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Cranberry and Other Supplements Used for Urinary Tract Infections
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[2008 updates are highlighted in red]
| Description: |
People with MS are prone to bladder difficulties, including urinary tract infections (UTIs). Cranberry, derived from the fruit of the cranberry plant, may prevent urinary tract infections. |
| Rationale: |
In the past, it was thought that cranberry might prevent UTIs by making the urine acidic. This does not appear to be the case. Instead, two chemical constituents of cranberry, a type of sugar known as fructose and another compound known as proanthocyanidin, appear to keep bacteria from adhering to the wall of the urinary tract. Like antibiotic medications, cranberry may also kill some bacteria. |
| Evaluation: |
Limited clinical studies with cranberry indicate that it may prevent UTIs in some people. Specifically, beneficial effects have been found in studies of UTI prevention in women with normal bladder function. However, in limited studies of people with abnormal bladder function, which may occur in MS, cranberry was actually found to be ineffective for preventing UTIs. The ideal clinical trial with cranberry has not been done in any group of people. Due to the availability of antibiotic medications and the complications that may occur with UTIs in people with MS, known infections should be treated with antibiotics and not cranberry. The evidence for two other UTI-related dietary supplements, vitamin C and bearberry (uva-ursi), is less clear than that for cranberry. Clinical studies do not provide strong support for either of these in the prevention of UTIs. In addition, there is concern about bearberry because it contains hydroquinones, which are chemicals that may have cancer-causing properties. |
| Risks: |
Cranberry is inexpensive and generally well tolerated. Cranberry may interfere with blood-thinning medications, which include warfarin (Coumadin®). Long-term use of high doses may increase the risk of kidney stones and may cause gastrointestinal discomfort, loose stools, and nausea. There is insufficient information about the safety of cranberry in women who are pregnant or breastfeeding. |
| Costs: |
Cranberry tablets are less expensive than juice. |
| Committee opinion: |
In the opinion of the Committee, cranberry is possibly effective for preventing UTIs in women with normal bladder function. In people with abnormal bladder function, cranberry does not appear to be effective for UTI prevention. Further clinical studies are needed to determine if it is definitely effective for UTI prevention in any group of people. Cranberry should not be used to treat known UTIs, especially in people with MS. It is usually well tolerated and is inexpensive. |
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