WhatsApp Discussion Series 42: "Shayya-mootratvam"(enuresis) by Dr Praveen Mandikoda, Dr. Deepmala, Dr. Mohit Arora, Dr. Anita Gayatri, Dr. Kirti Sachdeva & Others.
[7/24,9:01 PM]Sachdeva Dr. Kirti:
Respected teachers ! plz guide for nocturnal enuresis at the age of 9 yr old boy.
[7/24,11:27PM]Praveen Medi Dr:
We have some excellent approaches for the management of ENURESIS in Ayurveda
1. BIMBI MULA SWARASA is
mentioned in the context of Enuresis.
2. We can at least try to add more kunduru as a dietary supplementation for such kids........... I hav the experience of saying that kunduru as a Dietary supplement helped to reduce the frequency of Enuresis.
3. Satavari gritam orally and as a matra -vasti also helps in the same fashion.
4. Pinyaka ( tila powder after extracting oil portion) is a best rukshana dravya and it can be tried for its anti-diuretic measure.
5. Abhyanga, Swedana Matra vasti ( 20 ml of Tila taila + 20 ml of Ghee )which we very frequently do at our Panchakarma center hav grater result for enuresis than imipramine.
6. เคुเคเคเคค्เคตเค् เคถ्เคฒेเคท्เคฎเคชिเคค्เคคเคฐเค्เคคเคธाเค्เค्เคฐाเคนिเคोเคชเคถोเคทเคฃाเคจां ........... (Ref. Cha sut. 25)
Upashoshaka is very important quality of Kutaja...... which is nothing less than Anti-diuretic effect. Slightly lesser than ADH – desmopressin, but obviously with no side effects at all.
7. Mutra sangrahaniya kashaya ausadhi should be administered (charaka sutra 4)
8. Some times principles of prameha chikista also applicable
9. Medications for Enuresis sud be given before food. Apane vigune purve.
In apana vata vikruti ausadha kala is before food.
[7/24, 11:30 PM] Dr. Surendra A. Soni:
Exellent ! praveen sir !!
[7/24, 11:35 PM] Ravi Nagpal Dr:
Respected gurujans some Ayurvedic physicians prescribe Tarkeshwar ras in nocturnal enuresis.It has some indication or not....?
[7/24, 11:39 PM] Dr. Surendra A. Soni:
Already praveen sir has replied very well. I want to know that what did you find cause if any like krimi, fast food habits or UTI or other fever history.
We may say it is a kind of mutravah sroto shaithilya.
You can use tab bangashila of alarsin, dashmool kwath, mukta shukti, Vang bhasma etc with is easily available.
If specific cause is there, treat as per that.
[7/24,11:42PM]Haresh Soni Dr. :
Tab. Neo also found effective.
[7/24, 11:44 PM] Sachdeva Dr. Kirti:
Yes Sir, krimi I suspected, uti, constipation not present, not excessively eating fast food normal taken diet.
[7/24, 11:45 PM] Sachdeva Dr. Kirti:
I have given krimi kuthar ras, tab neo and anti worm syrup
[7/24, 11:46 PM] Dr. Surendra A. Soni:
One of my relative used to say that
*"เคเคธे เคฌเค्เคे เคธे เคเค เค เคฌैเค เค เคฒเคเคตाเคจा เคถुเคฐू เคเคฐ เคฆो เคเคธเคी เคเคฆเคค เคूเค เคाเคเคी ।"*
I think this is also a type of exercise to improve strength in the body.
[7/24, 11:47 PM] Sachdeva Dr. Kirti GSI:
But I want to discuss what can be reason behind this at this age and what type of diagnosis we can use to rule out further complications.
[7/24, 11:48 PM] Priy-ranjan Tiwari Dr.:
tab neo very good along with bangsheel
[7/24, 11:48 PM] Haresh Soni Dr.:
Yes, it's good exercise for pelvic muscles.... Can be useful.
[7/24, 11:50 PM] Dr. Surendra A. Soni:
1. Fear/psychological problem.
2. Prameha like santarpan.
3. Dourbalya/shaithilya.
4. Established GI or US diseases.
[7/24, 11:50 PM] Sachdeva Dr. Kirti:
In one of the literature I have studied that in such case, advise patient to control urine during day time for a short period of time.
