Scholar

Dr. Aditya Nema

Guide

Dr. S. K. Gupta Professor & HOD

Co - Guide Co - Guide

Dr. T. S. Dudhamal Dr. V. D. MahantaAsst. Professor Asst. Professor

Department of Shalya TantraInstitute for Post Graduate Teaching & Research in Ayurveda

Gujarat Ayurved University, Jamnagar

Role of Life Style for Prevention of Ashmariw.s.r. Urolithiasis – A Conceptual Study

INTRODUCTIONUrolithiasis is a phenomenon of formation of urinary stone

which is a solid concretion or crystal aggregation formed in the

kidneys and bladder from minerals.

The different types of stone are based on the origin places and

composition of the stone in the urinary tract.

In Ayurvedic literatures, it is referred as Mutrashmari. Mutra

means urine and Ashmari means stone. There are four types of

Mutrashmari described in Ayurveda as Vataja, Pittaja, Kaphaja

and Shukraja.

WHY THIS TOPIC ???Healthy life is always being the prime aim of the human but now

the preferences are changed due to developing scenario of the

world and persons are going away from the nature and inviting

many diseases in the early stage of their life.

In the present era, people are more susceptible to such diseases

originated due to disturbed life style and urolithiasis is one of

them.

The recurrence rate of urolithiasis is approximately 50%

within 5 years.

AETIOPATHOGENESIS

Acharya

Sushruta

Acharya

Charaka

Acharya

Kashyapa

Asamshodhana-

sheela

Apathya-Sevana

Ativyayama (heavy exercise)

Vidahiahara(spicy food)

TeekshnaAushadha (strong medicines)

Rookshaahara(dry food)

Atiadhwa(excess walking)

Ashwayana(riding the vehicles/horses)

Mamsaahara(non vegetariandiet)

Nidraalpata(less sleep)

Lavanaahara(salty food).

Bhaaravahana on

Kati and Skandha.

Conti….

Asamashodhana Sheela

(Non acquisition of the proper detoxification of body):

Vamana (therapeutic emesis),

Virechana (therapeutic purgation) and

Basti (medicated enemas)

If above these Shodhana therapies doesn’t applied on

regular intervals then such persons may be suffered from this

type of calumnious disease.

Apathya-Sevana (Practice of unhealthy diets and lifestyle)

Due to Apathya-Sevana Agnimandya and vitiation of Doshas

occurred which are responsible for Srotorodha and ultimately

held responsible for improper evacuation of the Mala

(metabolic wastes) from the body.

Thus they are deposited in the path way of urinary

excretory systems leading to kidney stones.

SAMPRAPTIEtiological factors

Vitiation of Kapha Dosha takes

place

With the help of Vata and Pitta

Doshas , dries up of Kapha Dosha

Ashmari

Reaches to urinary system

Etiopathogenicfactors

Dehydration

Animal protein, Calcium,

Oxalate, Sucrose & Fructose rich

diet

Excessive intake of vit. C&D,

electrolyte like Sodium &

Fluoridated tap water

Sedentary life style and

sleep after taking diet &

Obesity

Hyperthyroidism,

Renal Tubularacidosis,

Crohn’s disease,

malabsorptiveconditions,

sarcoidosis,

Global warming

PREVENTIONPathya Jalasevan (drinking water)

Puranashalichaval (Whole rice), Jau (barley),

Kulathi(horsegram)

Madya (alcohol)

Marusthaliyapakshiyokeandokaras (Flesh of birds residing on

dry soil or barren land),

PuranaKushmanda (matured pumpkin),Varuna

Ardraka(ginger), Gokshura, Pashanbheda, Renuka, Shalparni

Yavkshara

Basti (medicated enemas)Vamana(emesis)Virechana (purgation), Langhana (fasting or light diet)Jalkrida (Swimming)Swedana (sudation).

AHARAJA

VIHARAJA

ApathyaShushkahara-Rukshahara(Dry-food)

Pishtaanna(Grain-flour)

Kapittha

Jamboo

Bisa

Kashaya Rasa Sevana (Excess of astringent food).

