Urinary tract infections or UTIs are one of the more common conditions we see in clinical practice. The lifetime incidence rate for this illness for women is 50%, and 5% for men. Babies and the elderly form two of the high risk groups for UTIs. The more specific groups at higher risk of developing this disorder are sexually active women, diabetics, men with pre-existing prostate disease, those with urinary catheters, and babies born with anatomical disorders of the urinary tract that result in vesico-ureteric reflux.
UTI is a general term encompassing urethritis, cystitis and pyelonephritis. The disease is usually associated with a bacterial infection, and the organism most commonly implicated here is E.coli, although infection with mycoplasma or chlamydia, particularly in cases of urethritis, may also be involved. The symptoms reported for UTI’s commonly include chills, fever, dysuria, haematuria, urinary frequency, a feeling of fullness in the bladder after voiding urine, and suprapubic, back or loin pain.
Failure to successfully manage UTIs may result in the progression to a more severe infection, and the development of hypertension as well as kidney failure. Medically, UTIs are frequently treated with antibiotics, but the rates of resistance to these drugs, particularly the older antibiotics, are rising significantly, leading to increased levels of UTI recurrence that become harder and harder to manage. From a naturopathic perspective, berberine-containing herbs, Cranberry, Buchul and Olive leaf are often helpful, but patient compliance with regimes employing these herbs can often be problematic. Prevention using things such as super-hydration (while avoiding electrolyte deficiency), Cranberry and probiotics can be successful, but often fail to halt an active UTI.
In my experience and that of several noted authorities in this area1-9, there are a number of homeopathic medicines that have been found to be very effective in the management of urinary tract infections. Brief discussions on these medicines follow, and it should be noted that these appear here for educational purposes only, and are not intended to replace the advice of a competent and qualified healthcare practitioner.
This is one of the most commonly used homeopathic medicines in UTIs. The primary symptom is intense scalding or burning pain, either with or without urination. Urine is passed by drops and each drop of urine passed is often described as being like passing burning acid. There may also be anxiety, restlessness, urinary tenesmus, haematuria, the urine may appear jelly like or contain substances with the appearance of scales. Severe urging to urinate and cramping around the urinary bladder may be reported. Symptoms are worse from drinking coffee, drinking or hearing running water and better from cold applications, rubbing, and having completely voided the bladder.
The salient prescribing feature for Arsenicum is burning pain. The sufferer may appear thirsty, anxious and restless. There’s often frequent urging that produces very little urine, and the urine that is produced may be scanty, burning and albuminous. White cells, red cells, and epithelial cells may be present in the urine. Other indicators are diarrhoea, chilliness, as well as weakness or exhaustion. Symptoms are worse after midnight and from cold or cold drinks and better for heat and warm drinks.
The indicators here include a history of urinary and faecal incontinence with dull pain in the area of the bladder or right-sided lumbar pain, and a feeling of fullness or incomplete emptying of the bladder that is not relieved by urination. The urine is normally albuminous and is only produced drop by drop. There is often frequent urging to urinate with strong burning urethral pain, particularly at the end of urination. The UTI may coincide with pregnancy or may occur post-partum. Symptoms are worse on the right side, from motion, from sitting or pressure and are better in the afternoon and from lying down.
The common guides to this remedy for someone with a UTI are the colour and smell of their urine. It’s usually reported as being dark brown and having a strong and offensive ammoniacal odour. There may be a history of depression, asthma, enuresis, cystitis, gout, cracking joints and renal insufficiency. Sufferers may also have an odour about them like urine. Symptoms are worse from cold and motion and better from heat and profuse urination.
