Urinary Tract Infection is one of the most common infection in general medical practice and accounts for 1- 3% of consultations. Women are especially prone to UTIs. One woman in five develops UTI at least once during her life time. although it is not that much common in man, but they can be very serious when it occur. Urinary tract infection is defined as multiplication of organism in the urinary tract. It is usually associated with the presence of neutrophils and >105 organism/ml in a midstream sample of urine. The symptoms of urinary tract infection are similar to mutrakricha as described in Ayurveda. In Mutrakricha patients have complaints of increased frequency, urgency, hesitancy, burning micturation, painful micturation and red-yelloworange urine. Although modern medical system has many modern drugs but there are cases where patient suffer due to lack of desired results. The current available antibiotics drugs and other conservative measures are in practice to combat the condition in suppressing the symptoms.
Limitation of antibiotics, drug resistance of microorganisms, side effects of the drug in metabolic systems, immune system make think for alternative modalities of management.
Also, talking about Mutrakriccha, it is a disease of mutravaha srotas, which shows the sign of painful and difficulty in urination. Acharya has described various nidana for mutrakriccha are Adhyashan, Ruksha anna sevana, Yaungamana, Tikshna aushadha and Anupa mamsa sevana, Ajirna etc.
Acharya described Samprapti or Pathogensis of mutrakriccha in their classical texts as due to Nidansevana, the doshas collapsed by self or collectively and settled in Basti, from mutramarga to paripida. The prakupit doshas alongside kingdom of agnimandya (manda agni) continuosly produce aama. Aama gets mixed with the prakrut Doshas which forms saamadosha, Such samadosha revels signs and indications consisting of peetamutrata, sadah mutra pravrutti, basti and mutrendriya gurutwa, shweta and picchilamutra (turbid urination which contains leucocytes).
Although, For a urinary Infection to occur, there are many superimposing factors that play including host factors , inoculum size, and the virulence of the infecting bug. The first event that leads to a UTI is the inoculation. The most common theory for inoculation is the ascending route. Enteric bacteria colonize the perineum and ascend into the urethra and bladder.
As for the recurrence of urinary inflection, multiple factors play a role. On the microbiological level, one theory is the decrease of per-oxide producing lactobacillus, predisposing to increased colonization with pathogenic enteric bacteria. Another theorem is the formation of intracellular clusters of bacteria that are not sensitive to antibiotics, while others postolate a change in the glycosaminoglycan barrier of the urothelium that makes an individual more susceptible to enteropathogenic infection.
In Young women, Spermicide use and frequency of sexual intercourse are the main risk factors evidenced by increased urethral and vaginal colonization. In contrast, older women’s predisposing risk factors are high urinary residue, atrophic vagintis and cystocele.
If, we are talking about the microbiology of urinary tract Infection, then a urinary infection is rarely secondary to an underlying structural abnormality but rather the intraction between uropathogens and the normal urothelium. This interaction occurs as a result of the colonization of the vaginal and periurethral area with uropathogens originating from the gut. For unknown host factors, probably genetic, women who tend to have RUTI have an inclination to have a prolonged and heavier colonization with uropathogens.
One of the main bacterial virulence features is the binding of the uropathogens to the mucosal cellular layer. It has been well studied that E.coli type 1 fimbria is heavily associated with cystitis, and other pathogenic fimbriated strains are associated with pyelonephritis. Furthermore, these pathogenic fimbriae are associated with persistent colonization of the urothelium and elicting an inflammatory respose. It has been also theorized that these bacteria can mature into biofilms in the urothelial barrier to cause recurrence of inflections and elude the host immune systems.
Antibiotics remain the cornerstone in UTI management, targeting the causative pathogens. Commonly prescribed antibiotics include trimethoprim – sulfamethoxazole, nitrofurantion and fosfomycin.
Antibiotic selection is guided by factors such as local restistance patterns, patient allergies, and pregnancy status. However, escalating antibiotic resistance underscores the importance of judicious antibiotic use and adherence to prescribing guideline to preserve efficacy.
Adjunctive measures complement antibiotic therapy to enhance treatment outcomes and alleviate symptoms. Increased fluid intake promote urinary flow, flushing the bacteria, and diluting urine, thereby expediting bacterial clearance. Pain relieves like phenazopyridine provide symptomatic relief by alleviating urinary discomfort, albeit without treating the underlying infection. Urinary alkalizers like sodium bicarbonate help alleviate dysuria by neutralizing acidic urine PH.
Additionally, vaccine development represents a prophylactic strategy to prevent recurrent UTIs by bolstering the host immune response against uropathogens. Vaccines targeting common uropathogens like E.coli hold promises in reducing UTI recurrence rates, particularly in susceptible populations. However, vaccine efficacy hinges on antigen selection, formulation, and immunogenicity optimization.
On the other hand, Ayurveda perceives UTIs as a manifestation of imbalance in the body’s doshas, namely vata, pitta and kapha, along with the impairment of agni, the digestive fire. Imbalance in these fundamental elements disrupts the body’s innate healing mechanisms, predisposing individuals to infections. Ayurvedic treatment aims to restore equilibrium by harmonizing the doshas and bolstering the body’s natural defense mechanisms.
Promotes the excretion of urinary tract stones. ALKA 5 is a urinary Herbal remedies constitute the cornerstone of ayurvedic Intervtion for UTIs. Triphala, a classical formulation comprising these fruits, possesses potent antimicrobial properties and acids in detoxification and rejuvanation. Procedures like Yonidhawan with triphala kwastha gave effective results from inflammation and itching in UTI.
Gokshura and chandraprabha vati are renowned for their diuretic properties, promoting urinary flow and flushing out toxins, similarly daruharidra (Berberis aristata) exhibits antimicrobial activity against uropathogens, thereby alleviation infection symptoms.
Medicines like Samshaman vati which contains guduchi which acts on micro circulation and helps in homeostasis. Antipyretic, antacid, anti-arthritic, antibacteriol, anti-gout, Anti-Inflammatory, antioxidant, Digestive stimulant , hypoglycemic.
Also, Golshuradi gugullu, sheet-prabha vati has urinary movement on urinary tract is ‘Sheetprabha’. Eases burning & flimsy urination. It could be very beneficial for destroying urinary stones and tumors; way to Hajrut Yahud bhasma, his urine maybe excreted from the body. Helpful in signs because of intense warmness being dahashamak.
Alka 5 syrup which contain Yavashar, Dhanyak, Jeerak, Gokshura It is a herbal alkaliser that allows to hold ordinary urine PH balance. Yavakshara is a effective alkalizing agent with a slight diuretic effect. This will reduce the burning sensation when urinating. Dhanyak has a relaxing effect, has diuretic and antibacterial properties, at the same time as jirak (cuminum cyminum) has antispasmodic and antibacterial properties. Gokshura (tribulus teresstris) which has diuretic and stone crushing properties, promotes the excretion of urinary tract stones.
As a result, the Management of UTI with ayurvedic drugs shows better symptomatic improvements with lesser side effect over the allopathic drugs. So ayurveda contribute better possibility in management of UTI with slighter side effect or without any consequence.
