Basti Shula (Shoola) Meaning, Symptoms, Causes, Pathogenesis, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Basti Shula (shoola) means pain in the urinary bladder or pain originating from the urinary bladder.
Basti / Vasti – urinary bladder, Shula – colic / pain

Causes of Vasti Shula

Samrodhat – forcibly withholding natural urges of defecation, urination etc is said to be the main causative factor of vasti shoola. When the impending natural body reflexes / urges are forcibly controlled the vata gets aggravated and moves in abnormal directions, mainly upwards.
Read – Shoola Types, Symptoms, Treatment, Medicines, Remedies

Pathogenesis

• Due to forcibly withholding the natural urges of feces, urine etc the vayu gets aggravated
• This aggravated vata reaches the urinary bladder, envelopes the bladder from all the directions and gets lodged therein
• The patient experiences pain in the urinary bladder, groin and navel
• Following this obstruction of feces, urine and fart occurs
• This painful condition is called vasti shula i.e. pain in the urinary bladder – a pathological condition caused by aggravated vata
  Read – Do Not Suppress Body Urges: Charak Samhita Sutrasthana 7th chapter

Symptoms

Vasti shula – pain in the urinary bladder
Vankshana shula – pain in the groins
Nabhi shula – pain in the navel region
Vit samrodha – constipation
Mutra samrodha – urinary obstruction
Vata samrodha – obstruction to expulsion of fart

The pain of vasti shula is said to be caused due to withholding of urges, mainly those of feces and urine. When the person gets habituated to withholding of feces it might lead to constipation or difficulty in defecation. This will lead to pain in the colon and rectum. This is called vit shula i.e. pain caused due to impaction of feces. This will in turn impart pressure on the urinary bladder, the rectum and urinary bladder being neighboring organs. As a result the urinary bladder will be subjected to pressure from colon. When this condition gets chronic the urinary bladder will get inflamed leading to ‘bladder pain’. Similarly when the urine urge is forcibly withheld and when it becomes habitual, urinary obstruction occurs which further causes inflammation of the urinary bladder and consequentially urinary bladder pain i.e. vasti shula’ occurs.
Read – Kukshi Shula Causes, Symptoms, Pathogenesis, Treatment

Sanskrit Verses

Modern perspective

The pain in the urinary bladder or pain originating from the urinary bladder is caused due to –
Inflammation of urinary bladder – cystitis
Calculi in the bladder might cause pain in the region of urinary bladder and perineum, the pain may also be referred to the penis
Read – Cystitis (UTI) In Ayurveda – Symptoms, Causes, Treatment

Differences between Vasti Shula and Mutra Shula

Mutra Shula is a condition which has been explained by Master Charaka immediately after Vasti Shula. The origin of pain is from the same region i.e. urinary bladder but there seems to be a difference in pathogenesis and etiology in both these conditions. While Vasti Shula is caused due to forcible withholding of urges of feces and urine, mutra shula is caused by vata vitiated following consumption of incompatible foods and exposure to activities which tend to vitiate vata.
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

In Vasti Shula the vitiated vata first afflicts the urinary bladder and causes painful conditions in the urinary bladder, navel, and groins but in Mutra Shula the vitiated vata first afflicts penis and colon and causes pain in navel, groin, belly and flanks. The region wherein pain is manifested is almost the same with slight difference.

In Vasti Shula there is obstruction of feces, fart and urine but there is only obstruction of urine in mutra shula. Technically both are different manifestations of the same condition. Both are caused by aggravated vata.
Read – Effects Of Suppression Of Urge To Defecate, Treatment

Treatment

The treatment of Vasti Shula just like Mutra Shula has not been explained. But the treatment principles of both these conditions will be similar and should be done after analyzing the pathogenesis thoroughly.

Treatment principles

Vata alleviating measures is the first and foremost approach done to treat the pain of urinary bladder. Foods and life activities which are vata alleviating is adopted. Herbal enemas, purgation and external therapies like massage, tub bath, showering of vata alleviating oils and decoctions and fomentation is included. They not only balance vata but also will help in relieving pain.

Other treatment –
Udavarta – upward abnormal movement of vata
Mutraghata – obstruction of urine
Mutrakrichchra – dysuria
Mutrashmari – urinary / bladder calculi
Shotha – edema / inflammation
Mutravaha sroto dushti janya vikara – treatment of contamination of channels of urine

Click to Consult Dr Raghuram Y.S. MD (Ayu)