Difficult urination or dysuria is a general term referring to disturbances of varied nature in urinary flow and consistency, but by and large this condition represents difficulty in passing urine. Other problems in the urinary system include kidney failure, urinary tract infections, stone in kidney, ureter and urinary bladder, prostate enlargement and impaired bladder control. These problems usually manifest in the form of difficulty in urination, incontinence of urine, retention of urine or abnormally altered amount of urine. Urinary problems may be caused by the following:
- (1)Increasing age: As one gets old; changes appear in the structure and capability of kidneys, ureters, bladder and urethra. These age-related changes tend to bring about disturbances in the production and flow of urine.
- (2) Urinary Infections.
- (3) Urine incontinence: Decrease in the strength of pelvic muscles and bladder sphincters usually associated with age, can cause incontinence, i.e. inability to hold urine.
- (4) Functional damage to kidneys: Any illness or injury to the kidney and other parts of the urinary tract can impair urine formation and proper passing of urine.
- (5) Uncontrolled high blood pressure, diabetes, chronic obstruction in the path of urine and untreated prostate enlargement usually lead to a disturbance in kidney function.
Symptoms of various urinary disorders include frequent urination, particularly at night; burning or difficulty during urination; infrequent urination and presence of blood or any other abnormal component in the urine.
Depending upon the extent and nature of the underlying condition, the following symptoms may be associated with the main urinary disorder indicating failure of renal functions including: loss of appetite, nausea and vomiting, fatigue, puffiness around eyes, swelling of hands and feet, darkening of skin, muscle cramps, high blood pressure, frequent headache, and itching all over the body.
Whatever may be the cause of a urinary disorder, it is always important to treat the symptom. Judicious use of Gokshura, a traditionally used medicinal herb, is effective in successful management of urinary disorders and should be resorted to, in case proper medical facility is not readily available and the patient is not suffering from severe symptoms of urinary disorder.
Gokshura (Tribulus terrestris Linn.)
Gokshura is a prostrate, annual or biennial weed of the pasture lands growing in hot, dry and sandy regions in the rainy season. The herb has natural occurrence but it can be propagated by seeds. The fruits are small, rounded and spiny consisting of five woody chambers, each with many seeds. Harvesting should be done preferably in winter when the properly dried ripe fruits could be preserved to retain potency till the next rainy season. Fruits, roots and the whole plant alone or in combination with other medicinal plants are extensively used in Ayurvedic medicine for the treatment of genito-urinary disorders ranging from difficulty in urination to urinary stones and sexual weakness. Simple and multi-ingredient formulations made of Gokshura are listed in the Ayurvedic Formulary2 and Pharmacopoeia of India and scientific studies have provided enough evidence of its varied usefulness in urinary and other diseases.
The powder and decoction of Gokshura are made from dried ripe fruits or the entire plant.
|English name||Land caltrops, Puncture vine.|
|Latin name||Tribulus terrestris Linn.|
|Parts used||Fruits and whole plant|
Main chemical constituents
Potassium nitrate, sterols, sapogenin, diosgenin, chlorogenin.
Quality standards of Gokshura fruits as per Ayurvedic Pharmacopoeia are based on the following physical constants:
|Foreign matter||Not more than 2%|
|Total ash||Not more than 15%|
|Acid-insoluble ash||Not more than 2%|
|Alcohol-insoluble extractives||Not less than 6%|
|Water-soluble extractives||Not less than 10%|
Microscopically, the fruit shows small epidermal cells in each coccus with rosette of calcium oxalate crystals in abundance.
Method of preparation
Depending upon the duration of treatment take 50 to 100 grams of dried fruits or whole plant harvested not more than one year before. The raw material should be dried further by keeping it in sunlight or in a drier.
Make fine powder in grinder and filter it through a 85 mesh sieve to remove coarse woody particles and fibers. Keep the powder in an airtight glass or plastic food container away from moist surroundings.
Decoction of Gokshura is prepared by boiling 20 to 30 grams of the coarse powder of the raw material in 160 to 240 milliliters water till one fourth liquid remains. Decoction has to be prepared daily and consumed fresh same day.
Fine, pale-coloured powder and straw-coloured decoction.
Gokshura has cooling, diuretic, anti-urolithiatic, styptic, antimicrobial, muscle relaxant, aphrodisiac, emollient, anti-inflammatory and cytoprotective properties.
Dose and mode of administration
The adult dose of Gokshura powder is 3 to 6 grams, twice a day, with water before meals. The dose of decoction for adults is 40 to 50 milliliters and it should be taken lukewarm.
Indications and uses
Gokshura is indicated for burning urination, difficulty in passing urine, decreased urination, urinary crystals and stones, albuminuria, haematuria and spermaturia.
It is useful for improving the urinary function and management of urinary complaints resulting from inflammation, infection, ulceration, calculi and abnormal discharge.
Benign prostate enlargement and erectile dysfunction are the other indications where Gokshura alone or in combination with other medicinal herbs is used.
Precautions and safety aspects
- (1) Gokshura is conventionally regarded as safe. No side effects or toxic symptoms and contraindications are reported in Ayurvedic literature. However, in experimental studies seeds of the plant are found to be toxic to the liver of rats. Therefore, patients with liver dysfunction should use Gokshura without seeds and continue medication under medical supervision.
- (2) As Gokshura is cooling in nature and the indicated urinary disorders result from predominance of dry and hot contents in urinary system, it is always advisable to avoid during medication alcoholic beverages and diet rich in spicy, pungent, sour, acidic, hot and dry food items. Indulgence in aggression, anger, furious states of mind and suppression of natural urges of urination, passing stools and flatus should be avoided.
- (3) Simple, soft, digestible and liquid-rich diet is recommended while suffering from and medicating for urinary disorder. Old rice, barley, butter-milk, pumpkin and aloe are useful articles of diet for patients of urinary disorder.
- (4) Patients suffering from urinary disorder should abstain from strenuous exertion, excessive thirst and frequent sexual intercourse.
- (5) Severe urinary symptoms with presence of pus and blood in the urine and inability to urinate should be properly treated under medical advice. If the patient’s symptoms get aggravated or do not respond, medication with Gokshura may be stopped and medical advice should be sought.
- (6) Urinary symptoms usually worsen, if constipation is concomitantly present. In such cases due care should be taken to treat constipation with modification in diet or with the use of a soft, lubricating laxative.
- (7) The symptoms of urinary disease may mimic other medical conditions. Therefore, if empirical treatment with a given formulation fails, it is always advisable to consult medical expert for diagnosis and proper management
- (8) Use of Gokshura is safe during pregnancy and lactation.
- (1) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. I. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2001. p. 40.
- (2) India, Ministry of Health and Family Welfare. The Ayurvedic formulary of India. Part I. 2nd revised English edition. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2003. p. 67, 68.
- (3) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 229-230, 232.
- (4) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 229-230.
- (5) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 232.
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Source: Traditional Herbal Remedies for Primary Health Care - WHO