It’s Week Three of Nutrifit and I’ve just taught the class all about poop! It’s always a bit of a lottery teaching this instalment. I think it’s such a funny topic — although massively important, too — but not everyone shares my sense of humour.

Fortunately, there was a lot of laughing as we discussed the ins and outs of digestion. We get pretty detailed but they all dealt with it really well and we had lots of “aha” moments. That’s one of the things I love about Nutrifit …. when people have an obvious “Aha, so that’s why that happens” realisation! Suddenly, all their symptoms make sense!

I love “aha” moments in the clinic, too. Not too long ago, I saw a client who had been struggling with urinary tract infections on repeat. When I explained how antibiotics can impact the microbiome, which in turn can impact the health of the urinary tract, she had her “aha” moment. She was able to figure out why the infections just kept coming back and nip the cycle in the bud. Since she’s followed the protocol, she’s been UTI-free for a record number of weeks.

It’s not the easiest topic to discuss but as uneasy topics are my favourite, let’s get down to the nitty gritty.

I thought I’d share this information with you as people often feel shy about seeking help for UTIs. But it’s an extremely common problem and there’s no need to suffer in silence! If you have experienced regular infections, or know someone who has — read on. (Women and children tend to suffer most, but it’s not uncommon for men to get a UTI, too.)

A UTI is a bacterial infection of the urinary tract that usually makes peeing burn at best and at worst, makes it absolutely agonising. Think hot knives! Symptoms can also include urgency, pain in the lower abdomen, fever and nausea, among other things. One of the problems is that in most instances you need to drink plenty of fluids, but as this also increases urinary flow, many people are afraid to drink. On the upside, antibiotics can be swiftly effective but, unfortunately, they can also make a UTI more likely to reoccur. So, it’s important to identify the root cause if we’re going to interrupt the cycle!

We now know that several factors can trigger or exacerbate a UTI and it’s massively helpful to have an understanding of these. The vast majority of infections are E.coli based, although your doctor will check that this is the case. It’s always a good idea to seek a medical diagnosis and the severity of your infection will determine whether you should move straight on to medication, or if you can try a more natural approach. Below are the triggers, some dietary steps for prevention and some ideas for natural supplements too.

Triggers

1, Dehydration

By this I mean a lack of water, not just a lack of fluids. Sugary, artificially sweetened and caffeinated drinks can all irritate the urinary tract. Dehydration itself also irritates the urinary tract as the lack of urinary flow prevents bad bacteria being washed out. Each adult needs to drink approximately 1.5 litres of water daily (minimum) and an extra cup of water for every caffeinated or alcoholic drink.

2, Low levels of friendly bacteria

Friendly bacteria in your digestive tract are responsible for at least 60 per cent of your immunity. They are also present in the vagina. A low level can mean vulnerability to any infection. Although antibiotics are often given for bad UTIs, they also deplete friendly bacteria and so can trigger recurrences in the longer term. Therefore, it’s important to follow a course of antibiotics with a course of probiotics (friendly bacteria) — more on this in the supplements section! Please also bear in mind that the birth control pill, sugar, stress, alcohol and yeast are also known to deplete levels of friendly bacteria.

3, Excess alcohol

As well as causing dehydration and depleting friendly bacteria, excess alcohol can irritate the urinary tract. Ease up! Try flavoured Waterloo, Perrier or La Croix waters for a totally sugar-free and alcohol-free option. Pop it in a wine glass to make it more fun.

4, High sugar intake

Sugar depletes friendly bacteria and increases unfriendly bacteria. Cookies, candy, cakes, pastries, concentrated fruit juice, sodas and fruit punch are all obvious forms of sugar. Be careful of hidden sugars too, for example in sauces, soups and flavoured yoghurts. Anything that has 10g of “sugars” or more, per serving, is high in sugar.