[7/24, 11:51 PM] Dr. Surendra A. Soni:
Not advisable as per Ayurved.
Yoga pranayam are more helpful.
[7/24, 11:57 PM] Praveen Medi Dr:
'Sayya Mutra' is not a disease entity as such.
It should be considered as 'Apana-vata vikruthi'
The best measure from a panchakarma aspect is to strengthen the neuro-muscular aspects of pelvis, which is served by Matra vasti with satavari grita
Or Taila+Grita ( Yamaka vasti ) as we get good control over vata by these simple measures.
Rest of the medicines as per the suggestions Soni sir are very much practical.
[7/25, 12:00 AM] Sachdeva Dr. Kirti:
Thank u Sir !
[7/25, 6:48 AM] Dr Mohit Arora Ludhiana:
The purpose of trying to stop urine is to pull the pelvic-perinium muscles to tone it, called the 'Kegel's exercise'.
But as per Ayurveda, it's vegavrodha.
Thus, I recommend Kegel's exercise on empty stomach after morning defecation, and have found it very effective in enuresis, PME, incontinence in women and BPH.
[7/25, 6:50 AM] Dr Mohit Arora Ludhiana:
http://www.webmd.com/urinary-incontinence-oab/kegel-exercises-treating-male-urinary-incontinence.
[7/25, 6:57 AM] Sachdeva Dr. Kirti:
Thank u Sir
[7/25, 7:57 AM] Samta Tomar Dr Jmngr:
Kids with insecure feelings are the victim eneuresis , it is psychological disease. if we , parents give them joyful and blissful ambience , they r able to over cum. Aashwasan chikitsa.
[7/25, 7:59 AM] Samta Tomar Dr Jmngr:
Level is also prescribed in pregnancy, similar to ashwinikriya in yoga therapy.
[7/25, 8:10 AM] Arvind Aggarwal Dr.:
Yes sir ! ... It's a type of apaan vayu dushti and possible measures to cure it may be beneficial.
[7/25, 8:19 AM] Dr Bhadresh Nayak, Surat:
Many times physiological conditions
Fear
Night mare's
Over protection
Stress of school
Create problem
Counseling
Auto suggestions
Ask the question y like it
Where everyone do urinal
You do in bed it's good or bed
Don't talk every body about the problem in front of child
Put alarm clock in mignight time to wake up.
[7/25, 8:29 AM] Dr Rupesh Vadher Junagadh:
Exactly Sir
เคจเคตेเคाเคจ्เคจเคงाเคฐเคฏेเคค् by charak says
เคฌเคธ्เคคि เคช्เคฐเคฏोเค &
เค เคตเคชिเคกเค (เคृเคคเคชाเคจ) !
[7/25, 9:29 AM] Anita Gaytri Dr. DG:
Kegel exercises need not be done while voiding urine. They can be done anytime, anywhere. That way, we will not be going against our principle of vegavarodha.
[7/25, 9:31 AM] Dr Bhadresh Nayak, Surat:
Very true
It's vajroli Pranayam to strength the muscles and PMA
[7/25, 9:34 AM] Anita Gaytri Dr. DG:
Knowledge should be gained from everywhere.
[7/25, 9:35 AM] Dr Bhadresh Nayak, Surat:
According to charak every physian have a developped skills
By tadvidhsambhasa
By reading
Seminar and uplifting the satva of self
We cannot doubt to Acharya.
[7/25, 9:35 AM] Anita Gaytri Dr.:
Very true, Psychological counseling and changing the routine and diet help a lot. Like advising not to ingest any fluids after 7.30 pm.
[7/25, 9:41 AM] Anita Gaytri Dr.:
We should accept modern diagnostic procedures and modern principles to strengthen our ayurvedic principles.
[7/25, 9:42 AM] Dr Bhadresh Nayak, Surat:
Of course
But treatment must be based on ayurvedic Etiology !
[7/25, 9:46 AM] Anita Gaytri Dr. DG:
Yes, very true.
