UTI and homoeopathy: gentle healing for lasting relief

Dr Jessie Jeba Geetha S

ABSTRACT
Urinary Tract Infections (UTIs) are among the most common bacterial infections, affecting the bladder, urethra, kidneys or ureters. They present with symptoms such as burning urination, frequent urge to urinate, lower abdominal pain and in severe cases, fever and hematuria. Conventional treatments rely on antibiotics, but recurrent UTIs and antibiotic resistance highlight the need for alternative approaches.

Homoeopathy provides an individualized and holistic approach to UTI management, addressing both acute infections and underlying predispositions.

This article explores the pathophysiology of UTIs, key homoeopathic therapeutics and the importance of individualized remedy selection to ensure safe, effective and lasting relief while strengthening the body’s natural defenses.

KEY WORDS–

INTRODUCTION

• Coli (80%), Enterbacteriae, Proteus mirabilis, Klebsiella pnuemoniae are the causes of UTI.
• They enter the urethra and colonizes the area, causing URINARY TRACT INFECTION.
• Bacterias can cause LOWER URINARY TRACT INFECTION
• CYSTITIS-bladder
• PROSTATITIS-prostate
• URETHRITIS-urethra
• Infection of LOWER UTI can progress and result in UPPER URINARY TRACT INFECTION
• PYELONEPHRITIS-kidneys
• Pyelonephritis is a serious condition, which can cause ACUTE RENAL FAILURE
• UTI is more common in WOMEN
• Upto 1/3 of women with UTI have NEGATIVE midstream urine samples revealing any form of infection

PATHOPHYSIOLOGY

1.In Normal Person:

CONTAMINATION- Bacterias contaminates the lower urinary tract

COLONIZATION IN URETHRA, BLADDER- E.coli commonly affecting 80%. Initially colonize the urethra and bladder. This triggers an inflammatory response in lower urinary tract causing LOWER URINARY TRACT INFECTION

INFLAMMATION- The colonization triggers an inflammatory response in lower urinary tract. Where the neutrophils are recruited in this area

NEUTROPHIL INFILTRATION- Neutrophils are recruited, because in bladder there is bacteria and neutrophils. The bacterias multiply and are able to evade the immune system because of certain virulent factors

BACTERIA MULTIPLICATION- For example: E.coli can bind to cells in the lower urinary tract and hide from immune cells. Bacteria can form BIOFILMS. Biofilms are any group of microorganisms in which they stick to each other and often these micro organisms adhere to surfaces and allows them to survive

ASCENSION TO THE KIDNEY- If this urinary tract infection progresses and left untreated or if the patient is immune compromised, then it becomes a risk factor. The bacteria can ascend towards the kidney

COLONIZATION OF KIDNEY- And they colonize the kidney causing a UPPER URINARY TRACT INFECTION

BACTEREMIA- If left untreated, the bacteria can spread into circulation via renal veins causing SEPTIC SHOCK

2. In Catheterization:

A big risk factor for developing UTI especially in females is URINARY CATHETERIZATION.

Catheter can introduce infection straight into the bladder if not done hygienically

The bacteria colonizes the bladder initiating an immune response

Neutrophils enter further promoting inflammation

FIBRINOGEN ACCUMULATES ON THE CATHETER providing an ideal environment for the attachment of uro pathogens that express fibrinogen binding proteins

After these bacteria initial attachment to the fibrinogen coated catheters, the bacteria can multiply and  can again form biofilms, promoting epithelial damage and concede an infection of the kidney

And so the same story continues…

3. In Pregnant Women:

In PREGNANCY, the UTI is common, catheterization always results in UTI

The reason is not only the shorter urethra in women

But during pregnancy, progesterone relaxes smooth muscle causing stasis of urine which allows for colonization especially upto the kidneys and also the increased abdominal pressure

During pregnancy, it is important to perform urine analysis because, not only our urinary tract infections are common but are also asymptomatic

Untreated UTI during pregnancy can have consequences for the growing infant in the utero

RISK FACTORS

1. Females
2. Pregnancy
3. Menopause
4. Sexual intercourse
5. Condoms
6. Catheterization
7. Urinary tract malformations
8. Urinary stones

