Thursday, April 12, 2012

April's Healthy News You Can Use!

Urinary Tract Infections and Women's Health

By Marianne Marchese, ND

Ten to twenty percent of all women have some kind of urinary discomfort or infection at least once a year. Acute uncomplicated cystitis and recurrent cystitis are two important categories of urinary tract infections in adults. A narrow spectrum of bacteria causes infections in young women with cystitis: Escherichia coli in 80 percent, Staphylococcus saprophyticus in 5 to 15 percent, and occasionally klebsiella species, Proteus mirabilis, or on occasion other microorganisms. Sexual intercourse, diaphragm use and a spermicide, possibly spermicide used alone, delayed post-coital urination, and a history of a recent urinary tract infection, all increase the risk of infection.

Women who present with painful urination usually have either acute cystitis; acute urethritis due to Chlamydia trachomatis, Neisseria gonorrhea, or herpes simplex virus; or vaginitis due to candida or trichomonas. These problems can usually be differentiated on the basis of presenting symptoms, physical exam and urinalysis. A urine culture, vaginal culture and Chlamydia testing may be needed.

Postmenopausal women may also have frequent infections and are often due to residual urine after voiding or the lack of estrogen causing marked changes in the vaginal microflora including loss of lactobacilli and increased colonization by E. coli. These women often benefit from the use of vaginal estrogen cream.

Therapeutic Approach:

For most bladder infections, a naturopathic approach is usually very effective and the infection resolves quickly and without recurrence or complications. The primary goals are to:

1. Enhance internal defenses against the infection by providing immune support.

2. Restore vaginal microflora

3. Promote a proper pH

4. Prevent bacteria from adhering to the bladder epithelium.

Increasing the urinary flow is important and easily accomplished by increasing the quantity of liquids. Water and herbal teas related to the treatment goals are the most logical choices. 64 ounces is the common recommendation.

No natural approach to cystitis would be complete without mention of cranberry. Cranberry juice has been frequently used as a home remedy by women for decades. Several studies have shown that cranberries and cranberry juice are effective in women with active urinary tract infections. In one study, 16 ounces of cranberry juice daily was effective in 73% of individuals with an active infection. Many people still think that the action of cranberry juice is due to acidifying the urine. However, recent studies have shown that cranberry juice reduces the ability of E. coli to adhere to the lining of the bladder and urethra.

One of the most useful herbs for bladder infection is uva ursi (Arctostaphylos uva ursi), also known as bearberry or upland cranberry. The antiseptic, antibacterial and astringent activity of uva ursi is largely due to its arbutin content. Uva ursi is especially active against E. coli as well as having diuretic properties. Uva ursi has also been used with recurrent bladder infections and was very effective in a double-blind study of 57 women. After one year, five of twenty seven women had a recurrence in the placebo group while none of thirty women had a recurrence in the uva ursi group.

Pipsissewa, a Native remedy of the Pacific Northwest, is a traditional remedy for urinary infections. The mildly antimicrobial effects have been attributed to its arbutin content. Other naturopathic remedies include the use of D-Manose, buchu leaf and homeopathy. There are over 20 different homeopathic remedies for UTI’s and need to be individualized to the woman’s symptoms. The most common homeopathic UTI remedy is staphysagria.

Naturopathic treatments for urinary tract infections in women are very safe and effective once other causes of UTI symptoms are ruled out. If treated early and appropriately a urinary tract infection resolves quickly and without complications.

To schedule an appointment with Dr. Marchese call our front desk at 602-493-2273.

Sick Sleep

By Jake Psenka, ND

This last month some research was published which stated that the use of some types of prescription sleep aids were associated with a 3.6-fold increased risk of death. That’s a nearly quadrupling of a person’s risk of dying, and puts the risk of using these medications on par with the risk a regular smoker has of developing lung cancer. One of the most surprising findings of this research was that even modest use, described as using a mere 18 pills PER YEAR, was associated with a nearly 4-fold increase in risk of death. More regular users of these medications had even more exaggerated risk, and it was estimated that 320,000-507,000 people died in the US in 2010 as a result of using these medications.

So what are these drugs? They are the sleep aids that you’ve likely heard of: zolpidem (Ambien), temazepam (Restoril), eszopicolne (Lunesta), zaleplon (Sonata) and others such as benzodiazepines, barbituates, and sedative antihistamines. The drug with the highest mortality risk was Lunesta.

Nearly everyone has trouble sleeping at some time or another. At our office it’s not uncommon to see 5 or 6 people each week with sleep issues. After spending some time talking with people it is generally evident why they have a problem, and the most common reason is stress. The scene generally plays out like this….a tired person goes to bed, they lie down and close their eyes, and just when they start to drift off their mind lands on some particular thought. Then the mind fixates on that thought, and that thought leads to others, and pretty soon the wheels start turining and the person can’t stop the thoughts and the stress caused by them. At this point sleep isn’t coming easy.

The other common cause of insomnia occurs when someone tries to go to sleep right after being exposed to some sort of stress-inducing event or activity. An example would be “waiter dreams.” People who wait tables work in a high-anxiety world, and sometimes those people will dream about their jobs. While I was in medical school I waited tables at a restaurant and would frequently have fitful sleep after working. On more than one occasion I would jolt awake after dreaming of myself in a panic because I had forgot the catsup.

Of course there are other reasons for insomnia, it just seems that stress and anxiety are the most common problems for people struggling with sleep. It’s really not the stress that is the root of the problem either. The real problem is the amount of unchecked stress a person has to deal with everyday. Unchecked stress is stress that has no outlet, or put another way, it is the condition of having stress without having enough techniques in place to adequately compensate for life’s stressors.

Stress compensation techniques can be many different things depending on the person. A person’s anti-stress could be exercise, yoga, art, meditation, or guided imagery it could even be needlepoint. The only requirement is that it has to be something that induces that zen-like state where the mind flows freely and is no longer burdened by the “have to’s” and “gotta do’s” of everyday life. When someone participates in stress compensation their overall anxiety and stress levels are significantly reduced. This can be so effective that those people who do incorporate stress reduction techniques into their lives have much improved sleep. Not to mention that they have a decreased risk of developing several other stress-related illnesses as well.

It is unfortunate that people are often given a medication before they are educated about natural ways, like stress reduction, to improve their sleep. It’s even more unfortunate that sleep medications are habit forming and difficult to stop taking once started. With this new information regarding the danger of taking these drugs many people are going to find themselves in a sort of insomnia limbo- if they don’t sleep they feel terrible, and if they take the medications they are putting themselves at risk.

Thankfully there are options. There are several very good natural sleep aids that can be used in place of medications. Melatonin, valerian root, and chamomile are just a couple of examples of natural products that have worked for many people. Some people might have an imbalance of certain brain chemicals that are causing them to have sleep troubles. Several laboratory tests are now available to help determine if this is an issue. Addressing the high amounts of stress is the first and most important step to resolving poor sleep habits. However, many will find it helpful to take a natural sleep aid while beginning a stress-lowering program. If you are interested in learning more about reducing stress and natural approaches to improving sleep call 602-493-2273 today to schedule an appointment.