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Introduction

Ayurveda is one of the world's oldest holistic healing systems, it is the system of medicine which strongly believes in its objectives of keeping every individual healthy and away from diseases. According to Ayurveda, disease is caused when there is vitiation of Agni, Dosha, Dhatu, Mala &Mana1. It aims not only the radical removal of causative factors of the disease but also restoration of the doshic equilibrium. Ayurveda has described in detailed, both preventive as well as curative measures. The preventive measures are described in form of rutucharya (seasonal behaviour), dinacharya (daily behaviour), sadachar(ideal behaviour), vegadharan (inhibiting natural urges) and udiran2. Amlapitta is one of the vyadhi of gastrointestinal system. The basic compendium of Ayurveda like Charak samhita, Sushruta samhita & Ashtang hridaya has not described the disease. The detail description of Amlapitta is available in Madhavnidan, Kashyap samhita, Yogratnakar etc. According to Kashyap samhita, Amlapitta is closely related to the factors like type of food we consumed, Food habits & timing of taking food, lifestyle, nature of work etc. In Amlapitta, quantity of Pachak pitta is increased & its normal bitter taste gets changed & it becomes excess sour. Excess consumption of viruddha ahaar (incompatible food), dushta (rotten), ati-amla (sour) & vidahi aahar (spicy food), pittakarak aahar (pitta aggravating diet & drinks), guru aahar (food which is heavy to digest), Abhishyandi aahar (unctuous diet), Atidrava aahar (excess liquid diet), vegdharan (suppression of natural urges), atimadyapana (excess alcohol consumption), diwaswap (Day sleep) etc the different causes of Amlapitta given in Ayurveda classics. These factors cause vitiation of all three doshas but predominantly pitta dosha is vitiated. These vitiated doshas lowers the functioning of Agni (digestive power). Impairment of agni leads to improper digestion & metabolism which further leads to manifestation of Amlapitta.

Definition of Amlapitta: Amlapitta is composed of two words Amla+ Pitta. Also, it is said that Amla has been a natural property of pitta along with Katurasa.3 Sushruta has enlisted Katu as its original ras and mentioned that when Pitta becomes vidagdha changes into Amla.4

The augmented or increased Amla guna of pitta is known as Amlapitta5

The pitta which attains amla guna and vidagdhata is called as Amlapitta6

TYPES OF AMLAPITTA: Acharya Madhava explained 2 types based on the route :7

Urdhwaga Amlapitta: Urdhwaga Amlapitta is associated with chhardi which is of a harita, Peeta, neela, Krushna, aarakta, resembling mamsodak, atipichhila, shleshmayukta. Also, shirovedanam, hastapadadaha, Ushna, aruchi, kandu, mandala, pidaka.

Adhoga Amlapitta: In Adhoga Amplapitta, the patient has lakshana like trushna, daha, murchha, bhrama, moha & sometimes harita, peeta, krushna, rakta varna strava

According to dosha it is of 3 types: 1) Vataja 2) Vata-kaphaja 3) Kaphaja.

Vataja amlapitta shows symptoms like tremors, irrelevant talk, unconsciousness, weakness, feeling like ants are moving all around, pain, dizziness, confusion, horripilation, delusion.

Kaphaja amlapitta presents symptoms like excessive spitting, heaviness, stiffness in body, loss of desire to eat food, cold, coating in mouth, burning sensation, weakness, itching, excessive sleep.

Vata-kaphaja amlapitta presents symptoms of both doshas.

According to Kashyapa Acharya, it is of 3 types based on dosha dominance:

 1) Vataja 2) Pittaja 3) Kaphaja.

Vataja amlapitta shows symptoms like spasmodic pain around umbellicus, twisting pain in all over the body and yawning.

Pittaja amlapitta symptoms like giddiness and burning sensation.

Kaphaja amlapitta presents symptoms like heaviness and vomiting.

NIDAN:

Aharaj nidan8: Guru, abhishyandi, atiushna, paryushit aahar, aadhyashan, ajirna, Anshan, virudhashan, kulattha, dahi, lavanrasa, amlarasa, katurasa are the causative factors of pittaj vyadhi

Viharaj nidan: Bhuktva bhuktva divaswapnat Ati snan Ati avagahanat

Mansik nidan: Acharya charak mentioned that even the wholesome food also taken in proper quantity, does not get digested due to anxiety, grief, fear, anger, uncomfortable bed and vigil. It produces ama and that cause Amlapitta.

PURVARUPA:There is no unique purvarupa for amlapitta in ancient ayurvedic writings.

RUPA: Avipaka, klama, utklesha, tiktaudgara, amlaudgara, Gaurava, gurukoshtata hrit-kantha daha,aruchi

SAMPRAPTI: Doshaprakopa, namely Pitta Dosha, is caused by nidanasevana, according to Acharya Kashyapa. This eventually produces Mandagni, as a result of which consumed food takes the shape of Vidagdha and attains Shuktibhava. Amlata is created in Amashaya by the Vidagdha and Shuktibhava of food. This is known as Amlapitta.