Ativyayama(Heavy exercise)

Vegadharana (Suppression of the natural urges)

Pravatasevana (Exposure to breeze)

Arkatapa(Working in sunshine)

Ativyavaya(Excess of sexual indulgence).

AHARAJA

VIHARAJA

Conti….

Dhanurasana Pavanamuktasana

Halasana

Bhujangasana

Ushtrasana Pranayama

Yoga and Pranayama

Breathing techniques in Pranayama improves circulation in

the lower body parts.

The leg raises practiced in Yoga help in strengthening the

abdominal and digestive muscles and therefore are very

effective in flushing out kidney stones.

The restorative poses which involve placing the legs up the

wall are also a great remedy for getting rid of kidney stones.

How yoga & Pranayama works ???

1. Fluid intake (Drinking advice):

Potable water and other fluids should be encouraged to drink at

least 2.5 to 3 liters a day.

Research studies are also recommended to drink citrus drinks

like lemonade and orange juice protect against kidney stones

because they contain citrate, which stops crystals from growing

into stones.

MEDICAL RECOMMENDATION

2. Nutritional advice:

Healthy balance diet is recommended in routine which should be

rich in vegetable and fibers.

Minerals should not be increased from normal limit Normal

calcium content: 1000-1200 mg/day, sodium chloride content: 4-

5 g/day etc. Allopurinol is an inhibitor of xanthine oxidase,

reduced salting out effect, decreased risk of uric acid or urate

crystals and reduced excretion of oxalate rich stone formation.

Excessive intake of oxalate-rich products should be limited or

avoided to prevent a high oxalate excretion that causes the

urinary calculi.

Alkaline citrates are used for correction of hypocitrateturea and

urine alkalinisation, so that it inhibits the growth of calcium

oxalate stone.

High dietary intake of potassium appears to reduce the risk of

stone formation because potassium promotes the urinary

excretion of citrate. Magnesium inhibits stone formation and

increased urinary magnesium levels reduce the ion-activity

product of calcium oxalate and inhibit the growth of calcium

phosphate crystals.

Therefore, all minerals are used as preventional

measures for the high recurrence rate of urolithiasis.

Animal protein:

Animal protein is source of high calorie, cholesterol and

essential mineral density but should not be taken in excessive

amounts; it should be within limit i.e.0.8-1.0 g/kg body

weight.

Excessive consumption of animal protein gives rise to several

effects that favor stone formation, including hypocitraturia,

low urine pH, hyperoxaluria and hyperuricosuria

Vitamin:

Vitamin-C is a precursor of oxalate, so those have history of

calcium oxalate stone should avoid excessive intake of

Vitamin-C. Limiting of Vitamin-C intake i.e. less than 1000 mg

per day.

In routine life more Vitamin-D should be also avoided because

it acts as precursor of urolithiasis.

Vitamin-A deficiency is also one of the factors of stone

formation. So the adequate amount of Vitamin-A is

recommended.

3. Body mass index:

18-25 kg/m2 are normal for prevention of urolithiasis (Ashmari)

and increase BMI causes obesity. Urinary pH is also inversely

related to BMI, urinary super-saturation with uric acid

increases with increasing BMI and obesity is specially a risk

for uric-acid stone formation.

Other life styles measures like to limit stress, adequate

physical activity, balancing of excessive fluid loss are helpful

to reduce the risk factors of urolithiasis.

Ashmari (Urolithiasis) is a highly prevalent condition with a

high recurrence rate and it has a large impact on the quality of

life.

The importance of prevention of Urolithiasis in current

medical strategy is significantly decreasing the recurrence rates

by changing life style, work culture, adequate intake of water

and minerals, food habit as per analysis of stone.

But the guidelines given in Ayurveda for prevention of

Ashmari like adopting of proper Sodhana therapy,

Pathyaahara, Jalasevana may be recommended in routine life.

CONCLUSION