How D-Mannose Can Reduce Your Recurrent UTI
Of all of the problems you can experience with your bladder, Urinary Tract Infections (UTI) are probably the most common. UTI are the most frequent infections seen by health providers and more than half of all women will experience this kind of infection at some point in their lives. Furthermore, Urinary Tract Infections become more common as we age. After menopause, 10% of women will report at least one UTI each year. But for many women, the misery does not end once they have finished treatment for a UTI. Around 25% of women who have a bladder infection will go on to develop recurrent Urinary Tract Infections. Recurrent UTI are usually defined as 3 or more infections in 12 months or 2 infections over 6 months. They often recur very rapidly after completing treatment, often within just a couple of weeks. This recurrence can sometimes be so quick that it can be difficult to tell whether the first infection actually went away. The chances of developing a recurrent infection after treatment of a UTI go down 3-4 months after treatment of a first infection. There is more information about recurrent infections in the UTI section of the website.
How We Might Get Recurrent UTI
What is it that makes recurrent UTI so common after treatment of a bladder infection? At first, it seems logical that if you have factors that put you at risk of getting one infection, shouldn’t you be at risk for getting a second infection? A third? But the risk of recurrent UTI begins to decrease in the months after treating the first infection. This suggests that it may be something about the infection itself, or perhaps the treatment, that increases the risk of the next UTI. One plausible explanation is that since antibiotics kill many normal, healthy bacteria in the body, the treatment of UTI with antibiotics may be responsible for the increased risk. It seems possible that these bacteria are beneficial and that one benefit is a reduction in the risk of getting a bladder infection. So, when looking for therapies that can help to prevent the next infection, a lot of attention has turned to things that would reduce the risk of infection without harming the normal bacteria of the body. D-mannose seems to fit that description.
How D-mannose Works
Before we explain how D-mannose may accomplish that feat, it’s important to understand how bacteria can cause infections in the bladder. First, not all bacteria in the bladder are harmful and it may actually be beneficial to have some types of bacteria in the bladder. Previous studies have found that certain types of Lactobacillus bacteria appear to live within the bladders of healthy women. These studies also suggest that the loss of these Lactobacillus bacteria may lead to increased issues with your bladder. These issues would include frequent or urgent urination and more frequent Urinary Tract Infections. But, while some types of bacteria are healthy, others can cause real problems. One way that these bacteria may cause disease involves the bacteria sticking to the bladder cells. E. coli bacteria cause about 80% of bladder infections. These bacteria use special proteins (called adhesins) to help them attach to bladder cell walls. It is thought that this attachment to the bladder cells is important to causing infection. So, anything that can interfere with this attachment could reduce the likelihood of infection.
D-mannose is a sugar that is closely related to glucose and is quickly absorbed into the blood when taken by mouth. It is usually taken as a capsule or as a powder. Unlike glucose, D-mannose is mostly released into the urine instead of being completely used by the body. Once secreted into the urine, it has an impact on bacteria that may be in the bladder. Bacteria such as E. coli that use an adhesive protein to attach to bladder cells which allows them to cause an infection. D-mannose, once released into the urine, tends to attach to these proteins and can keep bacteria from sticking to the bladder cells. This is thought to decrease the likelihood of bladder infection.
What Do Studies on D-mannose Tell Us?
At least 10 separate medical trials have looked at the impact of D-mannose on infections over the last several years. Many of these studies combined D-mannose with other medications or were not meant to study people with recurrent UTI. This has made it challenging to know if D-mannose truly can help to prevent recurrent Urinary Tract Infections. However, at least 2 of the studies looked at whether D-mannose could be used specifically to prevent recurrent UTI. In addition, both of the studies compared the use of D-mannose to an antibiotic taken for an extended time. While long-term antibiotics can be taken to reduce recurrent UTI, one issue with using antibiotics as a preventative agent is that they may have a harmful effect on normal, healthy body bacteria. There also is very little evidence that taking an antibiotic beyond 6 months continues to reduce the risk of infection. Over time, infections with bacteria resistant to that antibiotic emerge. D-mannose was found to be at least as effective and possibly more effective than a low-dose antibiotic at reducing recurrent infections. In addition, it is unlikely that D-mannose would have such a negative impact on normal bladder bacteria. Few side effects were reported in any of these trials, with diarrhea occurring (in less than 10% of patients) in one study.
While there are many things that are commonly recommended to help prevent recurrent urinary tract infections, D-mannose may be one of the most successful with few side effects. With a quick internet search, you will find that D-mannose is quite affordable and widely available online and in stores. In my own practice, I frequently recommend D-mannose to patients with recurrent UTI, particularly those with a history of E. coli infections. My patients report few side effects and their success seems to mirror that described in the studies described here. This may be a simple way for many people to control a very troubling problem.
