Ashmari: The Ayurvedic Perspective on Kidney Stones
Pain- it is one experience that everybody loathes. Be it sudden or longstanding, ebbing or excruciating, endurable or intolerable- the thing about pain is that its intensity often surpasses our imagination. That is what makes it a daunting event most times. We go through different kinds of pain every day that we don’t even know the reason for. While most of them are temporary and less alerting, some of them are tough to ignore. Say, for example, a piercing pain below the ribs in the flanks and back that radiates to the lower abdomen and groin region, something that shifts to different regions and differs in intensity, and is aggravated during urination. Ringing any bells? If these have happened to you, you might be at risk of kidney stones, the third most common disease of the urinary tract.
Kidney stone, known by the names renal calculi, urolithiasis, and nephrolithiasis, is the formation and development of small crystals in the kidney. Your urinary tract, from the kidneys to the bladder, is vulnerable to hosting such crystals. Calcium, uric acid, oxalate, etc tend to crystallize in the kidneys (one or both), especially when the urine is concentrated (such as in dehydration). These can stick together and increase in size, forming what we call calculus or stone. Based on the material they are made up of, stones can be classified as below:-
1.Uric acid stones- In conditions such as diabetes, chronic diarrhea, reliance on a high protein diet, etc, uric acid may increase and form uric acid stones.
2.Calcium oxalate stones- Oxalate, a mineral obtained through diet and synthesis by the liver, can combine with calcium to form calcium oxalate crystals.
3.Struvite stones- formed mainly during a urinary tract infection
4.Cystine stones- due to the action of the amino acid cysteine. Common in cystinuria conditions.
Sometimes, the size of the stones will be much lesser so that we won’t even know if they’re eliminated. But if they exceed 5 millimeters, it may block the ureter, causing it to get stuck there and cause trouble.
The risk of getting kidney stones depend largely on sex, age, family history, geography, etc. Men appear more prone to renal calculi than women. People aged from 30 to 60 are reported to be experiencing this more. A dry and hot climate is another triggering factor.
What causes kidney stones?
- Dehydration- when the body is deprived of enough water, it switches to survival mode by reabsorbing water from the urine. This concentrates the urine and increases the risk of renal calculi.
- Dietary factors- Consuming highly salted, artificially sweetened, protein-rich food for a long time can make you prone to kidney stones. Certain fruits like tomatoes also promote the same.
- Certain medicines- some mineral-based medicines, antacids, vitamin supplements, etc can trigger kidney stones.
- Certain health issues- such as IBS, cystinuria, impaired calcium metabolism, some surgeries, etc increase the chances of getting affected.
- Family history
- History of renal calculi- if you have a history of kidney stones, you are at risk of developing them further.
Symptoms of kidney stone
The symptoms differ in accordance with the location of the calculus, but some of the commonly presented ones are:-
- Pain- called renal colic, a sharp and intermittent pain that radiates from the loin to the groin. This may be subject to fluctuations.
- Blood in urine or hematuria, as the descending stones scar the walls of the urethra. The urine will be red, rose, or brown, depending on the severity of the bleeding. The urine may appear cloudy with a foul smell in extreme cases.
- Nausea and vomiting
- The urgency to urinate or pass urine in small quantities
- Burning sensation during urination
- Urinary tract infection (UTI)
- Fever and chills associated with UTI.
Ayurveda and kidney stones
There are references to renal calculi in ancient Ayurvedic textbooks. Classically called ‘Ashmari’ or ‘Mutrashmari’, these are formed when the aggravated vata and pitta dry up the kapha, causing the latter to assume the shape of the stone. Though all three doshas are involved, ashmari is considered a kapha-predominant disease. Ancient texts cite apathya ahara vihara (improper diet and regimen) and improperly done panchakarma as the reasons for ashmari. Dietary causes include rooksha (dry), teekshna (hot and sharp), lavana (extremely salty), and vidahi (thirst-inducing) types of foods. Ativyayama (excess excercise), anidra (lack of sleep), excessive walking, etc as some of the faulty regimens that cause ashmari.
The first and foremost step is to avoid the causative factors. For this, one can follow an Ayurvedic diet and routine and undergo timely panchakarma procedures. Several medicines that promote urinary output and dissolution of the calculi are also mentioned in Ayurvedic texts.
Several medicines have been indicated classically for the management of ashmari. They can be categorized into different groups based on their activities, such as mutrala (diuretics), bhedana (that which breaks the stones), shothahara (that which removes edema), vedanasthapana (pain relievers), vasti-shodhana (renal function enhancers), etc. Medicines are available in all forms like churna, ghrita, kashaya, etc.
Drink plenty of water
Concentrated urine is one of the causes of renal calculi. To prevent this, make sure you drink plenty of water. Avoid aerated and synthetic drinks and prefer natural fluids such as coconut water, buttermilk, lime juice, gooseberry juice, etc. Barley water and water boiled with either Punarnava (Boerhavia diffusa- Spreading Hogweed) or Gokshura (Tribulus terrestris- Puncture vine) are excellent diuretics that can be prepared at home.
Pathya in ashmari
- Enhance your water intake
- Favor fiber-rich food and leafy vegetables
- Avoid exercising beyond your limit
- Do panchakarma procedures on time under proper guidance
- Panchakarma procedures such as uttara basti (administering medicines through the urethra) can benefit the patient.
- Void urine on time
- Avoid hot, sharp, pungent food substances such as pickles
Yoga might help to relieve pain and facilitate the easy passage of stones. Consider doing them with a qualified professional. Some of the commonly prescribed asanas are:-
- Ardha Matsyendrasana
With timely Ayurvedic intervention, one can surely avoid the threat of getting kidney stones. As we know, prevention is the best medicine, so rather than seeking treatment for a disease, try avoiding its manifestation.
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