TYPES-(3)

1.vatadhikya amlapitta

2.vata-kaphadhikya amlapitta

3.kaphadhikya amlapitta

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INTRODUCTION

Hyperacidity(Amlapitta) is one of the most common disease seen in the society. It is seen in all ages, all classes, and all community. Hyperacidity refers to a set of symptoms caused by an imbalance between the acid secreting mechanism of the stomach and proximal intestine and the protective mechanisms that ensure their safety. The stomach normally secretes acid that is essential in the digestive process. When there is excess production of acid in the stomach, it results in the condition known as acidity.

Amlapita in Ayurveda indicates a state of increased acidity in the digestive tract that irritates the gastric mucosa. To a great extent its manifestations correspond to the disease, which is known in Western medicine as chronic gastritis.

The development of this condition can lead to an ulcer. To a great extent the occurrence and development of amlapita, is associated with dyspepsia, as it affects not only the stomach but also the initial part of the small intestine.

The disease causes pain and overall digestive disorders, which, in addition to numerous manifestation of the disease, is accompanied by a severely reduced appetite. This condition is often underestimated by the patients, as many of them get used to it and live with it for years, but this is very dangerous. Because if not treated, amlapita over time can lead to perforation of the stomach, which may require urgent surgery, otherwise the patient may die. Moreover, if the disease is left to develop, amlapita can ultimately lead to cancer.

In order to explain what is amlapita in Ayurveda, we have to highlight the Ayurvedic concept with regard to digestion, and in particular, to the digestive fire Agni.

This is a biological fire that is only symbolically related to the visual image of fire. It comprises the chemical processes through which the degradation of food is executed, as well as its processing to simple substances for absorption, and the cell nutrition /metabolism/. Moreover, Agni destroys the harmful bacteria and microorganisms in the stomach and intestines, and various toxins.

In general, the fire Agni is responsible for all transformations, as there are 13 types with different functions. So in the broad sense, apart from digestion, the different types of Agni carry out chemical processes and changes in both the body and mind – sensory sensations, emotional and mental experiences.

With regard to digestion, Jathar Agni is the gastric fire associated with the formation of hydrochloric acid; Bhuta Agni is responsible for the hepatic bile acids; Kolma Agni controls the enzymes and pancreas.

Thus, the digestive fire generally carries out the transformation of the consumed food, as well as its processing with hydrochloric acids, juices and enzymes in the stomach, duodenum and small intestine. If for some reason the digestive fire Agni is suppressed, it cannot fully manage all chemical processes, which leads to an increase in acidity and occurrence of Amlapita.

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NIDANA

Diet (Ahara)

Spicy food habits like eating samosa, burger, pizza, Chinesefood. Excessive use of chilly,

Cinnamon, clove, mustard, garam masala powder (spice mixture), garlic etc. in diet

Salty and sour foods like chips,

Eating of stale, fermented foods (dosa, uttappa,idli etc. bakery food items).

Excessive intake of fast food

Excessive intake of Oily foods, pickles

Intake of food and beverages in its hot condition like soups

Excessive intake of tea/coffee.

Lesser intake of water, dry food

Irregular meal times

Repeated food intake (before the digestion of the previously taken food)

Incompatible food like taking non-veg., pizza followed by milk shake.

Skipping meals.

Eating too late at night

Regimens (Vihara)

Lack of rest, fast moving lifestyle.

Insufficient sleep at night.

Sleeping immediately after meals.

Suppression of naturalurges.

Excessive exposure to sun and fire

Mental factors

Stressful life style

Excessive anxiety, worry, jealousy, anger, fear

Job dissatisfaction,

Other causes

Living in anoopadeshai.eassam, Bengal and costal region.

Sharadritu (Autumn season)

Addiction ofalcohol, smoking, tobacco chewing

Prolonged intake of NSAIDS (pain killers)

Helicobacter pylori infection

All the above factors result in excessive increase of ‘Pitta dosha’ in body and exhibits symptoms

of amlapitta.

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SAPEKSH NIDANA WITH VIDAGDHA

Vidagdha me amla dhumra yukt hota h.

adrak swarasa se yadi vraddhi ho to amlapitta h.

adrak svarasa se lakshan ghate to vidagdha hoga.

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SAMPRAPTI

Nidana sevana-> Varsha ritu & anuppradsha -> pittavardhak ahar vihar-> pitta ka vidaghdha-> pitta amli bhava->amloudgaradi lakshana-> amlapitta

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LAKSHANA

Heart & chest burn (retrosternal burning),

Sour or bitter belching.

Nausea,

Throat burn.

Regurgitation of food or sour substance

vomiting

Gaseous distention of abdomen

Heaviness in abdomen

Indigestion.

Aversion towards food.

Pain in abdomen.

Chest pain.

Headache.

