Urinary tract infections

Urinary tract infections are very common  in adult women and may become recurrent. The most common is cystitis, an  infection of the bladder, but infection may occur in any part of the  urinary system, including the kidneys. Infection is caused by the growth  of the gut bacteria within the urinary system, but in many cases  bacteria are not found on urine culture, despite obvious symptoms of  bladder discomfort. The close proximity of the anus and urethra (opening  from the bladder) in women allows for the bacterial movement,  especially if there is irritation of the delicate perineal tissues.

Urinary tract infections are rare in boys and men because of the  length of the urethra. In most cases there is an underlying cause,  usually an obstruction to the normal urine flow, or reflux of urine to  the kidney. All cases of proven urinary infection in men and boys must  therefore be fully investigated, preferably by a urologist. Recurrent  infections in women, more than three within a year, also warrant  investigation, although the chances of finding an underlying cause are  less likely. Occasionally, kidney stones or bladder warts may present  with recurrent bladder infections.

Homeopathy can be used alongside conventional treatment with  antibiotics and for cases where no infection is found. It can be very  helpful in building up the constitution, thus reducing the risk of  recurrence. There are also many other simple measures that can reduce  the chances of re-infection.

In all cases of suspected urinary tract infection a detailed history  is essential, not least of all to find the appropriate homeopathic  remedy. A urine sample should always be sent off for analysis in the  laboratory. A preliminary inspection of the urine is very useful. A  strong smell, cloudiness or the presence of small amounts of blood are  highly suggestive of a bacterial infection, but clear urine does not  exclude it. The doctor may use a reagent strip to see if there are any  blood or pus cells not visible to the naked eye.

In a simple case of cystitis, when there is no fever or obvious  general illness, the GP will usually wait for the results of the urine  culture before prescribing antibiotics. As this can take several days,  it is well worth trying a homeopathic remedy in the meantime to  alleviate the discomfort.

Acute cystitis 

The most common symptoms of a bladder infection are pain on passing  urine and frequency of urination, although these are often absent in  very young and older people. An uncomplicated case of cystitis will  rarely give much more than a mild fever and does not make the person  feel terribly unwell.

Pain may be felt in the urethra, as a burning, scalding sensation  and/or as a dull ache in the pelvis. If the pain extends to the loins or  the temperature is very high, this indicates the infection has possibly  ascended to the kidneys (pyelonephritis) and medical intervention must  be sought urgently. The passage of blood also warrants prompt medical  attention.

Kidney infection may lead to scarring of the kidneys and prompt  treatment with antibiotics is imperative. It is perfectly safe to use  homeopathy alongside antibiotics.

Non–infective cystitis 

Many women present with symptoms identical to cystitis but urine  culture yields no growth of bacteria. Often they do get courses of  antibiotics prescribed which do little to help the symptoms. In some  cases there is a local cause such as inflammation of the urethra or  bladder (chronic interstitial cystitis), or the delicate tissues of the  perineum. Herpes infection can lead to cystitis-like symptoms, as can  chronic vaginal discharges or irritation. In the vast majority of cases  no cause is ever found and the patient is told she has an “irritable  bladder”.

Homeopathy can be very helpful in this situation, as treatment is  aimed at the whole person rather than the results of a single  investigation. Careful dietary management may be indicated as some women  do seem to be sensitive to certain acidic foods. A professional  homeopath should be consulted.

General management 

Drinking large amounts of clear water is essential. A very minor  infection may be cleared by this simple action. Coffee and regular tea  often aggravate the symptoms, so should be avoided. Certain herbal teas  may be helpful in controlling symptoms and helping to clear minor  infections, but are best avoided in pregnancy. Golden seal tea  encourages urine flow and is quite palatable.

Changing the acidity of the urine is helpful. Drinking cranberry  juice, or taking tablets of cranberry concentrate, make the urine too  acidic for the bacteria to thrive. The sachets of powder, available at  chemist shops to relieve the symptoms of cystitis, work on the same  principle. Some contain large amounts of bicarbonate to make the urine  too alkaline for the bacteria to thrive.

It is important to keep the bladder empty, however painful this may  be. “Holding on” to urine will only make matters worse and encourage a  more serious infection. If one is prone to recurrent infections, it is  helpful to “double void”, that is to return to the bathroom about five  minutes after passing urine and empty the bladder again. It is often  surprising how much urine has been left in the bladder.

In women infection may be precipitated by sexual intercourse, a  condition known as “honeymoon cystitis”. It is advisable to empty the  bladder after sex to avoid infection. In some cases there is no  infection, the urethra is irritated by friction and this can mimic the  symptoms. Adequate lubrication and a change in sexual position may often  solve this problem.

