AMLAPITTA: AN AYURVEDIC PERSPECTIVE Nirmala C Apaturkar*, Kiran S. Deshbhratar**,M.N.Suryawanshi*** and S.Y. Raut**** Ayurveda Mental Health Research Institute, Nagpur, Maharashtra, India. Abstract: Amlapitta can be described as a disease of modernization due to irregular eating habits, and it is more of psycho- somatic disorder caused due to mental stress & strain added with dietetic indiscrimination Introduction Though it can be described as a disease of modernization due to irregular eating habits, it is more of psycho- somatic disorder caused due to mental stress & strain added with dietetic indiscrimination. Amlapitta is probably a commonest digestive disorder. A drastic change in mankind has taken place mostly due to urbanization and industrialization. To copeup with the speed of the modern era, one has to adopt junk food preparations, over-work and stressful duty schedule. 30% of the general population is suffering from gastro-oesophageal reflux and gastritis resulting in heartburn. Amlapitta is mentioned in Kasyapa Samhita, Madhava nidana, Bhavaprakasa and Cakradatta. Acharya Caraka, Susruta and Vagbhata have not described this disease. Amlapitta,as separate though it has been referred at certain places. Nirukti: Literally amlapitta means the pitta is of sour taste. Etymologically the word Amlapitta comprises of two components i.e. Amla & pitta Def: 1) Chakrapani in his commentary on Charak Samhita defines Amlapittam Cheti amlagunoundriktam pittam - the augumented or increased amla guna of pitta is known as Amlapitta. 2) Shrikanthadutta in his Madhukosha vyakhya defines
Vidahadhyamla gunaoundrikta pittam amlapittam i.e. the pitta becomes augumented or vidagdha because of excessive increase of amla guna of pitta & Amlam vidagdham cha tat pittam amlapittam the pitta which attains amla guna & vidagdhata is called as amlapitta. Acidity is related to heartburn and gas formation in stomach. In acidity, acid reflux or Gastro esophageal reflux disease (GERD), or more commonly known as 'Urdhvag Amalpitta' in ayurveda, there is a movement of gastric juices ( acid in nature) from the stomach into the lower part of esophagus. Ayurveda considerds it to be caused by the aggarvation of Pitta dosha. CAUSES OF AMLAPITTA: The Amlapitta vyadhi is caused due to Viruddhashana and Pittaprakopaka bhojana and pana. Individuals with a Pitta imbalance are susceptible to hyperacidity, peptic ulcers, and some types of inflammatory disorders. The pathogenesis of amlapitta involves three important factores i.e. Agnimandya, Ama & Annavaha Strotodushti. Along with this, the vitiation of pitta leading to quantitative & qualitative increase of pachaka pitta especially in its ama & drava guna gives rise to amlapitta.the gastric glands produce acids, which help break down food during digestion. Excess production of acids in stomach is termed as the hyperacidity. There are varieties of reasons which cause excess acid production. The most important among these are: Excessive use of the oily and spicy foods Excessive intake of alcohol, smoking, keeping stomach empty for long time, skipping breakfast causes acidity. Excessive use of Analgesics esp. NSAIDs Anxiety, depression and anger Irregular eating habits. Consumption of Maida products in large quantity. To use leafy vegetables in excess Sleeping just after taking meal. Drinking of excessive water Excessive intake of the caffeine and nicotine products. Constipation Carbonated drinks Foods which are rich in fats, such as chocolates cause acidity or acid reflux diseases. Other causes of acidity or heartburn are pregnancy, aging, obesity, and bad eating habit, like eating junk foods. SYMPTOMS OF AMLAPITTA: Signs and symptoms of Amlapitta mentioned in the Ayurvedic texts are very similar to gastritis or hyper acidity. The most important presenting sign of Amlapitta is burning sensation of the stomach, heart and throat. This sign is most prominent and is in the middle stage of the disease. This is due increasing drava guna and vidagdhatva of the pitta. The symptoms of the Amlapitta varies from avipaka, klama, utklesha, amlodgar, angagaurava, hridaya / kantha pradesha daha and aruchi.
MANAGEMENT: The dietary interventions can be of much benefit in Amlapitta as the majority of causes are dietary.selection of the right food goes back to the ages of vedic period. There is beautiful food prayer that shows the devotional aspect of eating food. Annam brahma Raso Vishnu Pakto Devo Maheshwara Evam Jnatva tu yo Bhunkte Anna Dosho Na Lipyate i.e. Brahma gives us food, Vishnu makes the ability to find its essence. Shiva cooks this essence into us, when you eat with this awareness, the food becomes pure and no toxins stay in you. Ayurved has provided a simple and cost-effective treatment for Amlapitta.Main line of treatment is to correct ama formation & Agnimandya. Ama shodhana is done by mridu vaman, Mridu virechana, Anuvasana & Niruhan. In the persons who are already weak, ama paachan with the relevant herbs and medicines are to be employed. Langhan---by absolute fasting for few days or by only taking light for some days Paachan medicines mostly tikta rasa yukt herbs like patol, neem, giloy, triphala, shatavari, harad and prawaal. Yogratnakar says, if amalpitta is not cured with above methods, raktamokshan should be employed. IMPORTANT COMBINATIONS FOR AMALPITTA Avipattikar churna, kaamdudha rasa, Prawal pishti, mukta pishti, Kapardik bhasma Sootshekhar rasa, Amalpiitantak loha The outstanding benefits of 6 Rutuharitaki Rasayana therapies were already described in the ancient scriptures. Narikel lavann is also a good remedy to cure hyperacidity. Sukumara Ghrita is a specific treatment and is administered in doses of one to two teaspoonfuls mixed with a cup of milk and given first thing in the morning.it may lead to some impairment of the digestive powers of the patient in the beginning, but he recovers the power of digestion after some days. Dhaatri lauha (calyx of iron mixed with the juice of amla) may be taken in one teaspoonful dose twice a day. In acidity, iron absorption is impaired and this will be corrected with this medicine. In severe cases, Ayurvedic physicians may prescribe Swarna parpatee, Suvarna Soota sekhara ras etc. If needed, these medicines may be taken under medical supervision.
