Urinary tract infections (UTI) is the second most common infection affecting humans, first being respiratory infections. Interestingly, more than 50% of the victims of a UTI are women due to greater proximity of the bladder and shorter urinary passage to external environment (males have a longer urinary passage and lesser proximity of bladder to outside environment).

Many a time, UTI can come and go without much complications. But it is not always the case. A recurrent UTI pattern can lead to deleterious events if not prevented timely. Allopathic preventive and therapeutic measures are unfortunately heavily dependent on stronger medicinal interventions in most of the cases which comes with its share of side-effects too. Ayurveda treats diseases of the urinary tract in a wider perspective. Holistic changes in all spheres of life is what Ayurveda embraces to treat this problem. 

What is UTI in Ayurveda?

In the allopathic view point, diagnosing a Urinary Tract Infection (UTI) usually requires more than 10^5 organisms in a mid-stream collection of urine along with the presence of an array of clinical features in that person. Interestingly in Ayurveda, there are diseases called ‘mūtra kṛcchra' (dysuria), 'mūtrāghāta' (obstructive uropathy), the symptoms of which are quite analogous to that of of modern day UTI due to various causes.

Before we delve into UTI further here’s what Ayurveda thinks about urine and related concepts.

Urine is Not just a Waste Product

Urine is called mūtra in Ayurveda and it is considered one among the three major wastes (the other two being feces and sweat) generated as part of metabolism and meant for expulsion from the body. However mūtra also serves the function of regulation of fluid balance in the body. So its not ‘just’ an excreta, rather, it’s an essential part of a healthy body and right from the production to storage to transportation and expulsion, it has a major role to play in maintaining the so-called homeostasis of the internal environment.

Ayurveda considers disease pathology in relation to various components among which the metabolic pathways (srotas) is of great significance. Whenever there is an over activity, obstruction or reduced activity, a srotas may become abnormal or weak, increasing the chances of concentration of disease causing factors which can ultimately precipitate into a disease. The entire urinary system is made up of numerous such channels 'mūtravaha srotas’ which play active roles in urine formation, filtration, transportation, storage and finally excretion.

A natural urge is called vega in Ayurveda. Withholding a natural urge is called vegadhāraṇa. This becomes a very potent cause for initiating disease formation in the body by fundamentally provoking the powerful ‘vāta' responsible for movements internally and externally. Quite interestingly, UTI is a classic example of how a disease is formed by disruption of homeostasis when the natural urge to urinate is withheld.

What causes UTI

Ayurveda has classified dysuria (‘mūtra kṛcchra'- the nearest Ayurvedic analogue of modern day UTI) according to the concept of the three bio-energies (tridoṣa: vāta-pitta-kapha) inherent to it. Each doṣa can lead to this condition if respective triggering factors are involved. For instance if you experience over exposure to sunlight, chances are that you can get a dysuria with typical signs and symptoms of pitta doṣa imbalance in the body like burning micturition. However, if you subject yourself to over-indulgence in sweet taste, you might get kapha dosha predominant ‘mūtra kṛcchra' characterized by itching and heaviness of lower abdomen. Physical over straining, meanwhile, provokes vāta in the body and if it is localizing in the metabolic pathways of urine (mūtravaha srotas) in your body, stakes are high for difficult urination with predominant pain during or after urination. Trauma in the form of improper postures adopted during riding or sexual intercourse can also lead to this condition according to Ayurveda.

In modern parlance:

• Infection by many organisms are considered the most common cause of a UTI. Among them almost 85% of infections are attributed to E.coli, a bacteria hosted by human fecal matter. Any negligence regarding personal hygiene therefore, can act as a persistent causative factor throughout life. Other organisms include Staphylococcus, Streptococcus, Proteus etc. 
• Another cause in females is the minor trauma inflicted to the urethra during a sexual intercourse which can act as a medium to transfer bacteria to the bladder (especially due to shorter length of the urethra compared to males). Pre-existing vaginal infections can also contribute to UTI in females.
• A bladder obstruction caused by an enlarged prostate gland in older males can lead to incomplete evacuation of urine leading to UTI in the aged.

Other causes are:

• Dietary factors like excessive spicy, salty, fermented foods
• Low intake of water
• Strenuous jobs can lead to concentration of urine and alteration of urine pH.
• Trauma induced by previous infections or obstructive problems of the urinary tract
• Surgical trauma of urinary tract
• Existence of co-morbidities like Diabetes that decreases overall immune strength

What are the signs and symptoms of UTI?

Generally the part of the urinary tract involved, whether lower urethra or upper (involving the kidneys) determines the presentation of UTI and its far reaching consequences too. The following signs and symptoms are usually detected:

• Abrupt onset of increased frequency of urination
• Difficulty in passing urine
• Pain during voiding of urine
• Pain above lower abdomen corresponding to urinary bladder
• Intense desire to pass more urine immediately after urinating
• Fever, occasionally
• Vomiting
• Unpleasant odor of urine

How do they confirm a UTI?

A UTI is a seemingly common problem but with not-so-common consequences if neglected. A battery of tests (blood tests and imaging studies) can be performed to find exact cause and to rule out any possible damage in the bladder or kidneys especially in children and males. In females UTI is considered a more common clinical problem and hence rigorous assessment is less compared to males. 

Stop, Look, Proceed! Top Ayurvedic Suggestions on UTI to heed:

• Avoid vegadhāraṇa or holding the urge to urinate.
• Adopt hygienic practices in relation to washing of genital area.
• Sexual hygienic practices especially in women, such as avoiding:
  • regular intercourse, 
  • frequent intercourse in inappropriate postures (Ayurveda considers this as a causative factor for Vāta provocation),
  • intercourse while feeling hungry or thirsty or with the urge to urinate or defecate.   
• Limit usage of hot spicy sour fermented foods and drinks if you are prone to recurrent UTI.
• Limit over straining physically and mentally. Practice mindfulness and meditation techniques.
• Make use of tender coconut water which has natural bladder cleansing effects especially in summer. You can spruce up the drink with little bit of cardamom powder which is a also an effective herb against UTI.
• Water boiled with Caltrops seeds (gokṣura (San)- Tribulus terrestris) can be taken in place of plain drinking water for drinking purpose in active UTI conditions.