Urinary Tract Infection Health: YouTea!

Prostatitis

Prostatitis is loosely the male equivalent of a UTI in women as far as frequency goes. Prostatitis is an inflammation of the prostate gland, in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the United States.^[1]

According to uptodate: In one five-year survey of 58,955 ambulatory visits to physicians by men over the age of 18 years, genitourinary tract symptoms accounted for five percent of all complaints [2]. Prostatitis was listed as a diagnosis in nearly two million encounters annually in the United States National Ambulatory Medical Care Surveys.

The symptoms are very similar to a UTI.  The typical story goes like this:

45 year-old otherwise healthy male experiencing urinary frequency in the past 2 days.  His urine burns each time he goes to urinate.  He also has lower back pain with a fevers and chills.

The big bad E.Coli is the cause of bacterial prostatitis 80-90% of the time.  Treatment is with antibiotics for 2 weeks.

In theory, You-T!, and anything else with proanthocyanidins should reduce the incidence of prostatitis because it interferes with the adherence of e.coli.  I need to do more research on prostatitis and proanthocyanidins.  More to come.

Here’s the typical story, courtesy of my USMLE studying and Kaplan Test Prep:

A 52 year old woman comes to clinic complaining of persistent UTI.  She tells you that she has had a burning, almost scalding sensation when she urinates.  These symptoms have lasted months.  Additionally, she has suffered from intermittent urinary incontinence for the last year, which has tended to correlate with the symptoms.  Her PCP treated her with trials of trimethoprim-sulfamethoxazole and levofloxacin, but she has had no improvement in her symptoms.  She denies fevers, flank pain, discharge or recent sexual activity, though she notes that she is having hot flashes.  Physical exam reveals a think, friable vaginal mucosa with multiple small punctate hemorrhages.

Sound familiar?  If so, your PCP may be treating you for a UTI when you don’t have one.

This is a typical case of atrophic vaginitis and the treatment is not an antibacterial medication.  Instead, it is estrogen.  Atrophic vaginitis can cause urinary incontinence and is another mimicker of UTIs.  A topical estrogen can help dramatically.

I had a patient last night who has a history of kidney stones who came in with another episode.  To try to pass the stone, he drank 3 gallons of cranberry juice.  Here’s the low down:

Kidney Stones

Introduction

Kidney stones (nephrolithiasis) are relatively common with up to 12% of men and 5% of women having a stone in their lifetimes. The annual incidence of urinary tract stones in the industrialized world is estimated to be 0.2%.

Pathophysiology

Kidney stones are caused by crystal aggregations formed in the kidneys from dissolved urinary materials.  Kidney stones are mainly made of calcium oxylate crystals or uric acid (~75%).  Nearly 15% are caused by magnesium-ammonium-struvite (phosphate) which is usually the result of recurrent UTIs.

Treatment

Nearly 90% of stones 4mm or less will pass spontaneously and 99% of stones greater than 6mm will require some sort of intervention.

When a patient comes to the emergency department with a kidney stone the standard treatment is:

1. Pain control with an opiate (morphine, dilaudid) and/or anti-inflamatory (toradol)
2. Anti-nausea medication
3. Antibiotics, if evidence of infection
4. Intravenous hydration is recommended but using fluids to flush out stones is not shown to be beneficial.

Kidney Stones and Cranberry Juice

Apple and cranberry juice contain oxalates, and both have been associated with a higher risk for risk for calcium oxalate stones. Cranberry juice has properties that may increase the risk for both calcium oxalate and uric acid stones. On the other hand, cranberry juice helps prevent urinary tract infections and so may be helpful for reducing the risk for struvite and brushite stones. (These stones are far less common, however.) For many years it was believe cranberry juice could be used as a home remedy to help prevent kidney stones. After the latest research results were concluded it is now believed cranberries may very well be the causes of kidney stones.

References:

UptoDate.com

About.com

Emedicine

Newton CR, Khare R, “Emergency Medicine”

Re-post:

YouTea! delivers an over-the-counter solution to a prevalent women’s health problem. YouTea! is a start-up consumer health company that aims to improve women’s health through prevention and relief.  We are first targeting certain diseases to gain initial adoption but will position YouTea! as a general women’s health product as we grow our business.  We have developed a prototype that is less than 10 calories per serving and tastes great!

The YouTea! is looking for 1-2 experienced people to assist in multiple projects. The YouTea! is undergoing rapid growth and needs an intern to assist in marketing, strategy, and business development. We are looking for full time or part time interns to start immediately but we are flexible with the start date.   The intern can work remotely, but we would prefer for the intern to be in Boston.

