| A urinary tract infection (UTI) is a bacterial
infection that affects any part of the urinary tract. Although urine
contains a variety of fluids, salts, and waste products, it usually
does not have bacteria in it. When bacteria get into the bladder
or kidney and multiply in the urine, they cause a UTI. The most
common type of UTI is a bladder infection which is also often called
cystitis. Another kind of UTI is a kidney infection, known as pyelonephritis,
and is much more serious.
UTIs are most common in sexually active women and increase in diabetics
and people with sickle-cell disease or anatomical malformations
of the urinary tract.
Since bacteria can enter the urinary tract through the urethra (an
ascending infection), poor toilet habits can predispose to infection,
but other factors (pregnancy in women, prostate enlargement in men)
are also important and in many cases the initiating event is unclear.
A urinary tract infection, or UTI, is an infection that can happen
anywhere along the urinary tract. The urinary tract includes the:
• Bladder.
• Kidneys.
• Ureters - the tubes that take urine from each kidney to
the bladder.
• Urethra - the tube that empties urine from the bladder to
the outside.
Etiology
ACUTE U.T.I.
Causative organism
·
E. coli.
·
Staphylococci.
·
Klebsiella.
·
Candida.
·
Proteus.
·
Entrococci.
Predisposing causes
·
Female sex.
·
Enlarged prostate.
·
Neuropathic bladder.
·
Urinary tract calculi.
·
Polycystic kidney disease.
·
Diabetes mellitus.
·
Vesico-ureteric reflex.
·
Bladder catheterisation.
CHRONIC U.T.I.
·
Mal-treated
acute U.T.I.
- Urinary obstruction
- Enlarged prostate.
- Stricture.
- Stone.
- Stasis in bladder
- Cystocele.
- Neurogenic bladder.
- Vesico-ureteric reflux.
- Polycystic kidney disease.
- Diabetes mellitus.
Symptoms
For bladder infections
• Frequent urination along with the feeling of having
to urinate even though there may be very little urine to pass.
• Nocturia: Need to urinate during the night.
• Urethritis: Discomfort or pain at the urethral meatus
or a burning sensation throughout the urethra with urination (dysuria).
• Pain in the midline suprapubic region.
• Pyuria: Pus in the urine or discharge from the urethra.
• Hematuria: Blood in urine.
• Pyrexia: Mild fever
• Cloudy and foul-smelling urine
• Increased confusion and associated falls are common presentations
to Emergency Departments for elderly patients with UTI.
• Some urinary tract infections are asymptomatic.
• Protein found in the urine. Cloudy urine
• Foul or strong urine odor
• Frequent or urgent need to urinate
• Low fever (not everyone will have a fever)
• Need to urinate at night
• Pain or burning with urination
• Painful sexual intercourse
• Pressure in the lower pelvis
For kidney infections
• All of the above symptoms.
• Emesis: Vomiting is common.
• Back, side (flank) or groin pain.
• Abdominal pain or pressure.
• Shaking chills and high spiking fever.
• Night sweats.
• Extreme fatigue. Chills and shaking
• Fatigue
• Fever above 102 degrees Fahrenheit, which lasts for more
than 2 days
• Flank (side) pain
• Flushed, warm, or reddened skin
• General ill feeling
• Mental changes or confusion (in the elderly, these symptoms
often are the only signs of an UTI)
• Nausea and vomiting
• Severe abdominal pain (sometimes)
PREVENTION
- Drink plenty of liquids to flush bacteria out
of the urinary system.
- Wipe from the vagina to the anus after defecation
to avoid spreading bacteria.
- Drink water before and after sex so that one
will urinate a good volume with a steady stream afterwards. This
will help eliminate any bacteria that may have entered.
- Consider using another method of birth control
or a different brand of condom for your spouse if you suspect
that chemical over the condom is causing irritation.
- Avoid tight clothing. It may irritate tissues,
trap heat, and promote bacterial growth.
- Wear cotton underwear. Cotton is less irritating
and provides more ventilation than nylon.
Complication
- Renal calculi.
- Hypertension.
- Chronic renal failure.
GENERAL MANAGEMENT
- Bed rest.
- Plenty of fluids.