This is often useful where there is evidence of weakness, depression, nocturnal enuresis or enuresis from coughing or sneezing, excessive perspiration, a yellowish skin and a history of recurrent cystitis. The urine may appear thick and offensive and there may be haematuria. Fine gravel may be present in the urine. Urination may be slow and accompanied by a suprapubic bearing down sensation and may be preceded by a cutting sensation in the bladder. Symptoms are worse in the late afternoon and evening, from coitus, before a thunderstorm and after sweating. Symptoms are better from exercise, warmth, drawing the limbs up, and after sleep
This is a common prescription in nephritis and urethritis, particularly where there is haematuria. The urine may have a characteristic odour of violets, it may be scanty or suppressed and have a muddy sediment if allowed to settle. Tenesmus and strangury may be reported here with location of the pain alternating between the bladder and umbilicus. Symptoms are worse from pressure and better from walking and generally better for motion.
This is well worth considering where the sufferer experiences renal colic and produces urine in a thin weak stream of bloody urine. A descending burning pain in the region of the right kidney may be reported. Severe pain may be felt, particularly in the meatus, before and while urinating, but is more commonly noted when passing the last few drops. There may be a slight dribbling enuresis while sitting. Urinary tenesmus may be present and a chill may spread from the bladder when urinating. Symptoms are worse from cold, motion, pressure and while sitting and are better from warmth and standing.
The guides to the prescription of Merc cor include a constant urging to urinate, and an intense burning sensation on urination followed by perspiration. Haematuria, urinary tenesmus, diarrhoea and general irritation of most mucus membranes may also guide this prescription. There may be a stabbing pain ascending up the urethra into the bladder. The urine is characteristically albuminous, cloudy and bloody, scanty, hot and burning and is passed drop by drop. A greenish urethral discharge may also be noted. Symptoms are worse at night and better from rest.
UTI sufferers suited to this remedy may appear to be sensitive, nervous and irritable and have a history of recurring cystitis or prostatitis, and often it’s triggered by internalised anger, emotional upset or while convalescing. There may be urinary urgency, frequent but ineffectual urging to urinate, a feeling of pressure in the bladder as well as a feeling as if a drop of urine is rolling continuously along the urethra. The pain in this instance may be burning in character and occur during or long after urination has ceased. The UTI will commonly develop after sexual intercourse, giving rise to what’s often referred to as honeymoon cystitis. Foreign bodies such as catheters, cystoscopes and surgical procedures may also be implicated as the cause of the infection. Symptoms are worse from anger, touching affected parts or sexual excess and better from warmth, rest at night and lying curled up on the side.
In this instance, the symptoms often come on very suddenly, often from exposure to dry cold weather or very hot weather, and may be accompanied by fever. Fear and anxiety, as well as physical and mental restlessness may be observed. The urine may be scanty and blood stained and the sufferer may complain of sensitivity in the kidney areas, urinary tenesmus and severe burning pain on urination. Urinary retention may cause severe pain and increased restlessness. Symptoms are worse on the right side, from pressure, lying on the affected side and in the evening and night, and better from rest.
This can be particularly useful in cases where the UTI is associated with prostatitis. There may be urinary urgency inhibited by a restriction to urine flow, requiring straining to pass the urine, as well as burning on urination. The urine in this instance is often scanty and cloudy and contains a stringy mucoid sediment. The sufferer may complain of swelling of the prostate, as if he’s sitting on a ball. Symptoms are worse on the left side, from sitting on a cold surface and during cold, damp weather, and are better from walking.
Pulsatilla has a role in chronic recurrent UTIs, particularly when these are associated with hormonal changes related to pregnancy, menopause or menstruation. Weepiness, a clingy disposition, a lack of thirst and appetite for food as well as a dislike of warm, stuffy rooms may be noted, These features, along with a paroxysmal burning dysuria, urgency worse on lying down and urinary incontinence, particularly from coughing or sneezing, often guide the prescriber to the remedy. Symptoms are worse before menses, from lying on the back, from walking, cold, wet weather and getting the feet wet. Symptoms are better in open air and from consolation.
Robert Medhurst is the author of The Concordant Clinical Homeopathic Repertory, which was formed entirely from clinically confirmed remedies. You can read of review of it here:
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