Urinary track infection

                                Urinary tract infection (UTI)

                               (Burning Micturation, Cystitis,urethritis, Pyelonephritis, मूत्रकच्छ)                                                       

                                                      Frequent, painful urination\Burning Micturation

Getting rid of UTIs”

Urinary tract infections have been described since ancient times with the first documented description in the Eber's Papyrus dated to 1550 BC.A urinary tract infection (UTI) is a bacterial infection of any part of the urinary system (includes kidney, ureter, bladder. prostrate and urethra). When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as kidney infection (pyelonephritis). Urine may contain pus.

When you have UTI you are constantly running to the bathroom because of the persistent urge to void. Then when you go, you do not produce much urine, but you experience intense pain and burning sensation.

It is the second most common type of infection in the body. 150 million UTI occurs yearly worldwide. It's estimated that 50% of women will have at least one UTI in their lifetime. One in 5 women experiences a second urinary tract infection. Women are more likely to develop UTI than men, as the urethra is shorter in women than in men, also it is located closer to the anus, and the chances of transferring bacteria into the bladder are higher as compared to men. They occur most frequently between the ages of 16 and 35 years. Recurrences are common. UTIs in men are not as common, but they can be serious when they occur. 

Urinary tract infections (UTIs) are considered a severe public health concern caused by various pathogens. Often distressing and can lead to severe complications; thus, appropriate classification of UTIs and proper investigations and management are essential to obtain optimal outcomes and minimize antibiotic resistance. Urinary tract infections focusing on the infection sites and prevalence of UTIs in diabetes, pregnancy, post-menopause, and immunosuppressive patients.

According to Ayurveda, it is caused mainly due to the imbalance of "pitta dosha”. It is a humor in the body which symbolizes heat or fire.

“UTI is a recurring condition”

Introduction

The infections of urinary tract are often taken lightly, different connotations at different situations. Age : Infection of elderly is different from infection of somebody in middle age. Sex : Female urinary tract infections are different from males. Comorbidities : Like diabetes, immuno comprimized individuals the importance of UTI varies from situation to situation. 

Special situations : And these are some of the special situations like  

• Honeymoon cystitis - It is a very common infection in women, she has after marriage. It is in the first month of marriage when they are getting together and they have a terrible lower urinary infection. And if you don't pick it up or recognize as honeymoon cystitis they will be bothering with lot of unnecessary investigations and treatment. All you like to do is advise them about the adequate during sex and protecting them with simple measures before sex.
• UTI IN Pregnancy : It can't be treated as any other infection. UTI is common during pregnancy. Amoxicillin, Erythromycin, and penicillin are considered safe for pregnant women. Ciprofloxacin, Sulphamethaxazole, tetracycline or trimethoprim can effect baby's development. Complications : Pre term labor, severe infection, adult respiratory distress syndrome, anemia, long term infection. 
• Vesicular urethral reflex (VUR) :  Vesicoureteral reflux is the abnormal flow of urine from your bladder back up the tubes (ureters). Presence of vesico urethral reflex  in children  precipitate and hasten renal failure. And they may get into chronic kidney disease (CKD). So closely monitor them. Its a very gruesome problem affecting children If nor treated in time can lead to nephropathy, renal failure. Prevention of infection in this patients and keeping the urine sterile , and stopping further progress of disease. There are five grades. Reflex is nothing but a valve at the vesico ureteric junction, and the valve doesn't work and you have returning of urine to the kidney . This starts in utero. Dilated ureter, an early diagnosis is important. Intervention has to be done before the age of four.

 

• Acute pyelonephritis  : It is recognized these days because of ultrasound and CT Scan.

• Emphysematous Pyelonephritis : 

It is pus inside the renal system, its a gas forming organism , we have kiotically organized kidney. It is very dangerous . It come under upper UTI. It can be life threatening. In olden days the only treatment was nephrectomy. But now early diagnosis and putting in a stent to some how clear pus. many patients are given strong antibiotics and stenting.

