Written by:Dr.Shraddha Thakur
it is the condition in which microorganism actively multiply and persist in the genitourinary tract
- A disorder characterized by an infectious process involving the urinary tract, most commonly the bladder and the urethra
- The urinary system consist of the kidney, uterus, bladder and urethra
- Urinary tract infection is the second most common type of infection in the body
- UTI are a major cause of hospital admissions and are associated with significant
- Morbidity and mortality as well as a high economic burden
- If the urine contains significant bacteria but there are no symptoms the condition
- Is known as asymptomatic bacteria
Table of contents
Epidemiology
Etiology
Risk factor
Sign and symptoms
Diagnosis
Differential Diagnosis
Classification
Naturopathy understanding
Management through naturopathy
Yoga therapy
Epidemiology
- Urinary tract infection is an important cause of morbidity and mortality in Indian subject affecting all age groups
- UTI mainly affects women. One of two women suffer from UTI at least once in her life
- older adults especially women are at increased risk of a secondary infection after the development of a urinary tract infection
- Pregnancy is one of the factors which increase the risk of UTI partly due to the pressure of the gravid uterus on the uterus causing stasis of urine flow and is also attributed to the humoral and immunological changes during normal pregnancy
- Among female highest prevalence is seen in reproductive age group 21-30 (23%)and 31-40 (42%)
- Proximity of female urethral meatus to anus shorter urethra and sexual intercourse have been reported as factors that influence this higher prevalence in women
Etiology
the bacteria that most often cause cystitis and pyelonephritis are the following-
- Enteric usually GRAM NEGATIVE aerobic bacteria- Escherichia coli and staphylococcus cause about 80% of uncomplicated urinary infections particularly in women under 50 year of age uropathogenic E. Coli have specific virulence factor like type 1 fimbriae which help them to adhere to the uroepithelium
Risk factors
(1) IATROGENIC-
Indwelling catheter
Antibiotics
Spermicides
(2) BEHAVIORAL-
voiding dysfunction
Frequent and recent sexual
Intercourse
(3) ANATOMIC -
vesico uretral reflex
Female sex
Pregnancy
(4) GENETIC-
Family tendency
Susceptible uroepithelial cells
Vaginal mucus properties
Sign and symptoms
1. burning pain on urination ( dysuria)
2. Urinary frequency or urgency
3. Urinary inconsistence
4. Blood in the urine ( hematuria)
5. Foul smelling urine
6. Fever
7. Nausea and back pain ( less frequent)
Classification
1. uncomplicated infection
this is when the urinary tract is normal, and there is no associated disorder that impairs the host defence mechanism
2. Complicated infection
this is when infection occurs within an abnormal urinary tract such as when there is ureteric obstruction renal calculi, or vesicoureteric reflux
3. Isolated infection
when is the first episode of uti or episodes are 6 month apart, isolated infection affects 25-40% of Yang females
4. Unresolved infection
when therapy fails because of bacterial resistance or due to infection by two different bacteria with equally limited susceptibilities
5. Reinfection
this occur where there has infection but the same organisms regrows two weeks after therapy or when a different microorganism grows during any period this accounts for 95% of recurrent uti in women.
