A 43 years old patient came with c/o burning sensation in the epigastric region, hot burps and acid reflux since 2013. It all started after the stress conditions due to house buying / financial problems. It started with feeling of nausea on and off in the morning 6years back. Used to take Nexium (20mg) which made her felt better. She stopped taking after sometime and the symptoms came back very badly. Takes Nexium on and off especially after alcohol and chilli intake as they make pain and burning worse. Also taking slippery elm sometimes. Used to aspirin but worsens gastritis so not taking any more. Used to have a lot of coffee and spicy food.

GASTRITIS PEPTIC ULCER

Investigations-

  • Cardiac ECG done – nothing abnormal detected
  • H. pylori- negative
  • Echo and stress test- normal
  • H/o gastroscopy done in 2015-16 which showed Barrett’s oesophagus. H/O osteopenia but now bones not bad. Hesitant to take Nexium as causes osteopenia as side effect.
  • H/o early menopause at the age of 38years.
  • Medications taking- Vitamin D, magnesium, fish oil
  • F/H- Ischaemic heart disease to father.
  • AYURVEDIC EXAMINATION (Pariksha)
  • Nadi- Vata pitta
  • Jihwa- non-coated
  • Bowel- tend towards constipation
  • Eyes- normal
  • Skin- dry
  • Urine- normal
  • On auscultation- N/A
  • Abdominal examination- N/A

AYURVEDIC 10 FOLD EXAMINATION:

  • Prakruthi- Pittavata
  • Vikruthi- Pachaka pitta, kledaka kapha, samana vata, apana vata
  • Dhatu-  Rakta, rasa, meda, asthi, shukra
  • Srotas- Annavaha, Asthivaha, Shukravaha
  • Organ- stomach, bones

Samprapti- (Ayurvedic Pathophysiology)  Due to the intake of pitta aggravated food and drinks as well as stressful conditions lead to the vitiation of pachaka pitta along with kledaka kapha. This vitiation later also caused the apana vata and samana vata vitiation.

The aggravated pachaka pitta caused the ahara rasa to get overly cooked which lead to the formation of improper ahaar rasa and toxin formation. The toxins affects the digestive system causing the kledaka kapha decrease and when circulated through blood got lodged in the bones causing osteopenia. In the heart also toxins reached through rakta and caused problems there. The toxic ahaar rasa lead to improper rasa dhatu and so on till shukra dhatu got affected. Shukra dushti along with vitiated apana vata lead to early menopause.

Diet and lifestyle

Diet Chart- 

Pitta Vata Prakruthi

This diet advice should be considered as a guide to help improve your condition. Try and involve the foods favourable more into your daily diet and try and avoid the foods unfavourable as much as possible. But you may find some foods in the favourable list not suiting you occasionally. Avoid them and adjust your diet accordingly.

CATEGORY

OFTEN

IN MODERATION

SELDOM

Vegetables

Asparagus, Onion (Cooked), Squash, Leafy Greens, Pumpkin,
Cilantro, Okra, Carrots, Bok Choy, Celery, cucumber

Broccoli, Beets, Spinach, Sweet Potato, Cauliflower,
Cucumber, Parsley, Lettuce, Peas, Green Beans,
roquette/rocket, mustard greens

Peppers, Corn, Tomato, Eggplant, Mushrooms, Turnips,
Brussels Sprouts, Cabbage, Onion (raw)

Fruits

Figs (fresh), Pineapple, Dates, Mango, Watermelon, Coconut,
Apricots, Plums (sweet)

Lemons, Banana, Limes, Cherries,

Pink Grapefruit, Apples, Strawberries, Pears, Grapes,
Raisins

Avocado, Kiwi, Persimmon, Yellow Grapefruit, Cranberries

Grains

Basmati rice, Wheat, Oats (cooked), Barley, Couscous

Quinoa, Brown rice (cooked well), Amaranth, Wild Rice

Rye, Corn, Millet,

Nuts and Seeds

Coconut, Pepitas (pumpkin seeds), Sunflower seeds, Almonds
(soaked & peeled), Flax seed

Psyllium, Almonds (with skin),

Peanuts, all nuts and seeds in large quantities

Meat

None

Fish and seafood (esp. white fish), Chicken, Turkey,

Pork, Beef, Lamb, Kangaroo, Duck & other game birds,
Rabbit

Oils

Coconut, Olive oil, Sesame

Avocado, Almond, Canola, Safflower

Corn, Animal fats/lard

Beans/ Legumes

Mung

Tofu and soy products, Kidney beans, Navy beans, Black eyed
peas,

Urud Dhal, Aduki beans, Miso

Dairy

Ghee, Butter milk

All Dairy Products

Yoghurt at night time, Ice-cream, Salted butter, Sour cream

Sweeteners

Natural Sweetener (barley malt, amasake, brown rice syrup,
Maple syrup

Honey, Jaggery, Molasses, sucanat – whole cane sugar)

All white sugar and its products, Artificial sweeteners,
Large quantities of any sweet

Herbs and Spices

Cardamom, Coriander, Cinnamon, Fennel, Dill, Cumin, Mint,
Saffron, Turmeric, Basil, Peppermint, Vanilla, Fenugreek,
Nutmeg, Spearmint

Black Pepper, Ginger, Garlic, Bay leaf, Rosemary, Sage,
Thyme, Paprika, Mustard, Asafoetida

Chilli, Mustard, Cloves, Marjoram,

ADVICE:

Body Constitution (Prakruti) Type or for Current imbalances (Vikruti) – Combination of Vata and Pitta doshas. Favour diet and lifestyle of these doshas.

