Annadravashoola and Ayurveda: A Case Study

Pallavi Survase; Ashok Naikar; Vinod B

doi:10.21760/jaims.9.4.42

Annadrava Shoola is one of the diseases of the alimentary canal in which there is pain occurs after digestion, during digestion & patient feels relief after vomiting. It can be clinically co related with gastric ulcer on the basis of its signs & symptoms. Gastric ulcers are most commonly located at the lesser curvature, whereas duodenal ulcers are more common in duodenal bulb. The ulcer is round to oval with a smooth base. Acute ulcers have regular borders, while chronic ulcers have elevated borders with inflammation. An ulcer extends beyond the muscularis mucosa. Ayurveda encourages lifestyle interventions & natural therapies to regain a balance between body mind &the environment. In this paper a case study of Annadrava Shoola has been explained. A 43 yrs old female patient having complaint of pain in epigastric region after having meals radiating to back since 6 months. The nature of pain is burning type & exaggerated after having meals, Pain relieved after vomiting. On the basis of history of patient & endoscopy report, she was diagnosed as gastric ulcer (two small antral ulcers). We have done Shamana Chikitsa with a simple formulation of Yashtimadhu Kwatha for 4 months. After the treatment, symptoms relieved. So, there is hope in Ayurveda for treatment of Annadrava Shoola.

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Pallavi Survase, Second Year Post Graduate Scholar, Dept of Shalya Tantra, N K J Ayurvedic Medical College Pg Centre, Bidar, Karnataka, India.
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Survase P, Naikar A, Vinod B, Annadravashoola and Ayurveda: A Case Study. J Ayu Int Med Sci. 2024;9(4):267-269.
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Accepted

2024-02-11

2024-02-21

2024-03-02

2024-03-13

2024-03-24

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Introduction

Indian people used to have too much spicy food. As a result, they need to face many health problems. Among these health problems, the problems related to the alimentary canal is more common. Annadrava Shoola is one of them. The pathogenesis of gastric ulcer is mainly explained on the basis of impaired gastric mucosal defense against acid-pepsin secretions.^[1]

The colic which occurs after digestion, during digestion or on indigestion & which does not pacify either by wholesome or unwholesome food & by eating or fasting is named as Annadravashoola. There is continuous pain in the abdomen but was relieved after vomiting.^[2]

As in all kind of Shoola there is vitiation of Vata Dosha. This vitiation is mostly caused by Virudhasevan, Asatmyabhojana, Abhojana, Atibhojana & Ahara. The diet which is having Rukshyatikshna, Ushnaguna, Lavana, Katu, Amla-Rasa-Sevana, Vegadharan, Ratrijagarana, Krodha, Chinta etc. Nidanasevana also aggravates Vatadosha.^[3]

Annadravshoola can be correlated with gastric ulcer on the basis of similarities of symptoms. It falls under peptic ulcer disease later may cause IBS [irritable bowel syndrome] & may cause Arsha [haemorrhoids].^[4]

Gastric ulcer are more commonly found on lesser curvature but can be found in any part of the stomach.^[5]

Male to female ratio of gastric ulcer is 2:1. Chronic gastric ulcer is usually single.^[6] In modern science the main cause of gastric ulcer is H.pylori infection & use of NSAID’s. Research indicates the prevalence rate of H.pylori infection in Nepalese population is 16%.^[7] In modern science, treatment for gastric ulcer focused on H.pylori eradication therapy & reduction of NSAID’s & Aspirin.^[8] All types of bacteria is correlated with Krimi.^[9]

Case Report

A 43 yrs old female patient complaining of severe epigastric pain since 6 months. The pain was sudden on onset. Pain was burning in nature & radiating to back. Pain was relieved by vomiting & aggravated by spicy foods. There was no complaint

of bloating, fever. She had history of hypertension since 15 yrs, hypothyroidism since a year on medication with NSAID’s. She was Anaemic also with Hb% - 6gm. No history of DM & Surgical intervention. She had normal bowel & bladder habit. On examination, there was epigastric tenderness on deep palpation. Then she was advised for upper gastric endoscopy. Reports showed two small antral ulcers. The case was treated with Shamana Chikitsa as mentioned.

Yashtimadhu Kwatha - empty stomach, OD.

Quantity - 1 pala (24ml) for 4 months.

Results & Discussion

According to principle of Ayurveda, correcting the imbalancing of Dosha’s is the main line of treatment. As Yashtimadhu is having Madhura Vipaka which subsides the aggravated Pitta & Vata Dosha. It is having the properties like Anti-microbial, Anti-inflammatory, Anti-ulcer, Anti-oxidant. It acts by inhibiting growth of Helicobacter pylori. Flavonoids present in Yashtimadhu helps in healing the ulcer & has good acid neutralizing capacity. Yashtimadhu acts as H2 receptor antagonist.^[10] We have prescribed a simple formulation of Yashtimadhu Kwatha & thus it healed the peptic ulcer within 4 months.

Conclusion

Annadravashoola is the disease of the alimentary canal where there is colic which is not relieved by any wholesome or unwholesome food. 43 yrs old patient with two small antral ulcers cured with a simple formulation which is very effective to heal gastric ulcer. Thus, with Ayurvedic treatment & lifestyle management, Annadravashoola can be managed. It is a single study; it may be the lead point for the researchers for further studies.

References

1. Harsh mohan, 7^th edition, new delhi JP brothers medical publishers, the text book of pathology, chapter:18,pg no:535.

2. Himasagar Chandramurthy, 3^rd edition, chaukhambha Sanskrit series office,Varanasi 2013, Madhava Nidhana of shri Madhavakara Sanskrit Text & Madhukosha commentary with English translation and glossary. Nidhana sthana 26/21, pp-280-281.

3. Vaidya Shri Laxmipati shastri, Bhisagrantha shreebramha Shankar Shastri, 7^th edition 2002, Chaukhambha Sanskrit samsthana, Varanasi, Yogaratnakara Uttarardha, Parinama Shoola nidhanam:pp-13.

4. Divyakumari J solanki et al: Management of parinaama Shoola and Annadrava Shoola with Madhu yashti churna and Yogic practices. International Ayurvedic Medical journal[online] 2017.

5. Sah R.K., Shah B, Sonam R, Kshara sutra ligation in the management of internal Haemorrhoids [Arsha]- A case report Int. J. AYUSH CaRe. 2019;3[4]:272-277. Kumar Parveen Clark Michel, Kumar & Clark clinical medicine, Gastrointestinal disease 6, Saunders Elsevier 8^th edition 2012, pp-248.

6. H Raulston Staurt. D Penman Ian, WJ Strachan Mark, P Hobson Richards,Elseiver 23^rd edition 2018, Elsevier Davidson’s Principles and Practice of Medicine, Gastroenetrology 21.pp-798.

7. Ansari S, Gautam R, Nepal HP, Subedi SN, Shrehsta S. Mandal F. et al. Helicobactor pylori colonization in Nepal; assessment of prevalence and potential risk factors in a hospital-based patient cohort. BMC Res Notes; 9:59.

Case Report

Annadravashoola

Journal of Ayurveda and Integrated Medical Sciences