• Elderly - a . Prostrate in man- chronic prostatis can be there very menacing for the patients.

                             b .   Distil urethra stenosis- In women they get distil urethral stenosis because of the low hormones levels. And there symptoms are different and management is also different. So hormone replacement therapy may be useful in post menopausal women.

• Immunosuppression :  A very small infection has to be treated very aggressively and they may not present with fever, dysuria (pain during micturation) because of immuno suppression.
• Organ transplantation- Management same as immunosuppressant.
• Patient on indwelling catheter : It will be difficult to eradicate the infection. One may not be able to give importance to infections in these patients.

Infections can be :

• Asymptomatic vs symptomatic : One has to identify and treat them.
• Simple vs complicated :  You call it complicated when there is some structural deformity in the system which is precipitation this infection.
• Lower vs upper tract : Upper tract is called acute pyelonephritis and the seriousness is completely much more compared to lower urinary tract.
• Recurrence vs reinfection : Recurrence is when they get the same organism again and again. Reinfection is infection by some other organism 
• Sterile pyuria : There are plenty of pus cells but urine at culture won't give you any positive readings.

The humble bladder, a hollow organ that holds urine from the kidneys, often goes uncared for. Certain conditions can affect your bladder and cause painful, frequent urination. UTI is usually caused by the intestinal bacteria Escherichia Coli. These bugs are necessary for digestion, but if they find their way into your bladder and grow there, you get a UTI. But several other bacteria like staphylococcus, Proteus aurous , Strep faecalis, Klebsiella , Pseudomonas can cause UTIs too. Sometimes fungal infection like Candida albicans can also cause infections in Immunosuppressed persons. 

The bacteria that cause urinary tract infections typically enter the bladder via the urethra. However, the infection may also occur via the blood or lymph. Females are at a greater risk due to their anatomy. After gaining entry to the bladder, E. coli are able to attach to the bladder wall and form a biofilm that resists the body's immune response.

How does E. coli travel from point A to point B? They get incorporated into the stool, and while moving the bowel, some of the bacteria remain around the anus. From their, they get transported to the urethra, usually by careless wiping. Then they work their way into the bladder.

UTI can be caused by ageing, illness or injury. Muscles in the ureters, bladder and urethra tend to lose some of their strength. One may have more urinary infections because the bladder muscles do not tighten enough to empty the bladder completely. Illness or injury can also prevent the kidneys from filtering the blood completely or block the passage of urine.

Why are women the easy Victims?

●     Anything that puts pressure on the bladder increases the chances of UTI which is why many women get infected during pregnancy.

●     Women more prone to UTIs after menopause as the urethra and bladder become more fragile.

●     Many women develop UTI after intercourse which might irritate the urethra and increase the risk of moving anal bacteria into it.

●     Women's urethral and anal openings are close together than a man's, so bacteria can easily migrate from one opening to the other. Also, a women's urethra is considerably shorter than a man's so bacteria do not have to travel far to infect the bladder.

U.T.I in children

The importance of diagnosis

Remember the following important facts about urinary infections :

It is not an uncommon disease.

While proper diagnosis and treatment can help, carelessness in its management can lead to malnutrition and kidney damage.

A routine examination of urine may suggest a possibility of infection, but it must be confirmed by urine culture and colony count of bacteria. The diagnosis is clinched if the count is 1 lakh colonies or more per ml of a single organism. If the count is of this order, a sensitivity test must be done to select the right drug for treatment.

The diagnosis is considered in a child with unexplained fever, frequency of micturation (urination)  painful urination, unexplained loss of weight.

Isolated pre-auricular tags (tags of skin in front of ear) may be associated with urinary tract abnormalities. A urinary tract ultrasonography should be conducted in suspected cases.

The urethral opening (opening of the urinary tract above the vagina) is quite near the anal opening in a female child. Parent should clean the anal region after the passing of stool, in the backward direction, away from the urethral opening Children should be trained accordingly.

As long as you change diapers when they need to be changed. The incidence of urinary infection is not affected by whether you use cloth or disposable diapers.

