 How could any bacteria cause a bladder infection without just getting flushed away? Literally, certainly if you're not drinking enough, or men who have prostate enlargement can't empty completely, leaving behind a stagnant pool. But in most people, there should be a constant flow of water through there. Well, bladder infection-causing E. coli evolved these finger-like projections that they used to stick to the walls of the bladder so they don't get washed away. Almost 30 years ago now, it was demonstrated that if you drip cranberry juice on E. coli, they don't stick as well. Grape juice doesn't work, nor does orange or apple juice, or even white cranberry juice, made from unripened berries. So maybe it's one of the red phytonutrients that's doing it. Even if it works in a Petri dish, oh, I mean, we don't pee cranberry juice. How do we know that the anti-adherence phytonutrients in cranberries are even absorbed through the gut so they make it into the bladder? Well, subsequent studies showed that if you drip urine of someone who drank cranberry juice onto E. coli, you get the same anti-stick effect. Ah, well, now we're getting somewhere. Here's the stickiness of strains of E. coli waiting in urine from someone drinking water. And here's their stickiness in the urine of someone drinking cranberry juice. Within hours of consumption, there's a drop in E. coli stickiness that appears to last throughout much of the day. So, might cranberries really help prevent bladder infections? Well, the best way to prevent infections is to not get infected in the first place, which may involve the avoidance of chicken as we've already discussed, so you're not constantly reinfecting yourself. But if that doesn't work, if your gut remains stubbornly colonized with these bad bladder bugs, various tested cranberry products appear to reduce the recurrence of bladder infections by about 35%. Not as effective as antibiotics, but cranberries don't foster antibiotic resistance and have fewer side effects. There's good evidence to suggest that cranberries are effective for prevention, but not as an effective treatment. That makes sense, right? Cranberries prevent the initial adherence, but that occurs at the start of the infection. When the infection is present, it's already stuck there, but then there's no clinical data to suggest that cranberries aren't effective in the treatment of urinary tract infections, meaning cranberries don't work better than placebo. But, placebos work. For example, ibuprofen seems to work just as good as antibiotics for the treatment of uncomplicated urinary tract infections. Now, some people you really do need to treat with antibiotics. Pregnant women, children, men, those with kidney infections, systemic symptoms like nausea and vomiting, but for most healthy women, bladder infections just go away on their own without antibiotics. So all the women who drink cranberry juice and have their symptoms disappear may falsely attribute their recovery to the juice, but when it comes to most UTIs, nothing works. Nothing, in fact, actually works, leading doctors to try to figure out how they can harness the placebo effect for themselves.