If she finds herself in a situation, which has previously repeatedly led to bladder inflammation, for, example after hypothermia, then an attempt at prevention with D-Mannose is advisable in every case, possibly combined from the outset with kidney- and bladder-dragées. Whilst one can take D-Mannose for extended periods without any concerns, one should not use kidney- and bladder-dragées for longer than a week.
With an approach like this, one can appreciably reduce the frequency of recurrent infections.»
Source: Protection for the bladder, Consultation Dr. Stutz, Nr. 02.2016
Marlies von Siebenthal, a leading specialist in bladder and intimate conditions at the Canton hospital Frauenfeld, tells us how many cases of bladder inflammation can be managed without antibiotics.
Most women develop bladder inflammation in bed and because they do not drink enough, but not from sitting on a cold stone for example. During and after sexual intercourse, it is easy for gut bacteria to reach the bladder via the vagina and urethra. However, many sexually inactive women are also repeatedly affected by bladder inflammation. Urge to pass water, burning when passing water, turbid, foul-smelling urine, tugging pains in the lower abdomen – cystitis is in full flow. If this inflammation of the lower urinary tract occurs repeatedly more than two to three times in a year, then it is referred to as recurrent cystitis.
If pains in the kidneys or back, blood in the urine or fever develop, then a doctor must definitely be consulted, since in the worst case the inflammation can ascend to the kidneys, and lead to pelvicalyceal system inflammation, a condition that must be taken very seriously.
Luckily, this is very rarely the case. How can we knock recurrent bladder inflammation on the head? And above all, what can a woman do herself to avoid having to yet again swallow antibiotics?
A large problem is the increasing issue of resistance to antibiotics. Few new antibiotics are being developed, and so infections with multi-resistant organisms can become a serious problem. We also frequently do not give our body any time to allow its self-healing powers to activate and instead reach quickly for an antibiotic. It would be much more sensible to initially treat an uncomplicated bladder inflammation, with a phyto-therapeutic agent. In addition, it is important to drink two-and-a-half to three litres of water per day when the feeling of an infection develops, and also to take plant-based diuretic preparations such as kidney- and bladder-dragees over three to five days.
Through their diuretic actions, the constituents such as birch serve to increase the kidney’s excretion leading to increased flow from kidneys to ureter, bladder and urethra. Goldenrod also acts as a diuretic and additionally also as an anti-inflammatory. The bearberry has been known from time immemorial for its antibacterial actions. A prominent feature of bladder inflammation is pain, so that we may additionally add an anti-inflammatory painkiller to the treatment.
In other words, the affected woman should, before reaching for an antibiotic, take a sufficient dosage of kidney- and bladder-dragees – two dragees three times a day – drink plenty and also take anti-inflammatory medication for the first three days.
Healing is also promoted by using a hot water bottle and taking a break. An antibiotic is only recommended if the feeling of inflammation does not settle after three days or if the patient is not completely symptom free after five days. Naturally, if there is fever or kidney pain then one should not delay.
In that case a urine investigation is needed with urine culture – particularly in recurrent bladder inflammation – in order to be able to give antibiotics correctly targeted at the bacteria. However, even if antibiotic therapy becomes necessary, it is still worthwhile to support this with a diuretic, antibacterial phyto-preparation. Analysis of the urine culture generally requires three days. In order not to have to start blind treatment with an antibiotic before the result is available, it is worth starting the phyto-therapy as well as the agents fighting the pain and inflammation. This avoids the unnecessary use of antibiotics, which carries the risk of developing resistance.
Source: Phyto-power instead of antibiotics, Marlies von Siebenthal, Consultation Dr. Stutz, 11.2014
Florian Meier from the Adler-Pharmacy in Winterthur explains why bladder inflammation is a burdensome and frequently recurring problem for many women and what alternatives there are to antibiotics.
Any infection, which involves the urine-carrying organs, is referred to as a urinary tract infection, mostly due to bacteria. The bacteria reach the outer urethral opening by smear infection, that is by physical contact, and from there wander up to the urethra. If the bacteria reach the bladder then this is referred to as bladder inflammation or so-called cystitis.
If the inflammation persists untreated for an extended period, the bacteria can ascend to the upper urinary tract as far as the kidney, where they cause a pelvicalyceal system inflammation. The microbes can come either from the body’s own gut flora or can be transmitted from a partner during sexual intercourse. Women are far more frequently affected by bladder inflammation than men. This is due to the fact that their urethra is somewhat shorter than a man’s, meaning that bacteria only have to travel a very short distance in order to colonise the bladder. Inflammation of the urethra can often remain unnoticed, so long as it does not reach the bladder and does not provoke any symptoms.
Mostly, however, adults develop a painful or burning sensation upon urination as well as an urge to pass water with incomplete bladder emptying. As soon as the infection reaches the bladder lower abdominal pain also develops. What does not belong to the symptoms of such an infection, however, is any kind of vaginal itch or discharge. If the upper urinary tract or the pelvicalyceal system are affected, then fever and severe pain develop. However, even if these symptoms are present in a mild form, one can mostly recognise a urinary tract infection by the facts that the urine is turbid or discoloured and has an acrid, foetid smell.
