Abstract:
Urinary tract infection (UTI) is the infection of the kidney, ureter, bladder, and Urethra. It is one of the commonly encountered problems in clinical practice in the present scenario. It has been estimated that symptomatic UTIs result in as many as 7 million visits to outpatient clinics, 1 million visits to emergency departments, and 1,00,000 hospitalizations annually. Around 40% of women experience at least one episode of UTI in their lifetime. Among them, roughly 27% recur and sometimes present as chronic or resistant to treatment. By exploring the holistic principles of homeopathy and assessing its impact on UTI management, this study aims to provide valuable insights for healthcare practitioners, patients, and researchers alike.
Keywords: Urinary tract infections, homoeopathy, clinical implications.
The term urinary tract infection encompasses a variety of clinical entities.
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- Cystitis: an inflammatory disease of the bladder
- Pyelonephritis: an inflammatory disease of the kidney.
- Prostatitis: an inflammatory disease of the prostate
- Asymptomatic bacteriuria (ASB): asymptomatic infection identified by a screening urine culture unrelated to the genitourinary tract
UTIs are classified as Lower UTIs and Upper UTIs. UTIs are one of the major causes of antibiotic usage and antibiotic resistance. High recurrence rates and increasing antimicrobial resistance threaten to increase the economic burden of these infections. Therefore, it has been necessary to explore the role of alternative/ complementary therapies, including Homoeopathy, in the management of UTIs.
Etiology:
UTI causes considerable morbidity and accounts for 10% of primary care consultations. The Usual Uropathogens include Escherichia coli, Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis. Pathologically, it is associated with the multiplication of organisms in the urinary tract.
Pathology:
- PATHOGENESIS OF UNCOMPLICATED URINARY TRACT INFECTIONS:
Uncomplicated urinary tract infections (UTIs) begin when Uropathogens that reside in the gut contaminate the periurethral area and can colonize in the urethra. Subsequent migration to the bladder and expression of pili and adhesins result in colonization and invasion of the superficial umbrella cells. Host inflammatory responses, including neutrophil infiltration. Begin to clear the extracellular bacteria. Some bacteria evade the immune system, either through host cell invasion or through morphological changes that result in resistance to neutrophils, and these bacteria undergo multiplication and biofilm formation. These bacteria produce toxins and proteases that induce host cell damage, releasing essential nutrients that promote bacterial survival and ascension to the kidneys. Kidney colonization results in bacterial toxin production and host tissue damage. If left untreated, UTIs can ultimately progress to bacteraemia if the pathogen crosses the tubular epithelial barrier in the kidneys and causes complicated UTIs.
- PATHOGENESIS OF COMPLICATED URINARY TRACT INFECTIONS:
Periurethral colonization, progression to the urethra, and migration to the bladder. However, in order for the pathogens to cause infection, the bladder must be compromised. The most common cause of a compromised bladder is catheterization. Owing to the robust immune response induced by catheterization, fibrinogen accumulates on the catheter, providing an ideal environment for the attachment of Uropathogens that express fibrinogen-binding proteins. Infection induces neutrophil infiltration, but after their initial attachment to the fibrinogen-coated catheters, the bacteria multiply, form biofilms, promote epithelial damage, and can seed infection of the kidneys, where toxin production induces tissue damage. If left untreated, Uropathogens that cause complicated UTIs can also progress to bacteraemia by crossing the tubular epithelial cell barrier.
Risk Factors:
- Diabetes
- Advanced age
- Problems emptying the bladder completely
- Having a urinary catheter
- Renal stone
- Bowel incontinence
- Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine.
- Staying still for a long time (For example, while you are recovering from a hip fracture)
- Pregnancy
- Surgery or any procedure that involves the urinary tract
Sign And Symptoms:
- Dysuria
- Urinary urgency and frequency
- Sensation of bladder fullness and lower abdominal discomfort
- Suprapubic tenderness
- Flank pain and costovertebral angle tenderness (may be present in cystitis, suggesting upper UTI)
- Haematuria
- Fevers, chills, and malaise (may be noted in patients with cystitis, but are more frequently associated with upper UTI)
Diagnosis:
The clinical history itself has a high predictive value in diagnosing uncomplicated cystitis; in a patient presenting with both dysuria and urinary frequency in the absence of vaginal discharge, the likelihood of UTI is 96%.