[7/25, 11:09 AM] Praveen Medi Dr: sure sir ...
[7/25, 11:21 AM] pawan madan Dr:
After considering all causes like Psychological etc....I observed that krimi is the most imp cause and in almost 99% of cases respond to krimihar chikitsaa even after doing lifestyle changes and aahwaasan etc.
Please use krimihar chikitsa in all cases of shyiaamutra......it wont let u down.
[7/25, 11:34 AM] Dr. Surendra A. Soni:
Blood sugar must be done to rule out juvenile diabetes.
If you remember a case shared in AP where ultimately the child was diagnosed as JDM case.
Pawan Sir !!
[7/25, 11:53 AM] Dr. Mamta bhagwt:
Very aptly mentioned. In juvenile age, simple krimi chikitsa treats maximum conditions rather than going *big Tara* and *big Tama* !
[7/25, 11:53 AM] Dr. mamta bhagwt :
Blood sugar !! Very important point to be investigated.
[7/25, 12:06 PM] Sachdeva Dr. Kirti:
thank u Sir
[7/25, 12:32 PM] Dr. Anupma Patra:
Sir apana vaayu vikriti is also a disease condition.
[7/25, 12:41 PM] Praveen Medi Dr:
What exactly I mean to say is, we need only Dosha-pratyaneeka chikista in the form of Vasti.
[7/25, 12:44 PM] pawan madan Dr:
Ji sir.
True....
[7/25, 1:00 PM] Dr deepmala:
Almost all the causes and management of Shayyamutrata is being discussed here very well. few things can be added about Ashwasana chikitsa such as.....
1.parents should stop comparing child with his/her sibling about bed wetting.
2. Every night... One extra bedsheet and one pair of his/her clothes should b kept at his pillow side & instruct him to change the bedsheet or clothes himself if he voids... no need to call the parents.
3. A calendar should b maintained by tic ✅ marks whenever child doesn't void ....at the month appreciate the child for tics and motivate and reassure more tics to achieve for next month.
4. Some medhya drugs such as brahmi,shankhpushpi, ashwagandha etc.should b added in prescription. It's helpful as in improving psyche as well as conditions related to neurogenic bladder also.
[7/25, 1:07 PM] pawan madan Dr:
Second point may work adversly.
Third point also not works well.....tries many times.
[7/25, 1:26 PM] Samta Tomar Dr:
Practitioners aproach and behavioral therapy alter his perception about
eneuresis.
[7/26, 7:08 PM] Dr. Surendra A. Soni:
Baishajya ratnavali mentions in *เคฌเคนुเคฎूเคค्เคฐाเคงिเคाเคฐ*. I didnt use it. I have used bahumutrantak ras in geriatric patient with great results (means cure). It contains Ahiphena, so related care should be taken.
Dr Ravi Nagpal ji !
[7/26, 7:37 PM] Anju Navale Dr:
In My experience I have found that the child gets exhausted day through and if he doesn't take rest,or sleep he is unable to tell at night about the Vega.
So best thing I recommend is.....
1)see that he takes proper diet and sleep.( now a days due to studies,TV and mobile child is stressed but does not understand because he is getting joy through entertainment,this leads to lack of sleep).
2)Mother should see that the child goes to washroom and then sleep.
3)Put an alarm at midnight as many a times may be d child shows expressions of going for urination but the parents are in deep sleep and so the child is left unattended.
4)throw away the special mattress made for him to urinate at night.Parents usually keep a bedding to get spoiled. this way the thought will always persists in child and he won't be able to forget that he doesn't spoil the mattress.
5)change his undergarments if have been spoiled.(because if d same smell persists he will again recall his habit).
6)always keep him dry and fresh.
7)use warm clothes and do daily abhyanga.
It takes 10-15 consecutive days of great efforts to not let him spoil his bed,later this habbit goes away.
Rest medicines as suggested by eminent vaidyas.
Moreover I being a mother will never support a harsh behaviour of giving punishment or making the child change his bed as I believe in being human.
Aur pyar SE jab koi cheej ho Sakti hai to dand dekar kyu?
It's my opinion.
Respected teachers ! plz guide for nocturnal enuresis at the age of 9 yr old boy.
