Review of parinama-shoola and its management w.s.r. to duodenal ulcers
Journal name: World Journal of Pharmaceutical Research
Original article title: Review of parinama-shoola and its management w.s.r. to duodenal ulcers
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Teena Verma and Indumati Sharma
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Review of parinama-shoola and its management w.s.r. to duodenal ulcers
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20208-18322
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
Introduction
The changing dietary patterns associated with modern lifestyles have resulted in an increase in various health issues, particularly duodenal ulcers. These ulcers, characterized by the erosion of the mucous membrane in the duodenum due to gastric acids and pepsin, present significant morbidity, affecting approximately one person per thousand in the general population. Their clinical manifestation shares similarities with the Ayurvedic condition known as "Parinama-shoola," which involves acute epigastric pain during digestion. This review explores the relationship between Parinama-shoola and duodenal ulcers, their classifications, symptoms, and potential Ayurvedic treatments.
Parinama-shoola: Understanding its Symptoms and Classifications
Parinama-shoola, defined as a pain rooted in an imbalance of the Vata dosha, exhibits diverse symptoms based on the predominance of the three doshas: Vata, Pitta, and Kapha. Each type presents with specific characteristics. For instance, Vataj Parinama-shoola causes symptoms such as tympanitis, constipation, and anxiety, with pain relief associated with oily and warm foods. Conversely, Pittaj Parinama-shoola leads to epigastric burning and hyperhydrosis aggravated by spicy foods, while Kaphaj Parinama-shoola results in nausea and lethargy relieved by bitter and pungent items. Additionally, combinations of two doshas lead to Dwandaja Parinama-shoola, and when all three are involved, Sannipataj Parinama-shoola can occur, often indicating a more complex and difficult condition to treat.
Duodenal Ulcers: Clinical Features and Precipitating Factors
Duodenal ulcers are caused by the corrosive nature of gastric acid and pepsin, resulting in ulcers primarily on the duodenum's anterior or posterior walls. Key clinical features of duodenal ulcers include sharp or burning epigastric pain, nausea, and recurrent periodic pain that may radiate toward the back. Specific precipitating factors contribute to their development, such as hypersecretion of gastric acid and pepsin, bile acids, H. pylori infection, and lifestyle choices like excessive alcohol and tobacco use. Understanding these features and factors is crucial for effective diagnosis and management.
Treatment Approaches: Modern vs. Ayurvedic Management
Management of duodenal ulcers typically involves avoiding ulcerogenic agents, administering antibiotics for H. pylori eradication, and utilizing antacids, H2 receptor antagonists, proton pump inhibitors, or surgery for resistant cases. Ayurvedic approaches, however, emphasize a holistic treatment based on the dosha imbalance inherent in Parinama-shoola. Treatments include Langhana (lightening therapies), Vamana (emesis), Virechana (purgation), and Bastikarma (enema), tailored to the specific dosha imbalance. Classical Ayurvedic preparations like Shambookadi Vati and Lauha Mandoora Bhasma are utilized to ensure effective management of Parinama-shoola.
Conclusion
The analysis of Parinama-shoola and duodenal ulcers reveals considerable overlap, particularly in symptoms such as epigastric pain linked to digestive processes. The Ayurvedic perspective provides valuable insights into the treatment options by focusing on dosha imbalances, ensuring a tailored and holistic approach. Recognizing the interrelation between modern medical understanding and traditional Ayurvedic practices can pave the way for more effective management of duodenal ulcers and enhance overall digestive health.
FAQ section (important questions/answers):
What lifestyle changes contribute to duodenal ulcers?
Modern dietary habits such as excessive salty, spicy, and junk food consumption, along with certain analgesics, weaken the immune system, making the body more susceptible to infections, including duodenal ulcers.
What is Parinama-shoola in Ayurveda?
Parinama-shoola is characterized by acute epigastric pain during digestion, primarily caused by a vitiation of Vata-dosha, often accompanied by Pitta and Kapha doshas, leading to increased pain after meals.
How is Parinama-shoola classified in Ayurveda?
It is classified based on the predominant dosha causing symptoms: Vataj, Pittaj, Kaphaj, Dwandaja, and Sannipataj Parinama-shoola, each having distinct clinical features and pain relief methods.
