Ayurvedic Concept of Acid Reflux and its Management
Acidity or hyper-acidity (Amlapitta) is a condition that almost every one of us would have suffered through at least once in our lifetimes. However frequent incidence of hyper-acidity will affect the stomach and related body parts like the oesophagus and duodenum that are part of the digestive system and will lead to the ulceration of the epithelium, the inner lining of these parts. This will cause improper digestion and other related dysfunctions leading to symptoms like burning sensation in the stomach, fermentation, indigestion, etc., and will ultimately lead to GERD (Gastro-oesophageal Reflux Disorder), which is a condition which will cause the weakening of the oesophagus valve and disorders caused due to it like nausea, vomiting, fermentation, bloating of the stomach, anorexia, bad breath odour, wounds in the mouth, diarrhoea, etc.
This disease can be managed in the initial stages without any difficulty by adopting the correct treatment and by avoiding the consumption of food that causes the disease.
Acid Reflux in Ayurveda
The condition that is similar to Gastritis or GERD can be seen described in many instances in Ayurveda. To a great extent, GERD/Gastritis corresponds to the disease that is described as Amlapittam in Ayurveda science. And, in certain situations, these would bear similarities also with Vataja Chardi and Pithaja Chardi conditions.
Reasons for the Disease
Amlapitta is caused by the malfunctioning or excess production of the hydrochloric acid that is produced in the stomach and required for the digestion of food. Amlam means acid. Its uncontrolled flow to the upper or lower parts of the body is the reason for the patient exhibiting the symptoms of the disease. However, when we explore the reasons for this, it can be found that irregular food habits, mental stress, excessive use of painkillers, H pylori infection, etc. are all reasons for causing the disease.
Some of the reasons for the cause of the disease are:
- Regular consumption of food that is excessively sour and hot (spicy)
- Excessive consumption of fast food, fermented dosa and idli, and bakery items
- Excessive consumption of fatty foods, pickles, tea, coffee, and other bottled drinks
- Irregular food habits, consuming food again before the food has been digested, consuming food extremely late in the night
- Busy lifestyle and not finding enough time to take rest
- Sleeplessness and sleeping immediately after having food
- Speed (Vegadharanam)
- Work stress, anxiety, anger, fear, mental stress, tiredness, etc.
- Staying at a place that is always unclean (Klinnarayulla) and where there is water stagnation, i.e. living in low lying areas (Aanthapadeshavasam) – e.g. living in Bengal, Assam, Kuttanad, Alappuzha, etc.
- Alcoholism, smoking and chewing tobacco
- Excessive consumption of painkillers (NSAIDS)
- H Pylori infection
- Fasting for a long time
Rogha Samprapthi (Disease Maturation)
The reasons mentioned above causes the incidence of imbalanced digestive fire ( Jataragni Vaishamyam) which negatively affects the functioning of the digestive juices. The disease symptoms are exhibited because of this. The reasons will mainly cause inflammation of Pachaka Pitta and harm the digestive process. The Ama (a mixture of improperly digested food and digestive juices) travels from the stomach to the upper and lower parts of the body and exhibits the symptoms of the disease. Accordingly, two types of Amlapitta are caused – High (Urdhwagtham) Amlapitta and Depressing (Adhogatham) Amlapitta.
Apana Vayu vitiation also happens along with Pachaka Pitta because of the reasons mentioned above, the functioning of the Vyana Vayu and Udana Vayu also becomes abnormal. This causes the weakening of the gastro-oesophageal valve at the start of the stomach and will cause the entry to the upper side of the stomach juices that has to otherwise flow only to the bottom side. This causes a condition called GERD.
- Burning sensation in the chest
- Fermented or bitter-tasting burp
- Burning sensation in the throat
- Nausea and Vomiting
- Bulging of the stomach
- Pain in the stomach
- Bad breath odour
- Burning (Pukachil) sensation in the hands and legs
- Ulcer in the mouth
- Tiredness, fatigue, losing weight
Diagnosis is made after a detailed examination of the patient and the disease conditions. Modern diagnostic techniques could be employed for this.
- Stool/urine examination
- Barium meal X-ray
- Gastrin levels in the blood
- Oesophageal pH monitoring
- Finding out the symptoms of the disease and eliminating those.
- Shamana Chikithsa
Give medicines that will cause the healing of the Pitta (Pitta Shamana) but help in the enhancement of Ama (Ama Pachanam). Care should be given to ensure that medicines given for Ama Pachanam do not create an imbalance in the Pachaka Pitta.
