KEY FACTS
• Urinary tract infection is one of the most common bacterial infection which is seen in day to day life.
• Women are more likely to get affected with UTI. This is because women have a shorter urethra compared to men. This gives easier each for bacteria to contain bladder.
• Studies report that, 1 in 5 women will have experienced UTI in their lifetime.
• 80% recurrences is predicted in cases of women affected with UTI
• Men with diabetes and cases of enlarged prostate gland is also suspected to fall in risk category
• UTI if not treated properly can lead to serious infections that affects kidney.
OVER VIEW
An infection that affects any part of the urinary system is called as Urinary tract infection (UTI). It may an infection at the level of urethra, bladder, ureters or kidneys. But most commonly, the infection occurs in the urethra and bladder. Women are considered to be in greater risk than men.
Doctors recommend antibiotics for UTI management. However, if taken care with proper measures, the symptoms will reduce.

Understanding the urinary tract
Major role of the urinary tract is to produce and store the urine. Urine is a main waste product of the body which is generated in the kidneys, and travels down to bladder through the ureters. Urinary bladder stores the urine, and is emptied through the urethra. In males the urethral opening is at the end of the penis and in females its above the vaginal opening.
Kidney is a fist sized organ which is in pairs situated in the back. They filter the waste materials from the blood; remove it from the body through urine. Kidneys play a major role in balancing the chemical constituents’ like- sodium, potassium, calcium, phosphorous etc. They also play a major role in maintaining the acidic pH of the blood. The kidney has a major role in maintaining the blood pressure, body fluid homeostasis, production of RBCs and also acts as a major endocrine organ. The organ secrets renin, a key enzyme of the renin-angiotensin system which results in formation of hormone angiotensin.
The human bladder has a capacity to store 400-600ml urine. When a person crosses this, they will have a tendency to urinate. The muscles in the bladder squeeze and two sphincter valves open and the urination happens. The normal urine has no bacterial presence in it. Still due to unhygienic conditions, the bacteria might travel up into the bladder and causes UTI.

TYPES
Urinary infection can happen to any part of the urinary tract. The type of infection depends on the part affected.

• Cystitis: Cystitis is the type of infection that occurs in bladder.
• Pyelonephritis: Infections that happen in the kidneys are called as pyelonephritis.
• Urethritis: When there is severe infection in the urethra, it leads to urethritis.

CAUSES
Urinary tract infections occurs when the bacteria enters the urethra and travels up to the urinary bladder. Although there is no system of back flow sometimes the defense mechanism fails to protect from the infection. If the infection is not treated in the primary level, it takes a turn and multiplies creating severe trouble.
֎ Infection of the bladder (cystitis)
Cystitis occurs due to Escherichia coli bacteria. These type of bacteria are usually found in the gastro intestinal tracts. Sometimes, sexual intercourse can lead to cystitis. Most women are prone to develop cystitis due to their anatomy. This is due to the short distance from the urethral opening to the bladder and anus.

֎ Infection of the urethra (urethritis)
When the bacteria spread from the anus to urethra it leads to urethritis. In case of females, the vaginal opening is close to the urethra which is a major cause of spreading sexually transmitted diseases like gonorrhea, mycoplasma etc. These diseases can also lead to UTI.

֎ Infection of the Kidney (pyelonephritis)
When the E.coli bacteria reach the kidney through the ureters, it causes the infection in kidneys. However, a common infection in the blood stream has high chances to spread in to the kidney causing acute pyelonephritis.

Common risk factors for UTI include:
• Obstruction in the bladder or urethra which can cause back flow or trapped urine in the bladder.
• External insertion of instruments, like cystoscope or procedures like catheterizations
• Pregnant ladies are most likely to experience UTIs
• Due to existing medical conditions like diabetes, nephropathy etc.
• Sexual intercourse
• Age group – Elderly people are at an increased risk of getting UTIs. This happens due to incomplete emptying of the bladders in cases of Benign prostatic hyperplasia (BPH), and Prostate enlargement.
• Lack of intake of adequate liquids
• Bowel incontinence
• Trapping of the urine due to immobility or prolonged inactiveness.
• Any abnormality in the anatomy of urinary tract

SYMPTOMS
Common symptoms of urinary tract infections are:
• Urge to pass urine all the time
• Incomplete urination
• Burning sensation while passing the urine
• Aching pain while urinating
• Lower abdominal pain
• Cloudy or turbid urine
• Blood-tinged urine
• Urine with a strong odor or foul smell
• Fever associated with chills
• Increased frequency of passing urine
• Nausea or Vomiting
• Back pain
• Painful sexual intercourse
• Fatigue
• Mental confusions (often seen in elderly people)

Symptoms According to the types

CystitisPyelonephritis  Urethritis
Pelvic pressureDiscomfort in the lower abdomenUrge to pass urine frequently Presence of blood in the urine.Pain while urinatingUpper back painPain in the flanks (side of the body)High fever associated with chillsNausea, VomitingBurning sensation while passing urine.   Discharge from the urethra.

If these conditions are not checked promptly, it can create serious health problems.

DIAGNOSIS
If you suspect UTI, immediately go to doctor and get the urine analysis done.
If frequent UTIs occur, it would be necessary to screen through Ultrasound, CT scan or MRI scan. Cystoscopy is also adopted sometimes to check inside urethra and bladder.
How to prevent Urinary tract infections?
• Drink plenty of fluids
• Urinate when required and don’t postponed urination
• Clean the area after urinating
• Keep the toilet clean and flush the surrounding properly after urinating
• Avoid using public toilets
• Don’t hold urine while sleeping, empty the bladders and go to sleep
• In menstruating women, change the sanitary pads whenever necessary

AYURVEDIC VIEW
Medicines like,
• Guluchyadi Kashayam with Vettumaran gulika reduces the fever with chills during UTI
• Draksha (dry raisins) can be taken which pacifies pitta and reduces the burning sensation.
• Gokshura is an excellent diuretic. The seeds can be boiled in the water and consumed.
• Punarnava Kashaya or swarasa can be taken. It can also be added in the diet.
• Mixture of chandanasava and usheerasava can help to reduce the heat in the body
• Sudarshana gutika is a good choice for treating UTI
• The room should be fumigated with guggulu, sandal wood, neem, turmeric, agaru etc. to kills the bacteria.

Diet
• Ayurveda recommends diets that cool the increased pitta dosha. Avoid hot, spicy or excessive sour foods. Consume plenty of liquids like sugar cane juice, sweet lemon juice, tender coconut water etc. Intake of fluids frequently keeps the body cool as well as flushes the bacteria through the urine out of the body.
• Ayurveda believes UTI is caused due to the vitiation excess pitta dosha in the body. So the treatment and diet should be planned to pacify the excess pitta.
• Avoid taking packed and processed food, consumption of alcohol, coffee, carbonated drinks, refined sugars etc.
• Flaxseeds, oats, tofu, almonds and ginger are good sources of zinc which helps to generate more WBCs to fight against bacteria.
• Consume plenty of berries, beans and bell peppers as they are rich sources of antioxidants.
• Consuming juices of cranberry and/or blueberry. They contain proanthocyanidins which prevent the bacteria from entering the bladder.
• Consume a warm lemon water. It balances the pH of the blood and prevents from bacterial growth.