I became extremely depressed to the point of feeling desperate and suicidal. I had to choose between continuing with Septrin and feeling suicidal, or stopping Septrin and suffering the

agonies of cystitis. I chose the latter course, and simply stayed in bed, kept warm and drank masses of warm water. I very quickly regained my equilibrium and the cystitis went away, but it was a horrific experience.

Happily I have not had a recurrence; if I did I would consult my homeopathic doctor. J Y, Athens, Greece…….

A:About 10 years ago, I had a minor local infection and was prescribed Septrin. It made my urine cloudy and full of “bits”. It cleared up about two weeks later, so I thought no more about it.

However, two and a half years ago I took a course of amoxycillin. It reminded me of the Septrin incident, because the effects were even more dramatic. There were so many tiny “crumbs” and “clots” floating about in my urine that it looked like pond water!

Since then, I have been plagued by repeated bladder infections, and a succession of antibiotics which have effectively ruined my gut.

Is there a way of avoiding and controlling bladder infections without antibiotics? J T, Ely, Cambs……

Septrin (Septra in the US) and Bactrim, known chemically as cotrimoxazole, commonly used for urinary tract infections, bronchitis, earache caused by bacterial infections, and traveller’s diarrhea in adults, have been among the bestselling drugs of all times. Although usage is falling now, due to some bad publicity, they have enjoyed a revival among HIV positive patients as a “just in case” drug against Pneumocystis carinii pneumonia (PCP), associated with AIDS. And many doctors and dentists continue to prescribe it.

Cotrimoxazole resulted from an almost unheard of “marriage” of the products of two rival pharmaceutical companies, Wellcome and Hoffman-La Roche. According to Brian Deer, who published a large expose of Septrin/Bactrim in the Sunday Times (27 February 1994, Wellcome developed trimethoprim in 1957, an antibiotic that could rival penicillin, at a point when the drug company was relatively small. In order to launch the drug and maximize profits, executives decided tojoin forces with Roche by merging their drug with the Roche drug sulphamethoxazole.

However, according to the British Natural Formulary (1994), it is sulphamethoxazole, a sulphonamide, which has the most serious side effects: “There have been reports of deaths in patients over the age of 65 years being treated with cotrimoxazole and almost certainly associated with the sulphonamide component.”

As the Physician’s Desk Reference (1992/3) warns with Bactrim: “Fatalities associated with the administration of sulphonamides, although rare, have occurred due to severe reactions.” These include Stevens-Johnson Syndrome (a condition of the skin and mucous membranes, with swelling, blistering and ulcers), toxic epidermal necrolysis (in which most of the body’s skin becomes inflamed and the dead outer layer eventually strips off), death of liver tissue, agranulocytosis (lowering of white blood cells), aplastic anemia and other blood disorders.

Furthermore, says the BNF, although side effects of cotrimoxazole are similar to those of the sulphonamides, “a particular watch should be kept for [blood] effects and special care should be taken” in patients who are deficient in folic acid, such as the elderly and the chronic sick, and in those receiving “prolonged treatment or high doses”. This has particular application for HIV patients given this drug as a just in case measure for PCP.

This is even more worrying when you consider that there is a kiddy version which is popularly given to children with acute earache. This is despite the fact Roche notes in the PDR with Bactrim, “To date, there are limited data on the safety of repeated use of Bactrim in children under two years of age.”

The Sunday Times reported that at least 113 deaths linked to the sulphur based component have been reported by doctors to the Committee on the Safety of Medicines, a figure that may be only a tenth of the true total.

Recently, a UK group called Victims of Septrin formed in order to provide a support group for people allegedly damaged by the drug and to campaign for the drug’s withdrawal outside the courts.

Besides the damage listed by the PDR, the group also says Septrin causes reactions to sunlight and skin rashes, heart and blood complaints, energy loss, muscle pains, food allergies all side effects they say they weren’t warned of.

It’s not surprising that our first correspondent suffered depression and the second the presence of what were probably crystals in the urine, since both are known side effects of the drug.

If you believe you have suffered similar side effects you can Victims of Septrin via 01494 523269.

