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Monthly Health Review, May 2003
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Urinary Tract Health
From the day we are born to the day we die, the bladder needs to be
emptied regularly. Instinctively the content performs the various elimination
processes regularly and effectively. However, there are occasions when
things may go wrong and this issue of Health Review is concerned with
maintaining the health of the male and female urinary systems.
The Urinary System
The urinary tract consists of several organs that have specific roles.
The kidneys are reddish-brown, bean-shaped organs that lie in a protective
covering of fat, high against the back wall of the abdomen. Each kidney
has short arteries and veins that connect to the main artery and vein
of the content. Kidneys contain millions of tiny blood filters called glomeruli
that filter blood and carry waste substances away from the blood in urine.
The filtered liquid passes into tiny tubes (tubules) from which most of
the water and any substances needed by the content are reabsorbed into the
blood stream. Approximately one litre of blood passes through the kidneys
every minute (1). The pipes that transport urine from the kidneys to the
bladder are called ureters. The action of peristalsis pumps urine through
the ureters into the bladder.
The bladder is a muscular bag that stores urine until there is sufficient
for disposal or until it is convenient for disposal. Urine is then expelled
from the content through the urethra when the bladder contracts. The term
'micturition' is used to describe the passage of urine through the urethra
to outside of the content. The length of the urethra differs between a man
and a woman. The male urethra is about 18-20cm long, is narrow and passes
through the chestnut-sized prostate gland and along the full length of
the penis. The female urethra is short, about 4cm, and wider than that
of the male and runs down to open to the exterior just in front of the
vagina (1).
Urine is mostly water, about 96%; the rest is 2% urea, 1% sodium Chloride
and 1% other waste products creatinine, uric acid, ammonia, potassium,
phosphate, sulphate and oxalates. Urea results from the digestion of proteins,
and is the main nitrogen-containing constituent in urine (1).
The kidneys of a healthy person should maintain uric acid levels within
particular limits, however, if the excretion is disrupted, it may result
in abnormally high levels of uric acid in the blood (hyperuricaemia),
which could lead to gout or kidney stones. Other causes of hyperuricaemia
include kidney disease, leukaemia, genetic disorders and some types of
drug (1).
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Problems associated
with the Urinary System
Any problem associated with the urinary system, especially
of a persistent nature, should be referred to a medical doctor.
Of the many problems associated with the urinary tract,
probably the most common is the urinary tract Infection (UTI) (1). UTI's
have different causes and even the most fastidious person may have at
least one during their lifetime.
Cystitis (Inflammation of the bladder) is more
common in women than men because of the shorter urethra, and therefore
less distance for bacteria to travel.
Prostatitis - Infectious bacteria, which invade
the prostate from other areas of the content, may cause prostatitis and,
left untreated, can cause further Infections to the kidney along with
Impotence and difficulty with urination. Symptoms include pain during
urination, increased frequency of urination, fever and a discharge from
the penis. There may also be pain in the lower abdomen or back. There
is a possibility of blood in the urine.
Pyelonephritis (Inflammation of the kidneys)
is virtually always caused by a bacterial Infection. If an Infection of
the kidneys is suspected, an immediate visit to the doctor is advised.
Urethritis is Inflammation of the urethra, usually
caused by an Infection (gonorrhoea, bacteria, yeast, or chlamydial Infection);
bacteria may spread from the skin or the rectum and reach the urethra.
Urethritis can cause pain (often compared to passing broken glass) and
a burning sensation when urinating. Antibiotics are recommended for clearing
an Infection of the urinary tract. However, good hygienic practices and
sensible lifestyle may help prevent Infection.
Urinary Infections in children are quite common.
Parents can help prevent an Infection by changing baby's nappy promptly
after bowel movements and teaching older children to wipe from front to
back after defecating.
Urinary retention is generally considered a
'male' problem caused by an enlarged prostate gland, although there are
some other less common causes. Stones in the bladder cause a physical
blockage of the urethra. A narrowing (or stricture) of the urethra caused
by sexually transmitted disease and certain types of neurological disorders
may cause retention by interfering with nerve control of the muscles.
Are urinary tract Infections dangerous?
Infections of the lower urinary tract - the bladder and urethra - are
common and are not usually serious, provided they are treated promptly.