Bacteria persistence occurs when therapy is impaired by the accumulation of bacteria in a location that can't be reached by antibiotics, such as infected stone, urethral diverticula and infected paraurethral glands
6. Relapse
when the same microorganism cause a UTI within two weeks of therapy however it is asually difficult to distinguish a reinfection from a relapse
Differential Diagnosis
1. Herpes genitis
2. N. Gonorrhea
3. Chlamydia
4. Trichomonas infection
5. Vaginitis
6. Urinary tract trauma
7. Tuberculosis, neoplasm
8. Overactive bladder
Diagnosis
Symptoms
dysuria, frequency , urgency, hematuria, back pain, nocturia
Costovertebral angle tenderness and the absence of vaginal discharge or irritation should be documented
Physical examination
the history and physical examination should be focused on ruling out structural and functional abnormalities of the urinary tract
Pelvic examination
A midstream urine bacterial count of 1|105 CFU/L should be considered a positive culture while the patient is symptomatic. A negative culture or lack of response to treatment suggest another diagnosis. Patient may be recultured 1-2 weeks after initiating therapy adjusted to sensitivity to evaluate for bacterial persistence
Naturopathic understanding
- Naturopathy has a different perspective about the germ theory of disease. It considers germ as the secondary cause of the disease unlike modern understanding
- The bacteria which are found associated with acute , subacute and chronic disease are not primary causative agent but the morbid soil the toxic body is responsible for the disease
- Our body due to lowered vitality provides fertile ground for bacteria to breed and multiply. Hence it is the morbidity of the host that is of concern, not the microbes
- Most cells in our body are not human but microbial the ratio of them to us is about 10:1
- The cells and germs are the association of microzyma mutate into organisms that cause disease in the presence of favorable impression , microzyma do not cause of disease
Naturopathy management
AIM OF MANAGEMENT -
- Alkaline the urine , there by preventing irritation and burning sensation
- Assisting the body in elimination by restoring renal function
- Re- establishing immune host response
Diet therapy
- Enhanced consumption of fresh fruits or berry juice had shown to be associated with a lower risk of UTI recurrence. Berries are rich in flavanols such as epicatechin , which is a potent inhibitor of the adhesion of coliform bacteria to human cells
- Plants produce flavanols in response to microbial infection, suggesting a role for these substance in antimicrobial defense
- Some fruit such a apple , cherries and plums are rich in epicatechin but the flavanol content of berries is higher which may explain their association with reduce UTI recurrence
- Intake of foods richin zinc , protein, vitamin C
- Yogurt is recommended during infectious disease considering its prognostic efficacy
- Palliative and inflammatory effect of intermittent fasting are well proven entity long - term fasting lasting from one to 3 weeks has been shown to reduce pain and inflammation . However it is recommended that fasting should be followed by a vegetarian diet in order to sustain results
Lemon, strawberry, raspberry, peaches, limes, grapefruit, pineapple, fruit juice with soda , cookies, sugar, canay , frozen food , beverage, beef , peanut, processed meat , ketchup, canola oil, ice cream, corn oil , milk , doughnut, artificial sweetener, canned, hard liquor, tea , coffee, Tabaco , caffeinated coffee, caffeinated soda , spicy foods , acidic fruits
Food should be eat - alkaline - apple , blueberry, banana, dates , ginger, coconut water, papaya, pear , watermelon, musk melon, cucumber juice , carrot juice,avacodo, high fiber food , yogurt, barley water , more drinking water, lukewarm water, vegetables juices
Drinking at least 2.5- 3 liter of water every day helps flash out any harmful bacteria that may be present in the bladder
Hydrotherapy
- Water drinking most important therapeutic measure to be adopted fluid help in flushing out bacteria and prevent bacterial adherence epsom salt - hot hip bath for 20 minutes are recommended for relieving the painin the pelvic region
- Alternating hot and cold sitz bath are also an indicated Therapeutic measure for urinary infection by soaking the pelvis in hot water first for 4-5 minutes followed by soaking in cool water for 30-40 seconds. The procedure should be repeated 5-6 times ending with a cold soak . It improves blood circulation and speed up healing of vaginal and urinary tract infection
- The recuperative and heating properties of hydrotherapy are based on tí mechanical and thermal effects
Yoga therapy
diet - Sattvic diet
Overeating should be avoided
tea and coffee should be restricted
Alcohol and tabaco should be discontinued
Plenty of water is recommended
Adequate rest is a necessity
Asanas -
- Tadasana
- Utkatasana
- Trikonasana
- Viprit karani
- Savasana
- Supta badha konasana
- Setu banddhasana
- Anulom vilom
- Anulom Vilom Pranayam
- Nadi shodhan Pranayam
- Bhramari Pranyam
- Jal mudra
- Prana Mudra
Follow up measure
Apart from ensuring good personal hygiene practice , fasting once a week with fluids drinking adequate water, regular sun bath and consumption of large portion of food as salad and colored fruits are the common home remedies to be followed.