Ayurveda Treatment Methods

A Guide Line To Ayurveda Treatments & Principles

 ATISARA (DIARROHEA)  Treatment Protocol by Ayush

 

INTRODUCTION

Atisara is an acute gastrointestinal disorder characterized with increased frequency of stools with loose motions.1 This could be cor­related with various diarrhoeal conditions.

Case definition:

Excessive passage of watery stools as­sociated with discomfort in abdomen, cardiac, umbilical & anal region, and malaise.

Types:

Considering the cause, there are main types named as Vataja, Pittaja, Kaphaja, Sannipataja, Amaja, Bhayaja / Shokaja. Depending upon the stage, classics have classified Atisara as Sama or Nirama.

Table 14.1: Types of Atisara with their characteristics

 

 

Types

Symptoms

Aamatisara

Unformed stool with excessive mucus with foul odour, usually associated with features of Ama like flatulence, heaviness in abdomen or body, loss of appetite, lethargy.

Pakvatisara

Stool which is contrasting to characteristics and symptoms of Amatisara.

Vataja

Patient frequently passes small quantity of liquid stool with flatus or froth, with discomfort or pain in abdomen, anus, thigh or sacral region, associated with horripilation, increased respiration, dryness of mouth, weakness

Pittaja

Patient passes stool with yellow, green, black tinge which may contain blood with exceedingly foetid smell. Associated features may include increased thirst, burning sensation, sweating, fainting, colic pain, inflammation and suppuration in anus

Kaphaja

Patient passes stool as unctuous, white, slimy, foetid smell mixed with mucus, with frequent colic pain, or tenesmus. Associated complains may include heaviness in abdomen, anus, pelvis and groin, horripilation, nausea, lassitude and aversion to food.

Sannipataja

Mixed symptoms of Tridoshaja (incurable)

Bhayaja and Shokaja

The presentation of this variety is similar as Vataja Atisara. But in addition to it, psychological factors can be traced in the induction of loose stool

 

 

 

Differential Diagnosis:

  1. Grahani
  2. Pravahika
  3. Vishoochika
  4. Krimiroga
  5. Ajeerna

 

 

Line of treatment

  • Nidana Parivarjana should be the first line of treatment.
  • Shodhana Chikitsa – Nil
  • Shamana Chikitsa- Langhana, Pachana, Deepana, Grahi, Stambhana
  • External applications - Nil
  • Rasayana Chikitsa for Grahani
  • Treatment according to Doshik involvement
  • General line of treatment prescribed for Purishavaha Srotas

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

Clinical Diagnosis: On the basis of history and clinical presentation.

Investigations: Routine stool examination

Treatment: In the initial stage of Amatisara, it is not necessary to use Stambhana drugs. Pachana and Deepana should be advised.

Table 14.2: Medicines at level 1 for Atisar

 

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Shunthi Churna

Churna

2-3 gm

3-4 times

1-2 days

Takra

Sanjivani Vati2

Vati

1-2 Vati

Before food 2-3 times a day

Till symptom subsides

Plain water

Bilwadi Gutika3

Vati

1-2 Vati

Before food 2-3 times a day

Till symptom subsides

Plain water

Ativisha Churna4

Churna

125-250 mg

Before food 2-3 times a day

Till symptom subsides

Plain water

Bilwamoola Churna5

Churna

1-2 gm

Before food 2-3 times a day

Till symptom subsides

Plain water

Musta Churna6

Churna

3-6 gm

After meal /

thrice a day

Till symptom subsides

Plain water

Dadima Phala Twak Churna

Churna

3-6 gm

After meal /

thrice a day

Till symptom subsides

Plain water

Dadimashtaka Churna7

Churna

3-6 gm

After meal /

thrice a day

Till symptom subsides

Water / fresh butter milk

Kutaja Churna8

Churna

3-6 gm

After meal /

thrice a day

Till symptom subsides

Water / fresh butter milk

Balachaturbhadra Churna9

Churna

3-6 gm

After meal /

thrice a day

Till symptom subsides

Honey / water

Kutajaghan Vati

Vati

1-2 Vati

After meal /

thrice a day

Till symptom subsides

Plain water

Kutajarishta10

Arista

10-20 ml

After meal /

thrice a day

Till symptom subsides

Equal amount water

 

