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UTI, Urine Tract Infections & DMannose Clinical Trials


Waterfall D-Mannose provides an effective alternative for cystitis and UTIs. Users say it avoids the resistance created by antibiotic therapy, doesn’t have side-effects, and prevents recurrence of the infection when used as a maintenance product daily (each night).

Through the years there has been extensive research into the effects of D-Mannose on (in particular) E.coli. Some of the research that shows just how effective D-Mannose is at flushing away infections dates back to the 70's. But the best evidence is the evidence supplied by users.

Read Testimonials from users of Waterfall D-Mannose

Below you will find a links and a tiny selection of available abstracts and extracts from scientific research papers and reports on D-Mannose and E.coli.. This is a tiny selection and you will find extensive research on the net.

Protection Against Escherichia coli-Induced Urinary Tract Infections with Hybridoma Antibodies Directed Against Type 1 Fimbriae or Complementary D-Mannose Receptors (Abstract)

Abraham SN, Babu JP, Giampapa CS, Hasty DL, Simpson WA, Beachey EH

Published in Infection and Immunity, June 1985, p. 625-628, Vol.48 (3)

Hybridoma antibodies directed against quaternary structural epitopes of the type 1 fimbrial adhesin of Escherichia coli or against D-mannose, the sugar determinant in the complementary host cell receptor, prevented the attachment of mannose-sensitive E. coli to various eucaryotic cells. Passive intraperitoneal administration of the fimbria-specific or D-mannose-specific antibodies protected mice against retrograde colonization with mannose-sensitive E. coli instilled into their urinary bladders. Monoclonal antibodies directed against fimbrial subunits rather than quaternary structural epitopes or against N-acetylgalactosamine rather than D-mannose residues lacked protective activity. These studies provide evidence that bacterial colonization can be blocked or interrupted by antibodies directed against either the adhesin or the complementary host cell receptor of pathogenic microorganisms.

D-Mannose & Urinary Tract Infections (Including SCI)

Abstracted and Edited from a Report Submitted to Progressive Laboratories by Michael Blue, M.D., Urologist (Norman, Oklahoma)

Note from Anna - They didn't really know much about dose levels in this study. As we've repeatedly found to be true, both the curative and preventative effects of Waterfall D-Mannose can be greatly improved if dose levels are adjusted according to the severity of the symptoms, length of infection, and personal cystitis triggers. The amount of liquid intake is also important, as is avoiding acidifying the urine.


D-Mannose is a naturally occurring simple sugar that appears to be a safe, practical alternative for the treatment of urinary tract infections (UTI's). D-Mannose is absorbed eight times more slowly than glucose, and when ingested, is not converted to glycogen or stored in the liver, but rather goes directly to the blood stream from the upper GI tract. Hence, D-Mannose is almost entirely filtered through the kidneys and routed to the bladder. This has benefits in that Diabetics use it and it cannot interact with other substances. The purity of Waterfall D Mannose correlates with the purity of mannose already present in most body cells.

The bladder lining is comprised of polysaccharide molecules.


See D-Mannose & UTI overview article

Finger-like projections on the cell surface of E. coli bacteria adhere to these molecules, initiating an infection. In the presence of D-Mannose, E. coli preferentially attach to D-Mannose molecules forming a complex which is expelled with the next voiding.

D-Mannose probably works 80-90% of the time because the bacteria disabled by Mannose causes 80-90% of Urinary Tract Infection's. Whereas antibiotic treatment is thought to radically change the GI bacterial populations required for good health, potentially causing fungal or gastrointestinal infections, D-Mannose safely removes 'bad' bacteria by a process of symbiotic attachment and voiding.

DMannose Clinical Trials

Study subjects were Dr Michael Blue's long-term patients, who had a history of reoccurring UTI's. Subjects included 42 females (12-83 years old) and 18 males (25-71 years old). After urine culture to determine specific bacterial cause, if any, subjects were started on a D-Mannose daily regimen.


Of the 42 female subjects, 24 were confirmed by culture to have a Urinary Tract Infection. In 19 cases (~80%), E. coli was the diagnosed cause, in four, Klebsiella, and in one, mixed bacteria.

In the confirmed culture group, two scoops of D-Mannose daily were given for one week. Of the 12 (50%) who returned for follow-up cultures, eight were negative. Patients indicated that the symptoms had disappeared.

Statistically, 17 of the 24 (71%) females in the confirmed-culture, D-mannose-treated group reported symptom improvement. Although three of the 24 (12.5%) were unable to be contacted, they did not return for additional treatment. Only four of 24 (17%) reported no symptom improvement after D-Mannose treatment.

Those females who were not confirmed by culture to have bacterial Urinary Tract Infection but had UTI-associated symptoms were classified into a painful-bladder-syndrome (PBS) group. Of the 18 PBS females who were treated daily with two scoops of D-Mannose, 17 (94%) reported symptom improvement, the lone exception being a subject unable to be contacted, but also not returning for treatment. Eighty percent became totally symptom free.

