*A nice lady emailed me a question about UTIs recently, but a lame update from WordPress caused a bug where I didn’t receive her email address.  I decided to answer her question here in an attempt to get her to see my answer and also to help others who may have the same issue!*

Question:

“In the last few years I have gotten the infection every few months, and after having so many side effects taking oral antibiotics I have been hospitalized up to 5 days to have them be administered intravenously twice in the past 6 months, and given by injection only 3 weeks ago.
My question is: what did all of this do to my body, and will this D-mannose really work for me? I have already sent for it being at the point of trying anything.  I’m 80 years old, bad enough being at this age, but does this make me more prone to the infection?”

Dear Nice Lady Whose Email Address I Didn’t Get,

Thank you so much for writing to me!  First let me say that I am so sorry for what you’ve been through.  As someone who has experienced UTIs in the past, I can understand what an emotionally draining, frustrating, and extremely painful experience it can be.

I would love to help, but let me first say that I am not a doctor and have done all this investigation on my own.  Anything you decide to try is of your own accord and should be discussed with your doctor.

Ok, that being said, here are my thoughts!

Will D-Mannose Help?

D-Mannose will only help if the cause of your UTIs is E. coli bacteria specifically.  It will help attract the E. coli and flush it out of your system.  So if you haven’t already, make sure that your urine tested positive, not just for a UTI, but specifically for the presence of E. coli.  Often, doctors will test your urine for leukocytes and nitrite, but won’t bother testing to see which bacteria are actually causing the infection before prescribing antibiotics.

If you have verified E. coli is causing your issues, go ahead and try taking D-Mannose!  However, I don’t think you should take it daily for long periods of time.  Instead, take it the SECOND you start feeling symptoms and do so until the symptoms subside.  However, this is simply a temporary band-aid for a larger problem, which could be the fact that you’ve lost beneficial gut bacteria from all the antibiotic use, developed IBS and/or Interstitial Cystitis (IC), and/or are eating foods that are causing inflammation.  I’d suggest keeping D-Mannose around in case of a flare-up, but also work on your diet and getting good bacteria back in your body (more on that below).

Sometimes we have problems digesting certain foods, which could cause UTI/IC symptoms.  Perhaps keep a food journal to keep track of how you feel after you eat meals. A few examples of symptoms to track could be: gas, bloating, constipation, diarrhea, headaches, bladder pain, fatigue, etc.

Is Age a Factor?

Age can definitely influence how often you get UTIs for several reasons:

  1.  The lack of estrogen post-menopause may allow UTI-causing bacteria to grow more easily in the vagina and urethra.
  2. Our immune systems change/decline as we age.
  3. Older adults tend to be on types of medications that may affect the bladder/urine habits.
  4. Older adults are more likely to have bladder/bowel incontinence which can lead to increased chances of contamination of the urethra.

However,  I feel that we can fight against and lessen these obstacles by really trying to boost our immune systems. An efficient, effective immune system relies heavily on good bacteria, so it’s important to put more healthy bacteria in your body!   I’d also suggest getting outside in the sunshine for at least 10-15 minutes per day; going for a walk, working in the garden, etc. Vitamin D supports your immune system and all your body needs to make it is the sun! 🙂 If being out in the sun is not a possibility for you, consider adding a Vitamin D supplement to your routine.

Heavy Antibiotic Use

Antibiotics have saved millions of lives and were undoubtedly one of the best discoveries in the history of medicine.  Unfortunately, they can also have long-term detrimental side-effects that we’ve only recently discovered.  For instance, antibiotics can actually cause you to be more susceptible to infections.  Antibiotics do kill bacteria inside of our bodies, but they kill both the harmful AND the healthy, beneficial varieties.

Without going into too much lengthy detail, we have good bacteria that work nonstop to  keep us healthy and protected from foreign invaders.  So when you kill these poor little guys and gals and don’t add more good bacteria back in, the bad bacteria (such as E. coli that cause 90% of UTIs) are allowed to thrive and takeover.  It’s similar to what would occur if we removed all the police enforcement from a town… Crime would grow at an exponential rate!