Although the argument is that the dual drug is better for treating drug resistant strains of bacteria, there is evidence that it works no better than the safer trimethoprim alone. The Sunday Times reported that one study in the British Medical Journal (1972) demonstrated that trimethoprim had an identical cure rate as cotrimoxazole with “fewer than half the side effects.” Indeed, the BNF also says that “trimethoprim alone is now preferred” for most infections except PCP.

Many other antibiotics can do the trick without these potentially lethal side effects. Otherwise, Beyond Antibiotics (North Atlantic Books, 2800 Woolsey St, Berkeley, California 94705 $16.95) offers some good natural alternatives. Our Alternatives columnist Harold Gaier has successfully treated many a recalcitrant infection, including those of the urinary tract, with tincture of Berberis.

Ultrasound has largely replaced urography – radiography of the urinary tract using an opaque visualising medium – for assessing urinary tract infections (UTIs) in women and children. It’s also cheaper and quicker.

But men don’t have UTIs as much as they have kidney and urinary tract stones so, for them, urography is still the technique of choice.

However, a urology and radiology department team at Stevenage’s Lister Hospital concludes that, given the hazards associated with the ionising radiation found with urography, ultrasound and X-rays should be used first when investigating men with a known UTI (BMJ, 2002; 324: 454-6).

They have found that, in the six years until 2000, it declined from an 86 per cent effectiveness to just 76 per cent – and the researchers lay the blame squarely at the door at persistent antibiotic overuse.

Within the intensive care setting, the most common antibiotics are the fluoroquinolones, commonly prescribed for the treatment of urinary tract infections and pneumonia.

As with food infections, there are good herbal remedies to treat these problems – but we forgot, they’re banning them, aren’t they?

(Source: Journal of the American Medical Association, 2003; 289: 885-8).

One study of 31 children found that aminophylline did nothing to speed recovery.

It also failed to shorten hospital stay or improve breathing flow.

However, the drug did cause side effects in six of the children.

These included headache, nausea, vomiting causing two to leave the study. Pediatrics 1994 Feb; 93:201-10.

The second study suggests that albuterol, a common beta-2 agonist, may not always be much help, either. Doctors in Egypt looked at 128 young children suffering their first attack of bronchiolitis, wheezing caused by inflammation of the small airways that enter the lung.

They compared the recovery of those treated with inhaled or oral albuterol, with inhaled or oral placebo.

An hour after treatment the researchers found no difference in breathing rate, symptoms or oxygen saturation in any of the four groups J Pediatr 1994 Jan; 124: 131-8.

Cranberry for urine infections

Conventional medicine has finally woken up to the fact that cranberry juice is an effective treatment for urine infections something herbalists have known for decades.

Doctors at the US Harvard Medical School conducted a randomized, double blind placebo controlled study of 153 elderly women.

They were randomly assigned to drink either 300ml a day of cranberry juice or 300ml of a placebo that looked and tasted like the juice, over a six month period.

The researchers found that the monthly urine samples of those taking cranberry juice were less likely to show signs of infection than those taking the placebo (15 per cent compared with 28 per cent).

They also found that the cranberry group were half as likely to be prescribed antibiotics for urinary tract infections than the placebo group.

!AJAMA, 9 March 1994.

A decreased risk in UTIs is one of the most commonly cited justifications for circumcision of newborn boys. While previous studies have reported rates of UTI to be 10 to 20 times higher in uncircumcised boys, this Canadian study shows the risk is actually much less.

The study followed nearly 60,000 boys (half of whom were circumcised) born in Ontario between April 1993 and March 1994. What they found was that the relative risk of an uncircumcised boy getting a UTI was 3.7, substantially less than previously reported. Put another way, 195 circumcisions would be needed to prevent one hospital admission for UTI in the first year of life (Lancet, 1998; 352: 1813-6).

In the case of cystitis, gypsies use either the tough little leaves of the wild cranberry (also known as the cowberry), or its close relative, the upland cranberry (or bearberry). One heaped teaspoon of the leaves is added to two cups of water and then boiled down to one cup (Planta Medica 18:1-25 1970; J Uriology, AE Sobota, 131 pp1013, 1016, 1984).

