D-Mannose: Natural Therapy for UTI

Urinary tract infections are frequently initiated by bacterial adherence to mucosal surfaces in the lower urinary tract. Oral therapy with the naturally occurring simple sugar D-mannose may lessen this adherence. D-mannose is excreted unchanged and concentrates in the urine, and may relieve initial symptoms or a long-standing, chronic infection. E. coli, a bacteria that is the most common cause of UTIs, sticks to the walls of the bladder by attaching to mannose molecules that are naturally produced by the mucosa (tissue that lines the walls). When free D-mannose is present inside the bladder, it will competitively block the bacterial adherence to bladder mucosa. E. coli that attaches to the free D-mannose molecules are promptly eliminated in the urine. Clinical practice has shown that ingested D-mannose is a benign, practical, and effective therapy, sometimes as efficacious as antibiotics, but without the disruption in normal body microflora and increased risk for yeast infections caused by antibiotic therapy. D-mannose is one of the components of cranberry products, and may be responsible for cranberry’s benefits in fighting UTIs.

D-mannose is started at the first sign of infection. Children usually use ½ teaspoonful at a time while adults use 1 teaspoonful, with instructions to mix the dose in water or juice and drink every 2 to 3 hours. D-mannose may also be compounded as an easy-to-dose liquid preparation. Since D-mannose works very quickly on UTIs caused by E. coli, if the problem is not quickly resolved, another organism may be the culprit. If the infection doesn’t go away or drastically improve within the first day of D-mannose therapy, antibiotics are probably needed. Women who encounter UTIs after intercourse could use D-mannose before and after intercourse to decrease the risk of UTI.

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