Dear EndoMune Subscribers,

Appropriately, May’s newsletter is directed to women. May was named for the Greek goddess Maia…and men, don’t forget that Sunday, May 13th, is Mother’s Day.

Let’s start this month’s newsletter with a case report:

CASE REPORT

Susan is a 48 year-old woman who has suffered with recurrent urinary tract infections. She was aware that the symptoms of urgency, frequency and burning are typical warnings signs of an impending urinary tract infection. Her doctor would likely prescribe an antibiotic to treat the infection.

Unfortunately, two years ago, Karen ended up in the emergency room with fever to 1030, generalized aches and hypotension. She was hospitalized and given IV antibiotics for a serious bout of an E. coli bacterial kidney infection.

Susan read about the benefits of taking a probiotic to lessen the risk of recurrent urinary tract infections. She emailed me to say that since starting EndoMune two years ago, she has not had another infection!!

BACKGROUND

The female urinary tract is composed of the kidneys, ureters, bladder and urethra.

The short female urethra places women at increased risk for urinary infections. A urinary tract infection or UTI is a bacterial infection that occurs when bacteria invade the urinary tract system. Nearly 1 in 3 women will have had at least 1 episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UTI during their lifetimes. Financially, the estimated annual cost of community-acquired UTI is significant, at approximately $1.6 billion1.

DEFINITIONS

A urinary tract infection limited to the bladder can be painful and annoying. However, serious consequences can occur if a urinary tract infection spreads to the kidneys.

Susan’s recurrent infections occurred in the urinary bladder, or the cystitis. She was hospitalized because the bacteria were able to travel from the bladder to the kidneys and cause pyelonephritis, a serious kidney infection.

CAUSE

The urine is normally sterile. An infection occurs when bacteria are able to invade the lining cells of the urinary tract. The infection usually starts at the opening of the urethra and migrates into the urinary bladder and at times, up into the kidneys.

The culprit in at least 90% of uncomplicated infections is a type of bacteria called Escherichia coli, better know as E. coli. These bacteria normally live in the bowel (colon) and around the rectum.

These bacteria can accidentally contaminate the opening of the urethra and invade the lining cells of the urinary tract. Two common causes are limited fluid intake and sexual intercourse.

BENEFITS OF PROBIOTICS

There have been many studies2,3 that have evaluated the benefits of probiotic bacteria like the Lactobacillus species in preventing recurrent UTI’s. Different strains have been used in clinical trials. Trials have included oral probiotics and vaginal suppositories. Not all the trials have shown benefit, but no study has found that probiotics cause any adverse effects.

The theory has been that the Lactobacillus bacteria that normally inhabit the vaginal mucosa produce different protective products that destroy or inhibit the invasion of harmful bacteria like E. coli.

Taking probiotics that contain Lactobacillus strains will increase the stool concentration of these protective bacteria. The Lactobacillus bacteria can then migrate from the intestinal tract to the urethra area, stimulating the lining cells to activate an immune response against pathogens like E. coli and producing a biofilm that acts as a barrier against harmful bacteria.

PREVENTIVE MEASURES

For women who suffer with recurrent infections, physicians recommend several preventive measures such as voiding after intercourse, wiping from front to back, and drinking plenty of water.

Physicians will prescribe an antibiotic for UTI’s and sometimes will recommend use of antibiotics as a preventative.

TAKE HOME MESSAGE

While there is no perfect regimen to prevent recurrent UTI’s, may assist with prevention. If you or a loved one suffers from recurrent UTI’s, consider trying a probiotic like EndoMune.

Remember, Mother’s Day is May 13th! Men, consider giving the mothers in your life a bottle of EndoMune.

Eat healthy, exercise, take EndoMune and live well!!

Dr. Hoberman

1) Epidemiology of urinary tract infections: incidence, morbidity, and economic costsBetsy Foxman, PhD, Am J Med. 2002 Jul 8;113 Suppl 1A:5S-13S

2) Prevention and treatment of urinary tract infection with probiotics: Review and research perspective.Borchert D, Sheridan L, Papatsoris A, Faruquz Z, Barua JM, Junaid I, Pati Y, Chinegwundoh F, Buchholz N.Indian J Urol. 2008   Apr;24(2):139-44

3) Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Stapleton AE,

Au-Yeung M, Hooton TM, Fredricks DN, Roberts PL, Czaja CA, Yarova-Yarovaya Y, Fiedler T, Cox M, Stamm WE.Clin Infect Dis. 2011 May;52(10):1212-7