For fluid retention, gypsies expose sufferers to the rising smoke of smouldering juniper berries. Although an infusion made from juniper berries is an excellent diuretic, gypsies know that prolonged exposure can cause kidney infections and contractions in pregnant women. The smoke from juniper berries, which give off volatile oils, has a gentler diuretic effect (M Raida, “Zigeunermedizin”, reference as above). For resistant urinary tract infections, gypsies use a three day course of infusions of juniper berries (in non pregnant patients only) (Arzneimittel Foprschung, V May and G Willhun 28, 1-7, 1978). There is also evidence to suggest that it promotes interferon like (interferon is a protein which induces immunity to viruses) activity in cell culture and chicken embryos (Acta Pol Pharm, T Skwarek, 326:715-720, 1979).

To treat frequent urination, gypsies prescribe a tablespoon of dried yarrow with a teaspoon of arnica blossoms in half a litre of boiling water. This is allowed to draw for five minutes and then half of it drunk before bed. The rest of the mixture, slightly warmed, is then drunk the following morning on an empty stomach. Yarrow is believed to stimulate the body’s resistance to disease generally and is often used as a preventative medicine (H Wagner and A Proksch, Economic and Medicinal Plant Research, vol 1, London Academic Press, 1985).

For cystic catarrh or bladder inflammation, Romany medicine prescribes two handfuls of dried chopped black elder bark boiled in half a litre of water.

Leave to draw for 10 minutes, strain, and then drink the entire quantity in small cups throughout the day (Martindale 26th ed; Brit Phamacopoaeia (1934); Merck Index; Brit Herbal Pharmacopeia (1976) vol 1).

For weak bladders, spiny restharrow in pyelonephritis and the leaves of sugar beet are prescribed (RF Weiss, Herbal Medicine, Gothenburg; A B Arcanum, English translation 1988).

Harald Gaier is a registered naturopath, homoeopath and osteopath.

The History of Acupressure

Because acupressure evolved from acupuncture, an ancient Chinese healing practice, the history of this form of treatment begins with traditional Chinese philosophy as it applies to the healing arts. The fundamental principle of Chinese philosophy is the concept of yin and yang. The yin and yang are two opposite, yet complementary, forever-entwined forces that underlie all aspects of life. Yin-yang is depicted as the subtly curved light and dark halves of a circle. Both proceed from the t’ai chi (the Supreme Ultimate). According to this philosophical system, the human body, like all matter, is made up of five elements: wood, fire, earth, metal, and water. Each element corresponds to an aspect of the body, such as the organs, senses, tissues, and emotions, as well as to aspects of nature, such as direction, season, color, and climate. The five-element theory, combined with the principle of yin and yang, forms the basis of the Chinese concept of balance. The intention is to balance yin and yang and to balance the energies of the five elements.

Yin is earthy, female, dark, passive, receptive, and absorbing. It is represented by the moon, the tiger, the color orange, a broken line, and the shady side of a hill. Yin is cool, inward, still, and soft.

Yang is represented by the sun, the dragon, the color blue, an unbroken line, and the sunny side of a hill. Yang is hot, outward, moving, aggressive, and bright.

Because yin and yang are intertwined halves of the same whole, all things, and all people, contain elements of both, although at any one time, one or the other will be predominant. Thus, a baby or young child is more yin; an older child more yang. When your child asserts herself, it is her yang that is coming to the fore.

The sun is yang, the moon is yin. We awaken in the morning and greet the sun. It is natural to be active and moving throughout the daylight. As twilight descends into night, we become more passive and quiet. Nighttime expresses the qualities of yin.

Chinese medical theory teaches that the two branches of the body’s nervous system, the sympathetic and parasympa-thetic, correspond to the two halves of the yin-yang circle. The sympathetic branch is the part of the nervous system that mobilizes our bodies to respond to stress. It initiates the fight-or-flight re-sponse, a more yang part of the cycle. The parasympathetic branch replen-ishes and supports the body during rest, the yin part of the cycle. These two branches oppose and balance each other to create stability and health. When the yin and yang are balanced within the body, all the body’s functions are healthy. Illness is caused by an imbalance between yin and yang.

