This article is contributed by Dr MS Krishnamurthy and Dr Raghuram.
Urinary calculus is commonly known as kidney stones.In Ayurvedic literature it is referred as Mutrashmari. Mutra means urine, Ashmari means stone. It is a troublesome complaint which may become an emergency at any point of time. Though it is a structural condition, Ayurveda offers varieties of remedies and treatment regimen. Let us have a look.
Home remedies for kidney stones:
- Mix 1 teaspoon of Basil leaves juice with 1 teaspoon of honey, mix, take it early in morning
- Take 4 teaspoon horse gram, add half litre of water, hit his mixture up to it reduces to one fifth, collect soup, add 2 teaspoon crushed pomegranate seeds, mix, filter and take once a day.
- Take glass of tomato juice with pinch of salt and pipper every morning.
- Take watermelon juice daily.
- Take glass of lemon juice 4 times a day.
- Take 3 g Gokhru (Gokshura) and 7 g Kulthi (horse gram), soak for 6 hours in a liter of water, in morning boil to reduce half, filter and take this in a day at regular intervals.
- Boil 2 figs- Anjeer in a cup of water and take it in early morning.
- Regularly take celery.
- Drink plenty of purified water, coconut water, barley water every day.
Common clinical features of kidney stones:
Sudden pain in the right or left lower abdomen(flanks) which radiates from back to front,
Pain during urination,
Burning sensation during urination
Pain in the bladder and urethra,
Reduced urine output,
Yellow or reddish-yellow colored urine,
headache, bodyache etc.
Specific classical features of urinary calculi:
Severe pain in the umbelicus-median raphae, urinary bladder and inguinal region (nabhi-seevani-basti-kukshi shoola),
Obstruction to the flow of urine (visheerna dhara),
Pain during micturition (mootra pravritte sati shoola),
Quite pleasure and comfort on passing the stone/gravels in urine,
Bleeding during urination (rakta mutrata), due to the abrasion caused by the urinary calculi
Distention of bladder,pain in pubic area,bad odor of the urine, dysuria(difficulty in urination),fever and tastelessness are the other features appear in few of the cases.
Types of Kidney stones:-
There are mainly 5 basic kinds of stones. These build up may be of following kind.
- Calcium –
- Calcium Oxalate stone
- Calcium Phosphate stone
- Ammonia – Ammonium stone
- Uric acid – Uric acid stone
- Cystine – Amino acid stone.
Types of stones :-
Build up urinary calculi are classified according to their types depending on their location and the chemical properties.
Depending on location:-
- Nephrolithiais – These calculi are found in the kidneys.
- Urolithiasis – These calculi originates anywhere in the urinary system, kidneys and urinary bladder.
- Uretrolithiasis – These calculi are found in the ureter.
- Cystolithiasis – These calculi are found in the urinary bladder.
- Calyceal calculi – These are minor or major calyxex.
Depending on Chemical composition :-
1. Calcium oxalate crystals :- These are formed by dietary oxalate containing vegetables, fruits and nuts. In this kind urine becomes acidic and shows low pH value.
2. Calcium phosphate crystals :- These are due to alkaline urine and having high pH value.
3. Uric acid crystals :- These are formed by rich animal protein, purines, meat, fish etc. in the diet. In this urine is acidic and high pH value.
Cystine crystals ;- Cystine is a water soluble white coloured aminoacid derived from protein diet. When it is released in kidneys, crystals are formed.
Struvite crystals ;- It is a magnesium ammonium phosphate, derived from high magnesium based diet. These are formed due to the infection in , alkaline urine.
There are some factors responsible for kidney stone formation are as –
Due to worse lifestyle, sleeplessness, odd diets, heavy consumption of fast food, preserved foods etc.
Deficiency of Vitamin A.
Intake of Antacid drugs.
Excess intake of particular food item.
Use of catheter for long term.
Infection in kidneys.
Age.Generally calculi are found in the age group 20 to 45 years. In children these are found rarely. If it is found in the child then it is due to defect in metabolism and known as amino aciduria.
Sex. These are largely found in males than the females, because males remains away from home for a long time and their body water get lost due to exertion.
Geographical conditions – Peoples living in warm and dry region have dryness in their body, body water is evaporated.
Also may be due to the heavy water, fluoride containing water. Such heavy water resources are foun in many districts of India, particularly Jabalpur, Gaya, Amritsar, Chandigarh, Delhi to Kanpur belt, Jamnagar, Rajkot, Indore, Bhopal, Saurashtra and the hilly areas, where this disease is found on large scale.