Medicines that could be usually given:
- Single Herb Remedies (Ottamooli )
- Glycyrrhiza glabra (Irattimadhuram) – 3g twice a day with milk
- Dry Ginger Powder (Shunti Churna- Chukkupodi) – 1-3g twice a day with water
- Shathavari ( Asparagus racemosus) – 3g twice a day with water
- Amalaki Powder -Nellikka choornam ( Phyllanthus emblica) – 3g twice a day with water
- Sutashekhara Rasam – 125mg mixed in honey, to be taken twice a day
- Pravala Pishti – 125mg in Nellikkaswarasam
- Pravala Panchamruta Rasam – 250mg, twice a day
- Dhatri Lauham – 1g twice daily in Ghee
- Shankha Bhasmam – 250mg mixed in honey, to be taken twice a day
- Swarna Makshika Bhasmam – 125mg twice daily
- Mukta Pishti
- Nalikera Lavanam – 1g in water
- Nalikera Khandam – 6g, twice a day
- Shatavari Ghritam – 10g twice daily
- Sukumara Ghritam – 10g twice daily
- Dadimadi Ghritam – 10g twice daily
- Avipati Choornam – 6g dipped in honey
- Hingwashtaka Choornam – 6g dipped in honey
- Mahadhanwantaram Gulika – 2 twice daily
- Shodhana Chikithsa
If the disease has been persisting for a long time, Shodhana Chikithsa can be done along with or before consuming Shamana Aushada (medicines).
Vamanam (medicated emesis) is the best (Uthama) Shodhanam in Urdhavagatha Amlapitta condition. Snehapanam (consumption of medicated ghee) should be done with the suitable Ghritam from the ones mentioned above and after that full-body (Sarvangam) oil massage (Ennaidal) and sweating (Viyarpikkal) should be induced. Medicine for Vamanam can be given after this. Vamanam is ideal for the elimination of Urdhavagatha Dosham and Srothoshudhi. Along with this, the correct functioning of the pulse and hormones also takes place due to the excitation (Udheepanam) of the areas around the vomiting center of the brain. This paves the way for proper digestion and destressing of the mind.
Virechanam is the best Shodhana treatment technique for Adhogatha Amlapitta. For doing this, firstly internal Snehapanam should be done with any of the suitable Ghritam mentioned in the group of Sneha medicines (Aushadam). After this, Virechanam should be done by giving external Snehapanam and Swedanam. 20 to 25g Avipathi Choornam dipped in Honey can be given for Virechanam.
This is ideal for the digestion/processing / excretion (Anulomanam) of the Apana Vayu (the Vayu or force active in the pelvis and lower abdomen area and governs the eliminative functions – excretion, urination, menstruation, etc. – and the downward and outward flow of energy in the body). Apana Vaigunyam is the root cause of GERD. Vasti can be performed to heal this and for the suppression of illnesses related to the large intestine (Pakwashayagatha) like the bloating of the stomach/abdomen (Vayaru Perukkam). Vasti can be given in doses (Kramam) of Kala Vasti and Yoga Vasti.
Home Remedies for Amlapitta
- Add some sugar in water boiled with coriander and have a glass each three time a day
- Regularly consume tender coconut
- Take water boiled with gooseberry powder
- Chew cumin seeds after food
Dietary Control – What to eat and what to avoid
- Completely avoid all foods mentioned as reasons for causing the disease
- Make a habit of consuming food only as per the hunger level
- Follow a schedule for eating food
- Include large quantities of vegetables like pumpkin, snake gourd, bitter gourd, ash gourd, etc. and leafy vegetables in the diet
- Include rice, wheat, mung bean, jaggery, etc. that is at least one year old in the daily diet
- Consume gooseberry, raisin, pomegranate, fig (Athipazham), etc.
- Use for drinking, lukewarm water, water boiled with Coriander, water mixed with Vetiver, water cooked with flower (Malar)
- Drink/use milk daily
(it may cause some difficulties during the initial days, but later it will help in reducing the symptoms of the disease)
- 1 teaspoon ghee could be added in the daily diet
- Ensure proper sleep, rest, and exercise
- Avoid food that are sour and spicy (hot)
- Smoking, drinking alcohol, tea, coffee, bottled drinks, carbonated drinks, etc. should be avoided
- Avoid mental stress
- The influence of mental stress as a reason for the disease have been made clear. Hence, to reduce the impact of this, light Asana, Pranayama, Meditation, etc. should be made a regular practice.
- Asana will help in reducing mental stress and ensuring the proper functioning of the digestive system.
- Asana that can be practiced regularly
When all the processes in the body function properly as set by nature, the factors that enable the occurrence of the symptoms and the diseases are eliminated. This in turn helps in the healthy development of the body. By following an Ayurveda based lifestyle strictly, one can overcome acid reflux disease conditions and live a healthy life.