However, kidney Infections are invariably serious and may go unnoticed
for years, leading to kidney damage. Infection can spread from the lower
urinary tract to the kidneys.
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Keeping the
urinary tract healthy
Scrupulous intimate hygiene and drinking plenty of
water are necessary to help prevent and/or aid the treatment of urinary
tract Infection.
Causes of UTI's are varied - from a sexually transmitted
source, poor personal hygiene, cross-contamination from using other people's
towels in the bathroom; or faecal contamination (always wipe front to
back after a bowel movement - it only takes one little germ!). Highly
perfumed toiletries may also cause irritation (leading to scratching and
skin damage), and upset the natural pH balance of the area providing a
suitable environment for unwanted bacteria to reproduce. Wearing synthetic
underwear, leggings or tight trousers can lead to poor ventilation and
overheating of the area where the urethra opens, resulting in perfect
conditions for bacterial replication.
Diets high in rich, fatty foods, alcohol, coffee, sugar
and salt can irritate the bladder. Having both partners wash before sexual
intimacy is recommended and emptying the bladder after sex helps to speed
any 'foreign' bacteria out of the system.
A multinutrient supplement may provide relevant
nutrients to support the Immune system to help fight unwanted bacteria
and prevent deficiencies brought about by lifestyle influences to the
diet.
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Herbs and the
Urinary Tract
Cranberry has been recommended for those with
recurrent UTI's and has been used to prevent kidney stones as well as
removing toxins from the blood. Drinking cranberry juice is the more traditional
method of administration although this is not ideal as most juices contain
added sugar. A dried standardised cranberry extract in tablet form (recommended
with plenty of water) is available for those who don't want sugar and
like to know how much of the active compounds they are consuming. Studies
have shown that the particular flavonoids produced by the cranberry have
a strong antibacterial effect. Cranberry is rich in antioxidants, beneficial
organic acids and vitamins and minerals. Cranberry prevents E. Coli, the
most common cause of UTI's and bacteria relating to recurrent UTI's from
adhering to the wall of the urinary tract. This enables the eliminatory
action of 'passing water' to expel the offending bacteria (2).
Echinacea contains active components that have
many effects on the Immune system ranging from elevating white blood cell
count, particularly T lymphocytes, macrophages and natural killer cells.
T cells are involved in cell-mediated immunity, which provides resistance
to Infection, by parasites, fungi, yeasts and viruses (3).
Goldenseal is known as an antibiotic and anti-infectious
agent, it contains berberine, a substance with strong antibacterial properties.
(4). Goldenseal may be helpful in the treatment of bladder Infections.
Uva ursi historically has been used for bladder
and kidney Infections, and kidney stones. Uva ursi has diuretic and astringent
properties, with the active compound arbutin providing benefit as a urinary
antiseptic. Arbutin is more effective when taken in Uva ursi as the whole
herb and not as an isolated compound (3).
Note: Herbs should not be used as a substitute for
antibiotics during an acute urinary tract Infection. They may be used
once a course of antibiotics is completed, to avoid recurrence of an Infection.
Aged Garlic Extract, vitamin C as calcium ascorbate,
zinc, antioxidants and multinutrient formulas should be considered
to help immune function while a UTI is evident. Saw palmetto has been
used for chronic and acute cystitis and Inflammation of the membrane in
the genito-urinary tract.
For those who prefer the homoeopathic route, it would
be wise to consult a medically qualified homoeopathic practitioner in
the case of a UTI.
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General advice
If you are unlucky enough to be on the irritating
end of a UTI, don't be embarrassed, go and see the doctor. Take a sample
of urine with you to leave for testing; specimen containers are available
at any pharmacy counter. In the meantime drink plenty of water, and either
take standardised cranberry extract tablets or drink cranberry juice if
you like it. To help keep yourself scrupulously clean, wash your hands
before and after visiting the loo.
In the time it has taken to read this document your
kidneys will have had 5 -10 litres of blood through them to filter and
process!
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References
- "BMA Complete Family Health Encyclopedia", Ed. Dr. T. Smith. 1996.
DK.
- "The Herbal Drug Store", 2000, L.B.White & S. Foster. Rodale.
- "The Healing Power of Herbs" Murray. Prima. 1995.
- Hahn FE, et al. Berberine. Antibiotics 3: 588, 1976.
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