1. Avoid junk foods, spicy and hot & sour food, meat, frozen foods, acidic food, fried foods, processed and refined foods and foods that have been micro-waved. Avoid hamburgers, milk shakes, bacon and sausage.

2.Avoid food with a high fat content, such as fatty fried food, ice cream, heavy meats, and cheese. Eat lighter meals. Avoid known trigger foods.

3.Alcohol, aerated and caffeinated drinks like coffee, tea, cola, etc and ice cream are to be avoided. Avoiding cold milk and moderate consumption of milk is recommended.

4.Avoid food combinations with different rates of digestion, ie. Heavy and light foods. Some examples are: Fish with dairy; Yoghurt with sour fruits and melons (melons should be eaten on their own); Vegetables with fruit or milk.

5. Add the following herbs and spices in your cooking, to aid with digestion: ginger, cumin, turmeric, cinnamon, fennel, celery seeds, and oregano.

6.  Light exercise like walking, Yoga, pranayama.

7. Meditation in the morning and at night if possible. Or whenever comfortable to combat stress. Breathing exercise (pranayama) in the morning so as to manage and reduce stress.

8. Avoid too much salt in the food as BP was high during last consult.

9. Listen to calming music to destress yourself.

10. In the evening, drink two glasses of hot after dinner drink, even if you feel a little nauseous, which means that you are expelling toxins.

11. Keep taking slippery elm, vitamin B12 and D supplements. Also take Gut flora care probiotic.

12. Drink tender coconut water.

13. FOR STRESS REDUCTION:

Nadi Shodhana Pranayama:

Highly beneficial in reducing stress. Primarily aimed at clearing and purifying the subtle channels of the mind & body, balancing all aspects. It is pacifying for all Doshas and is a suitable daily practice.

Inhale/Exhale

Close the right nostril with your right thumb and inhale through the left nostril. Do this to the count of 5

Immediately close the left nostril with your right ring finger and little finger, and at the same time remove your thumb from the right nostril, and exhale through this nostril. Do this to count of eight. This completes a half round.

Inhale through the right nostril to the count of four. Close the right nostril with your right thumb and exhale through the left nostril to the count of eight. This completes one full round.

Complete at least four rounds to begin with and gradually increase up to eight to ten once you feel comfortable with the practice.

Recipes-

1. Coriander Cumin Fennel Tea (CCF tea)-Great After Dinner Drink

             ¼ tsp coriander seeds

             ¼ tsp cumin seeds

             ¼ tsp fennel seeds

Preparation: Boil 1.5 cups of water, add seeds to boiled water. Steep for 5 minutes, remove seeds and drink when the temperature is comfortable. OR steep overnight. Seeds can be used in cooking.

2. Coriander water: Soak 1 Tablespoon coriander seeds in 1L water overnight. Strain and drink the next day. This supports the kidneys, helps to flush the bladder OR chew a few coriander seeds after each meal.

Pitta Spice mix (Churna)

Ingredients:

1 tsp. coriander seeds

5g (5cm) dried ginger root

1 tsp. fennel seeds

1 tsp. cumin

5g (5cm) cinnamon stick

1 tsp. green cardamon capsules

½ tsp mustard seeds

Seeds from two anise stars

Shredded coconut

1 tsp poppy seeds

2 Bay leaves

1 tsp. turmeric

Preparation:

This combination is especially good for vegetable curries, sauces and soups. Dry roast all ingredients except turmeric in a Teflon-coated pan. Heat the items until they begin to pop and smoke, but do not let them turn black. Grind this mixture with mortar and pestle or in a coffee bean grinder and then add paprika and turmeric.

Herbs

1.  Shatavari- it increases the mucus secretion i.e. gastric mucosal barrier (kledaka kapha) in the stomach and keeps the pepsin and acid levels stable. Also it has in-vitro antibacterial properties. Rasa- madhur and tikta, pittavata balancing, shita virya helps cure amlapitta.

2. Guduchi- Helps to balance kledaka kapha.

3. Dadima- Helps to pacify pitta due to its cooling effect.

4. Triphala- Helps to balance pachaka pitta, samana and apanavata and kledaka kapha.

5. Licorice- Increases gastric mucosal barrier (kledaka kapha)

6. Nimba- Due to its shita virya, tikta, Kashaya rasa and balances pitta dosha. Acts on annavaha srotas.

7. Bhringaraja- Helps to reduce the amount of acid produced in the stomach.

8. Muktashukti bhasma- To neutralise the acidity of stomach.

Case is presented by Dr Lata under supervison of Dr Kumar at Jeeva health

For more information call us 03 9939 9474