Urolithiasis, commonly known as renal stone disease, is a prevalent condition of the urinary system characterized by the formation of crystalline deposits within the urinary tract. It commonly presents with severe colicky pain, dysuria, hematuria, nausea, and urinary discomfort, and may significantly affect the quality of life.
In Ayurveda, renal calculi can be correlated with Ashmari, which is described under Mutravaha Srotas Vikara. The formation of Ashmari is primarily associated with vitiation of Vata Dosha, along with the involvement of Kapha, Mutra and Meda, leading to crystallization and stone formation. Ayurveda emphasizes Nidana Parivarjana, Dosha-Samprapti, Mutrala, Ashmarighna and Shothahara therapeutic approaches for the management of Ashmari. Various classical formulations and Panchakarma procedures have been described to facilitate dissolution or expulsion of calculi and to reduce recurrence.
The present case study highlights the Ayurvedic approach in the management of renal stone, focusing on the clinical presentation, Ayurvedic diagnosis, Samprapti, treatment protocol, and outcome. This case provides an opportunity to understand the potential role of Ayurvedic principles as a supportive approach in the management of urolithiasis.
A 28 year old patient with complaints of burning micturition,pain at abdomen radiating from loin to groin with CT scan KUB report suggestive of kidney stone was treated successfully with mutral, Bhedan, Shothahar Ayurvedic drugs like Pashanbheda, Gokshur, Punarnava. The usg report after treatment shows removal of renal stoneand symptoms also get subsided after treatment. So Ayurvedic medicine plays important role in treatment of kidney stones.
Introduction
Urolithiasis, commonly known as renal stone disease, is a prevalent condition of the urinary system characterized by the formation of crystalline deposits within the urinary tract. It commonly presents with severe colicky pain, dysuria, hematuria, nausea, and urinary discomfort, and may significantly affect the quality of life.
In Ayurveda, renal calculi can be correlated with Ashmari, which is described under Mutravaha Srotas Vikara. The formation of Ashmari is primarily associated with vitiation of Vata Dosha, along with the involvement of Kapha, Mutra and Meda, leading to crystallization and stone formation.
Ayurveda emphasizes Nidana Parivarjana, Dosha-Samprapti, Mutrala, Ashmarighna and Shothahara therapeutic approaches for the management of Ashmari. Various classical formulations and Panchakarma procedures have been described to facilitate dissolution or expulsion of calculi and to reduce recurrence.
The present case study highlights the Ayurvedic approach in the management of renal stone, focusing on the clinical presentation, Ayurvedic diagnosis, Samprapti, treatment protocol, and outcome. This case provides an opportunity to understand the potential role of Ayurvedic principles as a supportive approach in the management of urolithiasis.
Aims and objectives-
The aim of this study is to evaluate the efficacy of Ayurvedic Chikitsa (treatment) in the management of Mutrashmari (renal calculi)
Materials and Methods-
The written informed consent was taken from the patient in his own language.
It is a a single case study.
Patient information-A 28 years old male patient was healthy before. Then he suddenly develops complaints of abdominal colicky intermittant pain radiating from loin to groin along with nausea and burning micturition.
visited OPD of Kayachikitsa department of G.N.Tank Ayurvedic Hospital,Amaravati
Demographic details-
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Name
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XYZ
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Sex
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Male
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IPD Registration number
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718
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Address
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Amaravati
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Age
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28 yrs
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Marital status
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Unmarried
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Economic Status
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High Class
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Profession
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Engineer
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Chief complaints with duration-
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Sr.no.
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Complaints
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Duration
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1
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Burning Micturation
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15 days
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2
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Difficulty in urination
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15days
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3
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Abdominal pain radiating from loin to groin
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15days
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4
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Bloating on and off
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15 days
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Past History-
There is no history of any major systemic illness such as hypertension, diabetes mellitus or bronchial asthama.
Medication history –Patient had taken allopathic medicine for above complaints by urologist which include hydrotherapy with IV fluids DNS, Inj Lasix, Inj Dotrovin, And tab Spasmelon at bed time, Tab Pantop DSR before meal.
Surgical History-There was no history of any previous surgical intervention.
Personal History-
Food Habits- Frequent consumption of junk food,bakery products, oily foods, Non veg diet,rooksha ahara.