Bad breathe.

Foul smelling loose motions.

Severe burning sensation over feet, hands

Thirst,

Mouth ulcer,

Fatigue (especially in legs)

Tiredness

Fainting.

Giddiness.

Itching all over the body

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UPADRAVA

AMLAPITA AND THE THREE DOSHAS IN AYURVEDA

The answer to the question what is amlapita in ayurveda? Can not be complete without explaining, although briefly, the essence of the three doshas. These are biological forces, essences that enable the existence of the body and its development.

These energies are set in a unique proportion for each person at birth. Each one of them manages certain processes in the body:

• The agni fire/transformations of matter/ belongs to pitta;

• Movements of matter in the body and of the body itself belong to vata,

• and the control of fluids /tissue fluids, blood, plasma – more than 70 % of the body’s water/ belong to kapha.

Their proportion is set in a certain balance in which one or two of the dosha is predominant, which in turn determines the type of constitution. If one of the doshas goes out of balance, the processes that are controlled by it get disturbed, and this also can cause imbalances in the other two doshas, respectively disturbances in “their” processes. Thus, complex diseases occur.

The digestive fire can be suppressed by imbalances of pitta, but also by imbalances in vata or kapha. Thus, the amlapita disease can be of the pitta type, of vata type or of kapha type.

If the imbalance is of the pitta type, people feel heaviness and weakness at the same time; coldness and burning in the stomach; usually accompanied by frequent vomiting, the tongue is covered with coating, as well as skin rashes occur.

If the amlapita is of the vata type, the discomfort is accompanied by trembling, weakness, anxiety, tingling, and needle-like shooting pain, as the person may fall into delirium – the consciousness is blurred and confused, and hallucinations may occur.

Eye pain is also a possible symptom, as well as dizziness and even seizures. This is because vata is the dosha of movements and, as such, it is related to the brain activity, its impulses and their transmission through the nervous system.

Seizures may occur also if amplapita is of the kapha type – this is the dosha that is responsible also for the brain fluids. Other common symptoms include headache, increased salivation, sweet taste in the mouth and lack of appetite.

In more severe cases, there is a strong thirst; besides the itching, skin rashes may also appear; burning in the stomach, chest and can be accomapnied by burning on the feet and palms, and sweating.

The vomiting may be green, black, blue, yellow, light or bright red with highly acidic material.

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INVESTIGATIONS

Gastroscopy (Upper Gastrointestinal Endoscopy)

Oesophageal pH monitoring

Gastrin levels in blood

Ba Meal x-ray

Serology + histology for H. Pylori

Stool routine examination

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COMPLICATIONS

If not treated timely or if unwholesome diet, regimen and habits continued, it may lead to

Gastric Ulcer

Chronic Gastritis

Duodenitis

Irritable Bowel Syndrome

Mal-absorption

Anemia

Peptic Stenosis

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SAMPRAPTI GHATAKA

DOSHA- pitta

DUSHYA- rasa, rakta

ADHISTHANA- amashaya

SHROTAS- annavaha

SVABHAVA-ashukari

SADHYAASADHYATA- sadhya

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PREVENTION

As the saying goes “Prevention is better than cure” it is better to avoid all the causative factors of

acid-peptic disorder (amlapitta).

1. Avoid excessive salty, oily, sour and spicy foods

2. Avoid heavy and untimely food

3. Avoid smoking and alcohol intake

4. Food should consist mainly of bitters like bitter gourd, matured ash gourd

5. Include barley, wheat, old rice and green gram in diet.

6. Avoid overcooked, stale and contaminated food.

7. The food must be properly cooked

8. Follow mental relaxation techniques

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PRICIPAL OF CHIKITSA

1)vamana-(udharvg amlapitta)

2)virechana-(adhog amla pitta)

3)asthapan & anuvasan basti(jeerna amlapitta)

4. Avoid causative factors

5. Palliative treatment

As the disease is of Pitta origin, all measures are undertaken to pacify pitta.

6. Panchakarma treatment

When patient cannot be well managed with oral medications ‘Panchakarma

procedures’ like Vamana (emesis) or virechana (purgation) whichever is needed

should be administered. In chronic cases Asthapanavasti (medicated enema) is

indicated.

