Peptic Ulcer (Parinamashula)

Background

Parinamashula mentioned in Ayurvedic literatures can be correlated to duodenal ulcer/peptic ulcer due to similarity in the symptoms i.e. the pain corresponding with the digestion of food. Peptic ulcers are a distinct breach in the mucosa of the stomach or first part of the small intestine, called duodenum or both. Helicobacter pylori are one of the most common causes of peptic ulcer. Ulcers can also be caused or worsened by drugs such as aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs. Abdominal pain and tenderness in the epigastric area are the main presentations. Ayurveda offers a wide range of drugs for this condition.

Intervention/ Approaches

The following are some interventions/ approaches based on CCRAS research from published sources.

For chronic patients of peptic ulcer who did not respond to Shamana treatment and when associated symptoms are of vata aggravation like abdominal pain:

Indukanata Ghrita for Snehana- The treatment consists of Snehapana, Sweda, Virechana Samsarjana and Shamana. Snehapana may be done for a maximum of 7 days or till samyak snigdha lakshanas are seen. Vashpa Sweda should be given for 3 days (8th to 10th day). Virechana may be given with Eranda Taila on 11th day, followed by Samsarjana Karma for 3 days(12th to 14th day). Respective Shamana medicines as per the requirement may be started after this.

When the patient complains of vata vriddhi lakshanas like gripping pain in the abdomen. Shamana is advocated if the patient is weak and contraindicated for Shodhana.

Indukanta Ghrita - 10 gm twice daily orally for 60 days with milk.

Chronic ulceration with pitta dominated symptoms such as sour eructation, regurgitation, heartburn and when the patient is eligible for Shodhana:

Mahatiktaka Ghrita Snehana- The treatment consists of Snehapana, Sweda, Virechana Samsaijana and Shamana. Snehapana may be done for a maximum of 7 days or till samyak snigdha lakshanas are seen. Vashpa Sweda will be given for 3 days (8th to 10th day). Virechana may be given with Eranda Taila on 11th day, followed by Samsaijana Karma for 3 days (12th to 14th day). Respective Shamana medicines as per the requirement may be started after this.

Peptic ulcer with pitta dominated symptoms and if the patient is weak and cannot tolerate Shodhana therapy:

Mahatiktaka Ghrita - 11gm twice daily orally for 60 days with milk.

Patients with gastric or gastric/ duodenal erosions with mild symptoms:

Shatavari Madhuyashti Ghana Satva Vati - lgm twice daily for 30 days.

Patients having mild symptoms associated with erosions and for the patients who are prone to stress and anxiety:

Amalaki Rasayana- 5gm twice daily for 30 days.

Medicinal Plants Useful in Peptic Ulcer (Parinamashula)

Source : Central Council for Research in Ayurvedic Sciences