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Herbal Treatment of Paraplegic Urinary Tract Infections (UTI's)
Urinary tract infections are common in those with spinal cord injuries who can lose partial or complete control over their bladder and sphincters. One of the primary tasks at rehabilitation centers is to impress upon those affected of the importance of maintaining kidney and bladder health by keeping up fluids and establishing routines for clearing the bladder.

At some stage or other most paraplegics are exposed to the use of catheters with the resultant risk of injury and infection. In fact, over the past 20 years, catheters and drugs to alternately contract and relax bladder sphincters are more and more the routines being encouraged in rehabilitation centers. The more traditional cap and bag, with continual drainage, is falling from favor even though it is a demonstrably safer system.

Herbal medicine can offer a great deal to assist paraplegic control of urinary tract infections and in my local area I have helped many such patients cease relying on antibiotics altogether. I point out to them that throughout the ages kidney and bladder health were a preoccupation of all herbal practitioners in all cultures and there is a vast body of knowledge and experience in those herbs and practices which can assist in maintaining good kidney and bladder health.

Let us review the system:

The Kidneys:

The whole of the body's blood supply passes freqauently though the kidneys, which are designed to filter, out impurities and chemicals of all sorts and discharge them into the bladder for storage, pending discharge. Each Kidney works independently of the other and they are critical to bodily health. If they are compromised, the toxic products building up in the blood quickly become life threatening.

The Ureter:

Each kidney drains into the bladder through a tube (the ureter) which is provided with a mucosal lining to protect the walls of the tube from corrosion or irritation by chemical substances. These tubes are provided with a sphincter at the opening into the bladder to prevent back-wash from the bladder (if overfull) from forcing urine back up to the kidneys. If reflux does occur it is extremely damaging to kidneys, and quickly causes major problems.

The Bladder:

Is a muscular hollow structure (as they say in the text books) really an elastic sack, which can stretch to hold fluid and then contract to assist in forcing urine past the sphincter and out through the urethra. (see below). The bladder is also lined with mucous cells to protect the walls from irritation from chemical substances in the urine. Such substances may become quite concentrated after a time as the body reclaims water from the bladder, especially when one is not drinking enough.

It is the process of waater reclamation which can produce strongly irritant and concentrated urine which can be so dangerous to the kidneys if it is forced back up from the bladder. Further, the concentrated urine can break down the mucous lining and irritate and inflame the walls of the bladder if left too long without being released. Infections don't survive in the urine itself, but can thrive in any area where damage has occurred and normal protective linings are no longer effective.

The Sphincters:

Are donut shaped organs, which circle the discharge end of the ureter at the top of the bladder and the entrance to the urethra just below the bladder. These sphincters act as valves and, when controlled by nerve signals, can contract to squeeze the tube closed and stop the passage of fluid. The upper sphincter protects the kidney from back-wash and the lower one relaxes when the appropriate nerve signals trigger its release which, along with a contraction of the bladder forces urine out under pressure in normal urination.

The Urethra:

Is the tube, which drains urine from the bladder much like the ureter but more robust than ureter. The tube emptied through the penis in the male and through an opening above the vagina in the female it is therefore of a different length in each sex. Catheters, when inserted, are pushed up through the opening all the way to the bladder to allow the it to empty. Some, catheters are designed to be left in place for longer periods and some are used each time the bladder is to be emptied. While quite robust, the urethra can easily be damaged using a catheter and is the channel through which infections can be introduced into the system.

Nerve Supply:

The bladder and the sphincter are supplied with nerve receptors, which can contract and relax their muscular tissue and register feelings of pressure or release. These are the messages we feel which trigger the urge to urinate and allow us to control the release and even pressurize the outflow from the bladder. It is also this nervous system which is partially or completely compromised through spinal injury.

Problems faced by Paraplegics:

The list of problems facing paraplegics in maintaining healthy urinary systems include the following; Fluid Intake, Reflux, Abrasion, Irritation, Infection, Antibiotic Resistance and Antibiotic Side Effects.

My experience with Herbal Remedies to assist Paraplegic Patients:

Herbal medicine offers valuable insight and cheap simple remedies, to assistance in all these problems areas. Over the past 20 years I have been able to assist most of paraplegics local to my area toward much healthier kidney and bladder function, better control of infection, and reduced dependence on antibiotics.