We are looking for an intern to work very closely with the co-founders. The intern will also interact with many experts including Harvard Business School professors, beverage company CEOs, and other entrepreneurs. He/she will participate in many meetings, focus groups, and will learn a great deal about entrepreneurship and building a business.

The ideal candidate will have experience in marketing, supply chain, or advertising. Interest in women’s health or healthcare is preferable. You must be excited to work in an entrepreneurial environment. You must be enthusiastic, trustworthy, bright, and industrious. We will not be able to offer visa sponsorship for our interns.  The internship will be at least 8 weeks with the opportunity to convert to a full time position.

Potential responsibilities include, but are not limited to:
• Conducting focus groups
• Product Development
• Contacting manufacturing companies
• Press Releases
• Contacting medical doctors
• Business Development

Please email your cover letter and resume to jobs@drinkyoutea.com.  Please state in your cover letter:
1.    Available start date
2.    Preferred end date
3.    Number of hours available to work per week (full time or part time)
4.    Current location
5.    Whether you have transportation
6.    Why you are interested in interning with YouTea!

Yesterday evening, I had a 19 year old patient who was having a miscarriage (spontaneous abortion). She was a very healthy girl with no past medical history, with the exception of recurrent urinary tract infections.

This time urinary tract infection had terrible consequences though.  Normally, she would just drink gallons of cranberry juice and sometimes take antibiotics, but she wasn’t able to slow the progression of this UTI.  Her simple bladder infection kept getting worse and worse and she soon got a kidney infection too.  We think that this kidney infection may have precipitated her miscarriage.

Getting UTIs during pregnancy is potentially dangerous.  According to healthline.com “Pyelonephritis [kidney infection/UTI] during pregnancy is also a leading cause of preterm labor, which puts the baby at high risk for serious complications and even death.”

Unfortunately, many women are uneducated about the consequences of UTIs, especially in pregnancy.  Try to prevent UTIs – your health and your unborn child’s health depends on it.

Alex: "Wow, so cool, RATM drummer" Brad: "Wow, dork"

Natural Products Expo East. THE place to be for all types of natural products: foods, beverages, dietary supplements, health and beauty products. All the hippest trends of the natural world came out to play. Probiotics. Acai Berry. Homeopathic Flu Remedies. Gluten-Free Pizza. Gluten-Free Brownies. Gluten-Free Tortilla Chips. Gluten-Free Salsa. Gluten-Free Shampoo. Gluten-Free Acai Berry. Rage Against The Machine?!?

Natural Products Expo was one of the best experiences of my life, up there with my wedding day and the day I touched down @ Fort Drum, NY from Baghdad International Airport. Well not quite. Still, much more than I expected. What did I expect? To learn a lot about manufacturing and marketing natural products. Check. To spot the latest industry trends. Check. To meet some movers and shakers among manufacturers, distributors, brokers, retailers and investors. Check. To meet one of my rock & roll heroes? Hadn’t quite expected that, but check.

From the opening keynote, I knew it was going to be a good conference. Bryant Terry, a self-described “food justice activist,” “eco chef” and omnivore who paradoxically wrote The Vegan Soul Kitchen kicked things off bright and early day one. Interesting and thought-provoking speech. Food is more than just what’s on the plate. A lot more. He made some salient points about revitalizing local farms and local food, retelling tales of summers in his grandparents’ urban oasis filled with fresh beans, peas, peaches and cabbage. Why must we now settle for Ho-Hos and Doritos today? He asked. I agreed, distracted by visions of his grandparents’ fresh vegetables. Some points I did not agree that seem to be more political than food-related. Such is life. Then he told us about THE song that changed his life. He started rapping it. “Beef, what a relief . . .” he began, with a decent impression of KRS ONE. I knew the song. Had heard it probably 2000 times. I loved Boogie Down Productions. I took the liberty of chiming in. He looked annoyed and stopped rapping. I blurted out “KRS ONE, Boogie Down Productions Edutainment!” As if I were a lifeline on “Who wants to be a millionaire” and my wife had just phoned me. Turns out I was the only one who knew the song in the entire audience. It must have looked pretty bizarre to everyone else in the audience, particularly considering I was wearing wool slacks and a blue button down shirt. I looked something like this dude (not really).

Great conference moment 2: Mark Bittman. Forget Bobby Flay or Julia Child, this dude is my culinary hero. He wrote a cookbook called How to Cook Everything. Why would I need anything else? I have used his cookbook 1000 times (sometimes while listening to KRS ONE). I’ve cooked everything from noodle kugel to buckwheat pancakes to steak au poivre to asparagus quiche with some help from my boy Mark. Contrary to my expectations, turns out seeing him was not the conference highlight . . .

