शनिवार, 5 नवंबर 2011

शैय्या मुत्र,Shayya Muthra/ Bedwetting/ Enuresis Ayurveda management.

   Bed wetting is a condition usually seen in children. It is defined as; if a child urinates in bed even after the age of 5 then it is called as enuresis.
            There are mainly two types of Enuresis.
1.Primary or involuntary
2.Secondary or Voluntary
 
Primary enuresis is a condition where a child continues bedwetting even after the age of five.

Secondary enuresis is a condition where the child stops bedwetting at certain age for at least 6 months and once again starts bedwetting abruptly.

The main cause for primary bedwetting is inability to hold urine in urinary bladder may be due to lack of elasticity, some problem in reflex action, or delay in getting the proper sensation of urination due to minor neurological problem, and many times exact cause is not known. This condition many times seen in members of same family, so genetic cause should also be considered.

Secondary enuresis is very rare condition and the main cause is due to psychological shock. The common cause is like daily quarrelling between parents, death of parent etc. Here bedwetting is always done knowingly and the child behaves like as if he/she knows nothing.

The main problem in primary enuresis is, most of the times this continues even after the age of 10 and the child urinates unknowingly but suffers a lot psychologically. This becomes a social problem and child becomes introverted, avoids mingling with people and avoids going for tour etc due to fear of enuresis. In Allopathy there is no definite remedy for Shayyamuthra.

In Ukkinadkas Ayurveda:
Here we consider the main treatment for primary enuresis. Secondary enuresis is a very rare condition and counseling is the best available treatment along with Ayurveda herbal preparation having Jatamamsi, Brahmi, Vacha etc.
For Primary Enuresis:
Regimen:
1. Ask the child to hold the urine as far as possible in day time. This helps to increase the elastisity of the urinary bladder.
2. Ask the patient to take more fluids in morning hours and less in evening hours.
3. Ask the patient to go for urination just before going to bed, everyday. If possible child should be woke up in midnight and should be asked to urinate during initial few weeks of treatment.
4. Avoid all spicy, deep fried and oily foods.
The above diet and regiment helps a lot in relieving bedwetting very fast.
Medicines: 
Chandanasava Saraswatharista- mix these two preparation, dose is 15ml twice daily up to the age of 12, above 12 yrs of age 20 ml twice daily T. Agnitundi vati- 50mg tablet should be given twice daily. This dose is from age 5 to 18. T. Chandraprabha vati 250mg half bid till age of 12 later 1 bid can be given. Here we can also consider many other preparation as per the need. But in Ukkinadkas Ayurveda this is the best acting combination in use, where we can expect result within 3 months. We have many such cases that got relieved of symptoms within 3 months and in some needed treatment for more than 6 months.
Here Saraswathisrasta is considered to treat the possible neurological problem and defective reflex action.

Agnitundi to treat defective reflex action. Agnitundi is a wonder drug to treat any condition where involuntary reflex is defective. Other than the classical indication we also use this tablet in GERD and incontinence of urine especially in females where weak reflex action is the cause once again for symptoms.

When we use agnitundi in children we should be very cautious regarding the dosage, because 50% of it contains KUPILU, which is highly poisonous. Fatal dosage of unpurified kupilu is 1.3g for healthy adults. Here we use this tablet in children of usually 20-30kg range, so we have to reduce the dosage by three times than adult dosage.
50mg Agnitundi contains 25mg kupilu, So in bid dose 50mg Kupilu, fatal dose for children is around 500mg. So fatal dose of agnitundi for children in terms of nonpurified kupilu is 20 tablets per day, because we don’t know the fatal dose of purified Kupilu. We in Ukkinadkas Ayurveda prepare Agnitundi of 50mg and our adult dose is 1 tid, which gives excellent action. But most of the company prepare Agnitundi of 150 to 250 mg so be cautious regarding the dosage.





Just use vidangasav 2 to 4 tsf twice a day
frequency of bedwetting wil decrease in just 15 days.






*In ayurveda,known as 'शय्या मूत्र' and causes include: worm infestation,weakness of the muscle of the bladder
*the later the onset of wetting,the more likely the cause due to
psycological stress.
*go for urine analysis for uti, and specific gravity;check bowel habits
*ent:for adenoids
*x-ray/scan of kidney/bladder
*consider:pt.age,developmental milestone,family milestone,child rearing
*limit fluid interval at night,empty bladder before bed time,talk about any fear,worry,anxiety,take diet of green vegetables with vitamins,zinc/mg
*drugs prescribed are:chandraprabha vati,badam rogan,krimi mrigdar,vidanga loha,kukutand twak bhasam,till ki gajak
**latest journal states
delayed functional maturation of the CNS which reduces the child's ability to inhibit bladder emptying at night

best treatment is use tab neo of charak pharmacy 1 tab bid or as wt of patient


 
Watch my video on Shayyamutra(Bed wetting/Enuresis). Though it is in Telugu language, You May understand the drugs and composition which are shown in this video.Drugs explained in this video for preparation of medicine as follows 1)Jatamamsi 2) Mustha(Nagarmotha) 3) Usthekhuddhus (Known as Same in Hindi) 4) Gum acasia(Gondh) All are taken equal quantity.Powdered separately then mixed together.Add equal or sufficient honey and stored in glass container keep it for 4-7 days.Dose:Children below 6 yrs 1/4 tea spoon and 6 yrs above 1/2 to1 tea spoon.Before food twice day.Till results achieved.http://www.youtube.com/watch?v=HjX2vNA6QDc