Causes for Kidney stones as per Ayurveda –
In Ayurveda, since from the Dhanwantari it is known and illustrated well. Dhanwantari had explained it as a “Mutra Asmari” meaning urinary calculi. After him in the Ayurveda texts- Ashtanga Hridaya, Sushrut sanhita etc also explained in detail the causes, symptoms, diagnosis, precautions, and treatment. As per these references the causes are determined by the factors like –
- Apathya Aahara (unwhisome/ odd food)
- Low water consumption.
- Urinary tract infection.
- Mutravirodh, Shodhana dosha (resistance in the urine elimination)
- Chemical drugs.
- Idiopathy etc.
Ayurvedic classical literature have emphasized two important factors as the reasons for urinary calculi.
Improper body detoxification(asmashodhana): If the person indulges in unwholesome food and habits for long and suppresses the natural urges like urination, bowel habits etc naturally the toxins are retained in the body. Ultimately they are sediment and precipitate in the bladder which is the organ related to the expulsion of kleda (moisture) from the body.
Improper food habits (apathya sevana): Untimely eating, over eating, indigestion, unwholesome food and beverages, sedentary lifestyle, less intake of water etc cause improper evacuation of the metabolic wastes. Thus they are deposited in the path way of excretory systems leading to kidney stones.
Other than this,
heavy exercise(ati vyayama) leading to dryness of the body,
spicy food(vidahi ahara),
strong medicines (teekshnoushadha),
dry food (rooksha ahara),
excess walking (ati adhwa),
riding the vehicles/horses(ashwa yana),
non vegetarian diet (mamsala ahara),
loss of sleep (nidra alpata),
salty food (lavana ahara) etc also stand as the supporting factors for Urinary calculi.
Basic causative factors for Dosha aggravation:
Accordingly to the doshas/ prakopa the causes are classified as Vata dosha, Pitta dosha, Kapha dosha and Shukraj dosha, called tidosh vyadhi.
Predominant cause is by kapha dosha.
Disease process and pathogenesis.:-
Vata dosha- Due to vata dosha the vata is accumulated in the vasthi (urinary bladder), its qualities are rukshaguna (dry- rough), it stimulates to dry up mutra, (Urine), shukra, pitta are converted to urine crystals.
Kapha dosha –It is Guru (dominant), snigdha (oily), it build up the crystals together to form a stone. It is a soft stone and whitish in colour.
Pitta dosha – It is due to high acidic urineand forms blakish stone.
Pathology of urinary calculi:
Due to the above said factors, the urine gets concentrated and its acidity increases. Reduced quantity of urine, leads to increased dryness, sedimentation of salts, leading to stone formation and obstruction to urine flow.
It results in painful urination. Often it is associated with burning sensation. As the muscular tone is reduced, fatigue is complained in the localized area, pain is found in the nearby parts like bladder, flanks, back, urethra etc. Due to the accumulation of toxic substances (morbidity) headache is also caused.
Common symptoms of Ashmari
Pain over nabhi (naval), bladder, veins, ducts.
Irritation on urination.
Frequently & obstructed urination. Mutravisarga dosh.
Symptoms of Urinary calculi (stones in the urinary tract)
विशीर्णधारं मूत्रं स्यात्तया मार्गे निरोधिते।
तद्व्यपायात्सुखं मेहेदच्छं गोमेदकोपमम्॥
Saamaanya lingam ruk naabhi sevanee vasti moordhasu
Visheerna dhaaram mootram syaat tayaa maarge nirodhite
Tad vyapaayaat sukham mehet achcham gomedaka upamam
Tat sankshobhaat kshate sa asram aayaasaan cha ati ruk bhavet (Ref – Ashtanga Hridaya Nidaana)
Pain in navel, perineum, head of the bladder (upper part of the bladder)
Urine coming in scattered and split streams (due to the stones blocking the urinary passages)
When the stone breaks in the urinary passages, the person passes the urine easily, the urine will be clear and will have reddish colour
If the stone rubs within the bladder and causes wounds, bleeding occurs in the bladder and the blood is eliminated in the urine
When the passages are obstructed by stones, if the person tries to pass the urine forcibly, he will suffer from severe pain
Features of Ashmari based upon Tridosha dominance:
Severe pain during urination,
pain in the genitalia,
long persisting pain in the umbilicus,
expulsion of vayu during urination(obstruction to the free flow of urine) and defecation,
Blue or bluish red colored urine,
and small sized stones are the features of Kidney stones due to Vata imbalance.