[7/24,11:27PM]Praveen Medi Dr:
We have some excellent approaches for the management of ENURESIS in Ayurveda
1. BIMBI MULA SWARASA is
mentioned in the context of Enuresis.
2. We can at least try to add more kunduru as a dietary supplementation for such kids........... I hav the experience of saying that kunduru as a Dietary supplement helped to reduce the frequency of Enuresis.
3. Satavari gritam orally and as a matra -vasti also helps in the same fashion.
4. Pinyaka ( tila powder after extracting oil portion) is a best rukshana dravya and it can be tried for its anti-diuretic measure.
5. Abhyanga, Swedana Matra vasti ( 20 ml of Tila taila + 20 ml of Ghee )which we very frequently do at our Panchakarma center hav grater result for enuresis than imipramine.
6. เคुเคเคเคค्เคตเค् เคถ्เคฒेเคท्เคฎเคชिเคค्เคคเคฐเค्เคคเคธाเค्เค्เคฐाเคนिเคोเคชเคถोเคทเคฃाเคจां ........... (Ref. Cha sut. 25)
Upashoshaka is very important quality of Kutaja...... which is nothing less than Anti-diuretic effect. Slightly lesser than ADH – desmopressin, but obviously with no side effects at all.
7. Mutra sangrahaniya kashaya ausadhi should be administered (charaka sutra 4)
8. Some times principles of prameha chikista also applicable
9. Medications for Enuresis sud be given before food. Apane vigune purve.
In apana vata vikruti ausadha kala is before food.
[7/24, 11:30 PM] Dr. Surendra A. Soni:
Exellent ! praveen sir !!
[7/24, 11:35 PM] Ravi Nagpal Dr:
Respected gurujans some Ayurvedic physicians prescribe Tarkeshwar ras in nocturnal enuresis.It has some indication or not....?
[7/24, 11:39 PM] Dr. Surendra A. Soni:
Already praveen sir has replied very well. I want to know that what did you find cause if any like krimi, fast food habits or UTI or other fever history.
We may say it is a kind of mutravah sroto shaithilya.
You can use tab bangashila of alarsin, dashmool kwath, mukta shukti, Vang bhasma etc with is easily available.
If specific cause is there, treat as per that.
[7/24,11:42PM]Haresh Soni Dr. :
Tab. Neo also found effective.
[7/24, 11:44 PM] Sachdeva Dr. Kirti:
Yes Sir, krimi I suspected, uti, constipation not present, not excessively eating fast food normal taken diet.
[7/24, 11:45 PM] Sachdeva Dr. Kirti:
I have given krimi kuthar ras, tab neo and anti worm syrup
[7/24, 11:46 PM] Dr. Surendra A. Soni:
One of my relative used to say that
*"เคเคธे เคฌเค्เคे เคธे เคเค เค เคฌैเค เค เคฒเคเคตाเคจा เคถुเคฐू เคเคฐ เคฆो เคเคธเคी เคเคฆเคค เคूเค เคाเคเคी ।"*
I think this is also a type of exercise to improve strength in the body.
[7/24, 11:47 PM] Sachdeva Dr. Kirti GSI:
But I want to discuss what can be reason behind this at this age and what type of diagnosis we can use to rule out further complications.
[7/24, 11:48 PM] Priy-ranjan Tiwari Dr.:
tab neo very good along with bangsheel
[7/24, 11:48 PM] Haresh Soni Dr.:
Yes, it's good exercise for pelvic muscles.... Can be useful.
[7/24, 11:50 PM] Dr. Surendra A. Soni:
1. Fear/psychological problem.
2. Prameha like santarpan.
3. Dourbalya/shaithilya.
4. Established GI or US diseases.
[7/24, 11:50 PM] Sachdeva Dr. Kirti:
In one of the literature I have studied that in such case, advise patient to control urine during day time for a short period of time.
[7/24, 11:51 PM] Dr. Surendra A. Soni:
Not advisable as per Ayurved.
Yoga pranayam are more helpful.
[7/24, 11:57 PM] Praveen Medi Dr:
'Sayya Mutra' is not a disease entity as such.
