Urolithiasis (Kidney Stone): Ayurvedic Treatment

Herbal Remedy for Kidney Stone (Mutrashmari)

Urolithiasis is defined as a stone or stonelike hard substance formed in the urinary tract. Formation of stones in the urinary tract is a global phenomenon and is described in ancient Ayurvedic scriptures as mutraashamari.

Classification of Renal Calculi

It is said to be one of the eight most troublesome diseases (mahaorgas). Ayurvedic texts have classified the stones according to dosic profiles, namely, vata-, pitta-, or kapha- related and others. The formation of a stone (calculus) can be at any level in the urinary system.

Ayurvedic texts have described four types of urinary calculi: sleshmaashmari, pittaashmari, vataashmari, and sukraashmari.

1.          Sleshmaashmari: stones are white, unctuous, and also big in size. They produce symptoms such as dysuria, cutting, incising, and pricking pain, heaviness, and a cold sensation over area the bladder region.

2.          Pittaashmari: stones are reddish, yellowish, and blackish and resemble the color of honey. They produce a sucking type of pain, burning sensation, a warm feeling over the bladder region, and ushnavata.

3.          Vataashmari: stones are dusty in color, hard, irregular, rough and nodular or spiny like the kadamba flower. Patients experience severe pain (and may scream, and have difficulty when passing flatus, urine, and stools.

4.          Sukraashmari: occurs in adults only. It is due to suppression of ejaculation for months or years and frequent coitus or coitus interruption. The semen to be ejaculated will be obstructed, condensed, and brought in-between the scrotum and penis (prostatic part of the urethra) by vata. This causes dysuria, scrotal swelling, and lower abdominal pain. The special characteristic of sukraashmari is that handling can dissolve it.

Ayurvedic Treatment

The management of urolithiasis in Ayurveda basically includes herbal formulas, alkaline liquid, and surgical procedures. Oiling, induced sweating, medicated emesis, purgation and enemas should be given in the prodromal state of the disease only in order to cure it completely.

Shamana Therapy

Palliative treatment includes administration of herbal drugs and herbal formulas orally. The palliative drugs used to treat renal calculi are analgesic, diuretic, and linthnotriptic agent and are able to balance

vata.

Preparations of varuna, gokshura, pashana bheda, shilajitu, ela, veerataru, brihati, kantakari, yava kshara, kushmanda, trapusa, hazrul yahud bhasma, etc. are commonly used in renal calculi.

Shodhana Therapy

Cleansing treatment includes prepanchkarma procedures such as external and internal oleation and induced sweating, and panchakarma procedures, such as medicated emesis, purgation, and enemas. Most of the Ayurvedic classics recommend medicated enemas for the treatment of urolithiasis.

Saindhavadi taila niruha vasti and vrushadi asthapana vasti are generally used in renal calculi. The idea here is that transmucosal fluxes are encouraged away from the kidney for removal of unwanted metabolites, thereby reducing the ionic load on the kidney filtration system. This may be considered as a type of dialysis procedure.

Alkali Therapy

Most of the alkaline materials (kshara) act as diuretics, lithotriptic, alkalizer, and antispasmodic agents. These pharmacological activities are shown to be effective in the management of different symptoms of urolithiasis. Examples include palasa kshara, yava kshara, and mulaka kshara.

Management

Vataashmari Treatment

A decoction is made for the following drugs: pashana bheda, vasuka, ashmantaka, satavari, gokshura, brihati, kantakari, bhramhi, artagala, usira, kubjaka, vrukshadani, bhalluka, and varuna, and fruits of saka, yava, kulutha, kola, and kataka. To this ushakadi group of drugs, kalka (paste) is added and thus ghrita is prepared. This preparation immediately destroys vatashmari.

Kshara (alkali), gruels, soups, decoctions, milk preparations, and food prepared from this vata-allaying group of substances should be administered.

Pittaashmari Treatment

A decoction is made for the following drugs: kusa, kasa, sara, morata, pasana bheda, satavari, pashana bheda, vidari, varahi, shalimula, trikantaka, bhalluka, patala, patha, kuruntika, punarnava, and shirisha. Ghritha has to be prepared by using the above drugs’ decoctions to which silajit, madhuka, seeds of indivara and trapusa, and seeds of eravaruka are added.

Alkalis, gruels, soups, decoctions, milk, and foods prepared from these pitta-allaying groups of substances should be administered.

Sleshmashmari Treatment

Medicine of this decoction include varunadi gana, guggulu, ela, harenuka, kushta, and drugs of bhdraadi gana, maricha, chitraka, and devadaru. The decoction, added with paste of the ushakadi group of drugs, has to be taken along with dehydrated butter. This preparation provides relief from sleshmaashmari.

Alkalies, gruels, soups, decoctions, milk preparations, and food prepared from these kapha-balancing groups of substances should be administered. Karpasa flowers, ankola, nirmali, saka, and indivara fruits powder have to be taken internally with water and jiggery. This mixture quickly reduces blood sugar levels. Gokshura, talamuli, ajamoda, roots of kadamba, and adraka are taken with wine or hot water to remove calculi. Gokshura seeds powder with honey should be taken with milk for a week to disintegrate the calculi.

Sukraashmari Treatment

If seminal concretions or fine particles spontaneously come in the urethra, they should be removed by the badisha instrument (a hook). After the wound is healed, the patient is advised not to undertake any physical activity, such as horse riding.

Alkali Treatment

In Ayurvedic texts, it is advocated that a formulation with medicated ghrita and kshara is made from the drugs mentioned above.

Kshara (alkali) prepared from pastes of tila, apamarga, kadali, palasa, and yava administered as a drink quickly relieves the symptoms. Kshara prepared from patala and karavera can also be effective.

Patients suffering from pain should be given milk processed with the above drugs or triphala groups or with punarnava as a drink. The drugs of the veerataru group can be administered by all modes.

Prevention

Ayurvedic texts provide detailed information regarding the dietary habits and lifestyles that are to be adopted in renal calculi. It is advised to take whole rice, wheat, barley, horse gram, green gram, matured pumpkin, varuna, ginger, gokshura and amaranthus, flesh of birds residing on dry soil or barren land, and measures such as medicated enemas, emesis, purgation, fasting or light diet, and sudation.

Patients are advised to maintain adequate fluid intake to produce at least 2 l/day of urine, maintain adequate calcium intake from food sources, cut down intake of animal protein, cut sodium intake, cut sucrose intake, increase dietary K intake, avoid grapefruit juice, and avoid unnecessary vitamin C. The intake of sour, dry, and heavy foods, food substances that cause indigestion, and unwholesome food items should be avoided. Coffee, tea, and alcoholic beverages should neither be avoided nor encouraged.