 

Pathya - Apathya (Diet and life style education):

Do’s -

  • Ahara: Laja Manda, Peya, Vilepi, Khichadi, Shritasheeta Jala, Takra
  • Vihara: Rest

Don’ts -

  • Ahara: Heavy Food, sweets and cold items, milk and milk products except buttermilk
  • Vihara: Overeating, daytime sleep, night wakening, physical & mental stress

Referral criteria:

  1. Cases not responding to above therapy

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

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

Investigations:

  • Serum electrolytes
  • RFT

Treatment: In addition to the management mentioned in Level 1, few of the following drugs may be added

 

Table 14.3: Medicines at level 2 for Atisara

 

 

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Bruhat Gangadhara11

Churna

500 mg-2 gm

After meal / thrice daily

Till symptom subsides

Water / fresh butter milk

Hingvastaka Churna12

Churna

2-3 gm

After meal / thrice daily

Till symptom subsides

With water

Mustakaranjadi Kashaya13

Kwatha

12-24 ml

6 am & 6 pm in empty stomach

Till symptom subsides

-

Anandabhairava Rasa14

Churna

250-500 mg

After meal / thrice daily

Till symptom subsides

Water

Shankha Vati15

Vati

1-2 Vati

After meal / thrice daily

Till symptom subsides

Water

Kutaja Avaleha16

Granules

5-10 gm

Before meal / twice daily

Till symptom subsides

-

Karpoorasava17

Asava

5-10 drops

Before meal / twice daily

Till symptom

                   

 

 

Pathya - Apathya (Diet and life style education): Same as Level 1

Referral criteria: Cases not responding to above therapy.

LEVEL 3: AYURVEDA HOSPITALS AT INSTITUTIONAL LEVEL OR DISTRICT

HOSPITAL / INTEGRATED AYURVEDIC HOSPITALS

Clinical Diagnosis: As mentioned above

 

Investigation:

  • Stool culture
  • Rapid rotavirus antigen test in stool
  • Antigen tests for Giardia, Crypto­sporidium and E. histolytica
  • USG abdomen, colonoscopy

Treatment: In addition to the management mentioned in Level 1 & 2, some of the following can be advised.

 

Table 14.4: Medicines at level 3 for Atisara

 

 

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Panchamruta Parpati Kalpa

Churna

125-250 mg This may be increased gradually upto 750 mg.

Before meal /

once a day

10 days

Madhu, Ghrita Bhrushta Jeeraka Churna

Karpura Rasa

Vati

1-2 Vati

Thrice a day

Till symptom subsides

Water

Picchha Basti: Shalmali, Lodhra, Vatankura and Yastimadhu Kalka mixed with ghee, milk, honey

Emulsion

400 ml

Once a day

Till symptom subsides

                   

 

 

Pathya - Apathya (Diet and life style education): Same as Level 1 and 2.

 

 

REFERENCES

 

  1. Acharya Sushruta, Sushruta Samhita with Dalhana Commentary - Nibandhasangraha, and Gayadas Acharya commentary - Nyayachandrika Panjika on Nidanasthana, Uttartantra 40/6, edited By Vd. Jadavaji Trikamji Acharya & Narayana Ram Acharya, Chaukhamba Surbharti Prakashana, Varanasi, 2008.
  2. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, PART “A” FORMULATIONS, Govt. of India, 2000. pg. 549.
  3. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, PART “A” FORMULATIONS, Govt. of India, 2000. pg. 523.
  4. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “B” FORMULARY OF SINGLE DRUGS, 2000, pg. 139.
  5. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “B” FORMULARY OF SINGLE DRUGS, 2000, pg. 196.
  6. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “B” FORMULARY OF SINGLE DRUGS, 2000, pg. 678.
  7. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “B” FORMULARY OF SINGLE DRUGS, 2000, pg. 243.
  8. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “B” FORMULARY OF SINGLE DRUGS, 2000, pg. 576.
  9. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 337.
  10. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 36.
  11. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 338.
  12. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 353.
  13. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 193.
  14. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 663.
  15. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 545.
  16. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 118.
  17. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. Of India, PART “A” FORMULATIONS. 2000, pg. 54.

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