Three little letters drive many women crazy. U, T, and I combine into Urinary Tract Infection in millions of women yearly, causing significant discomfort and inconvenience. For some, it is a short-lived condition that resolves with either natural remedies or antibiotics. For others, the bladder pain can persist for days or weeks after the actual infection is long gone. Both the suffering women and their medical providers are looking for answers to these persistent, non-infectious symptoms. This study offers an answer that involves our mast cells interacting with nerves in the bladder.
Many factors contribute to the development of UTI’s in women. Waiting too long between bathroom breaks can allow bacteria to grow into an infection. The simply shorter distance from bladder to urethral exit of urine allows bacteria to work their way backwards into the bladder. Sexual activity can be a risk factor. For post-menopausal women, drier vaginal mucosa from low estrogen can increase their risk.
For those unfortunate women who have to deal with more than one UTI, they may resort to natural therapies like D-mannose from cranberry, uva-ursi, or garlic to deal with prevention or treatment. Others will keep some antibiotics on hand for early symptoms, even taking a dose after intercourse to prevent the next infection. For post-menopausal women, topical vaginal estrogen can do a lot for prevention.
However, for those whose urine tests show that the infection is gone, but continue to have pain, such natural or pharmaceuticals don’t offer as much benefit. Some find out they have something called interstitial cystitis in which an allergic-type inflammatory response occurs in the bladder wall. They start reacting to foods or other chemicals passing through the bladder with pain and spasms.
In others, there is no clear inflammatory source continuing after the infection is treated, but the pain persists. In this study, researchers found that the sensory nerves of affected patients were highly active. Normally during an infection, not only is the superficial layer of mucosal tissue sloughed off from inflammation, but many nerves are damaged in the process. Both the mucosa and the nerves must regrow. The nerve regrowth is stimulated by growth factors released by mast cells in the bladder wall.
Mast cells are immune cells which respond to inflammation, directing where inflammation should occur and how much inflammation should occur during an immune response. They are like on-site sergeants directing the immune response.
In these patients with post-UTI prolonged pain syndromes, they found increased regrowth of these sensory nerves that likely lead to increased pain sensitivity. In a model of the disease process created in mice, they were able to prevent this process by inhibiting mast cells from producing the nerve growth factor.
For our functional medicine patients, we have found that some benefit from mast cell stabilizers therapies like quercetin or luteolin when they are having recurrent bladder symptoms despite clean urine cultures (meaning no infection is present). We find it helpful to learn of research like this which explains a potential mechanism for the efficacy of our therapies. Helping our patients restore healthier more abundant lives requires keeping our eyes open for how our patients respond to therapies as well as our ears open for new findings such as this one.
Original Online Article
An Overgrowth of Nerve Cells Appears to Cause Lingering Symptoms After Recurrent UTIs. Published February 21, 2024 | Updated February 21, 2024. Accessed May 22, 2024. https://corporate.dukehealth.org/news/overgrowth-nerve-cells-appears-cause-lingering-symptoms-after-recurrent-utis
Thanks to Science Daily
Duke University Medical Center. “An overgrowth of nerve cells appears to cause lingering symptoms after recurrent UTIs.” ScienceDaily. ScienceDaily, 2 March 2024. <www.sciencedaily.com/releases/2024/03/240302171534.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