What are the common symptoms of duodenal ulcers?
Symptoms include sharp or burning epigastric pain, nausea, periodic pain, and aggravation by certain foods and drinks, while often relieved by eating.
What factors contribute to the development of duodenal ulcers?
Factors include hypersecretion of gastric acid, H. pylori infection, poor immune function, and lifestyle habits like alcohol and smoking.
What Ayurvedic treatments exist for managing Parinama-shoola?
Ayurvedic management includes Langhana, Vamana, and Virechana therapies, alongside herbal preparations tailored to balance the predominant dosha, providing relief from symptoms.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Review of parinama-shoola and its management w.s.r. to duodenal ulcers�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Parinama:
Parinama refers to the transformation or change that occurs in the body due to various factors, including dietary habits and lifestyle choices. In the context of Ayurveda, it relates specifically to changes in the doshas that can lead to conditions such as Parinama-shoola, which is a type of abdominal pain associated with digestive disturbances.
2) Dosha (Dosa):
Dosha represents the three fundamental energies in Ayurveda—Vata, Pitta, and Kapha—that govern physiological and psychological functions in the body. Each dosha has specific characteristics, and imbalances can lead to various health issues, including digestive disorders and disturbances like Parinama-shoola and duodenal ulcers.
3) Ulcer:
Ulcers, especially duodenal ulcers, arise due to erosion of the mucosal lining by gastric acid and digestive enzymes. They can cause recurrent abdominal pain and discomfort, necessitating effective management through both modern medical treatments and traditional Ayurvedic approaches that focus on restoring balance among the doshas involved in digestion.
4) Pain:
Pain is an unpleasant sensory experience typically associated with bodily injury or illness. In Ayurveda, it can manifest due to vitiation of doshas, leading to conditions like Parinama-shoola. Understanding the nature and timing of pain can aid in diagnosis and treatment, guiding appropriate therapeutic interventions.
5) Food:
Food plays a crucial role in influencing health, particularly in Ayurveda, where dietary habits can impact the balance of doshas. Overconsumption of spicy, salty, or junk food can lead to digestive disturbances, contributing to conditions like Parinama-shoola. Proper dietary choices can help prevent diseases like duodenal ulcers.
6) Pitta:
Pitta is one of the three doshas in Ayurveda, embodying the principles of heat, transformation, and metabolism. It is associated with digestion and the production of enzymes. An imbalance in Pitta can lead to symptoms like burning sensations and exacerbation of conditions such as duodenal ulcers and Parinama-shoola.
7) Vata:
Vata, in Ayurveda, governs movement and functions of the body, including the nervous system and elimination processes. When Vata becomes vitiated, it can lead to digestive issues, manifesting as symptoms like pain and discomfort, thereby playing a significant role in conditions such as Parinama-shoola and duodenal ulcers.
8) Pittadosha (Pittadosa, Pitta-dosha):
Pitta-dosha is the specific dosha associated with the element of fire and governs digestion, metabolism, and energy production in the body. When aggravated, it can lead to increased acidity and pain during digestion, resulting in clinical manifestations similar to those seen in duodenal ulcers and Parinama-shoola.
9) Vatadosha (Vatadosa, Vata-dosha):
Vata-dosha represents the dosha associated with movement and is responsible for bodily functions such as circulation and nerve impulses. When Vata is vitiated, it can lead to symptoms such as bloating, constipation, and pain, particularly during the digestive process, relevant to conditions like Parinama-shoola.
10) Rajasthan:
Rajasthan, a state in India, is culturally significant in understanding traditional Ayurvedic practices and healthcare. The integration of local dietary habits and environmental factors plays a role in the prevalence of conditions like duodenal ulcers, making regional context essential in Ayurvedic treatment approaches.
11) Vomiting:
Vomiting is a reflex action that expels contents from the stomach and is often associated with gastrointestinal disturbances. In the context of duodenal ulcers and Parinama-shoola, it serves as a protective mechanism against irritation, yet frequent vomiting can worsen dehydration and the overall state of digestive health.