- Regular voiding of urine.
- Maintain alkalinity of urine.
- Local hygiene.
- Salt restriction, if blood pressure is high.
- Protein restriction, if blood urea is high.
Homeopathic Treatment
Homeopathy treats the person as a whole. It means that homeopathic
treatment focuses on the patient as a person, as well as his pathological
condition. The homeopathic medicines are selected after a full individualizing
examination and case-analysis, which includes the medical history
of the patient, physical and mental constitution etc. A miasmatic
tendency (predisposition/susceptibility) is also often taken into
account for the treatment of chronic conditions. The medicines given
below indicate the therapeutic affinity but this is not a complete
and definite guide to the treatment of this condition. The symptoms
listed against each medicine may not be directly related to this
disease because in homeopathy general symptoms and constitutional
indications are also taken into account for selecting a remedy.
To study any of the following remedies in more detail, please visit
our Materia Medica
section. None of these medicines should be taken without professional
advice.
Homeopathic Remedies
Apis mellifica
The symptoms of scanty urine always leads
one to consider whether Apis is or is not the remedy, for although
Apis produces scanty urine there are number of other drugs that
will do the same thing. The keynotes for Apis in urinary affections
are scanty or suppressed urine, drowsiness, oedema in various parts,
thirstlessness and suffocation on lying down. The urine is dark,
highly albuminous, and contains casts, so it is readily seen how
Apis may correspond to any form of Bright's disease. In difficult
micturition of children Apis is often a useful remedy. It has frequent
desire, with the passage of a few drops at a time. Among other symptoms
are great irritation at the neck of the bladder and incontinence
of urine. It is also the remedy to be thought of in retained urine
or inflamed bladder after abuse of Cantharis.
Apocynum cannabinum
Apocynum seems to act some what on the kidneys
and give rise to various dropsical conditions. It produces a scanty
urine, which is light in color, or, as it is given, sherry-colored.
Its first effect is to produce a copious diuresis; this is followed
by the scantiness of urine which results in dropsy. It also produces
an incontinence and may be useful in enuresis. A sinking bruised
feeling at the stomach is an indication for its use. It differs
from Arsenic and Apis in the fact that it has unquenchable thirst.
Arsenic wants little and often, Apis is thirstless.
Berberis vulgaris
Outside of its action on the genito urinary
system Berberis is seldom thought of,land it is one of our principal
remedies for troubles of this system. It seems to correspond to
many symptoms which occur in cases of renal calculi. It has severe
tearing pains in the kidneys, not merely backache, but pains deep
in the kidneys themselves; these pains extend down the back in the
kidneys themselves; these pains extend down the back and down the
ureters into the bladder;nor do stop here,for we find cutting pains
in the bladder extending into the urethra. These pains in the back
and along the ureters are very severe; they are worse stooping,
lying or sitting, and relieved by standing. In the bladder they
cause a desire to urinate, and the patient is constantly urinating,
for the bladder seems imperfectly emptied. The bladder aches. The
urine itself is reddish, has a reddish deposit consisting of mucus,
epithelium and lithates. It differs from the Pareira brava urine
in being more slimy. Another characteristic symptoms of Berberis
is pain in the hips while urinating. Coccus cacti has some similar
symptoms to Berberis, especially the tearing pains extending from
the region of the kidneys, the frequent urging to urinate, the deposits
of uric acid and the urine of Coccus cacti is dark. These remedies
must be distinguished very carefully as they present many symptoms
in common. Berberis has rather more back pains, and seems to act
deeper. It is especially indicated in genitourinary troubles, which
are due to conditions of atony, or faiblesse.
Cantharis
Cantharis symptoms are usually the first ones
inquired after when a case of urinary difficulty presents itself.
Its symptoms are clear cut, and should not be confounded with those
of any other remedy. There is a persistent and violent urging to
urinate, with great tenesmus; the urine is passed only in drops
and seems like molten lead passing through the urethra, so intense
is the burning. There is with this, usually an aching in the small
of the back. It is often indicated in acute cystitis, gravel and
urethritis, the great keynotes being the burning and the tenesmus
of the bladder; haematuria also calls for Cantharis under certain
conditions. Baehr doubts that Cantharis is ever suitable to the
chronic form of cystitis.