Conventional Western medicine typically pinpoints and directly treats only the affected part of the body. Chinese medical philosophy encompasses the entire universe. Everything that affects the patient is considered, including emotion, environment, and diet.

Chinese philosophy proposes a way of life based on living in accordance with the laws of nature. This profound connection with nature is reflected in the language used to describe illness. For example, a patient may be diagnosed with a “wind invasion” or “excess
heat.” Acupuncture (or acupressure) points may be chosen to “disperse wind,” “remove summer damp,” or “disperse rising fire.”

In traditional Chinese medicine, every aspect of health is described in terms of a balance between yin and yang. For example, yin illnesses are caused by excessive expansion (overweight as a result of eating too much sugar, for example), while yang illnesses are caused by excessive contraction (sunstroke or fever). An imbalance of yin and yang factors can be demonstrated by showing how red blood cells respond to different substances. When red blood cells are placed in water (yin), they absorb the water, expand, and finally burst. When red blood cells are placed in a concentrated saline (salt) solution (yang), they contract, shrink, and shrivel. In a solution of normal saline (0.9 percent salt), the yin and yang are perfectly balanced and the cells remain virtually unchanged. An example of how the ancient yin-yang theory can be used to describe concepts in conventional medicine can be found in the treatment of breast and prostate cancer: Female hormones (yin) help control prostate cancer (yang); male hormones (yang) help control breast cancer (yin). The interplay of the yin and yang-as one increases, the other decreases-describes the process of the universe and everything in it. In more familiar Western terms, as modern physical science teaches, “For every action, there is an equal and opposite reaction.”

The Five Elements and Their Correspondences
in Nature and the Human Body

In traditional Chinese Philosophy, all matter is considered to be composed of five elements (wood, fire, earth, metal, and water). The elements in turn have correspondences in various aspects of the natural world, including the human body. According to this philosophy, health is achieved when yin and yang, and the energies of the five elements, are all in proper balance. The elements and some of their corresponding characteristics and parts of the body are illustrated in the chart below.
THINGS IN NATURE	ELEMENT
	Wood	Fire	Earth	Metal	Water
Direction	East	South	Middle	West	North
Taste	Sour	Bitter	Sweet	Pungent	Salty
Color	Green	Red	Yellow	White	Black
Growth Cycle	Germination	Growth	Ripening	Harvest	Storing
Environmental Factor	Wind	Heat	Dampness	Dryness	Cold
Season	Spring	Summer	Late Summer	Autumn	Winter
HUMAN BODY
Organs	Liver, gallbladder	Heart, small intestine	Spleen, stomach	Lung, large intestine	Kidney, bladder
Sense/Organ	Eye	Tongue	Mouth	Nose	Ear
Tissue	Tendon	Vessel	Muscle	Skin and hair	Bone
Emotion	Anger	Joy	Meditation	Grief and Melancholy	Fright and fear

In Chinese philosophy, the energy that pulses through all things, animate and inanimate, is called chit Health exists when there is a harmonious balance under heaven of both internal and external forces. Each bodily organ must have the right amount of chi to function. Too much or too little chi causes an imbalance, resulting in illness or disease. Chi flows through all things, enters and passes through the body, creating harmony or disharmony.

Chinese medicine works directly with the natural, vital energy-or chi-of the body. The goal of acupuncture and acupressure is to normalize the body’s energies. Chi can tee tapped at specific points along channels known as meridians. Activating one key point sets up a predictable reaction in another area. By tonifying (increasing energy in) a specific area, the yin-yang balance is treated. Moving an excess of chi from one area and directing it to another, weaker area, corrects the yin-yang balance.

Acupuncture is an ancient protocol. As a component of Oriental medicine, it has been practiced for centuries. The Huangdi Neijing (Canon of Medicine), written about 500-300 B.C., is the oldest surviving medical text. Among other medical practices, it describes the use of acupuncture.