12) Vitiation (Vitiated):
Vitiation refers to the alteration or disturbance of the natural state of doshas, leading to health issues. In Ayurveda, understanding the process of vitiation is crucial for diagnosis and management, especially with conditions like Parinama-shoola, where it reflects the underlying imbalance of bodily energies.
13) Udaipur (Udaypur):
Udaipur, a city in Rajasthan, India, is noted for its Ayurvedic educational institutions and traditional healing practices. The study of local health patterns and dietary habits contributes to a better understanding of ailments such as Parinama-shoola and supports the application of Ayurvedic treatment modalities in the region.
14) Anxiety:
Anxiety is a psychological condition that can manifest as physical symptoms affecting the digestive system. In Ayurveda, stress and anxiety can aggravate doshas, particularly Vata and Pitta, leading to discomfort and conditions like duodenal ulcers and Parinama-shoola, highlighting the need for comprehensive mental health management.
15) Kaphadosha (Kaphadosa, Kapha-dosha):
Kapha-dosha is associated with the elements of water and earth, governing structure, stability, and the lubrication of bodily systems. An imbalance in Kapha can lead to symptoms such as lethargy and nausea, making its understanding crucial in diagnosing and treating conditions like Parinama-shoola and related digestive issues.
16) Ayurveda (Ayus-veda):
Ayurveda is a holistic system of medicine originating in India that emphasizes the balance of the body, mind, and spirit. It offers comprehensive approaches to diagnosis and treatment of conditions like digestive disorders, including the use of diet, lifestyle modifications, and natural remedies to restore harmony among the doshas.
17) Disease:
Diseases refer to pathological conditions impacting bodily functions. In Ayurveda, diseases arise from imbalances among the doshas and require a comprehensive approach that includes lifestyle modifications and dietary adjustments for effective treatment, particularly relevant for managing conditions like Parinama-shoola and ulcers.
18) Burning (Burn, Burned, Burnt):
Burning refers to a painful sensation often experienced in the epigastric region during episodes of digestive issues like duodenal ulcers and Parinama-shoola. This symptom is typically attributed to the aggravation of Pitta dosha and points to the need for treatment strategies aimed at pacifying this dosha to alleviate discomfort.
19) Nausea:
Nausea is a sensation of unease in the stomach that often precedes vomiting. In Ayurvedic terms, it can arise from imbalances in doshas, particularly Kapha and Pitta, making it a significant symptom to address in conditions such as Parinama-shoola and various digestive disorders.
20) Nature:
Nature, in the context of Ayurveda, refers to the inherent qualities and behaviors of substances and organisms. Understanding the nature of foods, doshas, and medical treatments is essential for effective management of health conditions like duodenal ulcers and for promoting holistic well-being through appropriate lifestyle choices.
21) Kapha:
Kapha is one of the three primary doshas in Ayurveda, embodying qualities associated with fluidity, stability, and nourishment. An imbalance in Kapha can lead to accumulation and lethargy, which impacts digestion and may result in symptoms that overlap with those of conditions like Parinama-shoola.
22) Lauha:
Lauha refers to iron-related Ayurvedic preparations, often used to enhance blood health and treat deficiency. Its incorporation into treatments aims to bolster overall health, vital for managing conditions like duodenal ulcers, where iron levels may be affected due to blood loss or chronic illness.
23) Salt (Salty):
Salty refers to a flavor associated with sodium, which can have distinct effects on digestion and hydration. Excessive salty food consumption can exacerbate thirst and irritation, triggering doshic imbalances and potentially worsening symptoms related to digestive disorders like duodenal ulcers and Parinama-shoola.
24) Vati:
Vati denotes a form of Ayurvedic medicine that is often prepared in tablet or pill form. These formulations, such as Shambookadi Vati, are made to provide precise dosha balancing effects, particularly in managing conditions like Parinama-shoola by addressing symptoms systematically through specific herbal combinations.
25) Saptamritalauha (Saptamrtalauha, Saptamrita-lauha):
Saptamrita-lauha is an Ayurvedic formulation containing iron and a blend of herbal components, known for its rejuvenating properties. It addresses conditions related to blood and digestion, serving as a key remedy in the management of symptoms associated with digestive disorders like Parinama-shoola and duodenal ulcers.
