Which alternative remedies work wonders?

Amid an ever-increasing appetite for health knowledge, the interest in alternative and complementary therapies is immense. Last year, my colleague Sylvia Thompson had a huge response to her alternative-health series.

Long before the explosion in alternative medicine, the area of what I call natural medicine was a vibrant one. And unlike some of the weird and wonderful alternative remedies, it seemed to fit comfortably with the prescribing practices of an older generation of doctors.

What do I mean by natural remedies? Some of them undoubtedly border on the terrain of herbal medicine, others appear to have acquired a spiritual element, while the more bizarre treatments defy categorisation.

I have been a "prescriber" of cranberry juice for urinary-tract infections for almost 15 years. In doing so, I was aware of the principal of acidifying the urine as a means of killing off the bugs infecting it. The cranberry juice worked, patients commented favourably on its efficacy and, with no scientific evidence to back me up, I continued to recommend it.

Vindication finally arrived with a June issue of the British Medical Journal, in which Finnish researchers reported on a trial comparing cranberry juice and lactobacillus drink in the prevention of urinary-tract infections.

Pointing out that up to 60 per cent of women will have a kidney or bladder infection at some time in their lives, and that a third of those affected will suffer a recurrence the following year, the Finnish doctors designed a simple but elegant research study.

They recruited 150 women with urinary-tract infections caused by the bacteria E. coli from a student health service and from the staff at a university hospital, then divided them into three groups. The first received 50 millilitres of cranberry juice every day for six months, the second got 100 millilitres of lactobacillus five days a week for a year and the third was left alone, to serve as a control.

Whereas between 35 and 40 per cent of the women in the control and lactobacillus groups had recurrent infections after six months, only 16 per cent of those taking cranberry juice did. In other words, taking 50 millilitres of cranberry-juice concentrate every day reduced the recurrence rate of kidney and bladder infections by about half.

The Finns offered an explanation for the success of the cranberry juice. E. coli, the commonest organism causing urinary-tract infections, makes its way into the bladder from the gut via faecal material. Usually it gets flushed away by urination, they reasoned, but the organism can use finger-like projections called fimbriae to penetrate and adhere to the bladder lining.

Cranberry juice contains substances called proanthocyanidins, which impair E. coli's ability to form fimbriae. Unable to stick to the bladder wall, the bacteria can be flushed harmlessly out of the system.

The implications of this research are considerable. Millions of pounds are spent every year prescribing antibiotics for urinary infection, with many scripts written for prophylactic doses aimed at preventing recurrence. With antibiotic resistance a growing problem, doctors now have an alternative and effective remedy.

After all these years, it is nice to have a logical, scientific explanation to back up my advice. But it is also worth acknowledging cranberry juice's place as a folk remedy long before scientific validation was ever considered.

There are many other natural remedies in regular use. A slice of potato is reported to have wart-killing properties. Bathing feet in urine allegedly helps chilblains. A few drops of warmed olive oil are a soothing remedy for earache. An ointment made from the herbs lesser celandine or elderberry leaf is reported to help the pain of haemorrhoids.

I am sure there are many other natural or folk remedies still in use. If readers would be kind enough to share some of these with me, I will publish your suggestions over the coming weeks. Please include details of the remedy's provenance as well as how it has helped you.

Send details to Dr Muiris Houston, Features Department, The Irish Times, 10-16 D'Olier Street, Dublin 2, or by e-mail to mhouston@irish-times.ie

Dr Houston regrets he cannot reply to individual problems