Acupressure Today

Acupressure is a form of body work in which pressure is applied to specific acupuncture points to balance internal function. Acupressure is practiced around the world.

The Chinese have a very descriptive term for taking advantage of a combination of two or more healing systems-a practice this book advocates. They say the’ patient is “walking on two legs.” A two-year study conducted jointly by the Northwestern University Medical School and Evanston Hospital in Evanston, Illinois employed a combination of acupuncture and acupressure. In this study, patients suffering from chronic head aches of all types, including migraine, cluster, whiplash, and tension, were first treated with acupuncture. The patients were then individually instructed in specific acupressure techniques to use when a headache seemed imminent. The researchers reported that the need for prescription painkillers and other drugs was eliminated entirely in most patients-thus verifying the effectiveness of “walking on two legs.”

Working with an Acupressurist

There are professionally trained and college-educated acupressurists, just as there are acupuncturists. If you wish to consult a trained acupressurist, check the yellow pages of your telephone book. You’ll find this category listed in most large cities.

For the most part, though, the gentle form of acupressure recommended in the Treatment and Care entries in Part Two of this book is something you can do yourself, at home, to ease a hurting or ailing child.

Treating Your Child with Acupressure

In The Chinese Art of Healing (Bantam, 1972), author Stephan Palos identifies the hand as “man’s original medical tool.” We instinctively use our hands to alleviate pain. When we suffer a bump or bruise, have a cramp, or hurt anywhere inside, we rub, knead, or massage the painful spot.

When your child is ill, gently working the acupressure points recommended in the appropriate entry in Part Two will probably be beneficial (the illustrations in Part Three provide guidelines for locating all of the acupressure points recommended). Your child will very likely love receiving an acupressure treatment.

Massaging a particular point will help relieve symptoms as well as strengthen and balance the yin-yang in your child’s body. For example, applying acupressure to the point identified as “Large Intestine 11” helps relax the intestine, thus relieving constipation. Another related

point is Stomach 36; massaging Stomach 36 helps tone an upset digestive tract. When your child is ill, the appropriate acupressure points, as well as other areas of your child’s body, will be tender. Use your intuitive sense. Ask what feels good.

Common Acupressure Points

In acupressure, there are twelve lines c ailed meridians that run along each side of the body. Each pair of meridians corresponds to a specific organ. For example, there is a pair of Lung meridians, Spleen meridians, Stomach meridians, and Liver meridians. Acupressure points are named for the meridian they lie on, and each is given a number according to where along the meridian it falls. Thus, Spleen 6 is the sixth point on the Spleen meridian. The table on page 38 lists some of the acupressure points most often recommended in the entries in Part Two of this book.

Administering Acupressure

When you give your child an acupressure treatment, your tools are your hands, notably your thumbs and fingers, and occasionally your palms. For the most part, you will be using the balls of your thumbs and fingers, never the nails. Before administering acupressure, make sure your fingernails are clipped short, so that you do not inadvertently scratch your child.

Choose a time of day when your child is most relaxed, perhaps after a warm bath and just before bedtime. Have her take a few deep breaths. This aids relaxation and will automatically focus your child’s attention inward on her body.

You might want to start an acupressure session with a loving and comforting back rub, a treat most children welcome, especially when ill. Remain calm and unhurried. Make sure to keep your child warm throughout the treatment. You can apply pressure to the points directly onto the skin, or through a shirt or light sheet.

Work right-side and left-side acupressure points at the same time. Use your fingers or thumbs to apply threshold pressure to the point. Threshold pressure is firm pressure, just on the verge of becoming painful The idea is to stimulate the point without causing the body to tighten up or retract a the pain. The pressure you exert should not hurt your child. Firm but gentle is the rule.

Apply from one to five minutes of continuous pressure. Or apply pressure for ten seconds, release for ten seconds, reapply pressure for ten seconds, release for ten seconds. Repeat this cycle five times.

To learn how to locate specific acupressure points, specific points
which are helpful for different childhood conditions are
included in
Administering an Acupressure Treatment.

