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Can Cranberry Juice Treat Bladder Infections?

Cranberries may reduce the recurrence of urinary tract infections, but their role in treating infections is limited.

June 12, 2013 |
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Sources Cited

C. Del Mar. Urinary tract infections in healthy women: a revolution in management? BMC Fam Pract. 2010 11:42.

M. A. Beerepoot, G. ter Riet, S. Nys, W. M. van der Wal, C. A. de Borgie, T. M. de Reijke, J.M. Prins, J. Koeijers, A. Verbon, E. Stobberingh, S. E. Geerlings. Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind noninferiority trial in premenopausal women. Arch Intern Med. 2011 171(14):1270-1278.

Y. Tao, P. A. Pinzón-Arango, A. B. Howell, T. A. Camesano. Oral consumption of cranberry juice cocktail inhibits molecular-scale adhesion of clinical uropathogenic Escherichia coli. J Med Food. 2011 14(7-8):739-745.

S. E. Geerlings. Should we prevent or even treat urinary tract infections with cranberries? Future Microbiol. 2011 6(12):1385-1386.

M. E. McMurdo, I. Argo, G. Phillips, F. Daly, P. Davey. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother. 2009 63(2):389-395.

M. Hisano, H. Bruschini, A. C. Nicodemo, M. Srougi. Cranberries and lower urinary tract infection prevention. Clinics (Sao Paulo). 2012. 67(6):661-668.

R. G. Jepson, J. C. Craig. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2008 (1):CD001321.

A. E. Sobota. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. J Urol. 1984 131(5):1013-1016.

C. R. Bergeron, C. Prussing, P. Boerlin, D. Daignault, L. Dutil, R. J. Reid-Smith, G. G. Zhanel, A. R. Manges. Chicken as reservoir for extraintestinal pathogenic Escherichia coli in humans, Canada. Emerg Infect Dis. 2012 Mar;18(3):415-421.

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R. G. Jepson, L. Mihalijevic, J. C. Craig. Cranberries for treating urinary tract infections. Cochrane Database Syst Rev. 1998 4:CD001322.

J. Bleidorn, I. Gágyor, M. M. Kochen, K. Wegscheider and E. Hummers-Pradier. Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection? - Results of a randomized controlled pilot trial. BMC Medicine 2010, 8:30.

Acknowledgements

Transcript

How could any bacteria cause a bladder infection without just getting flushed away--literally? Certainly if you're not drinking enough, or men who have prostate enlargement and can't empty completely, leaving behind a stagnant pool, but in most people there should be a constant flow of water through there. Well bladder infection-causing E. coli evolved these finger-like projections (fiubrae) that they use to stick to the walls of the bladder so they don't get washed away. 

Almost 30 years ago now, it was demonstrated that if you drip cranberry juice on E. coli they don't stick as well. Grape juice doesn't work, nor does orange or apple juice, or even white cranberry juice made from unripened berries, so maybe it's one of the red phytonutrients that's doing it.

Even if it works in a petri dish, though, you don't pee cranberry juice. How do we know that the anti-adherence phytonutrients are even absorbed through the gut so they make it into the bladder? Well subsequent studies showed that if you drip the urine of someone who drank cranberry juice onto E. coli they don't stick as well either. Ah, well now we're getting somewhere. Here's the stickiness of strains of E. coli wading in urine from someone drinking water; and here's the stickiness in the urine of someone drinking cranberry juice. Within hours of consumption there's a drop in E. coli stickiness that appears to last throughout much of the day. So might cranberries really help prevent bladder infections?

Well the best way to prevent infections is to not get infected in the first place, which may involve the avoidance of chicken, as I've already discussed, so you're not constantly re-infecting yourself. But if that doesn't work, if your gut remains stubbornly colonized with these bad bladder bugs, various tested cranberry products appear to reduce the recurrence of bladder infections by about 35%, not as effective as antibiotics but doesn't foster antibiotic resistance and has fewer side effects.

There's no good evidence to suggest cranberries are an effective treatment, though, which makes sense, right? Cranberries prevent the initial adherence, but that occurs at the start of the infection, but when the infection is present and already stuck there's no clinical data to suggest that cranberries are effective in the treatment of urinary tract infections, meaning it doesn't work better than placebo, but placebos work! For example, ibuprofen seems to work just as good as antibiotics for the treatment of uncomplicated urinary tract infections.

Now some people you really do need to treat with antibiotics—pregnant women, children, men, those with kidney infections, systemic symptoms like nausea and vomiting, but for most healthy women, bladder infections just go away on their own without antibiotics. So all the women who drink cranberry juice and have their symptoms disappear may falsely attribute their recovery to the juice, but when it comes to most UTIs, nothing works! Nothing, in fact, actually works, leading doctors try to figure out how they can harness the placebo effect themselves.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

The reference to poultry as the source of bladder-infecting E. coli is from my last video, Avoiding Chicken to Avoid Bladder Infections.