So given that you’ve been through multiple rounds of antibiotics, multiple times, and in large amounts, it seems like the overwhelming slaughter of your good bacteria could be a reason you’re getting UTIs more frequently.  This could also contribute to other issues such as recurring yeast infections, IBS, weight gain, auto-immune problems, food intolerance, etc.

What to Do

Most importantly, you need to get good bacteria back into your body.  You can do this in a couple of ways:

  1. With supplements: Make sure that whatever you purchase has capsules that are enteric coated to make it past your stomach acid and into your small intestine.  A few brands I trust are: Jarrow, Renew Life, or Now Foods.  Specifically for someone like you, who’s taking many rounds of antibiotics, I’d suggest a supplement that contains the Lactobacillus brevis because there’s evidence that some of these strains are antibiotic resistant. (Dr. Mercola’s Probiotic has this strain!)
  2. Like I say in my post on probiotics, food is the BEST way to get probiotics in you and it’s cheaper!  For instance, a one month supply of high potency probiotics can cost anywhere between $20 – $150!  However, you can make a jar of sauerkraut for the cost of a head of cabbage (usually less than a dollar).  AND, while one probiotic pill may have 50 billion strains of good bacteria, one 1/2 cup of sauerkraut (which contains L. brevis, mentioned earlier) can have TRILLIONS of good bacteria.  It’s really up to you to choose, but I feel that getting probiotics from foods is cheaper, safer, and more guaranteed.

Examples of foods high in good bacteria are sauerkraut, kimchi, kefir, beet kvass, pickles, kombucha, and yogurt (to name a few). You can make any of these items yourself or you can purchase them in the store. Bear in mind, though, that store bought options are required by the FDA to be pasteurized, which kills all of the bacteria, both good and bad. Food companies will then reintroduce a blend of good bacteria into certain products, like yogurt and kefir. Other fermented products, like pickles and sauerkraut, often will not go through this process, meaning that they have no bacterial benefit to your gut. Kombucha is the only product in this list that is not governed by the FDA, as it contains a small amount of alcohol. Because of this, it is not required to be pasteurized and the beneficial bacteria that result from fermentation remain alive and well! So, what’s the moral of the story? Store bought probiotic foods are available and can be very convenient, but some are better than others, so make sure you know what you’re getting. And homemade is always best when it’s available!

*Note: Try to eat probiotic-rich foods with a meal that has fat or dairy in it.  This helps the bacteria survive the stomach acid and make it to your small intestine.  This is why I feel like yogurt and kefir are some of the best probiotic foods because they’re comprised of fat and are dairy!

Once you’ve started adding the good bacteria, the next step is to feed them with prebiotics. In this post, I list the types of prebiotic foods you can eat. This should be pretty easy to do, considering so many dishes include onions and garlic!  Who doesn’t love that combo?  Crazy people, that’s who.

Another possible killer of good bacteria is processed foods.  An example of this can be found in this post about emulsifiers, so you’ll want to limit these types of foods.

What Else to Consider

After years of damage to your bladder, you may have developed Interstitial Cystitis, which is chronic inflammation of the bladder.  Basically this means that the inner lining of your bladder, which usually keeps your highly acidic urine from hurting your delicate tissue, has been compromised and broken down.  People who suffer from IC usually think they have a UTI when they don’t, as they have basically the same symptoms, and end up taking antibiotics that don’t help the situation.

If this is the case, you can manage your symptoms through diet and give your bladder what it needs to heal.  Here are a couple websites I suggest you look at:

ichelp.org

healinginterstitialcystitis.com

There’s also a yahoo group that has a ton of info, though they do require you to join the group to have access to the info: Living with Interstitial Cystitis.

You obviously don’t have to do all of these things (I know it can be overwhelming), and instead might want to pick one suggestion that’s easiest for you and start with that. You can build up to more changes slowly over time.

I hope you feel better soon and thank you for reading my blog!

-Lana