UPADRAVA: The Upadravas of Amlapitta described in classics are- Jwara, Atisara, Pandu, Shula, Shotha, Aruchi, Bhrama, Dhatukshinata

UDARKA: The long standing Amlapitta Vyadhi may produce one of the following diseases (Udarka) if treatment is not done. Amashaya and Antravrana, Ashayadaurbalya, Grahani, Raktadhatu Dushti Janya Vyadhi, Arsha, Parikartika, Pravahika

SADHYASADHYATVA:

Sukha Sadhya: Acute stage of Amlapitta is Sukha Sadhya i. e. easily curable by treatment.

Kashta Sadhya: In the chronic stage Amlapitta is Kashta sadhya i.e., difficult to treat. It is treatable only if Hita Aahara Vihara is followed.

Yapya: Amlapitta becomes Yapya in chronic stage in some patients who do not follow the rule regarding aahara, vihara.

Asadhya: non-curable in these and if Amlapitta is associated with complications it becomes Asadhya i.e. incurable

UPASHAYA ANUPASHAYA (ACCORDING TO ACHARYA KASHYAP)

Vataj Amlapitta: SNIGDHA UPASHAYA

Pittaj Amlapitta: SWADU & SHITA UPASHAYA

Kaphaj Amlapitta: RUKSHA & USHNA UPASHAYA

PATHYA & APATHYA

Pathya ahar: Puranshali, mudga, masur, harenuk, Goghrit, Godugdha, jangal mansa, Kalay shak, pautik, vasa pushp, vastuk, Rason, Haritaki, pippali, puran madira

Pathya vihar : Vamana, Virechana, Basti, shital jalpan

Apathya Ahar: Til, Urad, kulthi, Avi dugdha, Dhanyamla, Lavana, Amla, Katu Rasa Dravya, Guru anna, Dadhi, Madya

Apathya Vihar: Vegvidharan, Atap sevan, Diwaswap

CHIKITSA:

Nidan parivarjan: Withdrawal of the aetiological factors of the disease is called nidan parivarjana. In amlapitta excessive nidana sevana leads to Mandagni and Pitta vriddhi. So nidan of amlapitta should be removed in its first treatment. Nidana Parivarjana along with these Daivavyapashraya and Manonigrahadi Satwavajaya Chikitsa should be done as course of disease and response to the treatment also depend upon psychological factors like tension, worries etc.

Sanshodhana chikitsa: Samshoshana karma eliminates the vitiated doshas from their root cause and thus cures the disease entirely so that there is least probability of recurrence of disease. Acharya Kashyap has mentioned Amlapitta is developed from Amashaya (stomach) and kapha and pitta dosha are having ashrayas. Vamana and virechana karma as the best treatment for Amlapitta, for an example as if we cut down the root of any tree, the stem of the tree dies automatically 9.

Sanshamana chikitsa: Samshamana karma or chikitsa means prakruti vighata. According to Acharya Kashyap after vamana karma if some of the vitiated doshas remains in the body then they should be pacified through langhana, laghu bhojana, satmya kala, desh and pachana karma with Shamana yoga.

Discussion

Amlapitta is a dominant disease in the present scenario of unhealthy food habits & regimens. The etiological factors of Amlapitta are numerous. Most of the Nidan explained in Ayurvedic classics were observed in the patients especially Pitta Prakopak Aahar Vihar Sevana.  When the normal Amla and Drava Guna of Pitta gets exaggerated (i.e., Pitta Dosha is vitiated) there occurs sore belching, heart burn etc., this condition is regarded as to be pathological condition termed as Amlapitta. Most of the Rupa explained in Ayurvedic classics were observed in the patients especially Tikta Amlodgara,

Hrullas, Chardi. Aruchi, Avipak are the main Lakshanas found commonly. Aacharya asserts that since amlapitta is more prevalent in marshy areas, you should avoid the desha, as it is more susceptible to it. amlapitta can be treated with any tikta rasa medication by samuchaya tantrayukti. Tikta-kashaya rasa, Madhur Veepaki and Sheet Veerya and Laghu, Ruksha, Sheeta Gunas of Shamana Aoushadhi cause Tridoshashaman mainly Pitta Dosha Shaman. Tikta rasa reduces Vidahi Guna. Madhur Vipaka removes Shuktatwa. Ruksha Guna and Kashaya Rasa causes Shoshana of increased Drava Guna of Pitta. Its, Deepan Pachana properties cause Agnideepan and Amapachana. The basic principle of treatment is Nidan parivarjana, Sanshodhana, Sanshamana chikitsa. Also, pathya ahar & vihar plays important role in management of Amlapitta.  

Conclusion

In conclusion, Amlapitta is a prevalent condition in modern times, largely attributed to improper food habits and lifestyle choices. Rooted in the vitiation of Pitta dosha, particularly its Amla and Drava qualities, Amlapitta manifests with symptoms such as sour belching, heartburn, nausea, and indigestion, as described in Ayurvedic texts.

The treatment approach focuses on balancing the Pitta dosha using Tikta-kashaya rasa, Madhur veepaka, and herbs with cooling, light, and dry properties. The primary treatment principles include Nidan parivarjana (avoiding causative factors), along with Shodhana and Shamana chikitsa (detoxification and pacification therapies). Furthermore, adopting a pathya (wholesome) diet and lifestyle plays a critical role in managing and preventing the recurrence of Amlapitta, ensuring long-term relief and balance.