Ayurveda : Natural Calming Way to Heal GERD and Acid-Peptic Disorders

Gastroesophageal Reflux Disease (GERD) is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages—from infants to adults.

Ayurveda considers a group of such disorders as “Amla-Pitta”. Amla-Pitta can be interpreted as “denoting to a sour taste as a result of acidic bile juices.”

According to Ayurveda scholars such as Caraka and Sushruta, imbalanced Pitta (Digestive Fire Element) attains excessive or adversely composed Pitta from its’ balanced form, then becomes acidic and Acrid (Sour and/or Pungent in Taste).

GERD and other Acid-Peptic disorders, based on similarities in clinical features and symptomatic correlation, can be associated with Amla-Pitta in Ayurveda.

CAUSATIVE FACTORS ACCORDING TO AYURVEDA

  1. Food
    1. Virudh Ahara – Incompatible / mismatched food like milk & fish, milk shakes, milk with pulses/ lentils, milk & egg etc.,
    2. Polluted Food – with chemicals, heavy metals, pesticide, agrochemicals etc.
    3. Sour food like berries etc.
    4. Hot and Spicy food
    5. Pitta provoking diet i.e., extremely hot food (in terms of temperature), late night eating, untimely diet, overeating.
  2. Lifestyle
    1. Irregular sleep, staying up late at night, sun bath during extreme heat (a person’s tolerance to heat does not define how heat affects pitta).
    2. Psychological Factors – Excessive Stress, Anxiety, Irritability.
    3. Infections – H. Pylori (bacterial infection)
    4. Regional Factors/Season Factors – Being affected by the geographical factors such as humidity and being in hot climatic zones. Residing in cooler temperatures and staying away from humid weather tends to benefit people with Amla-Pitta symptoms.

Symptoms

Cardinal Symptoms

  1. Acid Eructation (Acidic, Pungent burping / belching)
  2. Heart Burn
  3. Retro-sternal burning sensation
  4. Excessive weakness – fatigue
  5. Indigestion
  6. Nausea
  7. Heaviness
  8. Anorexia
  9. Epigastric fullness and tenderness

Systemic Symptoms:Hives, Urticaria, skin eruptions.

Therapeutic Measures

    1. Daivavyapashraya (Spiritual Therapy)
    2. Yuktivyapashraya (Rational Approaches)
    3. Satvavajay (Psyche Healing Procedures)
    1. Samshodhan (Panchkarma & Purification Therapy)
      1. Therapeutic Emesis
      2. Therapeutic Laxation
      3. Nutritive oil enema in chronic cases.
    2. Sanshaman (Palliative Care)
    3. Combination of measures 1 & 2.
  3. The disease originates in the stomach and makes it way to the esophageal tract or, in the opposite direction towards the intestines, making Kapha and Pitta the dominating Doshas. Therapeutic Emesis is administered or offered as first choice (Depend upon client’s preference)
  4. After therapeutic emesis, demulcent herbs (anti-Kapha-Pitta herbs) are offered in the form of powders, capsules, liquids to soothe the gastro-intestinal tract.
  5. When composite doshas are eliminated, the stomach becomes clean & clear. At this point, digestive herbs/remedies are offered, and moderate fasting is recommended.
  6. If the doshas have translocated to the intestines, therapeutic laxation is then administered to expel the pitta.

In Amla Pitta fasting is offered with frequent easily-digestible food like moong bean, garbanzo, red lentils, coconut milk and coconut, pumpkin, bread toast, pomegranate juice, rice, to encourage normal process of digestion. Please note fasting is not considered here as crash dieting without any food.

 

Some Evidence based Herbs

Name of Herb Mode of Action
1. Patola (Pointed Gourd) Trichosanthes Diocia Antiulcer activity, antisecretory partly cytoprotective activity, antioxidant, and anti-inflammatory properties (Humdulay et al)
2. Nimba (Neem-Azadirachta Indica) Regenerative potential against ethanol induced mucosal damage. (Al-Rehaily et al)
3. Amalaki (Embelica Officinalis) Antisecretory, antiulcer and cytoprotective properties (Ofusoria et al)
4. Guduchi (Giloy) Tinospora Cordifolia (Wild) Miers. Antiulcer activities (Chandan N.G et al)
5. Haritaki (Terminalia Chebula Retz) Antiulcerogenic, as well as ulcer healing properties, which might be due to its antisecretory activity (Raju D et al)
6. Bhringraja (Eclipta Alba) Hassk Antioxidant property (Swati et al)
7. Chandan- Sandalwood Santalum Album Linn Anti-inflammatory, anti-ulcer (Simrendeep Singh et al)
8. Draksha (Vitis Vinifera Linn.) Antiulcer (Muhammad E. Guldur et al)
9. Musta (Cyperus Rotundus Linn.) Gastroprotective effect, antioxidant effect (Dushyant Kumar et al)
10. Shatavari Antiulcer effect (Anil Mangal et al)

 

References:

  1. N. Humdulay, Z. Attauraahaman, V. Shende, M. Lawar, Evaluation of Gastric Antiulcer Activity of Trichosanthes Dioica Roxb Leaves. IJPSR 2012, Vol. 3(11), 4332-4337.
  2. J. Al-Rehaily, T.A. Howiriny, M.O AL-Sohaibani, S. Rafatullah, Gastroprotective effects of AMLA- Embelica Officinalis on in vivo test modes in rats. Phytomedicine 2002; 9:515-522.
  3. David A. Ofusoria, d, Benedict A. Falanab, Adebimpe E. Offsoric, Ezekiel A., Caxton-Martinsa, Regenerative Potential of aqueous extract of neem, Azadirachta Indica, on the stomach and ileum following ethanol induced Mucosa lesion in Adult Wister Rats. – Gastroenterology Research 0 2010: 3(2):86-90.
  4. Chandan N.G., Tirthankara Deb, S. Manju Bhargavi, Evaluation of Antiulcer activity of Tinospora Cordifolia in Albino Rats. Int J pharm bio science 2013, Apr; 4 (2) (P) – 78-85.
  5. Raju D, Ilango K., Chitra V, Ashish K., Evaluation of antiulcer activity of methanolic extract of Terminalia Chebula fruits in experimental rats. J Pharma Sci. & Res. Vol.1 (3) 2009, 1017107.
  6. Swati, Sheila Bedi, Tanuja, In vitro antioxidant potential and phytochemical screening of Eclipta Alba, Asian J.Exp. Biol. Sci. 2012, 3(4): 785-789.
  7. Simrendeep Singh, Mohanjit Kaur, Amarjeet Singh, Bimlesh Kumar. Pharmacological evaluation of anti-inflammatory and antiulcer potential of Heart wood of Santalum Albam in rats. Asian Journal of Biochemical and Pharmaceutical research, 2014. 1(4), 140-153.
  8. Muhammad E. Guldur, A. Ozgonul, Ibrahim H. Kilie, O. Sogut, M. Ozaslan, M. Bitiren, M. Yalcin and D. Musa, 2010. Gastroprotective effects of Cyperus Rotundus extract against gastric mucosal injury induced by ischemia and reperfusion in rats. International Journal of Pharmacology 6; 104-110.
  9. Dushyant Kumar, P A Patil, H V Hegde, Kuntal Ganguly, S D Kholkute. Antiulcer activity of traditional formulation in rats. Pharmacology online 2009, 3: 900-904.
  10. Anil Mangal, Debashish Panda, M C Sharma, Peptic ulcer healing properties of Shatavari (Asparagus Racemosus Wild.), Indian Journal of Traditional Knowledge.