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Introduction

Amlapitta is a disease of Annavaha shrotas (G.I. tract). In present time most of the people are suffering from Ajeena and Amlapitta due to bad food habits and mental stress. so in present, Amlapitta is a burning problem of the society.

Vaghbhatta has described that all the diseases are caused by mandagni. Agnimandya is a pathological condition of delayed and improper digestion due to diminished power of digestive juices and initially leads to a clinical feature called Ajeerna (Indigestion). If ajeerna persists for a prolonged period, that leads to a Amlapitta condition (hyperacidity). The disease is having the sign and symptoms like heartburn, abdominal pain, sour belching, reflexes of food taken, nausea, loss of appetite etc.

In this study I have selected the Pathyadi choorna for clinical trial.

According to chakradatta :

(Cha 52/13)

Consuming the Harre choorna and Bhringraj choorna with gud helps alleviate vomiting caused by Amlapitta Janya Chardi and burning sensation in the chest. (anna vidaah).

Aims And Objectives :-

• To study the etiology and pathogenesis of the disease according to Ayurveda as well as modern medical science.
• To study Role of Pathyadi churna in the management of Amlapitta.

Methodology:
20 Patient suffering from Amlapitta were selected from OPD and IPD wings of Department of Kaya Chikitsa of Pt. Shiv Nath Shastri Govt. Ayurvedic College Burhanpur (M.P.)

1. Type of study: Clinical study

• Professor & HOD Department of Kaya Chikitsa, Pt. Shivnath Shastri Government Autonomous Ayurveda College and Hospital

1. Trial Drug: Pathyadi choorna

Dosage and duration:

• Dosage: 6 gm with old jaggery and water
• Duration: 30 days. (with 2 folllow ups in 10 days interval)

Inclusion criteria:

• Patient having age between 15 yrs to 70 yrs.
• Patient will be selected as per classical picture of Amla pitta.

Exclusion Criteria:

• Patient suffering from peptic ulcer or duodenal ulcer.
• Cancer patients
• Mental Disorder
• Diabetes patients
• Rakta pitta Patients
• Patient below 15 yr and above 70 yr.

Diagnostic Criteria:

• Classical signs and symptoms of the disease as mentioned in the Ayurvedic texts as well as modern medical books.
• By presenting proforma with detail clinical history and physical examination on the basis of principles of Ayurveda and Modern science.

Assessment Criteria:

All the cardinal features of Amlapitta i.e. Amlodgar, Daha, Shool, Chhardi, Avipak, Aruchi, Utklesh were taken into consideration for assessment and scoring pattern was adopted based on the intensity of these symptoms and each symptoms was assessed on the following grading system:

Observations and Results:

Maximum number of patients were between the age group of 35-52. 38% female, were 58% male. Maximum 100% patients were suffering from avipak, 82% patients were suffering from Amlodgara, 62% patients were suffering from Chardi, 61% patients were suffering from Daha, 55% patients were suffering from Aruchi, 35% patients were suffering from Utklesh and 33% patients were suffering from shool.

Effect of therapies (Role of Pathyadi choorna)

In this study highly significant results were found in cardinal sign like Amlodgara, Shool, Chhardi, Avipaka, Aruchi, Utklesh, and significant result in Daha.

Overall effect of Pathyadi Choorna:

• 48% patients had marked improvement.
• 44% patients had moderate improvement.
• 8% patients had mild improvement.
• 00% patients remained unchanged.

Mode of Action of Pathyadi Choorna:

Contents:

1. Haritaki - 1 Part (Fruit uses)
2. Bhringraj - 1 Part (leaf, stem, root uses)

Haritaki (Terminalia chebula):

Fruit contain - Tannic Acid, Gallic acid, Chebulinic acid, mucilage, Glycosides, Carbohydrates, Amino acids, Phosphoric Acid, succinic acid.

Action: digestive, laxative, stomachic, rejuvenator, anti-inflammatory, purgative, carminative. Reported to improve the secretory status of Brunner's gland involved in the protection against duodenal ulcer (Nader & Pillai 1989). It has been found cardiotonic & hypocholesterolemic effect.  Haritaki having Pancharasa (kashaya pradhan), laghu ruksha guna, ushna veerya, madhur vipak and Tridosh shamaka property.

Bhringraj (Eclipta Alba):

Chemical Composition: Glucosides, Phytosterol A, fatty acid, palmitic Acid, linolic Acid.
Action: Emetic, Analgesic, Spasmogenic, Antiseptic, Antiviral, Hepatoprotective, Stomachic, Digestive, Carminative, Antiinflammatory, Anthelmintic, Haematinic.
Bhringraj has Katu Tikta rasa, Laghu ruksha guna, Ushna veerya, Katu vipaka, Kapha-vata shamaka and pitta rechaka property.

3. Gud (Jaggery): Used as an ingredient.

Most of the drugs are having pitta kashay ras and also having deepan pechan properties. Madhur Divpak which might have counteracted the Tikshanaguna of Vitiated pitta in amlapitta. Ushana veerya, Katu vipaka improves agni functions and removes shrotoavarodha.

Discussion

Amlapitta is disease caused due to vitiation of certain attributes of pitta like the Drava guna and Amla guna causing vidaghdhajeerna at the initial stages and later causes inflammation and corrosion of the sleshmadhara kala of the Amashaya i.e mucous membrane of the stomach and duodenum. In modern science it can be correlated that vidagdhajeerna is a type of simple dyspepsia and amlapitta as gastritis.

Most of the aetiological factors of Amlapitta are related with the diet and habits. If one doesnot follow the Astavidha AharaVidhi Visheshayatana his agni will be diminished due to irregularities in the digestion and finally will cause Amlapitta. Charaka has advised to take food only after the previous meal is digested. If anyone takes the food with irregular intervals without proper digestion of the previous food,it may cause aggravation of Dhatus due to this insufficient rest to the stomach,where the people have the habit of eating now and then eat snacks,drinks tea or junk foods cause Agnidushti vitiate digestive fire,ultimately produce the disease Amlapitta. The mental stress and strain leads to irregular fluctuations in the production of gastric secretions ultimately causing damage to the gastric mucosa. While explaining the disease,Kashyap explained that the extreme vitiation of pitta dosha condition "Bhuyishtam pitta dushanat".

Conclusion

Amlapitta is a psychosomatic disease means Manasika plays major role with Sharirika bhava. When Ahara, Vihara and Manasika condition (due to hurry, worry and curry) get disturbed, they leads to Agnivaishamya which causes Anna visha formation and finally Vyadhi Amlapitta originates. The knowledge of etiological factors is very important as Nidana parivarjana is the first line of treatment. It plays very important role to cure as well as to prevent its recurrence. In the present study Pathyadi churna provided improvement in reducing the sign & symptoms of Amlapitta. It was observed that none of the patients remained unchanged. Drug have no side effect.