Excruciated pains, sever pains, pulses.
Pain gnashes upto teeth, palms.
Irritation, burning in penis, painful defecation and belching.
तत्र वाताद् भृशं चार्तो दन्तान् खादति वेपन्।
गृह्णाति मेहनं नाभिं पीडयत्यनिशं क्वणन्।
सानिलं मुञ्चति शकृन्मुहुर्मेहति बिन्दुशः॥
श्यावारुणाऽश्मरी: चास्य स्याञ्चिता कण्टकैरिव। (अ.हृ.नि)
Tatra vaataad bhrusham cha arto dantaan khaadati vepan
Gruhnaati mehanam naabhim peedayati anisham kwanan
Saanilam munchati shakrut muhuhu mehati bindushaha
Shyaava arunaa ashmareehi cha asya syaat chitaa kantakaihi iva (Ref – Ashtanga Hridaya Nidaana)
Vataja Ashmari presents with the below said symptoms:
Pain: The pain is so severe that the patient grinds his teeth and shivers
The patient presses his penis every now and then. He also presses his navel region
He excretes the stools with flatus but the urine dribbles in drops
Shape of the stone – looks like thorns
Colour of the stone – blackish brown, reddish yellow (golden yellow)
Burning sensation near the bladder,
warmth in the genitalia,
urinary calculi similar to the seeds of Bhallataka (marking nut) and
Reddish yellow colored stones are the features of Pitta dominant urinary calculi.
Burning, sucking, drawing like feelings.
Urine colour yellowish red.
Associated with fever, chills.
पित्तेन दह्यते वस्तिः पच्यमान इवोष्मवान्।
Pittena dahyate vastihi pachyamaana iva ooshmavaan
Bhallataka asthi samsthaanaa rakta peeta asita ashmaree (Ref – Ashtaanga Hridaya Nidaana)
Pittaja Ashmari symptoms are as follows:
Heat, just like in the wound which is undergoing suppuration
The stone has a size of the seed of Bhallataka
Colour of the stone: Red, yellow or black
Pricking pain in the bladder,
Sensation of cold and heaviness,
Large-soft-honey or white colored stones are the features of Kaphaja urinary calculi.
Part of bladder gets pains.
Stiffness at the reagion of pain.
Brusting feelings in the organs.
Urine colour whitish.
वस्तिर्निस्तुध्यता इव श्लेष्मणा शीतलो गुरुः॥
अश्मरी महती श्लक्ष्णा मधुवर्णाऽथवा सिता। (अ.हृ.नि)
Vastihi nistudhyataa iva shleshmanaa sheetalo guruhu
Ashmaree mahatee shlakshnaa madhu varnaa athavaa sitaa (Ref – Ashtanga Hridaya Nidana)
Kaphaja Ashmari presents with the below said symptoms:
Pricking pain in the region of urinary bladder
Coldness in the bladder region
Heaviness in the bladder region
The stone will be bigger in comparison to the other stones, it will be soft and have the colour of honey or have white colour
Shukraja ashmari – Spermolith
Constant suppression of semen results in this kind of stones in men.This is co-related to spermolith.
Pain in the bladder, dysuria, inflammation in the scrotum and decreased sexual libido are the features of this kind of stones.
Discharge of semen and sediment occurred by excessive coitus or abrupt or sudden stopping sexual act.
Associated with dysuria, scortum swelling.
शुक्राश्मरी तु महतां जायते शुक्रधारणात्॥|
स्थानाच्च्युतममुक्तं हि मुष्कयोरन्तरेऽनिलः।
शोषयत्युपसगृह्य शुक्रं तच्छुक्राश्मरी॥
तस्यामुत्पन्नमात्रायां शुक्रमेति विलीयते॥ (अ.हृ.नि)
Shukra ashmaree tu mahataam jaayate shukra dhaaranaat
Sthaanaat cyutam amuktam hi mushkayoho antare anilaha
Shoshayati upa sangruhya shukram tat shukraashmaree
Vasti ruk mootra kruchchratva mushka shvayathu kaarinee
Tasyaam utpanna maatraayaam shukrameti vileeyate (Ref – Ashtanga Hridaya Nidana)
Shukrashmari occurs in the adults who withhold the urge of seminal ejaculation. The semen leaves its site of production due to sexual urge or sexual intercourse. When the person withholds the semen at the point of ejaculation, the semen gets stagnated between the 2 testicles and is later dried up by the vayu. This dried up semen attains the form of calculi (stone). This is called Shukrashmari and it produces the following symptoms:
Pain in the region of the bladder
Swelling in the testicles
When the site of seminal calculi is pressed (immediately after its formation), it breaks and flows by getting mixed in the urine)
Structures of stones according to dosha–
Vataj stones are-
– dusty coloured,
– Hard, faceted and nodular.