DO s : Take tiny meals often times. Food must be taken in loving manner with attention and awareness. Eating is best done during Pitta period, between 10 A.M. and 2 P.M Drink juice of raw vegetables like cabbage. Take barley, paraval. Relax your mind and body at meal hour. Drink plenty of water before meals. Masticate food well. Get away from intensely hot and cool foods, Strong tea, black coffee, alcohol and junk food. The diet should consist of little old rice. Other recommended substances are: barley, wheat, rice (at least one year old), cucumber, bitter gourd, green banana, pumpkin, pomegranate, and cow's milk. Eliminate carbonated beverages from your diets. Remember that beer also contains gas. DONT s : Cut back on fatty meats. Exercise regularly. Reduce undue mental stress. Yoga is a good option. Avoid fatty and salted fish. Don t sleep just after taking the meal. Try to avoid high-stress situations. Avoid to skip meals Do not take the frozen foods and chilled drinks Avoid excess sugar and sweets. Avoid Alcohol, strong tea, spicy and fried food. Avoid Raw vegetables, Meat, pickles. EXERCISE FOR HYPERACIDITY:Exercise helps in controlling acidity Morning walk are good for health and keeps the acidity disease under control. YOGA FOR HYPERACIDITY:Yogic exercises and meditation keeps overall internal system (like digestive system, nervous system) and external system in good condition. Depression, anxiety worsens the acidity disease so try to live a stress-free life for healthy and happy living. Some of the useful yoga postures are - Suryanamaskar,Sarvangasan,Bhujangasan,Naukasan,Paschimottanasan,Vajrasan,Bhastrika Pranayam,Sitali Ptanayam and Sitkari Pranayam.. Authors: Dr Nirmala C Apaturkar*,Senior Research Fellow(Ayurveda),Ayurveda Mental Health Research Institute, KDK college Road, Nandanvan, Nagpur, Maharashtra, India.
Dr Kiran S. Deshbhratar**,Research Officer(Ayurveda), Dr M.N.Suryawanshi***,Assistant Director Incharge Dr S.Y. Raut****,HOD & Professor, Shalyatantra Dept.,Govt Ayurved College,Nagpur, Maharashtra, India. REFERENCES [1] Vagbhata,Ashtanga Hridayam in Sutrasthana 1/ Tripathi Brahmananda; Chaukhamba Sanskrit Pratishthan, Delhi, 1st ed., 2003,pp.15-19 [2]Charak, Charak Samhita, in Chikitsasthana 1/13; Tripathi Brahmananda, Chaukhamba Surbharti Prakashan, Varanasi, 1st ed.,2002, Vol.II, pp.12-13 [3]Charak, Charak Samhita,in, Sutrasthana 30/26; Tripathi Brahmananda, Chaukhamba Surbharti Prakashan, Varanasi, 1st ed.,2002, Vol.II, pp 447 [4]Bhavprakash Nighantu - of Sribhavmishra Edited with Vidyodini Hindi Commentary Shri Brahmasankara Misra & Shri Rupalalaji Vaisya 9th Edition Chaukhamba Sanskrit Sansthan, Varanasi, Haritakyadi Varga 7/34, pp 3-9 [5]Sushruta, Sushruta Samhita in Sutrasthanam 6/28-31; Ghanekar Bhaskar; Meherchand Lachhamandas Publication, New Delhi, ed.,1998,pp. 214 [6] Dr. Kamlesh S. Mahajan - The study of effect of Nidanparivarjan & Rutuharitaki Rasayana with special reference to Amlapitta; M.D. (Ayu.) Thesis Submitted to Amravati University, Amravati. 2007 [7]Kaideva, Kaideva Nighantu, in Oshadhi Varga/ 221-234,Sharma P.V.; Chaukhamba Orientalia, Varanasi, 1st ed.1979, pp. 45-46 [8] Nadkarni,The Indian Materia Medica, Part-1, Popular Prakashan 1st ed.1976, pp. 1205-1210 [9] Vijay Rakshit Kanthadatta, Madhava Nidana in Amlapitta Nidanam 51/1-2, Chaukhambha Sanskrita Sansthana, Varanasi, 1st ed., 2001, pp. 170-171 [10]Commentary by Satyapala Bhishagacharya,Kasyapa Samhita, Khilasthana [11] Yogratnakara