When your child is ill, acupressure is a wonderful way to use your hands with a loving, nurturing touch, while also stimulating your child’s body to heal. By using the acupressure points described in this book, you will be working to relieve the underlying cause of illness. At the same time, your gentle healing touch will convey your love and concern to your child.

Common Acupressure Points

Point	Effect	Indications
Bladder 23	Increases circulation to the urinary tract and reproductive organs.	Vaginitis, urinary tract infection; lower back pain.
Bladder 28	Master point for the bladder.	Urinary tract infection.
Bladder 60	Increases circulation to the urinary tract and reproductive organs.	Urinary tract infection.
Four Gates	Motion sickness; chickenpox; croup; hay fever; herpes; hyperactivity; pain; fever; poison ivy; sleeplessness; weight problems.	Urinary tract infection.
Kidney 3	Strengthens the bladder and kidneys; increases circulation to the reproductive organs.	Bedwetting; urinary tract infection; vaginitis.
Kidney 7	Strengthens the bladder and kidneys.	Bedwetting.
Large Intestine 4	Beneficial to the head and face; relieves congestion and headaches; removes energy blocks in the large intestine; clears heat.	Acne; common cold; headache; menstrual cramps; teething; sore throat; fever; toothache.
Large Intestine 11	Relieves itching; reduces allergic reactions.	Chickenpox; hay fever; constipation.
Large Intestine 20	Decreases sinus congestion.	Hay fever; sinusitis.
Liver 3	Quiets the nervous system; relaxes muscle cramps and spasms.	Asthma; menstrual cramps; teething; headache; eye pain.
Liver 7	Clears the lungs; moistens the throat.	Asthma; common cold; sore throat.
Neck and Shoulder Release	Relaxes the muscles of the neck and shoulders; relaxes the body.	Headache; weight problems.
Pericardium 6	Relaxes the chest; relieves nausea; relaxes the ming.	Asthma; motion sickness; croup; sleeplessness; stomachache; vomiting.
Points Along Either Side of the Spine	Improves circulation; relaxes the nervous system; balances the respiratory system; relaxes the spine.	Anxiety; colic; common cold; menstrual cramps; nervousness; insomnia.
Spleen 6	Reduces uterine cramping.	Menstrual cramps.
Spleen 10	Detoxifies the blood.	Acne; herpes; impetigo; poison ivy, boils, vaginitis.
Stomach 36	Tones the digestive system; strengthens overall wellbeing.	Colic; diarrhea; chronic runny nose; vomiting, constipation, indigestion; stomachache.

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

In the United States, urinary tract infections account for a significant number of the bacterial infections suffered each year. Perhaps only strep throat accounts for more. By some estimates, as many as 50 million cases of urinary tract infections are treated annually. Although these infections aren’t considered life-threatening or even a significant health risk for most people, their financial toll is enormous. Medication for each episode can cost about $30 and a visit to a physician, at least $40. Include time missed from work, and urinary tract infections cost billions of dollars a year.

Health-care providers have relied primarily upon antibiotics to treat urinary tract infections. However, increasing concern about bacterial resistance to antibiotics and rising interest in alternative medicine have prompted doctors and researchers to seek new treatments. Recent studies suggest that cranberry (Vaccinium macrocarpon), long reputed to have antibacterial properties, may have the potential to prevent or heal these expensive and painful infections.

Cranberry then and now

As early as the 1840s, German researchers were examining the connection between European cranberry species and urinary tract infections. They found that the urine of people who ate cranberries contained a chemical called hippuric acid. By the turn of the century, U.S. researchers were speculating that this attribute meant that cranberries could acidify urine and thereby prevent infection. By the 1960s, however, the idea of using cranberry to treat such infections had fallen out of favor because researchers failed to show that it increased urine acidity enough to prevent illness. Today, researchers are again addressing the relationship between cranberries and a healthy urinary tract, only this time they are focusing on a different action: cranberry’s potential to keep bacteria from attaching to urinary tract walls.

