Naturesupplies D-mannose is a simple sugar which is taken in powder of tablet form. When D-mannose is taken in any drink it simply sticks to the bladder wall and when the e.coli bug enters to bladder it sticks to the d-mannose instead of your bladder wall thus keeping the bladder healthy and next urination the d-mannose is flushed out of the bladder with the e.coli bug attached to it. Do you know bladder infections by e.coli are 90% the cause of uti's worldwide?