– it resembles uric acid stones.
Pittaj stones are –
Reddish, Blakish, Yelloish, honey coloured.
look like seed by shape.
it resembles to calcium oxalate stones, uric acid stone, cystine stone.
Kaphaj stones are-
whitish, brilliant coloured.
it resembles to calcium phosphate stones.
Complications of Urinary calculi:
Debility, fatigue, emaciation, abdominal pain, tastelessness, anemia, burning sensation during urination, thirst, chest pain and vomiting are the complications of urinary calculi.
Diagnosis of kidney stone is possible by physical examination, and other examinations.
- Physical examination by observations of pain sites
- Blood examination- for calcium, phosphorus, uric acid, electrolytes, blood urea nitrogen, creatinine, kidney function.
- Urine examination- for crystals, bacteria, blood particles, pus cells.
- Ultrasound examination – for size, shape and location of calculi.
- X- ray of abdomen.
Line of treatment of Urinary calculi:
Medicines which are penetrative (teekshna ushna) and break the stones (ashmari bhedana),
diuretics(mutrala dravyas) – to flush out the small sized kidney stones,
sufficient water intake, watery food intake,
coolants (sheetala upachara) and remedies to balance Vata (vatahara upachara) are helpful to relieve Ashmari (Urinary calculi).
According to the Dosha imbalance each variety of calculi is treated easily and successfully.
Single drugs useful in Urinary calculi:
Pashanabheda – Bergenia ligulata (Wall.) Engl.
Shunti – Ginger – Zingiber officinale Rose.
Varuna – Crataeva nurvala Buch-Hem.
Shigru – Moringa – Drumstick tree – Moringa oleifera Lam.
Gokshura – Tribulus – Tibulus terrestris Linn.
Punarnava – Boerhavia diffusa Linn.
Kooshmanda – Winter Melon – Benincasa hispida (Thunb.) Cogn.
Shatavari – Asparagus racemosus Willd.
Kadali – Stem of banana – Musa paradisiacal Linn.
Kutaja – Holarrhena antidysenterica (Linn.) Wall. Ex. G. Don.
Sukshma Ela – Cardamom – Eletharia cardamomum Matom.
Trapusha – Cucumis sativus Linn.
Kulattha – Horse gram – Macrotyloma uniflorum (Lamk.) Verdc.
Shilajit – Asphaltum punjabinum
Shaka – Tectona grandis Linn. F.
Ervaru – Cucumis melo
Karpasa – Cotton tree – Gossypium herbaceum Linn.
Tinduka – Diospyrus peregrine (Gaertn.) Gurke.
Formulations useful in Urinary calculi:
- Pashanabhedi kashaya
- Varanadi kashayam
- Veerataradi kashaya
- Chandraprabha vati
- Punarnavashtaka kashaya
- Punarnavadi kashaya
- Punarnavadi guggulu
- Gokshuradi guggulu
- Elakanadi kwatha
- Trivikrama rasa
- Shilajatu vati
- Jawaharmohra pishti
- Godanti(karpoora shilajatu) bhasma
Ideal diet for kidney stones –
Mushrooms, germinated beans, pulses, wheat, bajra, green peas, karela, sugar, jam, green chillies, papaya, mango, apple, wheat bran, bengal gram floor.
Ushnodaka (Warm water) – As per ayurveda, hot water relieves Vata and soothens the inner mucous membrane. Hot water benefits
Phalgu (Ficus carica Linn.)
Draksha (Vitis vinifera Linn.)
Ervaru (Cucumis melo)
Purana shali (older rice)
Mudga yusha (green gram soup)
Sita (sugar candy)
Peya (water) – drinking good amount of water throughout the day.
Kushmanda (ash gourd)
Narikela (coconut water)
Amalaki (goose berry) etc
Unwholesome diet and habits:
Milk, milk derivatives, vanaspati ghee, tea , coffee, eggs, green vegetables, non veg having bones, crabs, etc.
Heavy exercise (Ati vyayama), increases Vata and dryness of the body
Suppression of the natural urges (Vegadharana) – leads to urine retention in urinary bladder for a long period of time, leading to sedimentation.
