Management of Mootravahasrotogata Agantuja Vyadhi (UTI) By-Dr.K.M.Angadi Introduction • In Ayurveda all the diseases are due to the vitiation of the doshas.Which are known as nija vyadhis,some diseases are caused due to infectious organisms are known as oupasargika or sankramaka or agantuj karanajanya vyadhis.No where we find references of infectious diseases of urinary tract.When we analyses symptomatically,mutrarakrucchra etc are involving the infectious organisms. • The normal urinary tract is sterile except at its extreme distal end. • UTI are the commonest of all infections • They may be community acquired or nosocomial & may be defined as the presence of pathogenic bacteria in significant colony counts in the bladder upper urinary tract with associated clinic pathological consequences. Aetiology • The most common organism is Escherichia Coli which is present about 80 – 90 % cases • Others are – Pseudomonas Klebsiella Proteus Enterococci Staphylococcus etc. • Increased chance of UTI in females compared to males is due to: Short urethra (4cm) Close proximity of the external urethral meatus to the areas contaminated heavily with bacteria. Sexual intercourse. Catheterisation. Routes of infection • Ascending • Organisms Anorectal region Lower vagina Urethra Bladder Kidneys • Haematogenous • Intestine or septic tonsils or other septic foci Kidneys • Lymphatic • Periurethral lymphatics Bladder Kidneys Clinical Spectrum of urinary tract infection • Asymptomatic bacteria Presence of bacteria in significant numbers in the urinary tract without any symptom. • Acute pyelonephritis Characterised byfever with rigors, flank pain, vomiting, • Acute cystitis & Acute urethritis Are characterised byInflammation of urethra &bladder Dysuria Frequency Strangury Suprapubic pain Fever may or may not be present. • Acute prostatitis Dysuria Frequency Urgency Pain • Severe infection with gramnegative septicaemia Diagnosis • UTI is suspected on the basis of symptoms mainly involving the urinary tract,like • Frequency • Dysuria • Haematuria • Urgency • Strangury • In upper tract infection • Fever • Vomiting • Vague abdominal pain or Costo vertebral tenderness may be the symptoms. Others • Routine urine examination. • Complete blood count. • Serum creatinine,blood urea & electrolytes. • Ultrasonography of kidney,ureter,bladder. • Pelvic(women) & Rectal (men) examination etc. Management • Nidana parivarjana • WØûSrÉå qÉÑÎklÉï uÉxiÉÉæ cÉ lÉ×hÉÉÇ mÉëÉhÉÉÈ mÉëÌiÉÌ¸iÉÉÈ| iÉxqÉÉiÉç iÉåwÉÉÇ xÉSÉ rÉ¦ÉÇ MÑüuÉïÇÎliÉ mÉËUmÉÉsÉlÉå|| AÉoÉÉkÉuÉeÉïlÉÇ ÌlÉirÉÇ xuÉxjÉuÉ×¨ÉÉlÉÑuÉiÉïlÉqÉç| EimÉ³ÉÉÌiÉïÌuÉbÉÉiÉ¶É qÉqÉïhÉÉÇ mÉËUmÉsÉlÉqÉç|| Cha.Si 9/10 Good perineal hygiene. • Emptying the bladder before & after intercourse. The goals of treatment include • Symptomatic relief. • Eradication of infection. • Prevention & treatment of recurrence. • oÉÎxiÉqÉqÉÉïbÉÉiÉ-ÍcÉÌMüixÉÉ • uÉxiÉÉæ iÉÑ MÑüqpÉÏxuÉåSÈ,uÉiÉïrÉÈ,vrÉÉqÉÉÌSÍpÉaÉÉåïqÉÑ§ÉÍxÉkSÉå ÌlÉÂWûÈ,ÌoÉsuÉÉÌSÍpÉ¶ÉxÉÑUÉÍxÉkSÈ,vÉUMüÉvÉå¤ÉÑSpÉïaÉÉå¤ÉÑU MüqÉÑsÉ¤ÉëÑiÉ¤ÉÏUæ¶É……………(cÉ.ÍxÉ9/8) Drugs given for the UTI,which acts as the antibiotic & subsides the infectious organisms.They are likeGokshuraguggulu Chandraprabhavati Shilajatvadivati Rasasindura Talasindura The urinary anti infectives available in the market are:Ashmari Bangshil Calaxy Calcurosin cap,syp,etc CONCLUSION • Even though these diseases are the organisms origin then also,these involves the vitiation of doshas,in manifestation of the diseases. • These should be treated according to the involvement of doshas. • It is better to educate the patient about UTI and its preventive aspects. Kamalaxi M Angadi