Causticum
In paralytic conditions about the bladder
Causticum deserves first place. It is one of our great remedies
in enuresis, and its characteristics are involuntary micturition
at night in sleep, when coughing, sneezing or blowing the nose,
showing a weakness of the sphincter. Another indication of this
is the difficulty the patient has in passing the last few drops
of urine; the fact that he has to wait a long time before it starts,
and that during the act it is expelled very slowly, showing not
only a weakness of the sphincter but a weakness of the whole muscular
system of the bladder. Nocturnal wetting of the bed in children,
occurring during the first sleep at night,calls for Causticum. Paralysis
of the bladder after labor also calls for this remedy. Zincum is
another excellent remedy in these bladder troubles, and it has some
symptoms similar to Causticum, such as involuntary spurting of urine
when coughing or sneezing; there is apt to be more pain in Zincum
cases, however; Scilla and Natrum muriaticum also have involuntary
micturition when coughing. Another symptom of Causticum is an excessive
deposit of urates in the urine. Another remedy which clinically
has proved very useful in enuresis from weakened muscular action
is Ferrum phosphoricum. Rhus aromatica has enuresis of nervous origin,
and has been used successfully in senile cases.
Digitalis purpurea
The urinary symptoms of Digitalis consist
of a dragging and pressure in the bladder which micturition does
not relieve. It has been found useful in inflammation in the neck
of the bladder with intense desire to urinate, which is increased
even by the passage of a few drops. The patient walks about in great
distress; at the same time there is tenesmus of the rectum. The
patient is relieved somewhat of these symptoms by lying on the back.
The pain at neck of the bladder is throbbing. The urine is scanty,
thick and turbid, and contains a sediment of brick-dust, like Lycopodium.
The urging to urinate in cases calling for Digitalis is often due
to the enlargement of the prostate gland, for which it is a remedy.
Equisetum hyemale
Equisetum acts similarly to Cantharis, but
it has less tenesmus and haematuria, and the urine is less scalding.
There is pain in the bladder as if too full, not relieved by micturition;
the constant desire to urinate is not even relieved by copious urination.
The urine is scanty,high colored and contains much mucus. Much mucus
in the urine is more indicative of Equisetum than of Cantharis.
Chimaphila also has much mucus, is especially useful in prostatic
troubles, and has made some cures when there were great quantities
of ropy mucus in the urine, which was quite offensive. This is a
wonderful remedy in the cystic irritation of old men, characterized
by a constant teasing desire to urinate with little or no relief
following micturition; the patient being
frequently compelled to rise at night. The state
is one of irritation rather than inflammation. Dr. Hughes considered
it a favorite remedy in chronic cystitis. The general aggravation
of Equisetum seems to be after urinating. Difficulty in beginning
to urinate, strains a great deal, scanty urine. It has proved useful
in enuresis with marked vesical irritation,being similar here to
Eupatorium purpureum, which is a useful remedy in the vesical irritation
of women, with much burning in the urethra during urination. With
the foregoing symptoms, Equisetum becomes an important remedy in
the treatment of cystitis. It has been suggested in the dysuria
of children; the pain being worse after urinating will distinguish
it from Petroselinum, which has the symptom that the child dances
up and down with pain when the urging to urinate comes on.
Mercurius corrosivus
Has tenesmus of the bladder with intense burning.
The burning is less, but the tenesmus is greater, than in Cantharis.
The passing of the urine drop by drop reminds of Aconite, which
has the same symptoms. Aconite, however, is adapted to sudden retention
of urine, for as soon as the disease becomes fully localized as
an inflammation Aconite ceases to be the remedy. Cantharis and Nux
vomica have also a similarity in the frequent fruitless efforts
to urinate. In the region of the kidneys there is cutting pain which
extends into the abdomen, the bladder and urethra. The most distressing
symptom is the constant urging to urinate, even a few spoonfuls
of urine in the bladder bringing on this urging, which is accompanied
by the terrible distress at the neck of the bladder. This pain is
aggravated immediately following micturition, showing that with
this drug the trouble is more urethral. The urine itself under Cantharis
is of a deep red color, deposits a sediment of mucus and often contain
fibrinous casts. Belladonna, too, is a remedy for painful urination.