Dry food (Shushkahara-Rukshahara)
Grain flour (Pishtaanna)
Exposure to breeze (Pravata sevana)
Working in sunshine (Arkatapa)
Excess of sexual indulgence (Ati vyavaya)
Kapittha( Limonia elephantianum (Correa) Panigrahi.)
Jamboo – Jamun seeds – (Syzygium cumini (Linn.) Skeels.)
Bisa (Nelumbo nucifera Gaertn.)
Excess of astringent food (Kashaya rasa sevana)
Dear readers of Easy ayurveda, Ayurveda system of medicine and lifestyle explains several ways to prevent the occurring of urinary calculi. Ashmari (Urinary calculi) is a dreadful disease and its pain is intolerable and often it is irritant and disturbs normal day-to-day activities. After manifestation of urinary calculi, the victim should be very careful about his/her food and habits.
The altered food habits, busy life schedules and less intake of water or consumption of salty and packed foods are the true reasons for the kidney stones as well as worsening of the disease.
The sedentary lifestyle and intake of chilled water is the another major reason for this complaint. Even though role of chilled water in the causation of calculi is evident, much scientific explanations are not available in this regard. But Ayurvedic classics have emphasized that warm water acts as Basti shodhaka (clear the bladder) and hence it is worth to take luke warm water in case of Urinary calculi.
Surgery for kidney stones – Further, quite interestingly, Acharya Sushruta is the first person who has explained in detail about the indication of surgery and surgical procedures to be adopted in case of Urinary calculi in Sushruta Samhita -Chikitsa sthana- 7th Chapter.
Acharya Vagbhata too explained the surgical procedure based upon the ideology of Sushruta in his treatise Ashtanga hridaya -Chikitsa sthana- 11th chapter.
Ayurvedic medicines for kidney stones:
Ayurvedic remedies are given as per situations considering the stages.
- First stage- ( sever pains in the abdomen region- Vatahar chikitsa)
- Second stage– (burning at urination – Pittahara chikitsa)
- Third stage- ( Obstructed urination– Kaphahara chikitsa)
First stage remedies-
At this stage diuretics and analgesic remedies are given. These are Gokhru- Gokshura powder (puncturepine), Varuna powder (caper tree), Kulthi powder ( Dolichos biforus linn) Safed Musli powder, Talimkhana, etc.
Second stage remedies –
Along with first stage remedies, punarvasa, varnadav, pashan behda, tamilkhana, kolilaksh, mako- solenum nigrum, pashanmed, vayavana etc.
Third stage remedies –
At this stage remedies for brusting the stones are given are- Kokilaksh, punarnava, avipathy, hingavasad, ardhvilva, balpunarnava, chandraprabha, gomutraharitaki, vatsamayantaka, dantaharitaki, prvalbhasma, abhrak bhasma, shilajit, kanmada bhasma, brihatyakashya, chandanasava, kalyankshar. Etc.
In acute cases surgery is needed. Nephrolithotomy and Lithotrypsy are easier surgeries and does not need cuttings.
Diet for oxalate stone:-
Avoid:- Cashew, spinach, tomato, figs- anjeer, strawberry, beat, koko, sapota, custard apple, chocklet, coffee, etc.
Take:- Apple, bajra, cauliflower, banana, karela, curd, carrot, egg, green chilli, guava, milk, green peas, potato, green gram, red gram.
Uric acid stone:-
Avoid:- Meat, fish, eggs.
Take: Green vegetables, fruits, fruity vegetables, milk, curd, wheat, potato, bajra, sorghum, rice, carrot, sabudana- tapioca.
Yoga for Kidney stone patients:
Suggested Asanas of yoga for kidney stone patients are-
- Utta padasana
Panchakarma is suggested as it removes all the bad elements out bf body, by cleaning all body.
- Magnetic water therapy
- Warm water hydrotherapy
- Morning walk, airbath
- Wheat grass juice.
Conclusion and clinical experience:-
- Kidney stones are formed due to the worse lifestyle, uncontrolled diet.
- Water quality is also responsible.
- More than 95% of calculi can be brusted and expel out without surgery by Ayurvedic remedies.
- In the emergency for acute cases only surgery may be recommended because it is very expensive for poor peoples.
- Balanced diet can protect from calculi formation.
- Regularly panchakarm in every year keeps away from kidney dtone.
- Also after any surgery, regularly intake of Ayurvedic remedies can avoid chances of repetitions of calculi formation
Dr. Mahesh Annapure
M.Sc., D. N., M.D. (A.M.)
Address:- 303, Chintamani Park, Shashtrinagar,
Bhawsar Chowk, Nanded. 431605, Maharashtra