Nutrition IV - Common Ailments in Clinic - Urinary Tract Infections

Question 1

Urinary Tract Infections

Answer 1

An infection of any part of the urinary system – Kidneys, ureters, bladder and urethra (most commonly affects bladder – cystitis).

Question 2

Causes and risk factors

Answer 2

• Women are at greater risk than men (shorter urethra– increasing the chance of bacteria ascending to the bladder).
• Increase sexual activity introduces new bacteria to the area
• Antibiotic use reduces beneficial bacteria
• Menopause – low oestrogen = decreased vagina mucus = decreased monitoring of bacterial species in the area
• Elderly – lowered immunity, decreased mobility, increased chance catheteriaation

Question 3

General nutritional aims

Answer 3

• Avoid simple sugars and refined carbohydrates, they decrease immunity and have a negative impact on the microbiome
• Optimise colonization of microflora (prebiotic and probiotic foods)
• Increase foods rich in antioxidants and immune-boosting nutrients
• Reduce substances that irritate the urinary tract – caffeine and alcohol
• Ensure optimal water intake to flush bacteria through the urinary tract (inc. herbal teas)

Question 4

D-mannose

Answer 4

D-mannose (500 mg every 2 hours for 3-5 days)
* A naturally occurring simple sugar found in certain plant foods e.g. cranberries
* Functions:
o Inhibits adherence of pathogenic bacteria to the bladder epithelial wall
o Has an affinity for E.coli (predominant bacteria in UTIs) and binds directly to the glycoprotein that the bacteria normally uses to anchor itself

Question 5

Vitamin C

Answer 5

Vitamin C (500 – 5000 mg / day in divided doses)
* Food sources:
o Peppers
o Broccoli
o Kale
o Cauliflower
o Tomatoes
o Kiwifruit
* Functions:
o Has immunostimulatory effects
o Regulates lymphocytes, phagocytes and natural killer cells
o Helps maintain integrity of the uro–epithelial lining of the urinary tract

Question 6

Vitamin A

Answer 6

Vitamin A (25,000 iu / day)
* Animal sources:
o Liver
o Fish liver oils
o Egg yolk
o Oily fish
* Plant sources:
o Carrots
o Sweet potato
o Squash
* Functions:
o Maintains integrity of the urinary tract mucous membrane (first line of defense)
o Plays a role in re-epitheliasation of damaged mucosal surfaces
o Supports immune function; enhances T-cell proliferation

Question 7

Zinc

Answer 7

Zinc (25 – 60 mg / day)
* Food sources:
o Sesame seeds
o Pumpkin seeds
o Cashews
o Lentils
o Brown rice
o Oysters
o Salmon
* Functions:
o Increases phagocyte, natural killer cells T- and B-cell activity
o Increases resistance to infection

Question 8

Cranberries

Answer 8

Cranberries:
* Contain high levels of vitamin C & phytonutrients such as proanthocyanins which prevent bacterial adhesion to the bladder wall (most notably E. coli)
* Dosages and method of delivery:
o 500 mg powder 3 x day
o 15 – 30 ml unsweetened 100% (undiluted) cranberry juice daily and ensure plenty of water (2-3 litres / day) is also consumed
o Be sure to avoid sweetened cranberry juice

Question 9

Re-inoculate vagina bacteria

Answer 9

Re-inoculate vagina bacteria:
* Post-infection, re-introduce beneficial bacteria to the vagina area
* Apply one to 2 tsp. of probiotic yoghurt daily to the area for one week
* Alternatively one capsule of probiotic bacteria can be mixed into the yoghurt and smeared directly inside the vagina wall. Targeted supplements/powders also exist (e.g. invivo; Bio.Me Femme UT)
* Important: if symptoms are not improving within 48 hours or the client is experiencing back pain, fever, nausea or vomiting they must seek medical support