Urinary Tract Infections (UTI)

 © Dr.R.S.Mann 2010

UTI includes Pylopnephritis (Infection of Kidneys), Cystitis (Infection of Urinary Bladder) and Urethritis (Infection of Urethra)

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Urinary tract is make up of kidney,Ureter,Urinary Bladder and Urethra. 
It is divided in Upper and Lower Urinary Tract:

Upper Urinary Tract include kidneys and Ureters.
Lower Urinary Tract include Urinary Bladder and Urethra.

Infections in upper urinary tract infect Kidneys(pyleonephritis) and in lower urinary tract can infect bladder(Cystitis) and Urethra(urethritis).

One kidney is in each side of body. Urine is filtered from blood by kidneys and then ureters drain urine from both kidneys into Bladder. Bladder is a sac like structure which expand with urine but when it get full, muscles in wall of bladder contracts and urine pass through urethra to outside of body.
Infection can occur in any of these parts either in Urethra and Bladder means either in Lower Urinary Tract or infection can go upward in Upper urinary tract in kidneys and ureters.

A Case Of Urinary Tract Infection Extending to Kidneys by Dr. R. Mann

Facts About UTI

1. Infections of Upper urinary tract are more serious but less common as compare to infections of Lower Urinary tract.
2. Most of the infections in Urinary Tract are of ascending nature, means infections get entry from urethra and travel upward towards kidneys.
3. Infections are much common in Adults than in children, but infections in children are much more of serious nature than in Adults and it should not be ignored.
4. Infection of Urinary Tract are more common in females than in males, but infections in males are of more serious nature and reluctant than females.
5. Infections are much more common in females of young age who are sexually active, and infections are more common also in menopausal women due to vaginal bacterias grow rapidly after menopause.
6. 40% women and more than 10% men sometimes in their life face Urinary Tract infections.

Causes Of Urinary Tract Infections

1. Poor hygienic practices is most common cause of UTI.
2. Sexual intercourse is also the common cause in women because woman's vaginal and urethral openings are very near to each other.So infections from vagina can get into urethra easily. Females occupied in frequent sexual intercourse are more vulnerable to get UTI.
3. When women wipe from behind to forward,anal infections can enter into vagina and urethra.
4. Any condition which block the flow of urine,e.g.stones, it increase the chances of UTI.
5. Medical conditions that cause incomplete bladder emptying (as spinal cord injury or bladder decompensation after menopause or prostatic enlargement in males).
6. Men with enlarge prostate,fail to empty there bladder completely , and residual urine may promote the UTI. It is very common cause in Older men.
7. Uncircumcised males have more chances to get UTI then circumcised males.
8. Catheterization(putting Catheter in Bladder through Urethra) in pre and post operative care may injure Urethra, and injured urethra can be easily infected. Catheterization is very common cause of lower urinary tract infections.

Organism that cause UTI

1. In 90% cases Escherichia coli ( E.coli) is cause of UTI, usually this bacteria lives in and around anus.
2. Gonococcus,Chlamydia,Trichomonas,Candida Albicans, Streptococci, Staphylococci and some viruses can cause UTI.
3. Tuberculosis of Kidneys .
4. There are many other organism may cause UTI.

Symptoms and Signs of UTI

Symptoms of Lower Urinary tract( Bladder and Urethra) are different from Upper Urinary Tract(Kidney).

Symptoms and signs of Lower Urinary Tract                (Urinary Bladder and Urethera)

a. Dysuria- it is pain and scalding, burning during Urination.
b. Urgency- It means Unable to hold urine.
c. Frequency- It means frequent urination or awakening from sleep to urinate.
d. Hesitancy- It means sensation of not being urinate easily, or you passes few drops only and experiences "Does not finished" sensation.
e. Pain in lower abdomen, in supra pubic region or it may be feeling of discomfort.
f. Urine may be bloody,turbid and foul smelling.
g. Fever, chills(rigors) and just not feeling well(malaise) --these are mild in Lower tract infection.
h. In Females, presence of vaginal discharge suggests cause is vaginitis(inflammation of Vagina), cervicits(inflammation of cervix) or PID(pelvic inflammatory disease).
I. Supra pubic Tenderness on examination.

Symptoms and Signs of Upper Urinary Tract Infection       (Kidney and Ureter)

a. High Grade Fever.
b. Shaking chills.
c. Nausea.
d. Vomiting.
e. Pain in flank- pain in sides of abdomen,either in one side or both.
  
Some times infection of Bladder may coexist with kidney infection then symptoms of Lower Urinary tract may be present with these symptoms.

In cases of Pregnant women, children, infants and older persons these typical symptoms of UTI may not be present, so there cases should be evaluated accordingly.


Tests and Diagnosis of UTI

1. Urine Analysis.
2. Urine culture.
3. Complete Blood count is needed in severe cases and in infections of Upper urinary tract infections.
4. Examination of pelvis in young woman's is necessary to rule out pelvic infections and Rectal examinations in male necessary to rule out Prostatic enlargement.
5. Sometimes Imaging Techniques as Ultrasound, IntraVenousUrogram(IVU), CT Scan, Cystoscopy may be needed as indicated in case.

Prevention

1.Use Hygienic practices.
2. Take plenty of water at least 2 liter a day.
3. Women should wipe from front to behind after stool to prevent anal infection to get lodged in vagina and urethra.
4. Make habit of emptying bladder after sexual intercourse it stops entry of organisms in urethra.
5. Avoid coffee, alcohol and spicy foods, all of which irritate the bladder.
6. Quit smoking- Smoking irritates the bladder and is known to cause bladder cancer.
7.If u are on Antibiotic medicines always complete them according to prescription, missing doses may increase resistance of bacterias.

Treatment Of UTI

Conventional Treatment

1. Antibiotics- according the symptoms and severity of the case. Length of course depends on part, either Urethra, bladder or Kidneys, involved. And according the age and sex of patients.
 2. Analgesics -Pain killers are prescribed according the case.
3. Hot fomentation is advised to relieve the pain.
4. If nausea,vomiting and fever present - medicines accordingly prescribed.
5. Rest and avoid sexual activity.
6. Drink plenty of water and never retain urine.

Homeopathic Treatment

1. Homeopathy has more than 225 medicines for different disorders of Urinary tract infections. A historical article on cystitis is very useful on UTI.
2.Medicine are prescribed according the symptoms of the patient and their severity.
3. Homeopathy is safe to prescribe in cases of Kidney infection where use of antibiotics can be comparatively hazardous due to less functioning of kidney and toxicity of medicine. Safe for children, infants and pregnant women.
4. Very effective in recurrent cases of UTI where bacterial infections becomes resistant to Antibiotics, homeopathic medicines remove them permanently.
5. In acute cases 2-4 weeks medications is sufficient for permanent cure but in chronic and recurrent cases it takes longer time.
6.Homeopathy remove the tendency to get infections again and again.It improves immunity of a person.
7.Mental symptoms associated with urination and their indicated homeopathic medicines are given on "Mental Symptoms Before, During and After Urination" page.
8. A Case of Urinary Tract Infection Extending to Kidneys presented here.
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