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Revisiting the Age-Old Concepts on 'Acid-Peptic-Disorders'

Dr. Vijay Singh Chauhan, Dr. Naresh Khemani

A brief description of acid peptic disorders with ayurvedic herbs that give relief.

A brief description of acid peptic disorders with ayurvedic herbs that give relief. In ancient times, as the facilities did not exist to detect the exact location and presentation pattern of structure-functional disor- ders caused by excess acid secretion, the acid-peptic conditions were described under the titles of ‘Amla-pitta’, i.e., hyperacidity or chronic functional dyspepsia and the conditions where abdominal pain is predominant are termed as ‘Shoola’.

Functional Dyspepsia Vis-à-vis Amla Pitta

(Closely resembling to chronic dyspepsias and gastritis) This disease is claimed to be the result of vitamin of a vital humoral component ‘Pitta’ - which, in its normalcy, is responsible for physiologic enzymatic functions. Vitiated in G.I.T., Pitta produces ‘Amla-Pitta’ and is thrown out of body in the form of regurgitate reflexes and produces symptoms like nausea, excess thirst, vomiting, sour eructations, abdominal pain/discomfort, burning, severe indigestion, occasionally fever and some other systemic problems.

The treatment of ‘Amla-Pitta’ should comprise of the reduction of acidity and allevation of pain by correcting digestion/appetite, control of vomitings and improvement of general health.

Gastric and Duodenal Ulcers Vis-à-vis Annadrava and Parinama Shoolas

Acharya Susruta, the great Indian Surgeon 1000 years B.C has elaborately discussed about the external wounds and ulcers in the name of ‘Vrana’. His understanding on pathology (Vranoti iti varna’ Sanskrit = Discontinuity of the tissue) of ulcers more or less matches with the modern thinking, but in respect to the structural damage to mucosa in gastroduodenal ulcers he appears to have had no clear idea as he had no facilities to visualize or detect the ulcers in G.I.T. However, the chronic or subacute symptoms related to upper G.I.T were described by Susruta in a vague abdominal disease Gulma.

The lucid description of gastric and duodenal ulcers in Ayurveda was first presented before the world in 8-900 A.D in ‘Madhav Nidan’ in the chapter of Shoola Nidana. The word ‘Shoola’ actually stands for throbbing, pricking or colicky pain which, in absence of facilities to detect the underlying cause, must have been given the status of an independent disease entity. Among the 8 types of Shoolas described in ‘Madhav Nidana’ the clinical features of Annadrava Shoola and Parinama Shoola clearly match with the symptoms of gastric and duodenal ulcer respectively.

Annadrava Shoola

The Annadrava Shoola (gastric ulcer) is said to result due to the intake of over spicy, sour, hot, oily and irritating food, consumption of alcohol, exposure to sun and over exertion. Anger and worry are also said to be responsible.

The typical abdominal pain, the onset of which occurs during the ingestion of meals or soon thereafter and that which is chronic in nature, which does not generally respond even to the prescribed dietetic regimen is ‘annadrava shoola’. It is so named because it occurs during the secretion of ‘Annadrava’.

The pain in chronic cases is persistent, unrelated to meals but sometimes subsides after a vomit. A patient of ‘Annadrava Shoola’ is said to get symptomatically relieved by emesis of surplus acid and in long term therapy, by the addition of mild laxatives concurrently. The patient should relinquish the hot and sour food till he is fully alright.

Parinama Shoola

The causative factors behind Parinama Shoola’ (duodenal ulcer) are claimed to be: over exertion, late night working i.e less sleep, extra dry/fat free or uncongruous dietetic recipes, habit to starve, irregular eating habit, severe injuries leading to stress, constant tension and worry, sorrow, over annoyance, frequent consumption of cold and stored food consumption and the fermented materials like alcohol.

The ‘Parinama Shoola’, as the name itself is self-explanatory, is that type of pain which occurs at the time of ‘Parinama’, i.e, after the digestion of 1st meal, or to say 2-3 hours after meals when the patient starts feeling hungry again. The relief from this pain is possible only with ingestion of some food which should be bland, non-spicy and non-irritant in nature. In case of ‘Parinama Shoola’, a physician is required to study the case history in detail. Then, while prescribing the acid neutralizing and healing recipes, he should also give necessary instructions in regard to the personal conduct such as regularizing food habits; intake of bland food and milk; reduction in alcohol consumption, timely work and sleep, avoidance of tensions and worries etc.

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