Some women develop an allergic reaction to the latex of condoms or  the spermicide they contain, and this can lead to bladder symptoms. A  change of contraception may be indicated if this is the case.

Local vaginal infection with thrush also predisposes to urinary  infection. Many women get thrush after a course of antibiotics.  Antibiotics are not highly selective, they also eliminate the so-called  friendly bacteria, and the normal range of bacteria in the gut is  altered. Abnormal bacteria, thrush and other fungi proliferate, leading  to a condition known as gut dysbiosis. Abdominal bloating, bowel  disturbance and food intolerance may result, as well as recurrent  infections in the urinary system. This leads to further antibiotic  courses, which derange the bacterial content of the bowel even more. In  these cases homeopathy is immensely helpful in breaking the vicious  circle.

Acidophilus may be prescribed alongside the remedy to repopulate the  bowel with healthy bacteria, as well as remedies and anti-fungals to  clear the yeast infection.

Chlamydia, a sexually transmitted infection, may mimic a urinary  tract infection. It is becoming increasingly common in young women and  may lead to fertility problems if left untreated. There is often no  associated vaginal discharge and so the infection can go unnoticed. A  vaginal swab taken at the local genito­urinary clinic can detect  chlamydia and other infections, which will require specialised  antibiotic therapy.

Local irritation of the perineal tissues predisposes to infection.  Bubble baths, harsh soaps and deodorants should all be avoided, as well  as thongs and tight trousers. Pure cotton underwear is best, as are  stockings rather than tights. It is important to teach girls to wipe  their bottoms from front to back after a stool.

Homeopathic remedies

Treatment with homeopathy is in two parts: first to treat the  infection, and secondly to improve the general health so as to avert  further infections. This deeper treatment is best left to a professional  homeopath.

For an acute attack a relatively high potency, 30c, is indicated. It  can be repeated every hour, decreasing the frequency of the remedy as  the symptoms improve. If there is no improvement after three or four  doses, professional homeopathic treatment should be sought.

Arnica montana

Arnica is very useful for cystitis that occurs following bruising  injuries of the perineum. It is therefore well indicated for urinary  problems following childbirth. There may be trouble emptying the bladder  and some involuntary dribbling.

Sepia

Sepia is immensely useful for recurrent urinary tract infections,  especially when there is also a history of lots of antibiotic use and  thrush. The woman often loses her libido, because sex is painful and she  fears cystitis may result. She is often worn out by the recurrent  infections, so exhausted by the struggle to keep going that she cries  when expressing herself. Genital herpes may be present.

Aconite

The symptoms come on very suddenly and without any warning, often  after a fright or exposure to cold. Diving into icy water may bring on  cystitis. There is a lot of fear and this may lead to retention of  urine. There is a sensation of pressure in the bladder and burning  before urination.

Pulsatilla

This remedy is often prescribed constitutionally for shy little  girls with a highly emotional and changeable nature. As they do not  drink much they are more prone to urinary tract infections. Pulsatilla  is often prescribed for older women, who are soft and yielding in  character. They are prone to cry whilst relating their story, and evoke  sympathy in the listener. The pain is worse when urination is delayed,  and after urination. The symptoms are changeable, and the urine tends to  spurt out.

Cantharis

The Spanish fly is a urinary tract irritant, well known to the  Marquis de Sade and his followers. It produces the most agonising pain  before, during and after urination. Each drop of urine feels like  scalding acid and it may be easier to pass urine in a hot bath. The  surrounding skin may become excoriated, and there may be blood in the  urine. The patient is beside herself with pain and avoids drinking so  that she won’t have to pass urine.

Nux vomica

There is intense chilliness and the person feels very irritable with  the cystitis. There is constant urging and a sense that the bladder is  full, although tiny amounts of urine are passed. This remedy is well  indicated when frequency is the predominate symptom. A constitutional  Nux vomica is the typical Type A personality – driven, ambitious and  very competitive, with a short fuse.

Staphysagria

“Honeymoon cystitis” frequently responds very well to Staphysagria,  as do urinary tract infections that come on after pelvic examination,  operation or labour. It is indicated where there is suppressed anger and  grief. The anger is hidden, the person appears mild tempered and  gentle, yet there is often a history of abuse or deep sorrow. Cystitis  occurs after sex and the pain is felt during and after urination.

Sarsparilla

This remedy is frequently used for infections when the pain comes on  after urination. There may be some blood in the urine and severe  symptoms of cystitis. It is easier to pass urine whilst standing up and  there is a tendency to urinary retention.