STONES ALWAYS MAKES THE PATH MISERABLE – AN AYURVEDIC THOUGHT

Kidney stone disease, also known as nephrolithiasis or urolithiasis, is when a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine stream. A small stone may pass without causing symptoms. If a stone grows to more than 5 millimeters (0.2 in), it can cause blockage of the ureter, resulting in severe pain in the lower back or abdomen. A stone can also cause blood in the urine, vomiting, or painful urination. About half of people who have had a kidney stone will have another within ten years.

Common clinical features

• Sudden pain in the right or left lower abdomen (flanks) which radiates from back to front
• Pain & Burning sensation during urination with reduced urine output,
• Pain in the bladder and urethra,
• Yellow or reddish-yellow coloured urine,
• Lethargy,
• Vomiting-sensation,
• Headache, body ache

Specific classical features

• Severe pain in the umbilicus, median raphae, urinary bladder and inguinal region
• Obstruction to the flow of urine with severe pain
• Feels comfortable after passing the stone/gravels in urine,
• Bleeding during urination, due to the abrasion caused by urinary calculi.
• Distension of bladder, pain in pubic area, difficulty in urination, fever and tastelessness are the other features seen in few of the cases.

Types of stones: -Depending on location

Urinary calculi are classified according to their types depending on their location and chemical properties.

• Nephrolithiasis– are found in the kidneys.
• Urolithiasis– originate anywhere in the urinary system, kidneys, and urinary bladder.
• Ureterolithiasis– are found in the ureter.
• Cystolithiasis– are found in the urinary bladder.
• Calyceal calculi– are found in the minor or major calyces.

Causes, risk factors

Below are some factors responsible for kidney stone formation –

General factors:

• Bad lifestyle, sleeplessness, heavy consumption of fast food, preserved foods etc.
• Deficiency of Vitamin A.
• Intake of antacid drugs.
• Thyroid disease.
• Long term use of catheter.
• Gastric surgery.
• Obesity.
• Infection in kidneys.
• Age – Generally calculi are found in the age group 20 to 45 years.
• Sex – Mostly in males than in females.
• Geographical conditions – Peoples living in warm and dry regions are more prone due to dryness of body and usage of hard water.

Causes for Kidney stones as per Ayurveda

Acharya Dhanwantari had explained it as a “Mutra Asmari” meaning urinary calculi. Ashtanga Hridaya, Sushrut Samhita etc has also explained in detail the causes, symptoms, diagnosis, precautions, and treatment. As per these references, the causes are determined by factors like Apathya Aahara (unwholesome food), Low water consumption, Urinary tract infection, Chemical drugs, Idiopathy etc. Ayurvedic classical literature has emphasized two important factors as the reasons for urinary calculi.

Improper body detoxification: 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 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, overeating, indigestion, unwholesome food and beverages, sedentary lifestyle, less intake of water etc cause improper evacuation of metabolic wastes which will eventually be deposited in excretory systems leading to kidney stones.

Other than this, heavy exercise leads to dryness of the body, spicy food strong medicines, dry food excess walking, riding the vehicles/horses non-vegetarian diet loss of sleep, salty food etc also stand as the supporting factors for Urinary calculi.

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.

Vata dosha- Due to Vata dosha Vata is accumulated in the vasthi (urinary bladder), its qualities are rukshaguna (dry- rough), it stimulates drying up of mutra, (Urine), shukra, pitta and converts it to crystal form.

Kapha dosha –It is Guru (dominant), Snigdha (oily), it builds up the crystals together to form a stone. It forms soft stones that are whitish in colour.

Pitta dosha – It is due to highly acidic urine and forms blackish stones.

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 vayu. This dried up semen attains the form of calculi (stone) which is called Shukrashmari and it produces symptoms like pain in the region of the bladder, Dysuria, Swelling in the testicles etc. 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

Complications of Urinary calculi

Debility, fatigue, emaciation, abdominal pain, tastelessness, anaemia, burning sensation during urination, thirst, chest pain and vomiting are the complications of urinary calculi.

Line of treatment of Urinary calculi

• Mild oleation (snehana) – Medicines which are penetrative and which are capable to break the stones.
• Diuretics (mutrala dravyas) – to flush out the small-sized kidney stones, sufficient water intake, watery food intake, coolants, and remedies to balance Vata are helpful to relieve Ashmari (Urinary calculi).

Apart from that, formulations like Pashanabhedi Kashaya,Varanadi kashayam,Veerataradi Kashaya, Chandraprabha vati, Punarnavashtaka Kashaya etc has also been used widely. Single drugs like Pashanabheda – Bergenia ligulate, Shunti (Ginger – Zingiber officinale Rose, Varuna – Crataeva nurvala, Shigru – Moringa – Drumstick tree – Moringa oleifera, Gokshura(Tribulus terrestris Linn) etc can also be advised after consulting a physician.

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 flour, Ushnodaka (Warm water), Draksha (Vitis vinifera Linn.), Purana shali (old rice), Mudga yusha (green gram soup), Sita (sugar candy), Takra (buttermilk), Kushmanda (ash gourd), coconut water, Amalaki (gooseberry), drinking a good amount of water throughout the day, etc

Unwholesome diet and habits

Milk, milk derivatives, vanaspati ghee, tea, coffee, eggs, green vegetables, nonveg having bones, crabs, etc, Heavy exercise (Ati vyayama), Suppression of natural urges– lead to urine retention in urinary bladder for a long period of time, leading to sedimentation. Dry food, Exposure to breeze (Pravata sevana), Working in sunshine, Excessive sexual indulgence, Jamun seeds, Excess of astringent food etc.

Ayurvedic medicines for kidney stones based on stage

Ayurvedic remedies are given as per situation considering the stages. First stage there will be severe pain in the abdomen which can be treated with Vatahar chikitsa. Second stage there will be burning sensation during urination in which Pittahara chikitsa can be done whereas third stage will be having obstructed urination where Kaphahara chikitsa can be advisable.

First stage remedies- At this stage, diuretics and analgesic remedies are given like Gokhru – Gokshura powder, Varuna powder (caper tree), Kulthi powder, Safed Musli powder etc.

Second stage remedies – Along with first stage remedies, pashan bheda, kolilaksh, mako – Solanum nigrum, pashanbhed etc.

Third stage remedies – At this stage remedies for breaking the stones are given like Kokilaksh, punarnava, avipathy, ardhvilva, balpunarnava, chandraprabha, gomutraharitaki, vatsamayantaka, dantaharitaki, pravalbhasma, abhrak bhasma, shilajit, kanmada bhasma etc.

In acute cases surgery is needed. Nephrolithotomy and Lithotripsy are easier surgeries and are non-invasive.

DIET

Yoga – suggested Asanas

• Varunasana
• Paschimothanasana
• Dhanurasana
• Pawanmuktasana
• Uttanapadasana

Conclusion

Kidney stones are formed due to the worse lifestyle, uncontrolled diet, usage of hard water etc like many reasons. More than 95% of calculi can be burst out and expelled out without surgery by Ayurvedic remedies. In the emergency for acute cases, only surgery may be recommended. A balanced diet with regular panchkarma yearly can protect from calculi formation.