Collection of Urine sample and Treatment

Urine for culture must be collected in a sterile bottle procured from the hospital. A sample must be taken as per the direction of the hospital. The morning sample is not essential.. The sample must be taken to the laboratory immediately after collection. If that is not possible, it should be kept in a refrigerator.

Once a diagnosis is confirmed, the child is given appropriate drug.

 A close follow-up is essential. Urine culture is done a week or 2 weeks after the start of treatment. If the urine is normal, a culture is done once a month for 3 months, once in three months for 1 year and then twice a year as long as possible.

In all male children, a sonography for the urinary tract and a cystoureterogram (an X-ray taken after putting a dye into the bladder) is undertaken a month after  the diagnosis is made and treatment is started. . The same test is conducted in female children below the age of 5 years, if they get another attack of urinary tract infection.

If any abnormality is found in this two test , an intravenous pyelogram is done, In this test dye is given into the vein and its excretion is followed in  the kidneys, ureter and bladder.

Children who gets three infections in a year or those having severe  vesicouretral reflux are put on a single small dose of a drug, every night, for 2 years or more.

Less frequently, a surgeon's help is required where abnormalities of the urinary  tract have to be tackled surgically. There is evidence to indicate that  urinary tract infection is more common in small infants who have not been circumcised.

“Drink plenty of water”

Diagnosis 

●     Based on Symptoms:

Dipstick nitrates : Diagnosis of UTI is identifying a pus cells in the urine and the organism. Now a days dipsticks are able to pick up  the infection in the urine.

Urine sediments : Looking at the urine sediments is a very important step. 

Cultures : They are the gold standard

Collection / transport techniques : It is very important. Mid stream collection of urine is collected.

●     Bacteriuria can be detected by urine dipstick test. The urinary nitrite test will be able to detect any nitrate-reducing bacteria in the urine. The leukocyte test detects the presence of leukocytes (white blood cells) in the urine which can be associated with a urinary tract infection. The urine dipstick test is readily available and provides fast results. Laboratory confirmation:

●     Urine test: For routine and microscopic examination-  To look for pus cells, red blood cells, White blood cells (WBC). WBC in urine may indicate injury, infection or inflammation of kidneys.

●     Protein (albumin) or nitrates.

●     Glucose in the urine may be an indication of diabetes.

●     Presence of urea and creatinine.

●     Culture and sensitivity test: Bacterial culture and antibiotic sensitivity. Growing urinary tract bacteria in a lab. This test tells which bacteria is causing the infection and which medications will be most effective. To avoid potential contamination of the sample, you may be instructed to collect autoclave bottle from the lab. Procedure: first wipe the genital area with an antiseptic pad, then collect the urine midstream.  Bacteria E. coli (a gram negative rod shaped bacteria)  in > 70% cases.

●     Blood test for sugar- fasting.

●     Cystoscopy If one have recurrent UTIs, your doctor may perform a cystoscopy. A cystoscopy, which uses a small camera that's inserted through the urethra and up into the bladder to see inside the bladder. During a cystoscopy, your doctor may remove a small piece of bladder tissue and test it to rule out bladder inflammation or cancer.

●     Imaging: To detect the cause of frequent infections. Sometimes only imaging can tell us the infection in the urinary tract.

     a. Ultrasound To detect an abnormality in the urinary tract. In ultrasound, a device called a transducer is passed over your abdomen. The transducer uses ultrasound waves to create an image of your urinary tract organs that are displayed on a monitor. 

     b. CT scan: A computerized tomography (CT) scan to get more detailed images of the urinary system.
c. MRI: Magnetic resonance imaging (MRI). Your doctor may also use a contrast dye to highlight structures in the urinary tract.

●     An intravenous pyelogram (IVP), which involves injecting a dye into your body that travels through your urinary tract and taking an X-ray of your abdomen. The dye highlights the urinary tract on the X-ray image.

●     Clinical examination for a large prostate, renal masses, hypertension.

“The most common cause of infection is E.coli”.