Of the 18 male subjects, 10 were confirmed by culture to have a UTI. Seven had neurogenic bladders from spinal cord injuries, three of whom were on intermittent catheterization and four had indwelling supra-pubic tubes.

Two men had been incapacitated with recurrent sepsis, retention, and obstructive uropathy. Both men underwent insertion of supra pubic tubes. Once released from the hospital, both were placed on a D-Mannose daily regimen. Improvement was suggested by their ability to avoid additional hospitalization.

In the group diagnosed with E. coli-related UTI and treated with D-Mannose, significant improvement was reported. Due to the composition of the male group, few responded as dramatically as females.


Consistent with existing literature, about 50% of those reporting UTI symptoms were actually confirmed by culture to possess bacterial infection. The therapeutic use of D-Mannose on acute UTI's in this study was effective in eliminating or ameliorating symptoms.

In addition, 80% of the painful-bladder-syndrome group became symptom free using D-Mannose.

Over the six-month study, three females with different issues showed especially noteworthy responses to D-Mannose. The first was a 50-year old female with neurogenic bladder and incontinence suffering from a monthly UTI.

Endoscopically, her bladder revealed numerous areas compatible with recurrent Urinary Tract Infections. After three months of D-Mannose, her urine was sterile, and her bladder mucosa returned to normal. The second woman complained about bladder pain for which she had received numerous, unsuccessful therapies. After one week of D-Mannose, her pain ceased. The third woman presented an E. coli infection and pronounced structural findings in her bladder called Cystitis Cystica, all of which disappeared after three months on D-Mannose.

In conclusion, D-Mannose appears to effectively treat simple, uncomplicated UTI's.

Effect of D-Mannose and D-Glucose on Escherichia coli Bacteriuria in Rats (Abstract)
Michaels EK, Chmiel JS, Plotkin BJ, Schaeffer AJ.
Published in Urology Research, 1983, p. 97-102, Vol.11 (2.

The effect of D-mannose and D-glucose on bacteriuria due to Escherichia coli with mannose-sensitive adhesins was investigated in adult male Sprague-Dawley rats undergoing diuresis. Inocula of 10(5), 10(7), or 10(8) bacteria in 0.1 ml of normal saline or 2.5% or 10% D-mannose or D-glucose were injected intravesically and urine was cultured 1, 3, 5, 7 and 9 days later. The levels of bacteriuria on days 1 and 5 were significantly lower in rats inoculated with 10(5) E coli and 10% D-mannose than in controls (p less than 0.05 and 0.01 respectively) and the percentages of rats with less than 100 bacteria/ml were higher on days 1 and 3 (p = 0.05 and 0.02 respectively). Bacteriuria was significantly lower in rats inoculated with 10(7) bacteria and 10% D-mannose than in controls on days 5 and 7 (p less than 0.01 for each day) and the percentage of rats with less than 100 bacteria/ml was higher on day 7 (p = 0.01). D-glucose reduced bacteriuria significantly only with a concentration of 10% after instillation of 10(5) E. coli (p less than 0.05, day 1). The results indicate that D-mannose and D-glucose can significantly reduce bacteriuria within 1 day and that their efficacy is dependent upon the concentration of both saccharide and bacteria.

Grant Support:

  • AI 16014/AI/NIAID
  • CA 15145/CA/NCI

PMID: 6346629 [PubMed - indexed for MEDLINE]
Conservation of the D-Mannose-Adhesion Protein Among Type 1 Fimbriated Members of the Family Enterobacteriaceae (Abstract)
Abraham SN, Sun D, Dale JB, Beachey EH.

Published in Nature, December 1988, p628-4, Volume 336 (6200)

A variety of genera and species of the family Enterobacteriaceae bear surface fimbriae that enable them to bind to D-mannose residues on eukaryotic cells. Until recently, it was thought that the D-mannose binding site was located in the major structural subunit (FimA), of relative molecular mass (Mr) 17,000 (17 K), of these organelles in Escherichia coli. New evidence indicates that this binding site resides instead in a minor protein Mr 28-31 K (FimH) located at the tips and at long intervals along the length of the fimbriae, and is reminiscent of the minor tip adhesion proteins of pyelonephritis-associated pili (Pap) and S fimbriae. In contrast to the antigenic heterogeneity of the major FimA subunit, the antigenic structure of FimH is conserved among different strains of E. coli. Here, we report an even broader conservation of this minor adhesion protein extending to other genera and species of type 1 fimbriated Enterobacteriaceae. Our results may have implications for the development of broadly protective vaccines against Gram-negative bacillary infections in animals and perhaps in man.

PMID: 2904657 [PubMed - indexed for MEDLINE] (We supplied Waterfall D-Mannose to this research study)

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