26) Bastikarman (Bastikarma, Basti-karman, Basti-karma):
Bastikarma is an Ayurvedic therapeutic procedure that involves the administration of herbal medicinal oils through the rectum, aimed at balancing Vata dosha. This treatment is particularly indicated for managing Vataj conditions such as Parinama-shoola, enhancing overall digestive health and relieving related symptoms effectively.
27) Saptamrita (Saptamrta, Sapta-amrita):
Saptamrita generally refers to a group of formulations in Ayurveda that possess rejuvenating and restorative properties, promoting balance within the body. These formulations may be employed in treating various ailments, including digestive disorders like Parinama-shoola, ensuring comprehensive care through herbal interventions and therapy.
28) Discussion:
Discussion refers to the examination and analysis of findings regarding a particular topic—in this case, the relationship between Parinama-shoola and duodenal ulcers. Through analysis, healthcare practitioners can deepen their understanding, enabling the formulation of effective treatment protocols that integrate both Ayurvedic and modern medical perspectives.
29) Antibiotic (Antibacterial):
Antibiotics are pharmaceutical agents used to treat bacterial infections, including Helicobacter pylori, which is often implicated in duodenal ulcers. While they are essential in conventional medicine, Ayurvedic treatment may aim for a holistic approach, addressing underlying imbalances rather than solely targeting the infection.
30) Medicine:
Medicine, in the Ayurvedic context, refers not only to pharmaceuticals but also to a holistic approach focusing on wellness through diet, lifestyle, and herbal remedies. The effectiveness of Ayurvedic medicine lies in its emphasis on individuality, tailoring treatments based on the patient's dosha and specific imbalances.
31) Narikela:
Narikela refers to coconut, which is valued in Ayurveda for its cooling and nourishing properties. It can be beneficial for soothing Pitta aggravation and is often used in formulations to alleviate digestive issues, making it relevant in the treatment of conditions such as Parinama-shoola.
32) Indumati (Imdumati):
Indumati Sharma is likely a contributor or researcher involved in the study or application of Ayurvedic principles for diagnosing and treating conditions such as Parinama-shoola. The work of individuals like Sharma highlights the integration of traditional knowledge and modern scientific inquiry in healthcare.
33) Hingvadi:
Hingvadi refers to an Ayurvedic formulation that typically includes asafoetida and other herbs, known for its digestive benefits. It can be particularly effective in managing symptoms of digestive disorders by promoting digestion and alleviating gas, relevant in treating conditions like Parinama-shoola.
34) Langhana (Lamghana):
Langhana is an Ayurvedic treatment principle involving lightening therapies that help reduce excess dosha accumulation. It is particularly beneficial for addressing conditions like Parinama-shoola and related digestive issues by promoting proper digestion and balance among the doshas, thereby alleviating symptoms effectively.
35) Snigdha:
Snigdha refers to substances that are oily or unctuous, emphasizing qualities that can help soothe and nourish the body. In Ayurveda, snigdha properties are often used therapeutically in the management of conditions like Parinama-shoola, particularly beneficial in alleviating Vata imbalances in the digestive system.
36) Pungent:
Pungent describes a strong flavor that can stimulate digestion but may aggravate Pitta, leading to potential discomfort or conditions like ulcers. Limiting pungent foods is often recommended in Ayurveda for individuals experiencing symptoms related to Parinama-shoola or duodenal ulcers to avoid further irritation.
37) Bhasma (Bhasman):
Bhasma refers to calcined mineral preparations used in Ayurveda for their medicinal properties, particularly in enhancing bioavailability and efficacy. Bhasmas, like Lauha Bhasma, are incorporated into treatments for various ailments, including digestive disorders such as Parinama-shoola, playing a key role in restoring health.
38) Modaka:
Modaka refers to a type of Ayurvedic preparation often designed as a sweet or confection that includes medicinal herbs. It can be utilized in therapy to aid digestion and balance doshas, thereby supporting the management of symptoms associated with conditions like Parinama-shoola.
39) Vamana:
Vamana is an Ayurvedic therapeutic procedure focusing on emesis or induced vomiting to eliminate excess Kapha dosha. It is employed in cases of Kapha-related conditions, including digestive disorders like Parinama-shoola, providing relief by cleansing the digestive tract and restoring balance among the doshas.