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MEDICINE

Some important single drugs useful in Amlapitta

Shatavari, 3 gm twice a day with milk

Yashtimadhu 3 gm twice a daywith milk

Amalaki (Indian gooseberry) 3 gm twice a day with water

Sunthi (dry ginger) 1- 3 gm twice a daywith water

Some important Pharmacopeial Preparations

Kamdudha Rasa 250-500 mg twice a day with Honey

Sutashekhar Rasa 250 mg with Honey twice a day(or)

PrawalPishti 125 to 250 mg with Amalki Juice

PrawalPanchamrit Rasa 250-500 mg twice a day

DhatriLauha 1/2-1 gm BD with Ghee

ShankhBhasma 250 to 500 mg twice a day with Honey

SwarnaMashikBhasma 125-250 mg twice a day

Amlapittantakalouha 250 mg twice a day

NarikelaLavan 1 g with water

DashangKwath 14-28 ml twice a daywith 1 tsf of Honey

Bhoonimbadikwatha 15-20 ml twice a day

Patoladikwatha 15-20 ml twice a day

Gulucyadikashaya 15-20 ml twice a day

Aragwadhamrtadikashaya 15-20 ml twice a day

AmalakyadiChurna 3 gm twice a daywith water

AvipattikarChurna 3-6 gms with water twice a day

AmalakiRasayan 1-2 gm twice a day milk

Shatavarighrit 6-12 gm twice a day

Yashtighrit 6-12 gm twice a day

Sukumaaraghritam 6-12 gm twice a day

Dadimadighrta 6-12 gm twice a day

Nalikerekhanda 6-12 gm twice a day

Domestic Remedies

The Infusion of coriander seeds (Dhanyak) taken with sugar twice a day.

Water obtained from green fruit of Coconut 100-500 ml to be taken twice a day.

Powder of Amla 3-6 gm BD with water.

Powder of Shatapuspa (Saunf) (Anethumsowa) with sugar mixed in a glass of water - 20 ml

twice daily for 1 week or till the symptom subsides

Chewing of half a teaspoon of fennel seeds after food

1. DEEPAN/PACHAN-Shunthi curna 5gm bid before meal

2.SNEHAPANA-Satavari ghrita/Vasa ghrita

3.SVEDANA-1 DIN

4.VAMANA(IN UDHARVGATA AMLA-PITTA)

(VAMAN/ HRID PRADESH ME DAHA)

VAMAN KALP-

Patol patra 20 gm +

Nimba patra 20gm +

Mulethi 20gm-->100ml kada +50ml Satavari ghrita + 15 gm madanphala pippali-->2nd day add 50ml madhu + 5gm Saindhav--> vamana

5.VIRECHANA(ADHOGATA AMLAPITTA)

(GREEN-YELLOW-BLACKISH DISCHARGE WITH MALA)

MRIDU VIRECHANA KALP-

Nisoth curna 20gm +

Amaltas guda 20gm--> 100ml kada + Amlaki swarasa 20gm + madhu 20gm--> virechana

CHIRKALIN HO JAYE TO ANUVASAN BHI DENA H

YOG BASTI(8)/KAL BASTI(16)

A. ANUVASANA BASTI-Vasa ghrita/Satavari ghrita-30 ml

B. NIRUHA BASTI-

Patol patra +

Nimba chal +

mulethi +

Indrayava +

Amalki --> 300ml kada + Shatavari ghrita 50ml + Saindhav 5gm + madhu 50ml--> basti

*** VAMAN IS VERY IMPORTANT IN AMLAPITTA

Do’s (Pathya)

Follow the meal times.

Light food, Coconut water, articles having cooling properties

Vegetables like white pumpkin, bitter gourd, matured ash gourd,leafy vegetables except Methi

Wheat, old rice, barley, green gram, sugar candy, cucumber,

Fruits like gooseberry, dry grapes, black grapes, sweet lime, pomegranate, fig, dry fig,

Take adequate amount of fluids like pomogranate juice, lemon juice, amla juice, sweetlime

juice, Medicated water with ushir (wala) or coriander seeds, or laja (puffed rice). Warm water.

Dadimpak (sweet preparation made of pomegranate). Moramla (jam made from amla),

gulkand (jam made from rose petals) with milk

A cup of lukewarm milk after every two or three hours.

One teaspoonful of ghee with warm milk

Take adequate sleep & rest

Practice Yoga, Pranayam, meditation & exercise regularly

Don’ts (Apathya)

Avoid excessive spicy, sour and salty substances

Avoid fried and junk food items

Do not remain hungry.Avoid fast.

Do not overeat, take small frequent meals

Avoid untimely and irregular food habit

Avoid foods containing excess amount of garlic, salt, oil, chillies,etc. very often.

Avoid rice curd and sour fruits.

Avoid lying down immediately after food and in supine position. The best recommended

position is left lateral

Avoid, smoking, alcohol, tea, coffee and aspirin type drugs.

Avoid stress

EFFECTIVE REMEDIES FOR ACIDITY AND GASTRITIS

• Long pepper powder- half a gram with one spoon of honey – two times a day is one of the effective home remedies for gastritis.

• Lemon juice helps to relieve vomiting sensation and bloating.

• Boiled Ash gourd with jaggery relieves bloating and burning sensation in stomach associated with acidity and gastritis.

