Allergies of the Genital Urinary Tract

Allergies of the Genital Urinary Tract

By Thomas A Kruzel, ND

Allergies of the genital urinary tract (GU) is an often unrecognized and under diagnosed condition that can be the cause of considerable discomfort. More often than not symptoms are associated with an infection for which antibiotics are prescribed that ultimately have no effect. There are generally 3 areas of allergic reactions associated with the GU tract:

  1. Contact dermatitis involving the penis and scrotum in men and labia, vagina and perineum in women.
  2. The lower urinary tract involving the urethra and bladder in women and urethra, bladder and prostate in men.
  3. The upper urinary tract, kidney and ureter.

Signs and symptoms include edema, swelling, inflammation and itching during an acute attack, often with no fever present. Swelling can be severe. There is often frequency, urgency, dysuria, nocturia, and a dull, suprapubic ache that accompany lower urinary tract allergic reactions. Often there is no fever or pyuria (white blood cells) present, but flank pain, gross hematuria (red blood cells) and occasional urinary retention may be present.

Frequent urination at night or bedwetting is one of the most commonly encountered conditions associated with food allergy, but patients with asthma, hay fever, migraine and urticaria (skin rash) are also frequently found. The worst-case scenario is interstitial cystitis whose symptoms are often severe and prolonged and appear as if the person has a bladder infection. Patients with interstitial cystitis are prescribed numerous courses of antibiotics which do not clear the symptoms. Eventually this can result in bladder changes that can become permanent and debilitating.

Exposure of the urinary tract to potential allergens occurs throughout its entire length during the course of blood filtration and urine excretion. Our kidneys have evolved certain defensive functions against allowing allergens into the lower urinary tract and efferent tracts in the kidney itself. This protective barrier is accomplished by having a large surface area mucosa that secretes mucus which filters urine and protects against potential allergens. The mucus secreted is comprised of glycoproteins, which contain sialic acid residues that possess electrical charge to accomplish this purpose. Tamm-Horsefall mucoprotein, a component of urinary casts, is secreted specifically by the collecting ducts and acts as a protective substance against ascending or descending urinary tract insults. The protective barriers effectiveness depends upon a variety of factors such as patient nutritional status, frequency of exposure, and secretor status.

Serum immunoglobulins are found in urine and help to protect against bacterial, fungal and mycoplasma infection. Immunoglobulin IgA is secreted by the urinary tract mucosa in response to a microorganism infection while IgE is secreted in response to an allergen exposure. Antibody coated bacteria can be measured to assess immune response.

Allergic reactions in the GU tract are found to be in direct proportion to the frequency, duration and amount of exposure. Initial reactions produce a minimal response provided reaction-thresholds were not exceeded. However, if the level of exposure is great enough, then a reaction-on-top-of-reaction sequence is produced contributing to both symptom severity and pathological changes. If prolonged, or frequent in occurrence, pathological changes can become permanent as in interstitial cystitis, or chronic urethritis and prostatitis. Other factors such as secretor status and blood type also play a role in development of allergic reactions.

Allergic reactions of the GU tract can be caused by: inhalants, drugs, foods, bacteria, viruses, rickettsia, xenobiotics and lectins. Foods and drugs cause the greater number of reactions which can be primary [direct] or secondary [passed through the urine during elimination]. Increases in episodes of urinary tract allergy presentations have been correlated with holidays such as Christmas, Thanksgiving and Easter.

Some of the more common allergens that have been found are:

  1. Inhalants – dust, smoke, feathers, animal hair, dander, pollens, dyes.
  2. Drugs – antibiotics, sulfonamides, hypnotics, antihistamines, Salvasarin, salicylates, para-aminosalicyclic acid (PAS), Butazolidine, quinine derivatives, codeine, arsenic, ephedrine, isoniazid (INH), digitalis, Nirvanol, Pyramidone, mercury compounds, gold, insulin, contract media, disinfectants.
  3. Bacteria and parasites – almost all bacteria to some extent, Candida, Mycobacterium tuberculosis, helminthes, oxyuris, Plasmodium falciparum, serums and vaccines from immunizations.
  4. Foods – milk, cheese, eggs, meat, white flour, fish/shellfish, lobster, mushroom, fruits, lettuce, asparagus, carrot, tomato, cucumber, chocolate onion, lemon, melon – various, yeast, paprika, black pepper, alcohol.
  5. Contact allergens – rubber, contraceptives, and injectable materials.

The GU tract is not only the site of allergic reactions but under certain circumstances is also the site of formation and absorption of allergens. In cases of a reaction to drug therapy where the body secretes excessive mucus, the resultant compound of mucus and drug can elicit an immune system reaction, where as the individual compounds will not.

There are a number of treatments for GU tract allergies that are safe and effective. The most difficult part however, is recognizing that they exist in the first place, a condition that often is over looked by physicians.

References:
Increase in lectin binding sites on epithelial cells by chronic bladder infection in rats.          Nakagawa T et al. Urol Int Vol. 56 no. 2 pp. 90-5 1996
Expression of lectin, interleukin-2 and histopathologic blood group binding sites in prostate cancer and its correlation with integrated optical density and syntactic structure analysis.   Kayser K. et al.         Anal Quant Cytol Histol Vol. 17 no. 2 pp. 135-42   Apr. 1995
Natural human antibodies to dietary lectins. Tchernychev B; Wilchek M     FEBS Lett, 397(2-3):139-42 1996 Nov 18
Lectin histochemistry in the human epididymis.       Arenas MI
J Reprod Fertil Vol. 106 no. 2 pp. 313-20     Mar 1996
Native and/or asialo-Tamm-Horsfall glycoproteins Sd(a+) are important receptors for Triticum vulgaris (wheatgerm) agglutinin and for three toxic lectins (abrin-a, ricin and mistletoe toxic lectin-I).,
Wu AM et al.                       FEBS Lett 371: 1, 32-4, Aug 28, 1995.
Effects of hormones on the prostate in adult and aging men and animals. Sinowatz F et al     Microsc Res Tech, 30(4):282-92 1995 Mar 1
Inhibition of 5 alpha-reductase in genital skin fibroblasts and prostate tissue by dietary lignans and isoflavonoids.
Evans BA Griffiths K Morton MS   J Endocrinol Vol. 147 no. 2 pp. 295-302       Nov1995
Blood group antigens as tumor markers, parasitic/bacterial/viral receptors, and their association with immunologically important proteins.   Garratty G            Immunol Invest, 24(1-2):213-32 1995 Jan-Feb
Importance of lectins for the prevention of bacterial infections and cancer metastases.                    Beuth J ; et al.             Glycoconj J Vol. 12 no. 1 pp. 1-6            Feb1995
Abberrant Pattern of Lectin Binding in Low and High Grade Prostatic Intraepithelial Neoplasia   Drachenberg, C, & Papadimitriou, M             Cancer            75:2539-44      1995
The Allergic Diseases of the Male Genitourinary Tract with Special Reference to Allergic Urethritis and Cystitis                        Pastinskzy, I.              J. Urol.    9: 288-305       1959
Allergies of the Genito-Urinary tract             Powell, N.                                                       Annals of Allergy                   Vol. 19, Sept. 1961
Allergy of the Lower Urinary Tract
Powell, N. Powell, B. Orville, T. Queng, J. McGovern, J.                Journ of Urology                    Vol. 7             April 1972