Microbiology of UTI

●  Bacterial

●  Fungal

●  Viral ; Adeno virus in immuno compromised patient.

●  Tuberculosis a . Typical. b . Atypical. : When someone gets repeated pyurias and cultures come negative than one should suspect tuberculosis. And send the urine for 24 hours for TB culture or TB PCR. It can be typical mycobacteria or atypical mycobacteria.

Causes

●     Not drinking enough water.

●     Previous urinary tract infection.

●     Diabetes- Bladder not fully emptying as in diabetes.

●     Poor hygiene.

●     Urinary catheters: Post operations - Urinary catheters can cause UTIs due to Improper insertion technique, not maintaining closed drainage of the catheter, catheterizing when not necessary, are factors that can lead to infections. Persons with spinal cord injury are at increased risk for UTI because of chronic use of catheter,

●     Post Menopause:  Menopausal vaginitis- As a woman's estrogen levels decrease with menopause, her risk of urinary tract infections increases due to the loss of protective vaginal flora. Additionally, vaginal atrophy that can sometimes occur after menopause is associated with recurrent urinary tract infections.

●     Opportunistic infections like fungal infections (Candida albicans), after taking antibiotics.

●     Improper wiping: Using toilet paper from anus to opening of the urethra (back to front) instead of from opening of the urethra to the anus (front to back) can also lead to UTI.

●     In women, sexual activity is the cause of up to 90% of bladder infections.

●     Suppressed immune system: A weak defence mechanism of the body can increase the risk of UTIs especially in males.

●     The term "honeymoon cystitis" (for the newly married lady) has been applied to this phenomenon of frequent UTIs during early marriage.

●     Asymptomatic bacteriuria is bacteriuria without accompanying symptoms of a urinary tract infection. It is more common in women, in the elderly.

●     Men with an enlarged prostate: Prostatitis or obstruction of the urethra by an enlarged prostate can lead to incomplete bladder emptying, thus increasing the risk of infection. This is most common in older men

●     Blocked urine flow: due to calculi.

●     Spermicide and diaphragm use increases the incidence of UTI infections.

●     Hospitalization- They are the most common cause of hospital-acquired infections accounting for approximately 40 %. 

●     Use of toilet papers can cause UTI due to local irritation.

●     Synthetic undergarments.

●     Not being circumcised.

●     Genital -urinary (GU) inflammations involving particular sites e.g. kidney (pyelonephritis),  bladder (cystitis), prostate (prostatitis) or urethra (urethritis- non specific urethritis is the commonest cause of male GU infections).

●     According to Ayurveda:  Factors that aggravate Pitta Dosha contribute to UTIs. Like consuming food that is too hot, sour and spicy. Exposure to heat and exposure to sunlight. Suppressing the urge to urinate. Habitually retaining urine in the bladder for long periods of time.

“Most UTI are bladder infections”

Complication

●     Stricture urethra due to repeated UTI.

●     Retention of urine.

“For frequent UTI’s consult a Urologist”

Signs & Symptoms

Infections can be asymptomatic or symptomatic

Dysuria : 

Frequency and urgency, poor stream

Cloudy, dark bloody or strange smelling urine

Feeling tired or shaky

Fever of chills  (a sign that infections have reached kidneys.

Pain or pressure in the back or lower abdomen.

●     Foul smelling and cloudy urine

●     Hematuria- blood in the urine

●     Painful burning sensation before, during and after urinating.

●     The urgent need to urinate, and in serious cases, unable to control bladder and leaks urine. 

●     Urinary frequency or urgency.

●     Severe pain in the lower abdominal region.

●     Nausea/vomiting.

●     Frequent urination with very little urine may coming out.

●     Malaise or a general feeling of unwell.

●   A bacterial cystitis: As there is no urethral disease, It is induced by cold, stress and nylon underwear.

●     Vaginal discharge, loin tenderness.

●     Retention of urine. Even after passing urine person feels his/ her bladder is full.

●     Weakness and tiredness.

●     Fever only when the infection has gone up to the kidneys. 