Fluid Intake:

While all paraplegics are advised to drink plenty of fluid, preferably water and often struggle to keep up with the suggested amounts there are herbal teas which are much more valuable than just plain water. These teas are available readily from health food stores everywhere nowadays. The ones I prescribe regularly are as follows;
  • Rosehips Tea: Drunk hot or cold is a major kidney tonic, immunity-boost, blood cleanser, and source of Vitamin C and Iron. It contains valuable traces of copper and cobalt and functions as a secondary liver tonic and adrenal tonic. This stuff is 'rocket fuel' health wise. It is a pleasant refreshing drink besides. Drinking 4 or 5 cups of Rosehips daily (hot or cold) makes an immediate difference to kidney health. Over the longer term, Rosehips will go a long way toward rehabilitating struggling or damaged kidneys.
  • Cornsilk Tea: Will provide a great deal of mucilage which has a particular affinity for the Urinary Tract and will assist in relieving irritation or inflammation, in the linings of the ureter, bladder and urethra.
  • Chamomile Tea: Is a useful parasympathetic nervous system tonic which has the ability to reduce spasm and discomfort. It is also gentle and relaxing on the digestive and urinary system. There are probably a dozen or so other herbal teas, which can be taken to advantage, but I have found these three common and pleasant tasting ones all that are needed for immediate and long term urinary tract health improvement.
"If you continue with a high habitual intake of coffee, tea, fizzy or cola drinks or even fruit juice, after your accident, you are missing out on the opportunity to support your urinary system with every drink you take."

Reflux:

As I mentioned, reflux is the most immediate threat to kidney health and this is primarily a management problem. The bladder must be drained regularly either through a fixed catheter, a routine cathertization or more satisfactorily, through continuous flow or manually stimulated release.

Loss of nerve supply to the sphincter at the base of the ureter makes reflux a more likely problem for paraplegics. An overfull bladder can be sufficient to allow backwash or reflux back up through the ureter into the Kidneys. Infection in the urethra can cause blockages and also cause backup of urine in the bladder and lead to reflux problems. Poor management of sphincter function, inattention to fluid intake and production or to early signs of infection, quickly lead to problems.

My most successful and healthy patients all have very strict routines indeed concerned with sufficient and appropriate fluid intake and regular evacuation. Those who need to use catheters regularly, need to be fanatical about sterility and they have all experienced the results of not maintaining their program.

Abrasion/ Irritation/ Inflammation:

Abrasion will occur every time a catheter is inserted and a great deal can be done to ensure the tube is well lubricated and the mucosal lining of the urethra is maintained in good health. Herbs like Slippery Elm Bark, Uva Ursi, Liquorice, Marshmallow and Cornsilk are all valuable ingredients in a herbal treatment program. I often include several of these in a mix when I am rehabilitate severe cases of abrasion. The lining of the urethra is pretty fragile and is probably damaged every time a catheter is inserted. Any area injured like this can become inflamed and sore and more likely to host infection. The same herbs listed above will soothe irritation and inflammation if this does occur. Just as mucilaginous herbs are valuable in minimizing abrasion and useful in healing irritation and inflammation one should be looking toward using antiseptic and anti-infective herbs whenever damage has occurred to reduce the chance of infection occurring.

Infection:

Infection will usually show up as darker colored or odorous urine and elevated temperature. Each individual will learn their particular early signs of infection which can range from involuntary muscular twitches, other signs of discomfory or a subtle change in flow paterns. Normally simple anti-infective herbal agents, tonics and blood cleansers such as Garlic, Yarrow, and Echinacea will control infections if taken in conjunction with some of the mucilaginous herbs and Rosehips, above.

Antibiotic Resistance:

There are serious dangers to being exposed to repeated or long term courses of antibiotics. Paraplegics using catheters, are going to be profoundly affected as the resistance to antibiotics increases.

Already antibiotic resistance and the resultant super bugs, are out of control. Within another 5 years, we will be seeing more and more medical institutions shut down because they will not be able to provide any sort of assurance that patients coming in, for even simple treatments, will not catch life threatening infections. Already, some of you will be noticing that infections are harder and harder to treat and you are being prescribed cocktails of the strongest antibiotics known, to treat infection which previously responded quickly to the simple ones.

The prospect of resistant infections, is the one which must drive all routine users of antibiotics out of their comfort zone. Anyone using antibiotics regularly, should be striving to reduce to an absolute minimum their reliance on them simply because, in a very few years, your life quality, and even your life itself, will be threatened.

For treating antibiotic resistant infections and hospital-based infections such as Golden Staph, I am getting very good results by using Colloidal Silver and a herb called Thuja, together.

Nowadays also, I routinely prepare all my patients going into hospital for any sort of treatment or test, by giving them Rosehips and Rescue Remedy to reduce the shock of any such procedure. This helps to protect the immune system from the damage done by such shocks.

You should seriously consider the various suggestions and programs and try to reduce your dependence on antibiotics.

Robert McDowell
Herbalist.
October 2001.


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