• One table-spoon of Triphala powder added with one glass of water, boiled and reduced to half a glass, filtered. This water decoction when hot, along with one table-spoon of honey or ghee relieves gastritis.

• Regular chewing of half a teaspoon of fennel seeds after food is good for digestion and gastritis.

• Half a glass of buttermilk, added with a pinch of asa foetida, turmeric, half tea-spoon of fenugreek drunk at night, is good for effective treatment of gastritis.

• Crush cumin seeds into a fine powder. Add half a tea-spoon of cumin seeds to one litre of water. Boil the water for two minutes and filter. Drink this water, in place of normal water. But new water needs to be made everyday. This is a natural remedy for gastritis.

• Ginger – 5 grams. Milk – 100 ml Water – 100 ml. Boil this till there is only 80 – 100 ml remaining. (meaning water is emptied)

Filter and drink. This is a good gastritis remedy. In the same way, garlic – drink is also a good home remedy for gastritis.

ACTIVITIES AND DIET FOR GASTRITIS

Barley, wheat, green gram, old rice, warm water, sugar candy, inflorescence of the plantain, cucumber, matured ash gourd, pomegranate, gooseberry, dry grapes etc. are ideal.

ACTIVITIES FOR GASTRITIS RELIEF:

1. Avoiding heat and Sun light. According to Ayurveda, exposure to Sunlight increases Pitta and gastritis is a Pitta dominant disease. So avoid direct exposure to sunlight as much as possible. Use an umbrella or a hat.

2. Having food at the right time: Having food at fixed intervals of time helps the biological clock of the body to release gastric juice and enzymes at right times.

3. Avoiding fasting: Though Gastritis patients might have hunger disturbances, they should avoid fasting or delaying of meals.

Diet for gastritis:

Here is a list of food items that gastritis patients need to take regularly, according to Ayurveda.

Barley, Wheat and green gram.

Boiled and cooled water

Honey

Ash gourd – Many ash gourd recipes and herbal products are used in gastritis treatment. Regular use of Ash gourd is good.

Bitter vegetables like bitter gourd, asparagus, Indian Tinospora etc are good for stomach.

Asa foetida – Though it is not good to taste, it is used in many Indian dishes. It is very good for the stomach.

Cumin seeds / Jeera – Improves digestive power, increases hunger.

Coriander – coriander is a natural coolant.

Milk : Widely used in Panchakarma Gastritis treatment. Rich in calcium and good for gastritis.

Ghee: Calms Pitta and improves digestion.

Coconut water

Amla – Indian gooseberry – it will take one whole book to write about Amla benefits.

Ajowan: Improves digestive power, a cure for pain abdomen due to gastritis.

Ginger: Ginger processed in milk is a good home remedy for gastritis.

Fruits for Gastritis: Pomegranate, grapes, apple, and banana.

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Sutsekhar rasa-(parad,gandhak,tankan,swarna,visa,tamra bhasma,sankh bhasma)

- Leela vilasa rasa-(parad,gandhaka,tamra,loha,abhrak bhasma)

- Sankh bhasma-(sankh)

- Praval pisti

- Praval panchamrit-(praval,mukta,shankh,sukti,varatika)

- Amlapittantak loha-(rasasindur,tamra,loha,haritaki)

- Kamdudha rasa-(parad,gandhak,tamra,kast aushadhi)

- Sarvatobhadra loha-(hoha,tamra,parad,gandhak,svarnmakshik,sheelajatu,guggulu)

VATI-(250-500MG WITH USHNA JALA)

- Paniya bhakt vati-(triphala,trikatu,mustak,nisoth,parad,gandhak,loha,abhrah)

- Soubhagya sunthi modak-(triphala,trikatu,lavanga,raktchandan,mulethi,sunthi)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Avipattikar curna-(triphala,trikatu,vidanga,mustak,nisoth,lavang,mishri)

- Haritaki curna

- Triphala curna

- Mulethi curna

- Shatavari curna

- Amlaki curna

- Drakshadi curna

- Trivrit curna

KVATHA-(20-30ML WITH JALA)

- Patoladi kvatha-(patol,nimba,guduchi)

- Panch tikta kvatha-(guduchi,nimba,patol,parpat)

GHRITA/TAILA-(15-20ML WITH USNA JALA/MILK)

- Vasa ghrita

- Shatavari ghrita

- Drakshadhya ghrita-(amla,ikshu,goghrita,harad)

- Pippali ghrita

- Patol sunthi ghrita-(patol,sunthi,goghrita)

AVLEHA/PAKA(20GM WITH DUGHDHA)

- Khandkushmandavleha-(kushmanda,amla,sarkara)

- Narikela khanda-(nariyal,mishri)

- Pippali khnada-(pippali,satavari,sarkara)

- Shunthi khnada-(sunthi,sarkara,goghrita)