URINARY TRACT INFECTIONS

• An infection in any part of the urinary system, the kidneys, Bladder,or Urethra. Most infections involve the lower urinary tract i.e. Bladder and Urethra 

• Common among preschool and school-going children. More among girls

• Usually UTI in children caused by bacterial infection. Most common organism is E.coli

Predisposing factors

• Beyond infancy, UTI is more common in females. Vulvovaginitis may predispose to ascending infection. Good perineal hygiene can prevent this.
• In male populartion, tight phimosis may predispose to urinary retention and hence UTI. Phimosis may also be the initiating factor for balanophosthitis. In such cases circumcision may be considered.
• Pinworm infestation is another association with UTI.
• Constipation may cause some urinary retention due to the loaded colon pressing on the bladder and hence may be associated with urinary stasis and UTI.
• Vesico ureteric reflux, voiding dysfunction and obstructive lesions like the posterior urethral valve are other causes for repeated infections.

• The common symptoms of UTI are fever, frequency of micturition, enuresis dysuria, abdominal pain etc.
• In the newborn, the symptoms are non-specific like failure to thrive, irritability, evidence of sepsis etc.
• Burning pain on micturition may help to clinically localize the infection to urethra (urethritis).
• Suprapubic pain, frequency and dysuria are more suggestive of cystitis.
• High fever with toxicity, flank pain or tenderness of the renal angles point towards pyelonephritis.
• In older children- Dysuria, hypo gastric pain, frequency and urgency of micturition, foul smelling urine. 
• Severe cases- fever with chills & rigors, vomiting, flank pain 

• Urine examination- pus cells, bacteria
• Microscopic examination of centrifuged urine may show bacteria and more than 5 pus cells per high power field or more than 10 pus cells per cu.mm of uncentrifuged urine. Culture of midstream or supra pubic aspiration specimen may yield the causative organism. The commonest organism involved is E. Coli.
• Urine culture if there is bacteruria

Ayurvedic Treatment

Kashaya

• Punarnavadi kashaya, Bruhatyadi kashaya
• Up to 1 year: for mother: 2tsp sookshma choorna is boiled in 2 glass water, strained and given to mother. If agni bala permits give 1 tsp thrice to the child
• 1 year to 5 years: ½ tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
• 5 to 10 years: 1 tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
• 10-15 years: 1 ½ tsp powder boiled in 1 glass of water and given twice daily mixed with sugar or jaggery

 Gulika

• Chandraprabha gutika, Gopeechandanadi gutika
• 2-6 years ¼ tab twice daily
• 6-12 years- 1 tab
• 12-15 years- 1 tab tds

Arishta 

• Chandanasava , Punarnavasava
  • Up to 2yrs- ½ tsp arishta diluted with 1 tsp water
  • 2-5 years- 2.5ml-5ml diluted with 5 ml boiled water
  • 5-10 years- 10ml
  • 10-15 years- 15ml

 Others 

• Ushnodakam
• Nalikerodakam+Ela