D-Mannose For UTI Pain Relief, Treatment, and Prevention

Cranberries and cranberry juice are a good source of D-mannose



Written by:
Larry Trivieri Jr.

According to the National Center for Health Statistics, urinary tract infections (UTIs) are the second most common type of infection in the United States and account for more than 8 million visits to doctors each year. Broadly speaking, UTIs refer to infections anywhere along the urinary tract, which includes the kidneys, bladder, urethra, ureters, and penis (in men; especially the prostate gland, in the form of acute or chronic prostatitis). Usually UTI’s are treated with antibiotics but there is an alternative-D-Mannose.

Symptoms of UTIs vary, ranging from pain or burning sensations during urination, straining during urination, abnormal frequency of urination, inability to urinate completely, and incontinence. Muscle ache and abdominal pain are other associated symptoms of UTI, and usually occur in older women and in men with prostatitis. In some cases, UTIs can also cause fever, which is almost always a sign that the infection has moved into the kidneys or, in men, the prostate gland. Other signs of UTIs are urine that is cloudy, dark, and/or foul smelling, and urine that contains blood.

There are a number of ways that UTIs occur, including poor hygiene, impaired immune function, the overuse of antibiotics, the use of spermicides, and unprotected sex, but the most common cause, accounting for approximately 90 percent of all cases, is the spread of E. coli bacteria from the intestinal tract to the urinary tract. (The E. coli referred to here is not to be confused with E. coli 0157; H7, which is associated with contaminated food and, if left untreated, can be fatal.) As long as E. coli remains in the intestines (GI tract) where it belongs, it acts as “friendly” bacteria and does not cause problems. In fact, in the GI tract E. coli bacteria aid digestion and help in the production of certain vitamins, such as vitamin K and folic acid. But once the bacteria migrate to the urinary tract, UTIs and their associated symptoms can quickly follow.

That’s because the urinary tract reacts to bacterial infections the same way that the upper respiratory tract reacts to viruses. The tissues along the urinary tract become inflamed, irritated and swollen. As this happens, the inflamed urinary ducts can partially obstruct normal urine flow, making it painful and difficult to urinate normally.

UTIs are commonly treated by physicians with the use of antibiotic drugs. While antibiotics can be effective for eliminating the bacteria that cause UTIs—in some cases in as little as a week or less—they can also lead to other health complications in the future due to the fact that they indiscriminately kill both good and bad bacteria. Prolonged use of antibiotics can cause an increase in the spread of unhealthy bacteria, such as candidia albicans, the bacteria associated with systemic yeast overgrowth (candidiasis) and yeast infections, which in turn can lead to a host of other, more serious health problems.

Ironically, antibiotics can also increase the likelihood of a recurrence of UTIs. In addition, sometimes antibiotics are unable to effectively kill off E. coli and other bacteria in the urinary tract. This is particularly true in many cases of chronic prostatitis. As a result, though antibiotic treatments for UTIs usually do not last longer than two to four weeks, in persistent cases of UTIs, low dose antibiotics can sometimes be prescribed for as long as year or more. Such prolonged use, in addition to destroying healthy bacteria, can also lead to the development of antibiotic-resistant bacteria.

Fortunately, there is a safe alternative treatment for UTIs caused by E. coli that has proven to be just as effective as antibiotic drugs, without any of their side effects. What is this alternative?


But not any kind of sugar. (Most sugars are unhealthy and can exacerbate UTI symptoms.) A particular sugar known as D-mannose can offer relief from UTI symptoms.

How D-Mannose Works To Relieve Pain from UTI’s
Similar in structure to glucose, D-mannose is a naturally occurring sugar that is found in a number of fruits, including apples, blueberries, and cranberries. In fact, the D-mannose content in cranberries is the main reason why cranberry juice is often recommended for minor UTIs. D-mannose for UTI pain relief and treatment is ideal because it is produced by the body in the urinary tract lining and is available in health food stores as a supplement in powder and capsule form.

The reason why D-mannose is so successful at reversing and preventing UTIs caused by E. coli is because of how it attracts E. coli and causes it to bind to itself. For E. coli to cause UTIs, the bacteria, once they enters into the urinary tract, must be able attach themselves to the lining of the urinary tract. If they are not able to do this, then they simply get eliminated from the body during urination.

E.coli accomplishing this task using tiny, hair-like projections known as fimbria that line their cell walls. At the tips of fimbria are substances called lectins. These lectins are programmed to attach themselves and bind to mannose molecules. Since mannose is produced inside the urinary tract lining, mannose naturally occurs along the lining, enabling E. coli to secure their foothold and begin the process of infection.

The use of D-mannose for UTI pain relief and prevention takes advantage of these same mechanisms of action. Once ingested, D-mannose, unlike other sugars, is not readily converted to glycogen and stored in the liver. Instead, it enters directly into the bloodstream largely unchanged and passes intact through the kidneys, to circulate in the urine. There, D-mannose molecules not only attract free-floating E. coli, but they also cause most of the E. coli already sticking to the urinary lining to detach themselves and then reattach themselves to the D-mannose in the urine, after which the bacteria are quickly flushed away during urination. What little E. coli that are left still sticking to the urinary tract are then easily dealt with by white blood cells and other immune cells.

Because of D-mannose molecules’ ability to circulate throughout the urinary tract, they can even help eliminate E. coli attached to the prostate gland. Best of all, not only is D-mannose completely free of adverse side effects, because it is not metabolized in the body like other sugars, it is safe for people who are diabetic or who suffer from high blood sugar, and it also does not cause weight gain, since the body does not store it.

D-mannose typically eliminates UTIs caused by E. coli in as little as 24 to 48 hours. Moreover, D-mannose supplements can also be taken for UTI prevention, a benefit that antibiotic drugs cannot provide.

The typical dose of D-mannose for UTI treatment is 500 mg (capsule form) or one-half to one teaspoon (powder) taken in a glass of water or juice every two to three hours for five days. UTI symptoms should significantly diminish within the first 48 hours, but an additional few days’ worth of supplementation is advised to ensure best results. For UTI prevention, a daily dose of 500 mg or one-half teaspoon twice a day is advised, and can be safely consumed indefinitely.

Note: If you do not notice an improvement in your symptoms within 48 hours, most likely your symptoms are not caused by E. coli. If that is the case, you may need to be treated with antibiotics and should see your doctor.

Bar-Shavit Z, Goldman R, Ofek I, Sharon N, Mirelman D. Mannose-binding activity of Escherichia coli: a determinant of attachment and ingestion of the bacteria by macrophages. Infect Immun. 1980;29:417-424.

Bouckaert J et. al. Receptor binding studies disclose a novel class of high-affinity inhibitors of the Escherichia coli FimH adhesin. Mol Microbiol 2005 Jan; 55(2):441-55.

Ofek I, Beachey EH. Mannose binding and epithelial cell adherence of Escherichia coli. Infect Immun. 1978;22:247-254.

Ofek I, Goldhar J, Eshdat Y, Sharon N. The importance of mannose specific adhesins (lectins) infections caused by Escherichia coli. Scand J Infect Dis Suppl. 1982;33:61-67.

Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2006. National health statistics reports; no 8. Hyattsville, MD: National Center for Health Statistics; 2008.

About the Author

Larry Trivieri Jr.

Mr. Larry Trivieri Jr. is a frequent contributor to Integrative Health Review, the National University System Center for Integrative Health’s free open-access health resource. Larry Trivieri Jr.

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