Investigations:
- Dipstick urine: In low-risk cases, no further investigation is needed if a positive dipstick test is performed with characteristic symptoms. Perform a clean-catch midstream urine (MSU) for microscopy at 40x magnification (i.e., high-powered field). Look for pyuria (greater than 10^4 white blood cells per milliliter of urine) and organisms. The presence of white blood cell casts strongly suggests pyelonephritis.
- Culture: The sample should be cultured within 2h of Sampling. If not possible, store at 4 * (for <48h). Repeat Urine culture to confirm eradication post-treatment is not recommended.
- In cases of suspected pyelonephritis, consider the following investigations: – White Cell Count (WCC), C-Reactive Protein (CRP), Urea and Electrolytes (U&E)
Role Of Homoeopathy In The Management Of Utis:
Homoeopathy can be defined as a system of therapeutics based upon the law of similia,
Which states that a drug, capable of producing in a healthy person a disease state exactly similar to that observed in a diseased person, acts as a curative agent if the disease is in a Curable state. It is an important system of alternative therapeutics and popular medicine in the world, especially in the Indian subcontinent. Homeopathy, rooted in the principles of individualized treatment and holistic healing, offers a unique perspective in addressing health issues. As a system of medicine, homeopathy relies on highly diluted substances to stimulate the body’s natural healing mechanisms.
RUBRICS FOR UTIs:
BLLADER- INFLAMMATION
BLLADER – INFLAMMATION – Acute
BLLADER – INFLAMMATION – Chronic cystitis
BLLADER – PAIN
BLLADER – URINATION – Dysuria
BLLADER – URINATION – Urging to urinate – painful
Homoeopathic Medicines:
- Cantharis Vesicatoria: Intolerable urging and tenesmus. Nephritis with bloody urine. Constant desire to urinate. Urine jelly-like. Violent paroxysm of cutting and burning in the whole renal region.
- Ledum Palustre: Much uric acid and sand in urine. Urine often stops during the flow. Copious, clear, colourless urine, deficient in salts.
- Terebinthiniae Oleum: Burning, drawing pain in the region of the kidney, ureter. Urine: smoky with coffee ground or thick, yellow, muddy sediment. Cystitis.
- Sarsaparilla Officinalis: Pus in urine. Renal colic, can pass urine only while standing, painful urination, passes drops of blood or white acrid material at the close of urination, and sand on the diaper.
- Uranum Nitricum: Urine contains bile, profuse nocturnal urination, Urination painful, pale milky. Sugar found in urine, diabetes mellitus. Urine is greenish and smells fishy.
Conclusion: In integrative care models, homeopathy may be considered as a complementary approach for patients seeking alternative therapies, provided it is used under medical supervision. Homoeopathy may offer perceived symptomatic benefits for some individuals. With the help of homeopathic medicines, we can treat UTIs.
References:
- Longo, D. L., Fauci, A. S., Kasper, D. L., Hauser, S. L., Jameson, J. L., & Loscalzo, J. (2018). Harrison’s Principles of Internal Medicine (20th ed.) McGraw-Hill Education.
- Foxamen B. The epidemiology of urinary tract infections.
- Hooton, T. M. (2012). Clinical practies. Uncomplicated urinary tract infections.
- HOMOEOPATHIC MATERIA MEDICA – William BOERICKE, M.D.
- MATERIA MEDICA OF HOMOEOPATHIC MEDICINES – Dr. S.R. Phatak
- LECTURES ON HOMOEOPATHIC MATERIA MEDICA – J.T. KENT.
About the Author:
Dr. Jalpa R. Nakum (Intern) – B.H.M.S.; L.R. SHAH HOMOEOPATHY COLLEGE, GARDI VIDHYAPITH, ANANDPAR, RAJKOT
Dr. Bhakti A. Kareliya (Intern) – B.H.M.S.; L.R. SHAH HOMOEOPATHY COLLEGE, GARDI VIDHYAPITH, ANANDPAR, RAJKOT