How infection begins

These infections are generally divided into three categories. Urethritis is an infection of the urethra, the canal that transports urine from the bladder and in males also serves as a genital duct. The infection is usually caused by viruses transmitted during intercourse. Cranberry can’t be used to prevent or treat this condition because it is not effective against viral infections. Cystitis is an infection of the urinary bladder, the organ that stores urine. Pyelonephritis, or kidney infection, results when the bacteria in the bladder migrate to the kidneys. This type of infection is the most serious of the three; it is often accompanied by fever, chills, nausea, and severe back pain. Current cranberry research is focusing on cystitis and pyelonephritis because they are caused by the bacteria Escherichia coli (E. coli).

E. coli serve a positive purpose in the large intestine, where they break down the by-products of digestion. However, they also are responsible for about eighty-five percent of all urinary tract infections. E. coli, which enter through the perineum and travel through the urethra up to the bladder, attach themselves to cells in the bladder wall, where they reproduce, colonize, and cause a bladder infection. Because this infectious process starts to destroy the superficial lining of the bladder and disrupts the small capillaries, urine of infected individuals often contains blood. If the infection progresses, the E. coli will then travel up the urethers and infect the kidneys.

How cranberry works

Tamms-Horsfall glycoprotein, a natural substance present in the urine of some individuals, has the ability to attach itself to the E. coli bacteria and inhibit them from attaching to the bladder wall. Individuals with enough Tamms-Horsfall glycoprotein are unlikely to get a urinary tract infection from E. coli. However, those who lack or have low levels of this natural substance are more susceptible.

In 1994, researchers at Weber State University in Utah discovered that cranberry contains a substance similar in activity to the Tamms-Horsfall glycoprotein. While they have yet to release the substance name until they obtain patent rights, general information is available about how it works. Much like natural glycoprotein, the substance can inhibit the attachment of E. coli bacteria to the bladder wall. In tests where cranberry was added to a petri dish along with E. coli bacteria and bladder cells, the addition of the cranberry substance kept the bacteria from attaching to bladder cells.

Additionally, a 1994 Harvard University study involving 153 elderly women with histories of repeated urinary tract infections showed that regular consumption of cranberry juice cocktail can decrease the incidence of urinary tract infections. In a clinical trial yet to be published from Weber State, the same conclusion was drawn using a concentrated cranberry product. This product, in dehydrated, capsule form, is equivalent to twelve to sixteen 6-ounce glasses of cranberry juice.

Using cranberry

Our bodies do have natural barriers against urinary tract infections. In men, the urethra is up to 10 inches long with natural bends, both of which make it difficult for bacteria to reach the bladder. In females, the perineum helps prevent bacteria from entering the urethra. Females are at a disadvantage, however, because the perineum can be damaged or irritated by tight clothing, intercourse, poor hygiene, or bubble baths, and thus allow bacteria to make their way to the bladder. In addition, the female urethra is only 2 inches long and straight, making it easy for bacteria to reach the bladder. If a female infant or young girl has had two or three infections, X-rays of her urinary tract are in order to rule out possible anatomical abnormalities. In the case of young boys, X-rays are in order with the first infection to ascertain whether the urinary tract is intact and functioning properly.

Females also are more likely than males to get a second urinary tract infection, and within as little as two weeks of the first flare-up. During the initial infection, the lining of the bladder is injured, making it more susceptible to new E. coli seeking to attach themselves before the lining has a chance to heal. As such, some women have recurrent urinary tract infections simply because their bladder never really has a chance to heal.

When I see a patient with an acute (recent) urinary tract infection, I use several avenues of treatment. This may include a single or one-day dose of antibiotic to kill existing bacteria. I combine this with one pill of a concentrated cranberry capsule two times a day for at least one month to protect the bladder against reinfection while it heals. Alternatively, a short-term dose of a natural substance such as thyme (Thymus spp.), goldenseal (Hydrastis canadensis), or queen of the meadow (Filipendula ulmaria) can be taken instead of antibiotics to eliminate bacterial growth in the bladder.