SIGNS AND SYMPTOMS

LOWER UTI	UPPER UTI
Dysuria	All symptoms of LUTI
Increased frequency of urine	Malaise
Haematuria	Rigor
Supra pubic discomfort	Fever
Burning sensation while urination	Vomiting
Cloudy urine	Loin flank pain radiating to back
Offensive urine	Signs of septic shock (if infection is severe)

CLASSIFICATION

• COMPLICATED UTI- Decreased renal function accompanied by abnormal urinary tract
• UNCOMPLICATED UTI- Renal tract and function are normal

INVESTIGATIONS

1. SWAB TEST with genital examination for Sexually Transmitted infections (if there is persistent discharge and itching)
2. URINE DIPSTICK TEST(haematuria, proteinuria, positive nitrates and WBC)
3. URINE MICROSCOPY CULTURE SENSITIVITY(MCS)
4. BLOOD URINE for infections (FBC, CRP, β HCG [ectopic])

TREATMENT

LOWER UTI	UPPER UTI (serious)
Oral antibiotics (3-7 days course) 1.  Trimethoprim 2.  Nitrofurantroin 3.  Amoxicillin	IV antibiotics(until afebrile) ↓ Oral antibiotics(course of medication is longer)
If urine dipstick test is +ve →  treat with empirical antibiotics If urine dipstick test is –ve →  still suspect for UTI, then send for MCS

WHEN TO REFER TO RENAL SPECIALIST OR UROLOGIST:

1. If patient fails to respond to the antibiotic treatment
2. Recurrent UTI (3-4 times/ year)
3. Men with symptoms of Upper UTI ( it is uncommon to develop and can occur mostly of anatomical abnormality)
4. Significant haematuria

PREVENTION

1. Drink lots of water to help flush the bacteria from body
2. Craneberry juice ( red berry contains tannin which prevents the growth of E.coli)
3. Wash hands before and after using toilet
4. Empty bladder often as soon as you feel the need to pee
5. Wipe from front to back after using toilet( avoid wiping back and forth)
6. Avoid loofahs and bath sponges which can retain bacteria even after being washed. Use washcloth instead

FREQUENTLY PRESCRIBED REMEDIES

1.CANTHARIS

• Burning pain in kidney region extending to bladder
• Kidney sensitive to touch
• Burning during urination
• Drinking even small quantity of water increases pain in bladder
• Constant urging to urinate(2-3min) before, during and after urination
• Urine passes drop by drop, every drop feels like molten lead
• Urine burns like fire in bladder and about genitals
• Haematuria
• Desire for stool while urinating
• < during urination, touch, drinking cold water or coffee
• > rubbing, warm application

2. PULSATILLA

• A/F- taking chill, getting feet wet, least movement or strain
• Coughing, sneezing or laughing causes involuntary spurting of urine
• Increased desire, < lying down
• Nocturnal enuresis
• Burning in orifice of urethra, during and after urination
• Involuntary urination < night, passing flatus
• After urinating, spasmodic pain in bladder

3. EQUISETUM

• Nocturnal enuresis
• Dysuria after confinement and during pregnancy
• Frequent and intolerable urging to urinate, with severe pain at close of urination
• Urine flows drop by drop
• Sharp, burning pain in urethra while urinating
• Pain in bladder as if distended, not better by micturition
• Much blood and mucus in urine
• Incontinence in children, with dreams or night mares when passing urine
• Paralysis of bladder in old women

4. HYDRANGEA

• Burning in urethra
• Frequent desire
• Urine hard to start
• Heavy deposit of mucus
• Sharp pain in loins, especially left
• Great thirst, with abdominal symptoms and enlarged prostate
• Gravelly deposits
• Spasmodic stricture
• Profuse deposit of white amorphous salts

5. BENZOIC ACID

• Urine dark brown/ changeable color
• Repulsive odor/ intensified odor
• Nocturnal enuresis of delicate children
• Dribbling of urine in old men with enlarged prostate
• Excess of uric acid levels
• Vesical catarrh from suppressed gonorrhoea
• Cystitis

