AMLAPITTA Treatment Protocol by Ayush

 

INTRODUCTION

Amlapitta is a disease of Annavaha Srotas with main characteristics like Urodaha, Avipaka, Tikta Amla Udgara etc. The chronic conditions may cause Kotha, Kandu, Mandala, etc. The condition may be co-related with Acid Peptic Disorders.

Case Definition:

Patients presenting with Tikta Amla Udgara (Bitter and sour belching), Hrit Kantha Daha (Burning sensation in throat and chest), Aruchi (Tastelessness), Hrillasa (Nausea), Uthklesha (Nausea), Avipaka (Indigestion) etc. can be diagnosed as a case of Amlapitta.

Types:

Amlapitta is of three types according to Anubandha Dosha as Vataja, Vatakaphaja and Kaphaja. According to clinical presentation Amlapitta is of two types Urdhwaga and Adhoga. Urdhwaga is characterised with upper GIT symptoms and Adhoga is characterised with lower GIT symptoms.

Differential Diagnosis

  • Chhardi
  • Pittaja Gulma
  • Pittashmari
  • Annadravashoola
  • Parinamashoola
  • Udara Poorvarupa

Line of Treatment

  • Nidana Parivarjana should be the first line of treatment.
  • Shodhana Chikitsa – Vamana and Virechana
  • Shamana Chikitsa - Langhana, Pachana, Deepana
  • Treatment according to Doshik involvement

LEVEL 1: AT SOLO AYURVEDIC PHYSICIAN’S CLINIC/PHC

Clinical Diagnosis: On the basis of history and clinical presentation

Investigations: nothing specific

Treatment: any of the following drugs:

 

Table 3.1: Medicines at level 1 for Amlapitta

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Shunthi Churna

Churna

2-3 gm

Before meal / twice a day

1-2 weeks

Warm water

Amalaki Churna

Churna

2-3 gm

Before meal / twice a day

1-2 weeks

Warm water

Yashtimadhu Churna

Churna

2-3 gm

Before meal / twice a day

1-2 weeks

Warm water

Hingwashtaka Churna

Churna

2-3 gm

Before meal / twice a day

1-2 weeks

Warm water

Shivakshara Pachana Churna

Churna

2-3 gm

Before meal / twice a day

1-2 weeks

Warm water

Avipattikara Churna1

Churna

4-6 gm

Before meal / twice a day

1-2 weeks

Warm water / Madhu

Kamadudha Rasa

Vati

1-2 tab (125-250 mg)

Before meal / thrice a day

1-2 weeks

Warm water

 

 

Pathya-Apathya (Diet and life style education):

Do’s:

  • Ahara – Yava, Godhuma, Seasoned Shali, Mudga Yusha, Laaja Saktu, Karavellaka, Patola, Kushmanda, Dadima, Amalaki, Kapittha, Godugdha, Mamsarasa, Sharkara, Madhu, Narikelodaka
  • Vihara – Follow dinacharya, Yogasana

Don’t s:

  • Ahara: Heavy food, Vidahi, Viruddha Ahara, Kulatha, Udada, Navanna, Tila, fermented foods like bread, excessive intake of curd, spicy food, bakery food, untimely food habit, deep fried food, alcohol intake and smoking.
  • Vihara Suppression of urges, worry, anger, stress, day sleep.

 

Referral criteria:

  • Patients not getting relief
  • Chronic cases

LEVEL 2: CHC’S OR SMALL HOSPITALS WITH BASIC FACILITIES

Clinical diagnosis: Same as level 1 for a fresh case reporting directly.

Investigations:

  • Stool for occult blood
  • LFT
  • USG abdomen / pelvis

Treatment: Virechana and Rasaushadhis along with Shamana Aushadhi mentioned in Level 1 can be given:

 

 

Table 3.2: Medicines at level 2 for Amlapitta

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Pravala panchamrita Rasa2

Vati

1 to 2 tab

(125-250 mg)

After meal /

thrice a day

1-2 weeks

Warm water

Sutashekhara Rasa3

Vati

1 to 2 tab

(125-250 mg)

Before meal / thrice a day

1-2 weeks

Warm water

Shankha Bhasma4

Churna

125-500 mg / day

Before meal

1-2 weeks

Warm water / Takra

Narikela Lavana

Churna

1 gm

Before meal

1-2 weeks

Warm water / Takra.

Pravala Bhasma5

Churna

250 mg - 500 mg / day

Before meal

1-2 weeks

Warm water

Kapardika Bhasma

Churna

125-500 mg / day

Before meal

1-2 weeks

Warm water / Takra

Patoladi Kwatha

Kwatha

10-15 ml

Empty stomach

1-2 weeks

-

Kalyanaka Kshara

Churna

2-3 gms

Before meals

1-2 weeks

Warm water

 

 

 

Virechana Karma – Abhyantara Snehapana with Dadimadi Ghrita, Vidaryadi Ghrita, plain Gau Ghrita followed with Virechana by Trivritta Lehya, Panchasakara Churna, Eranda Bhrishta Haritaki etc.

Referral criteria:

  • Patients not responding to treat­ments mentioned in level 2

LEVEL 3: AYURVEDA

HOSPITALS AT INSTITUTIONAL

LEVEL OR DISTRICT

HOSPITAL/ INTEGRATED

AYURVEDIC HOSPITALS

Clinical diagnosis: Same as level 1 & level 2 for a fresh case reporting directly.

Investigations: In addition to those men­tioned in Level 2.

  • Endoscopy

Treatment:

Shodhana:

  • Vamana - Madanaphala, Vacha, Patola, Nimba Kalka, Yashtimadhu Phanta, Saindhava Lavana Jala.
  • Virechana

Pathya-Apathya (Diet and life style education): Same as mentioned in level 1.

 

 

REFERENCES

 

  1. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (7/2), 2000.
  2. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part II (16/37), 2000.
  3. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (20/52), 2000.
  4. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (18/18), 2000.
  5. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (18/8), 2000.