Mutra sharkara – gravel in urine – Ayurvedic understanding and treatment

Article written by Dr MS Krishnamurthy MD (Ayu), Ph.D (Ayu).
Mutra means urine and sharkara refers to sand or gravel in urine. Mutra sharkara is a condition which mimics the mutra ashmari (urinary calculi) but in lesser extent. Even though similar patho-physiology is involved in both the cases, urinary gravels remain in subclinical level and hardly appear with their full clinical features. In spite of that urinary gravels remain as troublesome complaints as they irritate at any period of time, once after manifestation.

Causative factors

All Acharyas have specified the same causative factors or urinary calculi (mutra ashmari) even for urinary gravels (mutra sharkara). Especially, Acharya Charaka pointed out the main reasons to Sharkara(urinary gravels) as:

1. Excessive physical exercise (vyayama)
2. Suppression of natural urges (vega dharana)
3. Dry-rough-protein and carbohydrate  rich food (shushka-ruksha-pishtanna sevana)
4. Exposure to sun shine (arkakara)
5. improper sexual indulgence (Vyavaya)
6. Kharjoora-shalooka-kapittha-jambu-bisa sevana (intake of date fruits, root or stem of lotus, fruits like kapittha – Feronia elephantorum, jambu- blue berry etc)
7. Astringent food (Kashaya rasa sevana) etc

Origin of the disease

Due to the causative factors, the food and beverages dominantly vitiate vata dosha and they in turn make the solid-hard-stable materials which dissolve / breakdown in urine. Also, they dry up the readily existing ashmari (urinary calculus). The finer particles (small, sandy) thus originated are excreted out. Thus, the disease urinary gravels (sharkara) is resulted.

Clinical features

1. Pain in umbilicus, bladder, suture or penis (nabhi-basti-seevani-mehana shoola)
2. Pain during micturition or dysuria (visheerna dhara)
3. Yellow or red discoloration of urine (peeta-rakta mutrata)
4. Expulsion of small sand like particles through urine (sharkara mutrena saha gamana).

Curability

The complaint of urinary gravels is easily curable by Ayurvedic medicines. But, if the complaint persists for long, it may cause Urinary calculi too; so, one should be careful if they have been diagnosed with any of these diseases.

Management

The line of treatment of Urinary calculus is adopted here also. But due emphasis should be given for cold (sheeta), unctuous (snigdha) and diuretic (mutrala) substances.

Single drug usage

Single drugs recommended in Sharkara

Usheera – Vetiveria zizanioides (Linn.) Nash.
Punarnava – Boerhavia diffusa Linn.
Gokshura – Tibulus terrestris Linn.
Sariva – Hemidesmus indicus Schult.
Erandamoola – Castor root – Ricinus communis Linn.
Pashanabheda – Bergenia ligulata (Wall.) Engl.
Shakabeeja – Tectona grandis Linn. F.
Trapusha –  Cucumis sativus Linn.
Varuna – Crataeva nurvala
Badarashma – Silicate of lime – Hajarul yahood (unani)
Karpoora shilajatu – Godanti – Gypsum salt
Yavakshara – Kshara prepared with barley.

Ayurvedic medicines

Ayurvedic medicines useful in Mutra Sharkara –
Punarnavasava
Usheerasava
Laghupanchamoola kashaya
Godanti bhasma
Gokshuradi guggulu
Sarivadyasava
Chandraprabha vati
Punarnavashtaka kwatha
Chandanadya ghrita
Varunadi kwatha
Ashmarihara kashaya
Varunadya ghrita etc.

Formulations mentioned in Sahasrayoa text book
1 Vastyamayantaka ghritam
2.Trikantaka Ghrritam
3. Dasamoolarishtam
4. Satavaryadi Ghritam

Wholesome diet habits

Shigru – drum stick
Haridra – turmeric
Amalaki – gooseberry
Yava – barley
Godhuma – wheat
Mudga – green gram
Kulattha – horse gram
Patola – snake gourd
Karavellaka – bitter gourd
Maricha – pepper
Jambu – blue berry
Vyayama – heavy exercise etc

Unwholesome diet

Kanda moola (root-rhizome)
Ikshu (sugar cane juice)
Taila (oil)
Ghrita (ghee)
Guda (jaggery)
Kanjika / shukta (sour gruel)
Madya (alcohol)
Pishtanna (protein and carbohydrate rich food)
Anupa mamsa (flesh of marshy animals)
Dadhi (curd)
Navanna (new grain)
Divaswapna (day sleep etc)

Last drop
Dear Easy Ayurveda readers, urinary gravels are the simple health complaints which are often neglected or unnoticed. But, pre-existing complaints like crystalluria (sharkara meha) often leads to urinary calculi due to favourable food and habits. Especially, due to our health consciousness, people consume more of green leafy vegetables, dry fruits like date, cashew nut etc, tomato, chikoo (sapodilla), milk and milk products etc. As these provide more calcium and other salts, often they are precipitated in the urinary system and hence urinary gravels are commonly found. Over health-conscious is also dangerous because the gut absorbs as per its requirement and it tries hard to expel out the unnecessary elements; but often it is trapped in urinary system and the condition like urinary calculi and gravels are caused.