SHAYYAMUTRA (NOCTURNAL ENURESIS) IN CHILDREN: AN AYURVEDIC REVIEW

Background: Shayyamutra also known as nocturnal enuresis is a common pediatric condition that is characterised by involuntary urination at night after the developmental age at which the bladder is supposed to be in control. Whereas it is not characterized by obvious physical impairment, the condition has a considerable influence on the psychological well-being and social growth. The Ayurvedic terminology refers to this condition as a symptom of Kapha avarita avarita apana vata which are predisposed by the contributory manasika factors. Objective: To critically examine Shayyamutra based on Ayurvedic classical Ayurvedic concepts and match it to the modern pediatric insights on enuresis with an aim of developing an integrative management strategy. Methods: The classical Ayurvedic texts and modern literature on the topic of pediatric enuresis were systemic in review and synthesise to clarify the etiological factors, pathophysiological processes and treatment plans. Results: Avarita apana vata dysfunction, kapha avarana, and maladjusted neurological maturation concepts in Ayurveda have strong similarities with the current pathophysiological processes, such as delayed bladder control, unregulated secretion of antidiuretic hormone, and sleep arousal dysregulation. Multidimensional treatment plan that includes medhya rasayana, Panchakarma, behavioural therapy and counselling have shown encouraging results. Conclusion: Shayyamutra needs a holistic and integrative management style that focuses on both physiological and psychological aspects. The Ayurveda offers a comprehensive system that fits very well into modern paediatrics.