5, Sexual activity

Sex can aggravate a UTI, especially in the absence of lubrication — natural or otherwise! In some instances, sexual contact can also put you at risk from infection if you are not using condoms. I’m not suggesting you don’t do it, but make sure you are comfortable and protected. Note: positions matter, too. As bacteria can travel from back to front, you might want to avoid any position that encourages bacteria to move in the wrong direction. Now’s a good time to fall back in love with missionary. Lastly, women who are prone to UTIs should always shower or rinse afterwards to wash away bacteria. Avoid using soaps or shower gels. Water or a weak solution of water and tea tree oil — approximately one drop of oil per 16 fluid oz — will do just fine!

6, Structural abnormality

Structural abnormality of the urinary tract can prevent free-flow of urine and cause irritation. Your doctor will be able to tell you if this may be a concern.

Dietary steps for prevention:

• Drink lots of water! Filtered, mineral, spring or clean tank water. Aim for 1.5 litres daily (adults) and have an extra cup for any caffeinated or alcoholic drink. Your urine should be pale yellow or clear.

• Eat plain, natural, live or “active” yoghurt as this contains friendly bacteria. You can add a little fresh fruit for sweetness. Avoid fruit flavours which have lots of sugar (often as much as six teaspoons per serving.)

• Replace tea/coffee with decaf herbal teas. My favourites are Rooibos (a South African red leaf tea that’s antioxidant rich) and any of the Pukka teas!

• Avoid alcohol totally if you have a UTI, until a week after you have got rid of the infection. Afterwards if/when you do drink, avoid sugary mixers and make sure you fully rehydrate afterwards. As a preventive measure, don’t exceed seven alcoholic drinks a week.

• Avoid all forms of refined sugar: sugar itself, cookies, candy, cakes, sodas, dried fruit etc. Snack on raw veg with salsa, hummus or guacamole instead. Try wholewheat toast with almond or peanut butter. Fresh fruit with nuts, sunflower and pumpkin seeds are also good options.

• Replace refined carbohydrates (white rice, white bread, mashed potato, most breakfast cereals) with complex carbs (brown rice and bread, sweet potatoes, wholegrain cereals). Note that sugar and refined carbs promote the growth of unfriendly bacteria.

• Try 100 per cent cranberry juice so long as it’s just real cranberry juice with no added sugar or artificial extracts (which are both irritants). Cranberry extract has been shown to prevent bad bacteria adhering to the wall of the urinary tract. Blueberry juice is also good! Eight fluid oz max daily though, and preferably diluted with water (still or sparkling). As unsweetened cranberry juice is very sour, see the supplement section below for an alternative.

Beneficial supplements (please consult your GP before taking supplements):

1, A quality multivitamin and mineral. Choose one with a good vitamin A content (soothes the mucous membrane of the urinary tract) so long as you are not pregnant, or planning on becoming pregnant (pregnant women should not exceed 750ug vA daily). Also choose one with a high antioxidant content as antioxidants boost immunity. I love the Garden of Life brands at Miles.

2, Friendly bacteria. Look for a women’s formula that also provides strains of bacteria for vaginal health. Yes, we have one at Miles! We also have an excellent chewable kids probiotic too.

3, 1000mg vitamin C daily. Look for Ester-C as this is gentle on the stomach. This helps to boost the immune system and fight infection. As vitamin C can thin the blood, consult your doctor before taking if you are on blood-thinning meds.

4, Uva Ursi, cranberry extract or grapefruit seed extract (warning this tastes very bitter!). These are natural antibacterial agents. Take at a different time of day to the friendly bacteria. Check with your doctor if you are already on any medications.

5, Clear Tract D-Mannose. Without a doubt my favourite for an E.coli based infection (especially if you couple it with probiotics). D-Mannose is the sugar found in cranberries that ironically (given that it’s technically a sugar) helps to wash away E.coli from the urethra walls. It’s incredibly effective and you can try it for a mild-moderate infection, or at the first sign of onset. Continue use for a few days after symptoms have disappeared. Completely safe for children at the dosage recommended on the package. Again, available at Miles!

• Catherine Burns is a qualified nutritional therapist. For more details: natural.bm, 505-4725, Natural Nutrition Bermuda on Facebook and @naturalbda on Instagram