Lifestyle-his job profile is sitting in his AC office for long time as he is engineer by profession. Suppression of natural urges, strenuous mode of work, insufficient water intake was present. the excretion of sweat is also minimum.
Sleep-proper but sometimes disturbed due to work stress, late night work.
Addiction-no any addiction found.
Family History-Not signigicant
General Examination-
Temp-Afebrile 97.5F
Pulse-78/min
BP-136/86mmof Hg
Respiratory Rate-18 breaths/min
Ashtavidha Pariksha-
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Nadi
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Pittakaphaj
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Mutra
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Asamyak-
difficulty during micturition,frequent micturition,burning mictuaration
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Mala
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Asamyak-
constipation on and off
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Jivha
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Saam
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Shabda
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Spashta
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Sparsha
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Samasheetoshna
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Drika
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Spashta
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Akruti
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Madhyam
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Nidan Panchak-1,2
Hetu- Ruksha aahara sevan (bakery products, biscuits, snacks, poha), Anupamaansasevan, Matsyasevana, Adhyashana, Ajirna, Jagarana, Alpa ambu sevan, Vegavidharana, shitaaaharaviharasevan
Samprapti-
Hetusevan-vitiation of Tridoshas (Vata, Pitta, Kapha)-Kha vaigunya at Basti and mutravahasrotas- leading to Mutravahasrotas dushti-mutra get dry due to vitiated tridoshas-Mutrashmari formation-Sakashta Mutrotsarga-Mutrashmari and Mutrakruchcha.
Dosha-Vata,Pitta,Kapha
Dushya-Mutra
Agni-Mandagni
Aama-Jtharagnijanya Aama
Srotas-Mutravaha Srotas
Adhishthan-Basti
Rogmarga-Abhyantar
Vyadhiswabhav-Chirakari
Sadhyasadhyata-Kruchchasadhya
Purvaroopa-Aadhman, Mutradaha,
Roopa-Sasewani mehan bastishoolam, bastipradeshe ruja (pain at bladder and urinary tract),
Mutrarujam (pain during micturition),
Vishirnadhaar (urine flow is bifurcated),
Muhushakrun munchati mehanama cha (he goes repetedly to deification and urination)
Upashaya-The symptoms were relieved with Shita avagahan, Parisechan.
(the patient experienced relief by these external procedures).
Anupashaya-The symptoms were aggrevated by ushna sparsha, particularly during work in hot and humid climatic conditions.
Ultrasonography findings-
Diagnosis-
Modern- The Scan reveals minimal right hydronephrosis with 5*5*7mm size dense ureteric calculus. According to this finding diagnosis was made as Renal Calculi.
Ayurvedic-(Vatkaphaj) Mutrashmari
Timeline of medical history-
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03/07/26
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pain in abdomen and back which radiates from loin to groin region,Dysuria
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03/07/26
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Patient went to allopathic hospital for consultation and was advised CT (KUB)plain which reveal stone size5*5*7 mm Modern treatment was started
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13/07/26
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CT reports reveals4*4*5mm at right ureteric region
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Patient taken modern treatment
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18/07/26
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Patient come to ayurvedic hospital as there is no relief of symptoms, patient had advised repeat scan
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Scan reveals stone of size4*3*4mm
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18/07/26
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Ayurvedic treatment started
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23/07/26
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Patient give information of fall of stone crustals from urine with no any other complaints present now. Repeat scan is advised which reveals no stone in KUB region,patient also clinically asymptomatic
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Therapeutic intervention-All ongoing oral modern medicines were discontinued before initiating Ayurvedic treatment.
Treatment Advised-By analysing above pathogenesis, the, Shaman Chikitsa advised as follow-
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DRAVYA
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MATRA
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KALA
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ANUPAN
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Pashanbheda
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1gm
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Three times in a day
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Koshna jala
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Gokharu churna
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1gm
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Three times in a day
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Koshna jala
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Punarnava Chur na
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1gm
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Three times in a day
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Koshna jala
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Yawakshar
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250mg
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Three times in a day
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Koshna jala
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Hriberpishti
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250mg
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Three times in a day
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Koshna jala
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Gokharu Kadha
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10ml
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Three times in a day
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Koshna jala
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Avipattikara churna
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3gm
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Before meal
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Koshna jala
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Assessement –Overall assessement of therapy was made on the basis of improvement in Mutapravrutti symptoms,pain and ultrasonography findings.