I was checking out the Olade booth. Love the logo, the packaging. Tastes great too, especially for a stevia-sweetened product. Talked to the brokers at the booth, and they told me the story of the product: this guy Brad woke up one day with blurry vision. Turned out he had Type I diabetes and lost part of his vision. He had a tough job and used to crush energy drinks. The kind with tons of sugar (incidentally, Red Bull and RockStar and Monster have fewer calories and less sugar per serving than Cranberry Juice Cocktail, but I digress). After the diabetes, he launched a crusade for drinks without tons of sugar and that nasty high fructose corn syrup. Hence Olade. “Oh yeah,” the broker said, “Brad is Brad Wilk, the drummer from Rage Against The Machine.”

OMG OMG OMG OMG. I blushed like a schoolgirl at a Backstreet Boys concert (ok I’m dating myself). I LOVE RATM. It all started in the weightroom. Blasting RATM to crank out that extra rep. Then in the Army. RATM to keep us going on patrol. The first Platoon that I led was nicknamed “The Renegades,” and I decided to adapt “Renegades of Funk” as our official theme music, blasting the song from a boombox during big events. Even today, nothing better than a little “Bulls on Parade” after a tough day on the Bolt Bus.

Who could’ve imagined that I would meet my favorite drummer from my favorite band at a natural products show? I wonder if RATM will soon release a gluten-free CD?

Why do you get a yeast infection after you get treated with antibiotics for a UTI?

The mainstay of treatment for an acute urinary tract infection is antibiotics plus lots and lots of fluid and anything with proanthocyanidins.

Like we have explained in other blogs, the most common cause of urinary tract infection is the little bugger, e. coli.  Usually, patients are prescribed a course of Cipro, or another antibiotic to kill the bugs in your urinary tract.

Bacteria aren’t always bad.  In your urinary tract, most bacteria are bad, but in the vagina, there are some good bacteria that battle yeast.  When you take antibiotics to kill off the bacteria in your urinary tract, it also kills some of the good bacteria in your vagina, thereby disturbing the normal balance.  According to Dr. Spock, “Anywhere from 25 to -70 percent of women will get a yeast infection after taking a course of antibiotics.”  The good bacteria die and the yeast then have the opportunity to thrive.

Can you prevent a yeast infection when you are taking antibiotics?

Sometimes.  Yeast thrive in wet, warm environments.  Cotton undies help to absorb some of the moisture and make the environment less conducive to yeast growth.  Better yet, when you go to sleep, go commando.  Wearing no underwear keeps the vaginal area dry, which also helps.  Lastly, keep the area clean.  Practice good hygiene- shower and take baths, but do not douche.  Douches can sometimes make things worse.

So, ladies, try not to get a UTI.  Not only can you get the consequences of a UTI, you also get the side effects of antibiotics!

Backstage @ the MIT 100K Entreprenuership Competition Finals: Tina and I felt kind of like the Hickory High School team in the locker room. Remember? From the movie Hoosiers? (check out the clip for goosebumps) We won the Products & Services Track. We were honored and humbled to be Finalists:

 So what made us successful?

1. Round Peg in Round Hole: We weren’t faking it. Our team clearly believed in YouTea! and were the right team to execute the plan. Judges noted our authentic passion for our product, women’s health and entrepreneurship. We certainly noticed that about all of the finalists: K Splice, MeterLive, Global Cycle Solutions etc.

2. We Feel Your Pain . . . And Might Be Able To Help You: We identified a problem (urinary tract infections). Women were not satisfied with current solutions (lots of calories, lots of sugar, lots of acidity, not optimized for women’s health). We developed a solution (YouTea!). The problem came first, we listened to the customer, and developed the solution. Not the other way around.

3. We Listened To Our Mentors . . . But Never Lost Our Soul: We were lucky to have fantastic mentors in nutritional medicine, venture capital, marketing, and food and beverage industry who taught us a ton about how to develop a successful business plan. Still, we were committed to reinventing the rules of urinary health and women’s health. That means that not every YouTea! strategy is “business as usual.” For instance, some suggested that we use artificial sweetener. But we are dedicated to making YouTea! all natural. It may take a little longer, and cost a little more, but we are committed to delivering an all-natural product.

4. We Had A Real Product: The majority of business plan entrants have great concepts, great powerpoints, great resumes, great financial projections . . . but nothing that you can hold. We used our $1000 budget to develop a prototype. Nothing special, but a working sample of what YouTea! will be like on the shelves.

So what could we have done better?