It should be considered as 'Apana-vata vikruthi'
The best measure from a panchakarma aspect is to strengthen the neuro-muscular aspects of pelvis, which is served by Matra vasti with satavari grita
Or Taila+Grita ( Yamaka vasti ) as we get good control over vata by these simple measures.
Rest of the medicines as per the suggestions Soni sir are very much practical.
[7/25, 12:00 AM] Sachdeva Dr. Kirti:
Thank u Sir !
[7/25, 6:48 AM] Dr Mohit Arora Ludhiana:
The purpose of trying to stop urine is to pull the pelvic-perinium muscles to tone it, called the 'Kegel's exercise'.
But as per Ayurveda, it's vegavrodha.
Thus, I recommend Kegel's exercise on empty stomach after morning defecation, and have found it very effective in enuresis, PME, incontinence in women and BPH.
[7/25, 6:50 AM] Dr Mohit Arora Ludhiana:
http://www.webmd.com/urinary-incontinence-oab/kegel-exercises-treating-male-urinary-incontinence.
[7/25, 6:57 AM] Sachdeva Dr. Kirti:
Thank u Sir
[7/25, 7:57 AM] Samta Tomar Dr Jmngr:
Kids with insecure feelings are the victim eneuresis , it is psychological disease. if we , parents give them joyful and blissful ambience , they r able to over cum. Aashwasan chikitsa.
[7/25, 7:59 AM] Samta Tomar Dr Jmngr:
Level is also prescribed in pregnancy, similar to ashwinikriya in yoga therapy.
[7/25, 8:10 AM] Arvind Aggarwal Dr.:
Yes sir ! ... It's a type of apaan vayu dushti and possible measures to cure it may be beneficial.
[7/25, 8:19 AM] Dr Bhadresh Nayak, Surat:
Many times physiological conditions
Fear
Night mare's
Over protection
Stress of school
Create problem
Counseling
Auto suggestions
Ask the question y like it
Where everyone do urinal
You do in bed it's good or bed
Don't talk every body about the problem in front of child
Put alarm clock in mignight time to wake up.
[7/25, 8:29 AM] Dr Rupesh Vadher Junagadh:
Exactly Sir
เคจเคตेเคाเคจ्เคจเคงाเคฐเคฏेเคค् by charak says
เคฌเคธ्เคคि เคช्เคฐเคฏोเค &
เค เคตเคชिเคกเค (เคृเคคเคชाเคจ) !
[7/25, 9:29 AM] Anita Gaytri Dr. DG:
Kegel exercises need not be done while voiding urine. They can be done anytime, anywhere. That way, we will not be going against our principle of vegavarodha.
[7/25, 9:31 AM] Dr Bhadresh Nayak, Surat:
Very true
It's vajroli Pranayam to strength the muscles and PMA
[7/25, 9:34 AM] Anita Gaytri Dr. DG:
Knowledge should be gained from everywhere.
[7/25, 9:35 AM] Dr Bhadresh Nayak, Surat:
According to charak every physian have a developped skills
By tadvidhsambhasa
By reading
Seminar and uplifting the satva of self
We cannot doubt to Acharya.
[7/25, 9:35 AM] Anita Gaytri Dr.:
Very true, Psychological counseling and changing the routine and diet help a lot. Like advising not to ingest any fluids after 7.30 pm.
[7/25, 9:41 AM] Anita Gaytri Dr.:
We should accept modern diagnostic procedures and modern principles to strengthen our ayurvedic principles.
[7/25, 9:42 AM] Dr Bhadresh Nayak, Surat:
Of course
But treatment must be based on ayurvedic Etiology !
[7/25, 9:46 AM] Anita Gaytri Dr. DG:
Yes, very true.
[7/25, 11:09 AM] Praveen Medi Dr: sure sir ...
[7/25, 11:21 AM] pawan madan Dr:
After considering all causes like Psychological etc....I observed that krimi is the most imp cause and in almost 99% of cases respond to krimihar chikitsaa even after doing lifestyle changes and aahwaasan etc.
Please use krimihar chikitsa in all cases of shyiaamutra......it wont let u down.