What else can cranberries do? Check out my recent videos Which Fruit Fights Cancer Better? and Cranberries Versus Cancer.

How can you consume cranberries palatably? Check out my recipe for Pink Juice with Green Foam.

I find it so fascinating that the white berries don't have same effect. For more on these elusive phytonutrients, see Phytochemicals: The Nutrition Facts Missing From the Label and for those doubting the power of plants, Power Plants.

I discuss the controversy around doctors giving placebos in The Lie That Heals: Should Doctors Give Placebos?

If cranberries are so good at keeping bacteria from sticking to the wall of the bladder, what about keeping bacteria from sticking to other places like our teeth? That's the subject of my next video, Childhood Tea Drinking May Increase Fluorosis Risk.

For more context check out my blogs: Does Cranberry Juice Work Against Bladder Infections? and Tea and Flouride Risk

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Risa

    Thank you, Dr. Greger. What about eating cranberries? Any anti-adherent effect here?

  • beccadoggie10

    Thank you, Dr. Greger. Drinking unsweetened cranberry juice always worked for me when on the rare occasion I had a bladder infection. They never seemed to return.

  • http://www.facebook.com/frances.morey Frances Morey

    I had an interesting experience with cranberry UT prevention. I don’t particularly like the taste so I started taking the cranberry food supplement capsules. One fine day I discovered red spots all over the lower half of my body. Not a rash but red spots had developed as if capillaries leaked just beneath the skin. I called the doctor and he said, “What’s new?”

    I told him about the capsules I had been taking. He advised me to stop taking them, and that each capsule contains the chemistry of a pound of cranberries. He told me that apparently I had set up a cranberry allergy and that I would have to avoid cranberries in the future. The spots went away when I stopped taking them. However they quickly come back if I eat or drink anything with cranberry in it. I have become mostly vegan so I never get the UTI’s anyway.

  • Ibili

    I had terrible bladder infections a few times per year for 10 years. I often had to go to emergency because of the pain and take antibiotics, of course. The doctors always seemed shocked that I had blood in my urine, and I always tested positive for bacteria even when I didn’t have an infection. I drank cranberry juice off and on for years, the real stuff. About six years ago I got into a phase of drinking very diluted apple cider vinegar every day. This was for a few months. I haven’t had a bladder infection since (6 years and counting), and my urine tests are clear of bacteria. Are there any studies that explain this?

    • Shary

      Curious how diluted was your apple cider vinegar drink? My mom who is 86yrs old has been dealing with UTI’s from 5/2012 to present. She has been on numerous antibiotics, some more thn once. They do fine until about 7-8 days after last dose then another UTI pops up. Feel so bad for her that I can’t help her in some way on a natural path. Tried the cranberry juice & pills but they aren’t doing any good. I am at a loss & no faith in the medical field at this point. U can contact me at satynros@aol.com

  • Wegan

    I used to get bladder infections pretty regularly and cranberry juice seemed to help but then it stopped working. I then discovered D-mannose ( there is some in cranberries, secret ingredient?) I would take a couple of caps at the first sign and for a day or 2 after – worked for me. I still carry it with me, though I haven’t needed it in quite a while. I wasn’t eating or cooking chicken at the time, mostly vegan diet but too much sugar and peri menopause perhaps. There is no way I could sit around and wait for it to go away on its own, that sucker hurts!

  • OutsideMom

    This is so interesting. I have a duplicated ureter and required kidney surgery for a horrible infection when I was 19. I wonder if it didn’t show up before then because I never really ate a lot of chicken? I was vegetarian (but not vegan) at age 19.

    Anyway, this is the same advice my urologist gave me when I was sick, and I pass the same info on to my friends with UTIs looking for treatment. The thing I found that works the best is to drink a lot of water. Since you feel the constant urge to pee, actually having urine in your body makes it a little more comfortable to do so. I haven’t had a UTI treated with antibiotics in years.

  • pickaname

    nasturtium and horseradish also seem to be effective against UTIs.

  • Kirk

    Dr Greger, please comment on D-mannose. Are there any studies which show its effectiveness treating UTIs? I have been told it is always effective if the bug is E.coli.

  • Jax

    Am interested to know more research on uti studies, are there any suggestions on helping with regular bouts that isn’t antibiotics?

  • jocy

    The important factor of a human being can experience is “healthful body”. But, how can we have a healthy living? By eating a nutritious food such as vegetables and fruits. And we also need to drink juices from vegetables & fruits. In extracting liquid needs a machine. What is the best juicer?. Visit: http://www.benefits-of-juicing.net/

  • Howard Johnson

    What about oral sex and bladder infections?