On occasion, there may even be blood in the urine. Further, bacteria and white blood cells can be demonstrated in the urine.
Often, bladder inflammation may simply vanish without special treatment within three weeks just as a result of regular toileting. However, since the bacteria can disseminate to the kidney, it is not usually advisable to do nothing. If one does not immediately want to go to the doctor for it, there are several very good home remedies. However, it is important to know that, whilst it is certainly possible to alleviate the symptoms of bladder inflammation and shorten its course, there is no certainty that they will work for everyone and lead to the complete disappearance of the infection.
At the Adler-Pharmacy we advise patients to drink plenty and regularly. It is one of the best and most established home remedies, because it washes the bacteria out of the bladder. It should be at least two litres per day, and alcohol, coffee and citrus juices should be avoided, since these drinks can irritate the bladder. In addition to drinking plenty and washing out, one should also not avoid going to the toilet, even if it is unpleasant.
Careful and correct hygiene of the intimate areas are also very important. After urination, attention should be paid to wiping from front to back and not the other way around, as otherwise the flora from one’s own gut can reach the urethral opening. Furthermore, it is important to find a happy medium for one’s daily hygiene: insufficiently frequent bodily hygiene favours colonisation and growth of bacteria, whilst excessive showering destroys the natural acidic barrier of the vagina, which normally inhibits the entry of microbes.
We also recommend hipbaths, where one sits immersed up to the hips in approx. 36 °C warm water infused with common horsetail, camomile or sage.
Thereafter, hot water is added until the bath reaches a temperature of around 41 °C. In general, heat in the form of hot water bottles or heat pads applied to the lower abdomen helps to alleviate pain. Finally, there are several herbs and berries, which possess antibacterial and diuretic properties and are excellently suited for use as a tea. Bear berry leaves work especially well against microbes and inflammation in the region of the bladder and urethra and have thus proved to be particularly effective.
Juniper has particularly good diuretic properties and is thus ideal for flushing out a bladder inflammation.
Beyond this, there are extra kidney and bladder teas or – very convenient to take - dragées, which contain many medicinal plants such as birch leaves, nettle, liquorice and other constituents. Cranberry juice can also help reduce dissemination of the infection, since the active agent proanthocyanidin makes adhesion of the bacteria to the walls of the urinary tract more difficult. Huckleberries and bilberries also possess this agent.
Source: This is how to get rid of the inflammation, Florian Meier, Consultation Dr. Stutz, 12.2014
Now we have D-Mannose , a natural, gentle substance to prevent recurrent bladder inflammation. A specialist explains its action.
Woman and the bladder – or better put – bladder inflammation. This is an unending story. Nature intended it. «The female urethra is, at 2 to 3 cm, very short, which favours the ascent of bacteria from the gut to the bladder», says Associate Professor Dr. Daniele Perucchini, a urogynaecologist in Zürich.
He has been engaged on this topic for 20 years and runs his own bladder centre. «It boils down to the fact that, in contrast to men, the urethral opening is located immediately adjacent to the vaginal introitus and the anus.». After menopause, hormonal deficiency makes the bladder mucosa more prone to infections. Dr. Perucchini: «Local hormonal deficiency is one of the most important reasons that bladder inflammation occurs increasingly frequently after menopause. Sexual intercourse also seems to increase the frequency of bladder inflammation.» Around half of all women suffer from urinary tract infections, which can keep recurring. The most common culprits are gut bacteria called E. coli.
The management of acute urinary tract infections with antibiotics is routine. However, what should be done when the next inflammation arrives before the original one is fully healed? Is there an alternative to prescribing an antibiotic, which is unavoidably associated with the risk of resistance formation? Yes, one exists. And it is called D-Mannose. This is a simple sugar, which is closely related to glucose. Dr. Perucchini has many years of good experiences with D-Mannose in women with recurrent bladder inflammation. In his specialist clinic, he specifically directs his patients to the possibility of preventing bladder infections in an entirely natural and effective way. How does this specialist explain its action? «D-Mannose is a sugar which is hardly absorbed when one consumes it. It is excreted almost unchanged into the urine and thus concentrated in the bladder. There, due to its chemical structure, it binds to the bacteria and prevents them from adhering to the bladder wall. As a result, aggregates formed of E. coli and D-Mannose are excreted with the urine.
Scientifically, this action is supported by a study. Dr. Perucchini describes D-Mannose as an outstandingly well tolerated option for preventing urinary tract infections, with no danger of causing resistance, and therefore as a gentle alternative to the repeated use of antibiotics. The urogynaecologist warns however, that for severe inflammations, and in the presence of fever, antibiotic therapy can still be necessary. The simple sugar D-Mannose has no effect upon either calorie balance or blood sugar and can also be used by diabetics after consultation with their doctor.
Source: An end to bladder infections, PD Dr. Daniele Perucchini, Consultation Dr. Stutz, 12.2015