All About Ayurvedic Approach To Prameha Or Urinary Disorders

According to Ayurveda Prameha is derived from the Sanskrit root word ‘mih skharane’ that means to water. The prefix Pra refers to excess and Meha literally means increased passing of urine. So Prameha can be translated as excess urine both in frequency and quantity.

Prameha in Ayurveda is similar to diabetes and Prameha vyadhi/roga (diseases) are largely urinary disorders. Prameha vyadhi/roga are not just limited to the urinary tract but also affect other bodily functions such as circulatory, endocrinal, lymphatic and gastrointestinal among others.

• Pathogenesis or Samprapti of Prameha

Prameha vyadhi develop due to imbalances of the tridoshas (Vata, pitta & Kapha) but are mainly Kapha dosha related. Also, dushyas such as meda, rakta, shukra, ambu, vasa, lasika, majja, rasa, ojas and mamsa in mutravaha srotas or urinary system also manifest into 20 types of Prameha.

Fluctuations (increase or decrease) in the ratio of combinations of doshas, dhatus (body tissues), mala (waste matter) and ahara (diet) in the body are the main factors that lead to the development of Prameha.

• Types of Prameha and their Clinical Features

Both Acharya Charak and Acharya Sushrut have stated in ancient Ayurvedic medical texts that there are overall 20 types of Prameha roga. They are further divided as per the three doshas.

10 types of Kaphaja Prameha (early diabetes) are Sadhya Prameha which means they are curable.

• Udak meha – urine is similar to water (udakopama), excess (bahu), transparent (accha), cold (sheeta), odurless (nirgandha), white (sita), slimy (picchila) and murky (avila)
• Ikshuvalikarasa meha – very sweet urine resembling sugarcane juice, slimy and murky in nature
• Sandrameha – urine is dense
• Sandraprasad/sura meha – Low density urine with transparent upper layer
• Shukla meha – whitish rice flour like urine
• Shita meha – white urine with excessively cold touch
• Shukra meha – urine appears like semen or containing seminal fluid
• Sikata meha – urine that contains sand like substance
• Shanairh meha – urine that passes very slowly with difficulty
• Alala meha – urine containing slimy material like saliva

6 Types of Pittaja Prameha (acute diabetes) are Yapya Prameha meaning they are controllable due to inconsistencies in line of treatment.

• Ksharmeha – urine that has color, odur, texture and taste of alkaline solutions
• Nilameha – urine that is blue in color
• Manjishtha Meha – Manjishtha is an herb that gives a red color juice. The urine in this type has a bad smell and reddish color
• Kala Meha – black color urine in large quantities that resembles coal
• Rakta Meha – urine that has the color and smell of blood (rakta)
• Haridra Meha – the urine in this type of Prameha is Katu (pungent), darkish yellow in color similar to haldi/turmeric and gives a burning sensation while passing

4 types of Vataja Prameha (chronic diabetes) are termed Asadhya or incurable as not only do they exhibit severe complications but also due to the variety and presence of antagonists – substances that stops the action or effect of another substance – in the treatments.

• Vasa Meha – repeated passing of urine which appears murky and slimy
• Majja Meha – the urine appearance is similar to marrow with frequent excretion
• Hastimeha – urine is passed without force but in some cases lymph with clots may be found
• Lasikameha – urine mixed with lymph

According to Acharya Vagabhata Pramehas are a serious condition and if not treated timely and properly can ultimately lead to Madhumeha or chronic insulin dependent type II diabetes.

Upadrava or Complications of Prameha

Complications of Prameha include

• Thirst or thrishna
• Diarrhea or atisara
• Fever or jwara
• Weakness or dourbalya
• Anorexia or aruchi
• Indigestion or avipaka
• Development of Prameha Pidakas or diabetic blisters or boils
• Cellulitis or Alaji
• Abscess or vidhradhi
• Cardiac pain or hrit shola

• Causes of Urinary Disorder

According to Ayurveda some general causes of urinary disorders include

Excessive eating (asyasukha), having a diet that aggravates the kapha dosha (kaphakara ahara), consumption of curd (dadhi), extra sleep (swapnasukha), eating sweet jaggery products (gudavikriti), extra consumption of milk and its products (payamsi), lack of exercise (avyayama), laziness (alasya) earign meat of marshy & aquatic animals, consuming new grains (navaana), including stale, oily, too sweet food products in the diet (sheeta, snighdha, Madhura ahara) etc.

These general factors aggravate the Kapha dosha and it affects the functioning of medas (fat), mamsa (flesh), udaka (endocrinal secretions) as well as the dhatus (body tissues are driven towards the urinary tract) and digestive fire/agni resulting in Prameha.

Some other serious causes of urinary disorders are

• Pitta dosha imbalance in the body giving a burning sensation while passing urine
• Stones or infection in the genito-urinary tract which can lead to Haematuria or adhoga raktapitta meaning blood in urine
• E.coli bacteria which are common causes of UTI (urinary tract infections)
• Bacterial infections that cause Prostatitis or inflammation of prostate gland which leads to frequent urination, pain in the lower genital area
• Improper functioning of the kidneys which can result in abnormal amount of protein in the urine known as proteinuria
• Other known causes of urinary disorders include aging, illness, congenital disorders or injury. Reduced strength of muscles of the sphincters and pelvis can cause incontinence

• Prameha Chikitsa

Prameha Chikitsa includes a variety of treatments for Prameha or urinary disorders

Therapies –

Samshamana/alleviation, samshodhana/elimination, santarpana/energizing, samshodhana/cleansing, ropana/healing

Ayurveda prescribed diet habits –

Indian gooseberry (amla/amalaka), drumsticks (shigru), snake gourd (patola), barley (yava), horse gram (kulith/kulattha), bitter gourd (karela), turmeric (haridra), green gram (moong), garlic (lashuna), blueberry (jambu), wheat (godhuma), pepper (maricha) etc.

Ayurvedic herbs –

haridra, amalaki, udumbara, jambu, haritaki, gudduchi, guggulu, meshashringi, lodhra, nimba, ashwattha, gokshura, manjishtha, durva etc.

Read more about Prameha, Prameha Purvarupa and its connection with Madhumeha or diabetes mellitus here

Ayurvedic health care classifies Prameha or diabetes as a lifestyle disease and recommends a regulated diet and lifestyle as supplements to prescribed medicines (from an expert Ayurvedic doctor) to control the disease. Make an appointment for an ayurvedic consultation with an experienced Ayurvedic Vaidya to help you successfully overcome Prameha and urinary disorders to lead a long, healthy and happy life.