Urinary Tract Infection (UTI) & Homoeopathy

Keywords  

UTI, Homoeopathy, Aetio pathogenesis, Remedy, Prevention 

Introduction 

 UTI is the presence of microbial agent in urinary tract which is usually sterile. UTI is the condition in which microbial agent enter and multiply within the urinary tract. UTI is a common, distressing and occasionally life-threatening. UTI can be either symptomatic or asymptomatic. 

Uncomplicated UTI occurs in healthy women. Complicated UTI is associated with anatomical, functional, or metabolic abnormalities of the  urinary tract that disable the natural innate host defences and lead to tissue injury.  

Epidemiology  

The incident of UTI is 0.5 to 0.7 episodes per person per year in females of whom  25% of them have recurrences. 

Host Factors for urinary tract infection 

Anatomical factors  

• Posterior urethral value  
• Vesico-ureteric reflux  
• Urethral stricture  
• Benign prostatic hypertrophy  

Functional factors  

• Neurogenic bladder  

Other factors

Males and females  

• Diabetes mellitus
• Immunosuppression (post-transplant)
• Calculi Congenital abnormalities  
• Foreign bodies: catheters, stents

Females  

• Post-menopausal state (oestrogen deficiency)  
• Voiding habits  
• Spermicidal jelly  
• Vaginal douching
• Perineal hygiene  

Clinical Feature  

Clinical features depend on whether the infection involves the upper or lower urinary tract. Irritative voiding symptoms are more common in lower tract  infection whereas constitutional symptoms are more common in upper tract infections. 

Asymptomatic UTI- Significant bacteriuria is often not associated with symptoms and does not require treatment except in pregnant women, in infants and before urological surgery.  

Cystitis and Urethrtitis- Infection of the bladder is common in women during  their reproductive years. Patents with cystitis or urethritits may be Urinary Tract Infections asymptomatic or present with frequency, urgency, dysuria, nocturia, urge incontinence, suprapubic pain or a sensation of incomplete bladder  emptying. The urine may have an offensive smell and haematuria occurs in  approximately 30% cases. Physical examination usually may reveal mild  suprapubic tenderness.  

Prostatits and Seminal Vesiculitis- The usual symptoms of prostatic infection  are frequency, dysuria, perineal or groin pain, difficulty in voiding and painful  ejaculation. Per-rectal digital examination may reveal an enlarged, tender prostate or seminal vesicle. Relapsing UTI, associated with the above symptoms  in men is suggestive of chronic bacterial prostatitis. In acute bacterial prostatitis, the patent is often acutely ill with sudden onset of fever and chills in addition to other symptoms. Per-rectal digital examination should be avoided in them  during the acute stage.  

Pyelonephritis- Infection of the renal parenchyma is called pyelonephritis. It may  be acute or chronic. Symptoms of acute pyelonephritis include fever with  shaking chills, myalgia, nausea, vomiting and loin pain which develop rapidly  over a period of hours to days. Chronic pyelonephritis is diagnosed by  radiological demonstration of clubbed calyces associated with focal or diffuse  renal scarring and it may be unilateral or bilateral.  

Renal Abscess- Renal cortical abscess (renal carbuncle) occurs as a result of  haematogenous spread of Staphylococcus aureus from a primary focus  elsewhere in the body. Patients present with fever and loin pain. Bladder  symptoms are absent. The diagnosis of abscess can be confirmed by aspiration  and culture from the suspicious areas under ultrasound guidance.  

Xanthogranulomatous Pyelonephritis (XGP)- XGP is a distinct form of chronic  kidney infection which predominantly affects elderly women. The condition is  commonly associated with renal calculi or obstructive uropathy and is usually unilateral. Infections are caused by Proteus mirabilis, E. coli or Klebsiella group  of organisms.  

Complicated UTI presents as symptomatic disease in a man or woman with  an anatomic predisposition to infection, with a foreign body in the urinary tract,  or with factors predisposing to a delayed response to therapy  

Modalities of diagnosis 

Microscopic examination of urine is the crucial first step in confirming UTI. A  properly collected early morning sample of urine is ideal. Random samples may  also be used for regular testing. Pyuria is defined as presence of more than 5 WBCs/high power field (hpf) in a centrifuged urine sample. In women of child  bearing age group, more than 10 WBCs/hpf is considered significant.The gold standard for diagnosis of UTI is urine culture.  

Investigation of patents with urinary tract infection

All patients 

• Dipstick estimation of nitrite, leucocyte esterase and glucose
• Microscopy/cytometry of urine for white blood cells, organisms 
• Urine culture  

Infants, children, and anyone with fever or complicated infection

• Full blood count; urea, electrolytes, creatinine 
• Blood cultures  

Pyelonephritis: men; children; women with recurrent infections

• Renal tract ultrasound or CT  
• Pelvic examination in women, rectal examination in men 

Continuing haematuria or other suspicion of bladder lesion

• Cystoscopy  

Homoeopathic Remedies  

Chimaphila Umbellate: Urging to urinate. Urine turbid, offensive, containing ropy or bloody mucus, and depositing a copious sediment. Burning and scalding during micturition, and straining afterwards.  

Equisetum Hyemale: Severe, dull pain and feeling of fullness in bladder, not relieved by urinating. Frequent urging with severe pain at the close of urination. Urine flows only drop by drop. Sharp, burning, cutting pain in urethra while urinating. 

Jonosia Asoka: Frequent, bloody, scanty and involuntary micturition at night; tenderness in bladder and pain in loin  

Ocimum Canum: High acidity, formation of spike crystals of uric acid. Turbid, thick, purulent, bloody; brick-dust red or yellow sediment. Odor of musk. Pain in ureters. Cramps in kidneys.  

Ocimum Caryophyllatum: Frequent micturition; extreme burning during  urination, passage of pus with urine; haematuria.  

Tinospora Cordifolia: Frequent passage of small quantity of urine with burning while urinating; urine mixed with pus 

Prevention of UTI 

• Ensure proper hydration
• Urinate regularly and after intimacy 
• maintain good hygiene practices. Wiping from front to back contribute to reducing the risk of infection
• Address any underlying medical conditions promptly.  

Conclusion  

Lifestyle changes can significantly reduce risk of UTI occurrences, but whenever  you experience symptoms, it’s essential to visit the doctor. If you experience  three or more UTIs annually, you might need an extensive evaluation. Homoeopathy is based on the law of Similia and it shows a promising result in  the treatment of UTI promptly with a safety.  

Reference 

1. API Textbook of Medicine 9^th edition 

2. Golwalla’s medicine for Students Twenty-Fifth edition 

3. Davidson’s Principles and Practice of Medicine 23^rd EdiƟon 4. Pocket manual of Homoeopathic materia medica & repertory by William Boericke, MD