1. Product Or A Business? YouTea! will develop a women’s health functional beverage product line for many indications. In the future. For now, we are focused on urinary health. Some judges felt we were too focused, noting that it is difficult for a 1 product company to survive in a retail environment. I’ll take the hit for that decision. I’ve always believed in focus. Call it my Army experience. I have that poster on my wall (not really).

2. Wow Factor We weren’t building a rocketship. Just a functional beverage. This is an MIT competition after all, and super cool technology gets people excited. Then again, if Tina and I tried to build a rocketship, it would probably look like this.

Another day in the Emergency Department, more urinary tract infections.

It’s a question that I get asked all the time:  Why does sex cause urinary tract infections?

Well, sex in and of itself does not cause UTI’s, per se.  Bacteria in the urinary tract cause UTI.

Let’s go through some definitions first.

• UTI: Urinary tract infection, some also refer to it as a bladder infection
• Urinary tract: kidneys, ureter, bladder
• E.Coli: Escherichia coli, bacteria that causes 90% of UTIs.  It also causes meningitis, pneumonia, food poisoning and other bad illnesses.  E.Coli are bacteria normally found in your large intestines and everyone has it in their bodies.  E.Coli is in everyone’s fecal matter.
• Urethra: the opening through which urine leaves the body. The opening is right below the clitoris.

Sex is associated with UTIs because placing anything near your urethra is going to increase your chance of getting a UTI.  Similarly, wearing tight underwear (thongs) or synthetic underwear (nylon, silk) is also going to increase the chance of getting a UTI.

Simply stated, when you have sex, sometimes you get a tiny amount of fecal matter near your urethra.  E.coli are very smart and they climb into your urethra and crawl up your urethra, up into your bladder.  That’s when the UTI begins.  E.Coli multiply like rabbits in your bladder and then you feel the pain, need to urinate, and bladder spasms.  If you don’t get it treated, it can up to your kidneys and then you get a kidney infection (pyelonephritis), then the bacteria can get into your bloodstream and causes urosepsis (bacteria in your blood from a urinary source), and death.

Most of the time however, you get a UTI, you get treated, and it will not be complicated.  In fact, according to iVillage: “In young healthy women, the vast majority of urinary infections are mild. More than 80 percent actually resolve without any treatment. However, I recommend seeking treatment in all suspected cases of urinary tract infections, to avoid the rare risk of serious complications.”

Hope that answers your question.

One of the many reasons that Tina and I founded YouTea! together lay in our mutual desire to be creative. We did not believe that pharmaceutical and biotech companies should have a monopoly on women’s health solutions. And we did not believe that the pain relief products on the market are proper solutions for urinary health. They are merely band aids that mask symptoms, they are not optimized women’s health solutions. YouTea! rests on a foundation of providing creative solutions for women’s health and urinary health.

So now I have our first dilemma, where our mission and “tried and true” marketing tactics are not quite aligned. I am no marketing expert, just a dude with an MBA, a vision, a goal, and several pairs of Old Navy cargo pants. So I need help from professional marketers. I spend several hours a day speaking with marketing experts and consultants and much of their advice is valuable. However, many want to simplify YouTea!’s vision, and I am just not so sure . . .

Case in point: A Type Proanthocyanidins. What are proanthocyanidins? They are powerful antioxidants, found in a host of foods such as grapes, red wine and many types of berries. One of the many benefits of proanthocyanidins is that they bind to E. coli. A-Type proanthocyanidins are better at binding to bacteria than other types[1]. What does this matter for YouTea!? Studies demonstrate that 80-90% of urinary tract infections are caused by E. coli[2]. E. coli cause urinary tract infections because they bind to the urinary tract and release toxins. A Type proanthocyanidins bind to E. coli, thereby preventing the bacteria from attaching to the urinary tract.

This seems like a simple concept: proanthocyanidins are good because they bind to the bacteria that cause UTIs. So proanthocyanidins are our friends, our heroic promoters of urinary tract health. Right? Right?

“Not necessarily!” say the marketers, wagging their well-manicured fingers in my face:

“It’s such a complicated word.”

“7 syllables in 1 word!”

“Doesn’t exactly roll off the tongue”

“Consumers like simple words: Coke. Pepsi. Nike. Mac.”

“Why not just say supercalifragalisticexpeolidocious (idiot)?”

Some creative suggestions have been made. “Let’s simplify proanthocyanidins to (wait for it) . . .  PACs.” Woohoo. Too bad it rhymes with one of the most heinous words in the English language: “tax.”

So what do you think?!? Can we say “forget the old school, let’s rewrite the rules” and learn to say “proanthocyanidins” together? Or is the first of many lessons I have to learn about the conflict between idealism and feasibility?

[2] http://bit.ly/hfMYb