[7/25, 11:34 AM] Dr. Surendra A. Soni:
Blood sugar must be done to rule out juvenile diabetes.
If you remember a case shared in AP where ultimately the child was diagnosed as JDM case.
Pawan Sir !!
[7/25, 11:53 AM] Dr. Mamta bhagwt:
Very aptly mentioned. In juvenile age, simple krimi chikitsa treats maximum conditions rather than going *big Tara* and *big Tama* !
[7/25, 11:53 AM] Dr. mamta bhagwt :
Blood sugar !! Very important point to be investigated.
[7/25, 12:06 PM] Sachdeva Dr. Kirti:
thank u Sir
[7/25, 12:32 PM] Dr. Anupma Patra:
Sir apana vaayu vikriti is also a disease condition.
[7/25, 12:41 PM] Praveen Medi Dr:
What exactly I mean to say is, we need only Dosha-pratyaneeka chikista in the form of Vasti.
[7/25, 12:44 PM] pawan madan Dr:
Ji sir.
True....
[7/25, 1:00 PM] Dr deepmala:
Almost all the causes and management of Shayyamutrata is being discussed here very well. few things can be added about Ashwasana chikitsa such as.....
1.parents should stop comparing child with his/her sibling about bed wetting.
2. Every night... One extra bedsheet and one pair of his/her clothes should b kept at his pillow side & instruct him to change the bedsheet or clothes himself if he voids... no need to call the parents.
3. A calendar should b maintained by tic ✅ marks whenever child doesn't void ....at the month appreciate the child for tics and motivate and reassure more tics to achieve for next month.
4. Some medhya drugs such as brahmi,shankhpushpi, ashwagandha etc.should b added in prescription. It's helpful as in improving psyche as well as conditions related to neurogenic bladder also.
[7/25, 1:07 PM] pawan madan Dr:
Second point may work adversly.
Third point also not works well.....tries many times.
[7/25, 1:26 PM] Samta Tomar Dr:
Practitioners aproach and behavioral therapy alter his perception about
eneuresis.
[7/26, 7:08 PM] Dr. Surendra A. Soni:
Baishajya ratnavali mentions in *เคฌเคนुเคฎूเคค्เคฐाเคงिเคाเคฐ*. I didnt use it. I have used bahumutrantak ras in geriatric patient with great results (means cure). It contains Ahiphena, so related care should be taken.
Dr Ravi Nagpal ji !
[7/26, 7:37 PM] Anju Navale Dr:
In My experience I have found that the child gets exhausted day through and if he doesn't take rest,or sleep he is unable to tell at night about the Vega.
So best thing I recommend is.....
1)see that he takes proper diet and sleep.( now a days due to studies,TV and mobile child is stressed but does not understand because he is getting joy through entertainment,this leads to lack of sleep).
2)Mother should see that the child goes to washroom and then sleep.
3)Put an alarm at midnight as many a times may be d child shows expressions of going for urination but the parents are in deep sleep and so the child is left unattended.
4)throw away the special mattress made for him to urinate at night.Parents usually keep a bedding to get spoiled. this way the thought will always persists in child and he won't be able to forget that he doesn't spoil the mattress.
5)change his undergarments if have been spoiled.(because if d same smell persists he will again recall his habit).
6)always keep him dry and fresh.
7)use warm clothes and do daily abhyanga.
It takes 10-15 consecutive days of great efforts to not let him spoil his bed,later this habbit goes away.
Rest medicines as suggested by eminent vaidyas.
Moreover I being a mother will never support a harsh behaviour of giving punishment or making the child change his bed as I believe in being human.
Aur pyar SE jab koi cheej ho Sakti hai to dand dekar kyu?
It's my opinion.
*******************************************************************************************************************************
Above discussion held on 'Kaysampraday" a Famous WhatsApp discussion group of well known Vaidyas from all over the India.
Compiled & edited by
Dr.Surendra A. Soni
M.D.,PhD (KC)
Associate Professor
Dept. of Kaya-chikitsa
Govt. Ayurveda College
Vadodara Gujarat, India.
Email: surendraasoni@gmail.com
Mobile No. +91 9408441150
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