Antibiotics are widely regarded as one of the great success stories of the last century. And rightly so: since their introduction into medical practice just a few decades ago, they have revolutionised the treatment of conditions such as pneumonia and meningitis, and countless lives have been saved. Despite their undoubted place in modern medicine, there is growing concern that the widespread use of antibiotics is leading to the emergence of an increasing number of superbugs - infectious organisms that are immune to the effect of antibiotic drugs. Because of this, doctors are being urged to curb their antibiotic prescribing habits. It appears that the gleaming reputation of what have been widely regarded as the wonderdrugs of modern medicine have become somewhat tarnished of late.

Given current medical thinking, it makes sense for us to give natural approaches to common infections due consideration. Infection in the bladder, commonly referred to as cystitis, deserves special mention here. This problem affects more than half of all women at some point in their lives, and it is the second most common reason for antibiotic treatment in this sex. However, the good news is that natural help for cystitis is at hand. In this respect, traditional herbal medicine has put much faith in cranberry, and this tart little fruit has been lauded as an effective treatment for cystitis since way before the antibiotic age. Recent evidence suggests that the beneficial properties of cranberry are not merely the stuff of folklore either. Scientific studies have shown that cranberry can help to protect against cystitis and reduce the need for antibiotic treatment in the long term.

Cystitis, the medical term for which is urinary tract infection (UTI) is almost always caused by bacterial organisms. Typical symptoms of this condition are discomfort on passing water and frequent and/or urgent urination. The vast majority of UTIs are caused by an organism called Escherichia coli (E. coli). E. coli makes its way into the bladder from the outside by migrating up the urethra - the tube that takes urine from the bladder to the outside. However, even if E. coli does manage to get access to the bladder, it has to stick to the bladder wall before it can set off a full-blown infection. E. coli has the ability to form finger-like projections called fimbriae, and it uses these to literally grab hold of the bladder lining.

One simple measure that can be taken to keep E. coli from infiltrating the bladder is to drink plenty of water. This, quite simply, tends to flush the organism out of the urethra and bladder before it gets a chance to take get a grip here. About 1½ - 2½ litres of water each day is probably enough to exert significant protective effect here. Urinating as soon as possible after sexual intercourse is of particular importance, because sex increases the risk of E. coli being introduced into the urethra and bladder.

As an adjunct to these simple measures, cranberry appears to offer real potential in protecting against cystitis. Cranberry is rich in substances called proanthocyanidins which reduce E. coli’s ability to form fimbriae, thereby preventing it from getting its sticky little fingers into the bladder wall. The evidence suggests that this disabling effect of cranberry can dramatically reduce the risk of UTIs. In one study a daily dose of 300 mls of cranberry juice effectively halved the number of UTIs and the need for antibiotics in a group of women. More evidence for the benefits of cranberry came from a study recently published in the British Medical Journal. Here, 50 mls of a concentrated mix of cranberry (and some added lingonberry) juice taken each day also halved the number of bladder infections.

Cranberry juice is widely available, and taking a glass or two of this each day may indeed help keep cystitis at bay. However, personally, I have my reservations about taking cranberry in this form. Most commercially available cranberry juices contain are only about a quarter cranberry juice, with the rest often being made up of sweetened water. Refined sugar is likely to have a number of adverse health effects in the long term, and my preference is to avoid it whenever possible. Plus, there is some thought that the processing of cranberry juice may remove or deactivate a proportion of its active ingredients.

To my mind, cranberry extracts (usually in tablet or capsule form) are a better bet for many people. One such supplement is Cran-Max, which is actually a powdered concentrate carefully prepared from the whole cranberry fruit. A recent pilot study compared the protective effects of Cran-Max with low dose antibiotic therapy. Of 12 women treated with a daily dose of 500 mg of Cran-Max for six months, only one had another bout of UTI. In contrast, women treated with antibiotics suffered from an average of two UTIs per person during the same time period. Supplementing with Cran-Max may be a good option for women who tend to be prone to recurrent cystitis attacks. It is available by mail order on 0800 085 2370.

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