●     Uncomfortable pressure over the pubic bone.

"UTIs are not contagious".

Lifestyle

●     Drink more water as water flushes out the bacteria in your bladder. This helps to get rid of the infection faster. It also dilutes your urine, so urination may be less painful. 

●     Urinate before and after sexual activity.

●     Use of sanitary pad during menstruation. The pads should be changed frequently as blood is an excellent medium for bacterial growth.

●     Maintain strict genital hygiene. Wash hands before and after using toilets.

●     Keep the genital area dry by wearing cotton underwear and loose-fitting clothes. Avoid tight jeans and nylon underwear- they can trap moisture, creating the perfect environment for bacteria growth.

●     Empty your bladder frequently as soon as you feel the need to go; don't rush, and be sure you've emptied your bladder completely.
*     Ensure you urinate completely.
*     Cut down on caffeine and alcohol: as it can upset your bladder.
*     Eat right : Avoid chocolate, spicy food and tomatoes.
*     Stop smoking : It can cause bladder cancer.
*     Go for a walk : If you are sedentary or have a heart disease, there may be fluid build up in the legs in the day. At night, fluid can make you urinate more often. Wailing can help you relieve that fluid build up, as can flexing your calf muscle.
 *     Use clean toilets.

●     Cleanse the genital area before sex.

●     Urinate after sex to flush away any bacteria that may have entered your urethra.

●     If you use a diaphragm, unlubricated condoms, or spermicidal jelly for birth control, consider switching to another method. Diaphragms can increase bacteria growth, while unlubricated condoms and spermicides can cause irritation. All can make UTI symptoms more likely.

“Pee when you need to”

Bladder exercises

Holding the urge for urination sometimes then urinate. This will strengthen the bladder muscles.

Yoga

●     Padmasana

●     Shalabhasana

●     Sarvangasana

●     The cat and camel pose

●     Bhujangasana

Pranayama

Kapalbhati

This rapid abdominal breathing is an advanced pranayama technique. Essentially, kapalbhati is a rapid pumping of the diaphragm (lower abdominal breathing). It is a general energy cleanser that is toning and rejuvenating the internal organs like kidneys. It is generally practiced in sets of 60-120 breaths. 

Mudra

Varuna Mudra

Touch the tip of the little finger with the tip of the thumb. 

Apana Vayu Mudra

This mudra can save a person from 'heart attack', hence a mudra is called Sanjeevani Mudra, one that gives life to a dying person. This mudra gives instant results and the pain is reduced immediately.

Formation :

This is combination of two Mudras Vayu and Apana. From Vayu mudra by placing the tip of index finger at the base of the thumb and then form Apana Mudra by joining tip of the thumbs with the middle and ring fingers.

Effects :

There is combined effect of Vayu mudra and Apana Mudra. Vayu mudra relieves the pain instantly and Apana mudra maintains space to reinforce blood circulation to the heart. 

Benefits: 

• If urination is blocked this mudra relieves the problem and within 10-15 minutes block os removed.and the person passes urine.

Perform Apana Vayu Mudra-

1. When there is sleeplessness.
2. When there is over exertion.
3. When there is stress.
4. When climbing staircases and hills.
5. When there is crises.

“Eat garlic an antioxidant, anti-inflammatory, and immune System booster, which could help you fight off a UTI.”

Diet

●     Eat lots of citrus fruits. Vitamin C strengthens the immunity to fight the infection. So load up on vitamin C for a healthy urinary tract.

●     Pineapple has an enzyme Bromelain, which contrails anti inflammable agents that may decrease UTI symptoms.

●     Eat yoghurt regularly, as it contains probiotics (lactobacillus) which balance the vaginal flora and protect from infection. 

●     Ash gourd (white pumpkin, Kushmanada) is good for cystitis and acts as a diuretic. It can be consumed in form of juice, petha (a sweet).

●     Drink unsweetened cranberry juice a day, it helps to flush away the bacteria and keep them away from sticking to the bladder wall.

