Urinary Tract Infections

Urinary tract infections can enter the body via the urethra, then pass into the bladder causing cystitis. From the bladder infection can pass along the ureters to the kidneys and cause pyelonephritis. Other serious kidney infections can develop as secondaries from other childhood infections such as streptococcal throat infection causing tonsillitis. Infections in babies may be related to structural abnormalities, but most often they are caused by E. coli bacteria from the bowel that creep round from the anus. Their journey is aided by wiping from back to front rather than vice versa after urination or a bowel movement. Urinary tract infections tend to affect girls more than boys due to their anatomical differences, in that the passage from the urethra to the bladder is much shorter in girls. Vaginal infections such as thrush can also be related to urinary tract infections.

To flush invading bacteria out of the urinary tract drinking plenty of water is always recommended. Herbal teas can be alternated with water and other fluids such as barley water. This can be made by simmering 4oz / 100g of washed barley in 1 pint / 600 ml of water until the barley is soft. This is then strained and a little lemon juice and honey added. Children can drink this lukewarm several times daily.

Treatment of urinary tract infections

• Herbs can also be given to soothe the irritated lining of the urinary tract and help overcome infection. Soothing diuretic herbs such as comfrey leaf (Symphytum off.), corn silk (Zea mays), marshmallow (Althea off.) and couch grass (Agropyron repens) given as lukewarm infusions / decoctions will relieve burning and pain on passing water. In acute infections these may need to be given every 2 hours throughout the day.

• These can be combined with anti-inflammatory and antiseptic herbs including fennel (Foeniculum vulgare), chamomile, horsetail (Equisetum arvense), uva ursi and yarrow.

• Certain herbs such as Boerhavia and uva ursi (Arctostaphylos uva ursi), commonly used in urinary tract infections have been proved through research to have antimicrobial properties. Uva ursi contains arbutin which has been found to be effective against E. coli, a common urinary tract infections (UTI) pathogen.

• Infusions / decoctions of these herbs can also be used for hand and foot baths and can be effective used in a shallow bath for the child to sit in for about 10 minutes, two or three times a day.

• If there is accompanying fever and malaise, herbs can be added to teas and hand and foot baths for fever management such as boneset (Eupatorium perfoliatum) yarrow, chamomile, elderflowers and limeflowers (Tilia europea).

• Cranberry juice has received some attention as a treatment for urinary tract infections. Cochrane reviews indicate that there is evidence for its effectiveness in preventing urinary tract infection. Cranberry juice, sweetened with passionfruit / apple juice (not sugar), can be given regularly to counteract infection. It does this in two ways: firstly by making the urine too acid for bacteria like E. coli to survive; secondly (as mentioned above) by stopping bacteria from adhering to the walls of the urinary tract. It may be difficult to drink sufficient amounts of cranberry juice to be an effective deterrent to infection (the normal recommended dose is 3-6 fl oz daily or l ½  oz of the berries) and concentrated extracts in the form of tablets may prove more effective.

Should urinary problems start after a course or regular treatment with antibiotics giving probiotics containing Lactoacidophilus to re-establish normal bacterial population of the gut may be a valuable adjunct to herbal treatment.

Ayurvedic approach

Dysuria or scanty, painful and difficult urination can occur with or without an accompanying infection. It can be caused by disturbance of any of the three doshas.

Vata type is characterized by severe pain in the lower back, rectum and urinary channel. Urination will be frequent but scanty, with strangury and sharp or colicky pain. There may be constipation, insomnia and other Vata symptoms including mental agitation.

Pitta type is characterized by yellow or strong-smelling urine, urination is frequent, often profuse, with burning. There may be fever, irritability and other Pitta symptoms.

Kapha type is characterized by pale or milky urine, feeling of heaviness in the lower abdomen and dull pain in the kidney area.

• For all three doshas barley water is generally recommended as well as \ tsp of gokshura powder with honey, twice daily. Gokshura (Tribulis terrestris) is considered the best general diuretic and its tonic properties to the kidneys prevent it from aggravating Vata.

• For Vata type: A Vata reducing diet is recommended and demulcent, diuretic herbs can be given to soothe irritated mucous membranes and enhance urination. These include gokshura, bala, purslane (Portulaca oleracea), fresh holy basil juice, and marshmallow root (Althea off.). Traditional formulas used in India include Gokshuradi guggul and Chandraprabha tablets, three times daily. An infusion (pour boiling water over herbs and leave to infuse for 4 hours) of sesame seeds and liquorice taken in small quantities sipped throughout the day has a soothing and relaxing effect. Rubbing sesame oil over the abdomen is also recommended.

• For Pitta type: A Pitta reducing diet is recommended avoiding spices, oils and sour fruit. Cooling diuretics such as gokshura, punarnava (Boerhavia diffusa), amalaki juice with raw sugar or sugarcane juice, and bringaraj root, sandalwood with rice water, honey and sugar, decoction of raisins, juice of watermelon with a little raw sugar and cumin seeds are also used. Chandanadi is a popular formula, the main constituent of which is sandalwood (Santalum album). Gotu kola can be used to soothe pain.

• For Kapha type: An anti-Kapha diet is recommended, avoiding cold drinks, fruit juice, dairy products, oils and fats. Warming spices and diuretics are indicated such as cinnamon, juniper berries (Juniperus communis), coriander seed, celery seed (Apium graveolens) and fennel (Foeniculum vulgare). Formulas include trikatu and chandanadi.