It does matter that cystitis recur, dramatically impacted on quality of life for women who have suffered the disease. As my experience, I literally talked with fewer patients whom frequently suffered the bladder infection almost every single month. This article will mainly describes about how to lowering the recurrence rate of Escherichia coli reinfection by yourself without using an unnecessary antibiotic which sometimes drug-resistance bacteria getting more and more problems in Cambodia and elsewhere in the world.
- Life-style modification
Strong evidences show that a frequent of sexual activity mainly related to a recurrent bladder infection. Spermicide using, new sex partner, multiple sex partners, history of STDs and Obesity (BMI > 30) all involved and participated. Some suggestions, for instance, changing spermicide agents, changing method of contraceptive or losing body weight may receive such a good benefit on this issue.
- Topical Estrogen cream
Postmenopausal women always experience a vaginal dryness which causing an Estrogen deficiency and this is a primarily factor making cystitis more easily to recur. Strong evidences show that there’s only a topical vaginal Estrogen cream will gain benefit on this, but taking oral Estrogen is uncounted. Nevertheless, no benefit on the recurrent cystitis and the oral Estrogen tablet has also reported on an abnormal vaginal bleeding and breast tenderness.
- Non-antibiotic supplements
- Cranberry juice – Pro-anthocyanin, a chemical which rich in Cranberry has effect on E coli adherence to and displacement from bladder mucosal cells. There is a randomised trial shows that both 20% Cranberry juice and 18% Cranberry extraction is able to lowering at least 1 symptomatic bladder infection over 12 months.
- Vitamin C – Ascobic acid be able to acidify the urine pH which have bacteriostatic effect. There is a trial shows that 100 mg of daily Vitamin C supplement significantly lower risk of bladder infection after 3 months treatment.
- D-Mannose – A monosaccharide sugar can be excreted via urine. D-Mannose mimics bladder mucosal cells, the target of E coli invasion. Once the bacteria are trapped with D-Mannose, then they are eliminated by normal urination. The latest literature shows 2 – 3 gram of daily D-Mannose is recommended.
- Intravaginal Lactobacillus – Enrich Normal flora at the vagina is able to prevent E coli invasion to the bladder. Intravaginal supplement significantly reduces bladder infection rate in premenopausal women. The recommended regimen is once daily for 5 days then followed by once weekly for 10 weeks.
- Methanamine Salts – US FDA has approved Methanamine salts for recurrent urinary tract infection prophylaxis in whom ages 6 years old or older. When Methanamine salts are in the urine, it turns into formaldehyde which has bacteriostatic effect. Most literatures show significantly reduction in bacteria persistence in the urine. The regimens are varied from 500 mg twice a day to 1 gram four times a day with unclear duration.
- Vaccinations shot – There are several vaccinations currently in the clinical trials with various routes of administration such as oral form and vaginal suppository. From the data I have reviewed, it seems promising in term of recurrent bladder infection prophylaxis.
I think these information might be a values and will be some light shedding in the dark cave for patients whom suffered with a chronic bladder infection. And please don’t forget the principle that we shouldn’t use unnecessary antibiotics because you will be at risk of a drug-resistant infection in the future.