Hughes says that it is a rarely failing remedy for nervous dysuria.
Nux vomica.
Nux vomica affects powerfully the urinary
organs, yet it is seldom thought of as having anything specially
characteristic about these organs. It affects the lower part of
the spine, and we have as a consequence, in the first place, incontinence
of urine; there is irritability at the neck of the bladder, and
the same symptoms is found here as with the rectum. There are frequent
ineffectual Efforts to urinate, and these are accompanied by burning
and tearing pains; the urine passes in drops. Again, it is indicated
in vesical torpor or paralysis; here we have dribbling of urine
or retention. Haematuria from abuse of drugs calls of Nux vomica.
Cystitis, with this painful urging and scanty urine indicates the
remedy. The straining is violent at times, and the urine is dark
with a red brick-dust sediment, or bloody, or mixed with a tenacious
mucus. Opium is similar to Nux in having a partial paralysis of
the bladder with spasmodic condition of the sphincter, but with
Opium the patient is unconscious that the bladder is full, and there
is no desire to pass water. The Stramonium patient passes no water
because the urine has been suppressed; it is not secreted. Camphor
gives prompt relief in spasmodic retention of urine. Nux is useful
in the irritable bladder of gout and alcoholism, and to relieve
pain and spasm in the passage of urinary calculi.
Pareira brava.
This is another drug very similar to Berberis
vulgaris-as to pains in the back it is quite similar; yet they do
not stop in the hips with Pareira as they do under mostly clinical.
It has been found useful in cystitis where there is violent straining
to urinate, where the patient has to kneel to urinate, where the
urine scalds terribly and where these violent pains in the thighs
are present. The urine has a strong ammoniacal odor. Contains thick
viscid white mucus or deposits or red sand. The three- legged stool
of the drug seems to be: the pain in the thighs, the getting down
on all fours to urinate, and the ammoniacal odor of the urine. It
is also a useful remedy in the condition known as irritable bladder,
dull aching in bladder, feeling as if the bladder were distended,
with pain.
Sepia.
One of the prominent remedies for lithaemic
conditions is Sepia, and the condition of the urine becomes an indication
for its use. It has a reddish clay-colored sediment adhering to
the vessel, a sediment of red sand so-called. The Sepia urine differs
from others in being offensive. Sepia is also a remedy for wetting
the bed at night during the first sleep. Lycopodium is a prominent
remedy for the indication of red sand in the urine. It is a sort
of gravel and is passed in quantities, so that often the child will
scream with pain on passing the water. Lycopodium will then help.
Sarsaparilla and Benzoic acid have similar symptoms, the latter
having as a characteristic a strong
horse-like urine. Natrum muriaticum also has their
red sand or brick-dust sediment. Another remedy having this symptom
very marked in Ocimum canum. This is a very useful remedy in renal
colic and gravel. The patient has to micturate every few minutes,
during which he wrings his hands and groans with pain. Nausea is
often present. The quantity of sand deposited is very large. In
cystitis, with a constant desire to urinate and dragging in the
bladder, Sepia may prove useful; here it will be indicated by its
general Symptoms. Vesicaria is recommended to favor expulsion of
gravel and sand in urine, also Thlaspi bursa Pastoris.
Terebinth.
The urine of Terebinth is one of its most
characteristic features. It is smoky, turbid, depositing a sediment
like coffee grounds, which indicates the presence of disintegrated
blood cells. Haematuria from venous congestion of the kidneys calls
often for Terebinth. It has burning during micturition and most
painful strangury; the urine, too, may contain albumen and has the
odor of violets. Peculiar odors to urine may be fond under the Viola
tricolor, where it smells like that of the cat, and Benzoic acid,
where it smells strong and ammoniacal,like that of a horse. Terebinth
is a useful remedy in cystitis, with much tenesmus of the bladder
and the scanty, bloody urine; there is also pressure in the bladder,
which extends to the kidneys. In acute and chronic nephritis it
is often indicated. The urine, oedema and the bronchial catarrh
may all point to the remedy.
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