A duodenal ulcer is a type of peptic ulcer that occurs in the first section of the small intestine (duodenum). An esophageal ulcer is a condition that occurs in the lower part of your esophagus. Peptic ulcers are open sores on the inside lining of the stomach and the upper portion of the small intestine.
Causes of PARINAMA SHOOLA (DUODENAL ULCER)
Helicobacter pylori
Use of NSAIDs such as aspirin and
Stress
ibuprofen
Smoking
Radiation therapy
Symptoms Of PARINAMA SHOOLA (DUODENAL ULCER)
- The pain is usually in the upper middle part of the abdomen
- Spicy foods do not cause ulcers but can make them worse.
- The pain can feel like burning or gnawing, and it may go through to the back.
- Nausea
- Vomiting-Blood mixed
- Malina
- Loss of appetite
- Loss of weight
Upashaya and Anupashaya DUODENAL ULCER
Samanya Vishesa Siddhanta is applied in all fields of Ayurveda. The extension of this siddhanta in the form of Upashaya and Anupashaya respectively is used for diagnosis of a disease as well as for therapeutics. The avoidance of factors that aggravate the Shula and indulgence in those that relieve the Shula is advisable.
Upashaya
Relieving factors for Parinama shula are:
- Immediately after Bhojana
- Following vomiting
- On completion of aharapachana
Vataja parinama shula:
Snigdha, ushna annapana
Pittaja parinama shula:
Sita annapana
Kaphaja parinama shula:
Katu, tikta annapana
Anupashaya:
The aggravating factors for Parinama shula are:
Pachyamanavastha of aharapachana
Sastika Sali, vrihi Odana
Pittaja parinama shula:
Katu, Amla, Lavana annapana
Investigations For Duodenal Ulcer:
Inspect the stool, and test it for occult blood.
fiberoptic endoscopy or a double-contrast barium study of the upper GI tract.
Test for the presence of Hpylori infection.
Differential Diagnosis of Duodenal Ulcer:
| Features | Parinama shola | Annadrava Shoola |
| Pain | During Paka (digestion) | Occurs before food, during digestion and after food |
| Relief | Relieves after complete digestion of food | By vomiting |
| Aggravating factors | Pitta Prakopaka | No |
| Dosha | Pitta | – |
| Modern comparison | Duodenal ulcer | Gastric ulcer |
| Effect on Weight | Weight gain | Weight loss |
| Cause | Hurry, worry and curry are the causative factors | None |
- Vamana is indicated when the dosa is Amashayagata and in Kaphaja Parinama Shoola.
- Virechana is indicated when the dosa are in the Pachyamanashaya and in Pittaja Parinama Shoola.
- Basti is indicated in chronic stage
- Pachana, Vatanulomana
Ayurvedic Treatment Of Duodenal Ulcer
Principles of Treatment
Panchakarma
Shamana Snehapana- Maha tiktakkam Ghritam 20ml BD with milk Avapeedaka Sneha with Dadima Ghrita
Vamana is to be performed using Tikta and Madhura dravya. The dravyas to be used are Madanapala kvatha with Ksira, Kantakari rasa, Nimba kvatha, or Katutumbi rasa. Akanthapana of any of the above is indicated.
Virechana with Trivrit, Danti, or Eranda taila.
Yashtimadhu Ksheerabasti
Shirodhara: Takradhara
Single drugs Usefull in duodenal Ulcer:
- Amalaki
- Yashtimadhu
- Shatavari, Patola
- Mandoora Bhasma
- Pravala Pisti.
Naimittika rasayana Usefull in Duodenal Ulcer:
- Amalaki rasayana
- Drakshamalaka leha
- Dhatri Loha
- Saptamrita Loha
- Ksheera Mandoora
- Shatavari Mandoora
Ayurvedic Formulations for Duodenal Ulcer:
- Sutashekara Rasa-1-2 tab with water thrice a day before meal
- Kamadugha Rasa-1-2 tab with water thrice a day before meal
- Tiktaka Ghrita-2-4 tsf with warm water twice a day before meal
- Avipattikara churna-1-2 tsf with milk twice a day before meal
- Shatavari Ghrita [B.R]-2-4 tsf with milk twice a day before meal
- Shatavari-yashthimadhu ksheerapaka-30 ml BD
- Bhunimbadi Kashaya [S.Y.]-20ml TID
- Saptamrita Lauha [B.R]-250-500mg TID BF with milk
- Shatavari Mandoora [C.D.]-250-500mg TID BF with milk Ksheera
- Mandoora [C.D.]-250-500mg TID BF with milk
- Muktapanchamrita Rasa [B.B.R]-250-500mg TID BF with milk
- Pravala panchamrita Rasa [B.R]—250-500mg TID BF with milk
Proprietary Ayurvedic Formulations For Duodenal Ulcer:
- Syrup. Normocid (DHC)
- Cap. Amalapittantaka (AAF)—1 TID
- Tab. acinorm (UAP)—1 TID
- Tab. Alsarex (Charak)-1 TID
- Syrup Kalm (Prakriti)—2 tsf TID
- Syrup Himcocid (Himalaya)-1-2 tsf with water thrice a day before meal
- Syrup Amlapitta Mishrana (SDL)-2 tsf TID
- Syrup Pepcer (Ayulabs)-2 tsf TID
| Si No | Name of Medicine | Kala | Anupan |
| 1 | Avipattikara churna-3gm Pravala panchamrita-250mg Sootashekhara Rasa-250mg Saptamrita Loha-250mg Shatavari Mandoor-250mg Giloya Satva-500mg or Cap. Amlapittantaka-1 | Samana kala; TD Pragbhakta | Milk |
| 2 | Kamdugdh Ras- 250 mg | Pragbhakta – 3 Time | water |
| 3 | Mahatiktaka Ghrita-10-30ml or Amritottara Kashaya-20ml or mahatiktaka Kashaya | Pragbhakta – 3 Time | Lume warm Milk |
Yoga Therapy: Same as Amlapitta
Diet and Lifestyle: Same as hyperacidity
Prevention of Duodenal Ulcer:
Avoiding the pitta-aggravating diet, smoking, tobacco chewing, and alcohol.
Avoid stress, tension, anxiety, anger, etc.
Persons of Pitta Prakriti should take purgation therapy once in year Avoiding aspirin, ibuprofen, naproxen, etc. NSAIDs.
Frequently Asked Questions About Duodenal Ulcer
Yes, After completing treatment, one can permanently cure gastric or peptic ulcers. Ayurvedic herbal medicines reduce stomach acid and ease the symptoms of gastric ulcers.
Oatmeal, apples, pears, and other high-fiber foods are beneficial for ulcers in two ways. In addition to reducing bloating and pain, fiber can reduce the amount of acid in your stomach. Additionally, studies suggest that eating a diet high in fiber may help prevent ulcers.
Ghee is used in Ayurveda to treat chronic peptic ulcers and gastritis by healing the intestinal tract’s ulcers. When consumed, ghee lubricates the connective tissue and promotes the production of digestive enzymes, which helps with digestion.
Undiagnosed and ongoing H pylori infection and covert or unintentional NSAID use are the most frequent causes of refractory ulcers. H pylori contamination The H pylori bacterial load is suppressed and the diagnosis may be masked by the use of antibiotics, bismuth, or PPIs.
Coconut Water, Plain Water, and Water Mix with Shadang Paniya.