Cranberry juice and Cystitis

I have long been an advocate for the benefit of cranberry juice for urinary problems. However, if we want to practice evidence based medicine, based on facts, perhaps we should re-appraise our attitude to cranberry juice. Many of the treatments we have used for generations (who can remember castor oil-Ugh) are now no longer used because they did not work, and sometimes do harm. Doctors used to bleed people for just about all illnesses in the past – they knew no better. They did not have the Cochrane Centre to help them. Just as an aside, a patient told me during the week that she saw her own GP with a sore joint. Her GP diagnosed Arthritis and gave her an anti-inflammotory pill. She was not happy with this diagnosis so did her own research on google. She diagnosed herself as having bursitis, went to another GP with this diagnosis, who confirmed it as being correct. After an injection into the bursa, the pain went away and she was cured. I mention this not to cast aspersions    doctor’s diagnostic skills, but to remind everyone to always have some scepticism over doctor’s diagnoses and treatment, and seek a second opinion if you are not sure. I must also mention that using the internet for self diagnosis is fraught with risk, as there are many charlatans sprouting false treatments and cures, not to help the patient (who they do not know anyway), but to enrich themselves.
21 January 2013, 2.33pm AEST

Monday’s medical myth: cranberry juice prevents bladder infections

You might eat them in a sauce alongside your Christmas turkey or drink them juiced, perhaps with a shot of vodka. But the sweet, tart cranberry is also well known as a remedy for preventing urinary tract infections (UTIs). Cystitis – an infection and inflammation of the lining of the bladder – is the…

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 There are good reasons why cranberry products could work, but the weight of scientific evidence shows cranberry products are ineffective for preventing UTIs. Flickr/Half Chinese

You might eat them in a sauce alongside your Christmas turkey or drink them juiced, perhaps with a shot of vodka. But the sweet, tart cranberry is also well known as a remedy for preventing urinary tract infections (UTIs).

Cystitis – an infection and inflammation of the lining of the bladder – is the most common form of UTI, with symptoms including:

  • the frequent urge to pass urine
  • a stinging or burning sensation when passing urine
  • smelly urine
  • cloudy or blood urine
  • pain in the low abdomen or pelvis.

This condition occurs frequently in women, with one in three experiencing cystitis at least once in their life. As a general practitioner, it would be unusual for me to not see a case of cystitis most weeks. In most cases, cystitis is easily treated with a course of antibiotics.

As a folk remedy with a long history among Native Americans, cranberry juice was dismissed for years by the medical establishment. But this changed in the 1980s and 1990s when it was discovered that cranberry juice contained chemicals that seemed to stop E. coli (the most common bacteria causing UTIs) from sticking to the lining of the bladder.

Conceptually, if bacteria cannot attach to the bladder lining, then it would be flushed out with the urine and thus not cause an infection.

This thinking has been popularised in the last couple of decades. Cranberry juice and capsules have been widely recommended and promoted as a treatment for preventing bladder infections, particularly for women who suffer from recurrent infections. Health literature aimed at consumers, including high-quality sources, often advise that cranberry products can be used to reduce the frequency of UTI episodes.

Research into cranberry juice and UTIs is still underway. ArunKamaraj

In such a setting, it would be natural to believe that cranberry products were a proven therapy! Indeed, I was taught in medical school that cranberry was effective, and have personally prescribed it for my patients in the past.

Curiously, although there appears to be good scientific reasons why cranberry products could work in preventing UTIs, evidence that it does in real patients has been rather murky.

A 2009 Cochrane Library systematic review, which independently analysed all the available evidence, noted that there was some evidence that cranberry products might work, but it wasn’t clear what the “optimum dosage or method or administration” was.

The large number of dropouts from the available trials also suggested that it might not have been an acceptable treatment over a longer period of time.

This review was updated in October 2012 with the inclusion of newer and larger studies. Disappointingly, this revised appraisal of the empirical evidence seems to suggest that cranberry does not reduce the likelihood of a recurrence of UTIs in women.

I doubt that we have heard the last word on cranberry and there are studies in the pipeline.

But the weight of evidence, especially those from larger and better-designed trials, points towards the likelihood that cranberry products are ineffective for preventing UTIs.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on June 15, 2013, in Uncategorized. Bookmark the permalink. Leave a comment.

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