6. SARSPARILLA

• Urine scanty, slimy, flaky, sandy, bloody
• Renal colic and dysuria in infants, Pain from right kidney downward
• Severe pain at conclusion of urination
• Urine dribbles while sitting
• Bladder distended and tender
• Child screams before and while passing urine
• Sand on diaper
• Tenesmus of bladder
• Urine passes in thin, feeble stream

7. BELLADONNA

• Retention; acute urinary infections
• Sensation of motion in bladder as of a worm (as if ball)
• Dark and turbid, loaded with phosphates
• Urine becomes extremely hot. It looks as if mixed with brick dusk and is strongly acidic
• Vesical region sensitive
• Incontinence, continuous dropping
• Frequent desire to urinate with a scanty discharge of urine
• Haematuria where no pathological condition can be found
• Prostatic hypertrophy
• Women loose their urine < when becoming chilled/ cold

8. SOLIDAGO

• Scanty, reddish brown, thick sediment
• Dysuria, gravel
• Difficult and scanty
• Albumen, blood and slime in urine
• Pain in kidneys extend forward to abdomen and bladder
• Clear and offensive urine
• Sometimes makes the use of the catheter unnecessary

9. THLAPSI

• Frequent desire
• Urine heavy, phosphatic
• Chronic cystitis; urethritis
• Dysuria and spasmodic retention
• Haematuria
• Accumulation of gravel
• Renal colic
• Brick-dust sediment
• Urine runs away in little jets (often replaces the use of catheter)

10. SABAL SERRULATA

• Constant desire to pass urine at night
• Enuresis
• Paresis of sphincter vesicae
• Chronic gonorrhoea
• Difficult urination
• Cystitis with prostatic hypertrophy

11. PAREIRA BRAVA

• Black, bloody, thick mucous urine
• Constant urging, great straining
• Pain down thighs during efforts to urinate
• Can emit urine only when he goes on his knees, pressing head firmly against the floor
• Feeling of the bladder being distended and neuralgic pain in the anterior crural region
• Dribbling after micturition
• Violent pain in glans penis
• Itching along urethra
• Urethritis with prostatic troubles

12. VERBASCUM

• Constant dribbling
• Enuresis
• Burning urination
• Increase with pressure in bladder
• < talking, sneezing

13. BERBERIS VULGARIS

• Left kidney and left ureter involved
• Bubbling sensation in the region of kidneys
• In acute cases- urine is greenish, turbid, flocculent having a copious mucous sediment
• In chronic cases-urine appears reddish, bloody, turbid with copious sediment, urine flows slowly with constant urging
• Pain in bladder region
• Pain in the thighs and loins on urinating
• Frequent urination, urethra burns when not urinating

14. NUX VOMICA

• Ineffectual urging to urination- diabetes, renal colic, haematuria and cystitis
• Irritable bladder; from spasmodic sphincter and strangury
• Frequent calls; little and often
• Renal colic extending to genitals, with dribbling urine
• While urinating, itching in urethra and pain in neck of bladder

15. CHIMAPHILA

• Urging to urinate
• Urine turbid, offensive, containing ropy or mucus and deposits of copious sediments
• Burning and scalding during micturition and straining afterwards
• Must strain before flow comes
• Scanty urine
• Acute prostatitis, retention and feeling of a ball in perineum
• Fluttering in region in kidney
• Sugar in urine
• Unable to urinate without standing with feet wide apart and body inclined forward

16. CLEMATIS

• Tingling in urethra lasting sometime after urinating
• Frequent, scanty urination
• Burning in orifice
• Interrupted flow
• Urethra flows constricted
• Urine emitted drop by drop
• Inability to pass all the urine, dribbling after urinating
• Pain < night, pain along the spermatic cord
• Commencing stricture

17. LYCOPODIUM

• Red sand in urine, on child’s diaper
• Child cries before urinating
• Pain in back, relieved by urinating, ceases after flow, slow in coming, must strain
• Renal colic, right side
• Retention
• Polyuria < night