Criteria for assessement of results-
1.>75%complete disappearance of known symptoms-Complete releif.
2.50%-75%disappearance of known symptoms-Marked Releif
3.Approximately 50%releif in symptoms-Moderate Releif
4.25%releif in symptoms-Mild Releif
5 No relief in symptoms-No relief
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Subjective parameters
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Grading
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Parameters
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Pain
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0
1
2
3
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No pain
Occasionalpain did not require treatment
Occasionalpain require treatment
Constant dull ache pain require treatment
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Burning Micturation
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0
1
2
3
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No burning micturition but clear urine
Occasional burning but clear urine
Occasional burning mild pain after micturition, requires treatment
Constant burning micturation
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Dysuria
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0
1
2
3
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No Dysuria
Occasional Dysuria
Occasional Dysuria requires treatment
Constant Dysuria requires treatment
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Tenderness in renal angle
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0
1
2
3
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No tenderness
Mild tenderness
Moderate Tenderness
Severe tenderness
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Result-
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complaints
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Before treatment
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After treatment
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Pain
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3
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0
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Burning Micturation
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3
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0
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Dysuria
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3
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0
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Tenderness in renal angle
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2
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0
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USG findings-
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13/07/27
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18/07/26
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23/07/26
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4*4*5mm renal stone
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4*3*4mm ureteric stone
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normal
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-In the present case, the complete ayurvedic protocol was continued for days.
After completion of active treatment phase,Pathyaharavihara was advised and continued strickly as a routine lifelong because long term dietary and lifestyle regulation is essential to reduce chances of relapse and maintain remission.
Discussion
Acharya Charaka has stated that treatment of Ashmari is same as treatment of Kaphapittaj mutakruchcha like use of different Kshar, Ushna, Tikshna, Katurasa aushadhi, Swedan, Abhyanga, Parisechan, Avagaha in Sheetal Jala.. He had given different Yogas like Pashanbhedadi Churna, Gokshuradiyoga, Shobhanjan yoga, Punarnavadiyoga for removal of this Mutrashamari.3
Acharya Sushrut also stated that oral medication having Mutrala,Chhedana, Lekhana, Bhedana properties such as Kwatha, Kshara kalpana,Ghruta,Taila should be tried before going to surgical procedures.4
Hence as per these Chikitsa Sutras the Shamanaushadhi having above mentioned properties were selected for the management of Mutrashmari.
Yavakshara-5,6,7,8
It reduces burning micturition as it is potent urinary alkalizer with mild diuretic activity.
It breaks the urinary stones by its Bhedana, Shodhana and Lekhana properties.
It helps in breaking pathogenesis of stone by its Deepana, Pachana properties helps in reducing indigestion.
It is also Tridoshaghna.
Pashanbheda9,10,11-diuretic and lithotropic properties.
Punarnava12,13,-Shothahar, Mutral
Hriberpishti14-diuretic and lithotropic property
Gokharu kadha15,16-Mutral, Vatanulomak properties., it inhibits stone formation
Avipattikarchurna17-Deepan, Pachan, Vatanulomak
Conclusion
In the present case, the renal colic is managed through a multimodal ayurvedic treatment protocol planned according to Ayurvedic observed Nidana,Dosha-Dushya involvement and overall Samprapti of disease.The treatment was mainly focused on Samprapti bhedana, with the use of internal medicines, Pathyahara and lifestyle regulation. The involvement of Tridoshas along with vitiation of Mutra was considered while planning the treatment.
Ayurvedic medicines having Mutrashmari bhedana, Vatanulomak. Vatapittakaphahara properties helps in reducing symptoms like burning and painful micturition.
No recurrence was reported after completion of active treatment phase.The lifelong advise for Pathya- pathya Kalpana highlites the importance of wholesome diet and lifestyle regulation in maintaining remission and preventing relapse.
This case revalidates the internal ayurvedic medication helps in correcting complex pathophysiology of acute disease like renal colic without any surgical intervention. Thus multimodal ayurvedic management leads to speedy substantial recovery in acute case of renal colic and may be considered as a valuable approach in similar clinical condition.
An attempt must be made for further exploration of this shaman therapy in large population for establishing standard treatment protocol.
Financial support and sponsorship-Nil
Conflicts of interest-there are no conflicts of interest.