40) Lavana:
Lavana indicates salt in Ayurveda, associated with enhancing flavor and appetite but also potentially leading to dosha imbalances if consumed excessively. It underscores the need for moderation in dietary choices for digestive health and may be significant in the management of conditions like Parinama-shoola.
41) Sharman (Sarma, Sarman, Sharma):
Sharma, likely referring to Indumati Sharma mentioned in the text, underscores the importance of scholarly contributions in Ayurveda that enhance understanding and treatment approaches for conditions like Parinama-shoola, indicating the blend of traditional insights with modern research.
42) Reason:
Reason in the context of medicine involves understanding the underlying causes of symptoms and conditions. In Ayurveda, identifying the reason behind vitiation or imbalance of doshas is crucial for effective diagnosis and treatment of ailments like Parinama-shoola and duodenal ulcers, ensuring holistic care.
43) Tikta:
Tikta refers to the bitter taste in Ayurveda, which is considered beneficial for detoxifying and enhancing digestion. Incorporating tikta foods can be beneficial for pacifying Kapha and Pitta dosha, presenting therapeutic options for management of symptoms associated with digestive disorders like Parinama-shoola.
44) Ushna (Usna):
Ushna refers to the hot quality in Ayurvedic terminology, often associated with Pitta dosha. Foods or treatments that are ushna are used to help mitigate cold or stagnant energies in the body. This concept helps practitioners formulate appropriate dietary strategies for conditions like Parinama-shoola.
45) Blood:
Blood in Ayurveda is considered essential for nourishment and vitality, and its health is closely monitored in the context of digestive disorders. Conditions causing blood loss, such as ulcers, warrant careful management to restore balance and overall health through holistic treatment methods.
46) Study (Studying):
Study refers to research and investigation efforts to enhance understanding of medical conditions and their treatments. This is vital for advancing Ayurvedic practices and integrating them with modern medical frameworks, particularly in areas dealing with common ailments like Parinama-shoola and duodenal ulcers.
47) Katu:
Katu denotes the pungent taste in Ayurveda, known for stimulating digestion and enhancing metabolic processes. However, excessive consumption can lead to irritation and heat in the body, thus requiring a balanced approach in dietary choices to avoid issues like Parinama-shoola or ulcers.
48) Bile:
Bile, produced by the liver, aids in the digestion of fats and is crucial for overall digestive health. An excess or deficiency in bile can lead to complications such as ulcers, making its management an essential aspect in treating conditions like Parinama-shoola and ensuring proper digestive function.
49) Wall:
The wall refers to the lining of the duodenum where ulcers can occur due to erosive action from gastric acid. In understanding digestive health, the condition of the wall is paramount in diagnosing and treating duodenal ulcers, guiding therapeutic approaches in Ayurveda.
50) Line:
Line here refers to the treatment approach or protocol established in Ayurveda for conditions like Parinama-shoola. This strategy involves understanding the dosha predominance and selecting appropriate remedies that align with individual health concerns, advocating for a comprehensive and tailored healthcare approach.
51) Seat (Seated):
Seat refers to the primary location or center of a specific dosha in the body. Understanding where each dosha resides enhances diagnosis in Ayurveda, allowing practitioners to target treatments effectively, especially for conditions like Parinama-shoola associated with epigastric pain related to Pitta.
52) Sour:
Sour taste is one of the six tastes recognized in Ayurveda, often stimulating digestion but also having the potential to aggravate Pitta dosha. Therefore, managing sour food intake is vital for digestive health, particularly for individuals suffering from ulcers or symptoms of Parinama-shoola.
53) Drug:
Drug generally refers to pharmaceutical interventions used in modern medicine. While Ayurvedic practices may utilize herbs and formulations, knowledge of conventional drugs can enhance practitioners' holistic approaches, especially in the treatment of conditions such as duodenal ulcers and facilitating overall patient care.
54) Life:
Life in the Ayurvedic context signifies a holistic approach to health and wellness encompassing physical, mental, and spiritual well-being. The integration of lifestyle, diet, and herbal remedies shapes a person's overall health, guiding interventions for conditions like Parinama-shoola and related digestive disorders.
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