●     Garlic extract: Garlic has been shown to have antimicrobial properties and may be able to block the growth of bacteria to prevent UTIs 

●     Consume more fruits such as gooseberry, papaya.

●     Consume vegetables like eggplant, snake gourd, bitter gourd, carrot and spinach.

●     Regular intake of carrot juice. Lemon juice, tender coconut water, sugarcane juice (helps to increase the quantity of urine)

●     Barley water can help to control urinary infection.

●    Hot Soups of pulses seasoned with ginger and asafetida, pepper, long pepper good for digestion. Hot soups to relieve the blocked feeling which comes with urinary tract infections (U.R.I ). It helps to  boost immunity. They also enable the toxins of the body to get flushed out, maintaining one's health and reducing vulnerability

“Vitamin C strengthens the immunity to fight the infection.”

Herbs

●     Coriander seeds/ Cumin seeds/ Fennel seeds 

●     A decoction can be prepared using coriander seeds by itself or along with cumin seeds and fennel seeds. They act as an anti-inflammatory. These instantly dispel excess Pitta from the body and relieves burning sensation.

●     Punarnava (Boerhavia diffusa) They are cool a fun soothing in properties and hence help in regularising the inflamed urinary tract caused by infections.

●     Shatavari (Asparagus racemosus) It has cooling properties and helps to relieve Pitta inflammation from the urinary system. A decoction of roots of Shatavari should be taken with sugar or honey. 

●     Crataeva nurvala or Varuna Three-leaved caper, a decoction made from the bark is consumed twice daily for seven days in urinary tract infection.

●     Include antibacterial herbs in your daily food. Many Indian herbs, spices and condiments like garlic, clove, basil, turmeric etc. have effective antibacterial properties.

●     Gokshura (Tribulus terrestrial) It's a cooling herb, used as a diuretic and herbal tonic. It clears away the obstruction in the urinary tract and is also act as anti-infective. 

●     Rakta Chandana (Red sandalwood) It is a urinary alkalizer. It is anti-infective. It acts as a cooling agent in the urinary tract and is a urinary alkalizer. 

●     Palash (Butea monosperma) It is known as flame of the forest. It is a urinary alkalizer and also relieves painful micturition. 

●     Sariva  Hemidesmus indicus relieves burning sensation in urine. A plant which smells like Vanilla.

Home remedies

Til, Gur ajwain Laddus

• Urine Frequency :Til, Gur and Ajwain Laddoos for frequent urination: 100 gm til, 50 gm gur and 15 gm Ajwain. Make 10 laddus. eat at night for 10 days.

●     Fresh juice of  Amla should be taken as such or diluted with water.
●   Prepare a concoction using a cup of hot (boiling) water, 1 tsp coriander seeds, 1 tsf cumin seeds. After adding all the ingredients , cover it with lid and keep it aside for 30 minutes. Strain the concoction and consume this throughout the day.
●   Cold infusion prepared with Sariva (Hemedesmus indicus) is also of use.Quantity -200ml.

●  Banana stem juice (only the core part) is an excellent remedy for all kinds of urinary infections.

●     A paste of dried black grapes should be taken with milk and jaggery. 

●    In a bowl of water, put some petals of lotus and pink rose and bring it to boil. Strain the    liquid after it cools. Have an ounce of this, three times a day.

●    Take one cup of hot water. Add 1 tsp of coriander powder. Close the lid and keep it for 5- 10 minutes to cool. Drink this infusion twice a day.

Avoid

●     Stay away from feminine hygiene sprays, scented douches, and scented bath products- they'll only increase irritation.

●     Avoid too hot, sour and too spicy foods like green chilies .

●     Avoid wearing tight clothing.

●     Women need to avoid using tampons.

●     Restrict intake of dry vegetables.

●     Avoid drinks that may irritate your bladder like tea, coffee, alcohol, and carbonated drinks until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate.

●     Avoid vaginal douches, tampons, synthetic underclothes, tub baths, swimming. Maintain strict vaginal hygiene.