When one of my patients has a series of urinary tract infections, I recommend the same treatment, except the daily dose of cranberry capsule should be taken for three to four months. If the patient suffers no infections during that time, I take her off the product. Some patients will experience subsequent but infrequent infections that can be easily treated. However, others will suffer frequent recurrences. For them, I recommend maintaining the daily dose of a cranberry capsule, possibly for the rest of their lives.

If you enjoy the flavor of cranberry juice, one way to reap its benefits is to drink two to three glasses a day. Most cranberry juice or cocktails contain between 10 and 20 percent cranberry, and for some individuals such amounts are effective enough to prevent urinary tract infections. Although the benefits of drinking cranberry juice outweigh the negative effects of the sugar it contains, for people who are concerned about sugar, such as diabetics, sugar-free juice is available. If you don’t find the cranberry flavor appealing or you require a higher cranberry concentration, many health-food stores carry concentrated cranberry capsules.

Why cranberry holds promise

Currently, the only alternative to cranberry for preventing urinary tract infections is to take an antibiotic regularly. This, however, is not always a good solution because of the risk of allergic reaction and of developing strains of bacteria resistant to antibiotics. On the other hand, the risk of allergic reaction to cranberry is negligible, and the bacteria have not been shown to be resistant to it. Thyme, goldenseal, and queen of the meadow are not effective as preventives, and some, such as goldenseal, should not be taken for long periods of time.

Cranberry also may be effective for patients who have difficulty emptying their bladder, such as men with enlarged prostates or patients with neurologic abnormalities including stroke or spina bifida. When urine remains in the bladder, bacteria have a greater chance of attaching to the bladder lining. Individuals with catheters also face an increased risk because bacteria can be introduced any time a foreign object enters the bladder. Although I know of no studies on this group of patients, it seems likely that cranberry may offer them badly needed relief.

D. Paul Barney is a family practice and emergency room doctor in Layton, Utah. He also is an adjunct professor at Weber State University and author of Clinical Applications of Herbal Medicine (Woodland Publishing, 1996).

Avorn, J.M., M. Monane, J.H. Gurwitz, R.J. Glynn, I. Choodnovskiy, and L.A. Lipsitz. “Reduction of bacteriuria and pyuria after ingestion of cranberry juice”. Journal of American Medical Association 1994, 271:751 – 754.

Fowler, J.E. “Urinary Tract Infections in Women”. Urologic Clinics of North America 1986, 13(4):673 – 683.

Cancer is the second leading cause of death in the United States (heart disease is first). Current estimates say that 30 percent of all Americans will develop some kind of cancer in their lifetimes. The most common forms are cancer of the skin, lungs, colon and rectum, breast, prostate, urinary tract, and uterus.

Exactly what causes all cancers has not yet been found. Evidence suggests, however, that cancer could result from complex interactions of viruses, a person’s genetic make-up, their immune status and their exposure to other risk factors that may promote cancer.

These risk factors include:

• Exposure to the sun’s ultraviolet rays, nuclear radiation, X-rays, and radon.
  
• Use of tobacco and/or alcohol (for some cancers).
  
• Use of certain medicines such as DES (a synthetic estrogen).
  
• Polluted air and water.
  
• Dietary factors such as a high fat diet, specific food preservatives, namely nitrates and nitrites; char-broiling and char-grilling meats.
  
• Exposure to a variety of chemicals such as asbestos, benzenes, VC (vinyl chloride), wood dust, some ingredients of cigarette smoke, etc.).
  

• Do not smoke, use tobacco products or inhale second hand smoke.
  
• Limit your exposure to known carcinogens such as asbestos, radon, and other workplace chemicals as well as pesticides and herbicides.
  
• Have X-rays only when necessary.
  
• Limit your exposure to the sun’s ultraviolet (UV) rays, sun lamps and tanning booths. Protect your skin from the sun’s UV rays with sunscreen (applied frequently and containing a sun protection factor (SPF) of 15 or higher) and protective clothing (sun hats, long sleeves, etc.).
  
• Reduce stress. Emotional stress may weaken the immune system that is relied on to fight off stray cancer cells.
  ]]> 14564