18. STAPHYSAGRIA

• Urging to urinate, has to sit at urinal for hours, in young married women, after coition, after difficult labor
• Burning in urethra when not urinating
• Urging and pain after urinating in prostatic troubles of old men
• Prolapse of bladder
• Cystocele (locally and internally), in lying-in patients
• Pressure upon bladder, feels as if it did not empty
• Pain after lithotomy

19. TEREBINTHINIAE

• Strangury with bloody urine, sediment like coffee grounds, cloudy, smoky, albuminous, profuse, dark or black urine
• Scanty, suppressed
• Odor of violets
• Urethritis with painful erections
• Inflamed kidneys following any acute disease
• Constant tenesmus
• Violent burning and drawing pains in kidney, bladder and urethra
• Cystitis and retention from atony of fundus

LESSER KNOWN REMEDIES

1. ARISTOLOCHIA SERPENTARIA

• Irritation of urinary and genital organs
• Violent desire to urinate with passage of increased quantity of urine
• Frequent desire to urinate but passes a little quantity
• Brownish urine

2. BAROSMA CRENULATUM

• Useful in cases where, muco- purulent discharge from genito-urinary organs
• Irritability of bladder with vesical catarrh

3.COPAIVA OFFICINALIS

• Retention of urine, with pain in bladder, anus and rectum
• Painful urination
• Constant desire to urinate
• Urine has odor of violets, greenish turbid color, peculiar pungent odor
• Catarrh of bladder
• Swelling of orifice

4. DORYPHORA DECEMLINEATA

• Urethritis in children
• From local irritation, gleet
• Difficult urination with excruciating pain in urethra while urinating
• Severe pain in back and loin is associated with urinary symptoms

5. FERRUM IODATUM

• Sensation as if something crawling in urethra and rectum
• Incontinence of urine in anaemic children
• Dark urine with sweet smell
• Sensation as if urine were stopped at fossa navicularis
• Difficulty in retaining the urine

6. HELONIAS DIOCA

• For urinary symptoms associated with diabetes mellitus
• Albuminous
• Phosphatic
• Profuse and clear
• Saccharine

7. NAPHTHALINUM

• Irresistible desire to urinate
• Black urine of offensive odor
• Pain in bladder region
• Meatus red, swollen and oedema of prepuce
• Cutting pain down penis
• Terribly offensive odor of decomposing ammoniacal urine

8. POPULUS TREMULOIDES

• Useful in vesical troubles after surgery and in pregnancy
• Indicated in old people with dyspepsia and catarrh of bladder
• Urine is scalding, with mucus and pus
• Pain at the end of urination behind pubis
• Severe tenesmus
• Prostate enlarged

9. RHUS AROMATICA

• Pale and albuminous urine
• Senile incontinence of urine
• Severe pain at beginning and before urination
• Which causes agony in children
• Constant dribbling
• Haematuria
• Cystitis
• Diabetes, large quantities of urine of low specific gravity

10. PETROSELINUM

• Burning, tingling, from perineum throughout whole urethra
• Sudden urging to urinate
• Frequent, voluptuous tickling in fossa navicularis
• Gonorrhoea
• Sudden, irresistible desire to urinate
• Intense biting, itching, deep in urethra
• Milky discharge

11. VESPA CRABRO

• Burning urination with itching
• Left ovary markedly affected, with frequent burning micturition

REFERENCES

1. Allen, H.C. (1905). Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica. Boericke & Tafel.
2. Boericke, W. (1927). Pocket Manual of Homoeopathic Materia Medica and Repertory. Boericke & Runyon.
3. Mohanty N. All in One Homoeopathic Materia Medica. 1^st
4. Kinra R. Materia Medica for Students. Part 1.
5. Kinra R. Materia Medica for Students. Part 2.
6. Khaneja H. Find Your Remedy: An Illustrated Homoeopathic Guide.
7. Homoeopathic medicines for urinary tract infection. World Journal Pharmaceutical Research

Dr. Jessie Jeba Geetha. S
PG Scholar, Department of Homoeopathic Materia Medica
Guide: Dr. Amitha P Baliga
Father Muller Homoeopathic Medical College And Hospital, Mangalore-575018.