●     Avoid using a diaphragm or spermicide and change to an alternate form of birth control.

Prevention.

●    Hydration : Take plenty of water.

●    Not holding urine as that can lead to residual urine , and organism to multiply and simple infection can become complex infection.

●    Double and triple voiding is advised so there are no left over urine in bladder.

●    Vaccines and things that boost your immune system.

●    Hormone replacement therapy in post menopausal women.

●     Regular urological checkups, after 45 yrs of age can detect, cure and help in prevention.

●     Keep your blood sugar under control.

●     Using lubricated condoms.

●     Local hygiene: Wash perineum well always from front to back.

●     Catheterizing only when necessary, using the aseptic technique for insertion, and maintaining unobstructed closed drainage of the catheter.

●     Peeing after sexual intercourse can also reduce the risk of U.T.Is by preventing the spread of bacteria.

●     Antibiotics following short-term urinary cauterization decreases the subsequent risk of a bladder infection

●     Double voiding (going again after 5 minutes) and voiding after relationship may be helpful in preventing infection.

“Soothe UTI Pain with Heat”

Retention of urine

●   Apply wet cloth over pelvic area

●   Soak coriander seeds over night , drink its water in the morning

●   Do Apana mudra, Apana Vayu mudra, varun mudra and kidney mudra

●   Start the tap water before passing urine

●    Keep your self well hydrated

●    Tea is a diuretic

Treatment

●     Allopathy

●     Antibiotics after culture and sensitivity is done

●     Drug of choice: Tab Ofloxacin 200/ 400/ 800 mg twice a day for 5- 10 days.

●     A single dose of antibiotic after sexual intercourse if the infections are related to sexual activity.

●  Severe infection of  UTI,  may need treatment with intravenous antibiotics in a hospital.

●     Urinary alkalizer,  Syrup Alkacitron 2 tbsp. three times a day.

●     In postmenopausal women, topical vaginal estrogen has been found to reduce recurrence. 

●     Urinary analgesic- Tab Pyridium (phenazopyridine ) or Urispas can ease pain  200 mg tab, three times a day after meals (urinary - analgesic)

●     Take vitamin C to fight infection.

●     Tab Paracetamol may be used for fevers.

●     Hot compression: Place a heating pad or hot water bottle on the lower abdomen area to provide relief from pain. It helps to decrease inflammation

●     Removing obstruction of the urinary tract  by surgery or medicine.

●     Dilatation- For stricture urethra.

Chronic UTI Treatment

A low dose of antibiotic over a longer period to help prevent repeat infections.

A single dose of antibiotic after sex which is a common infection trigger.

Antibiotic for one or two days  every time symptoms appear.

A non anti biotic prophylaxis treatment.

Antiseptics like Septran, or furadantin can be given for months together to prevent the recurrent infection.

Ayurveda 

●     According to Ayurveda: One needs to balance Pitta dosha and strengthen the urinary tract in order to avoid recurring infections.

●     Understanding and removing the cause begins with the healing process.

●     Eating cooling foods and avoiding Pitta producing food such as hot spicy like chilies

●     Tab Chandraprabha Vati one tab thrice daily.

●     Chandana Asava 2 tbsp thrice daily.

●     Eladi churna ½ tsp with milk.

●     Shatavari ghrita 2 tsp twice a day.

●     Kamadudha rasa 240-480 mg twice a day.

Ayurvedic medicines balance the infection-fighting properties of the urinary system and pacify the toxins. Whereas modern medication works on the bacteria.

MESSAGE

DON'T TAKE UTI'S LIGHTLY.

NOT ALL UTI'S ARE SAME

UTI IN SPECIAL SITUATIONS WARRENT SPECIAL ATTENTION.

CAN LEAD TO RENAL FAILOUR.

CAN WORSEN UNDERLYING RENAL FAILOUR

CAN BE LIFE THREATHENING.

“So say adieu to UTI”

Link: https://madhuchhandacdmo.blogspot.com/2018/02/getting-rid-of-utis-urinary-tract.html

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.