Pathya & Apathya (Wholesome & Unwholesome diet and regimen) in Yakrit Kshaya (Liver Cirrhosis) : A Narrative Review
Abstract
Yakrit Kshaya (Liver Cirrhosis) is associated with vitiated Agni (digestive power), production of Ama (Undigested food) and Anuloma and Pratilomakshyaya (forward and backward depletion of Dhatu). Approximate 20% compensated cirrhosis patients and 65-95% decompensated cirrhosis patient have either Anuloma Dhatu Kshaya (forward depletion) or Pratilomana Dhatu Kshaya (backward depletion) or both types of malnutrition. Pathya (wholesome diet and regimen) is defined as the Ahara (Diet) and Vihara (regimen) that give proper nutrition to body and mind, clear the micro channels of Body (Pantha/Marga/Srotas), and provide happiness; that opposite is Apathya(unwholesome diet and regimen). A Pathya and Apathya chart for Yakrit Kshaya (Liver Cirrhosis) is prepared and presented. Chinta (anxiety), Shoka (depression), Krotha (anger), Duhkha (sorrow), Dukkha Shaiya (uncomforted bed) and Ratrijagarana (insomnia) can contribute for the indigestion even if a small quantity of Pathyaahara (wholesome diet). Normal diet with Goghruta (ghee) prepared from curd (Emulsified fat), Mamsa Rasa, milk can balance the protein. The Yakrit Kshaya patients should eat 6-8 times in small quantity (snax, mini meal ) as their Agni is low to very low. Mid night meal is also advisable for reduce protein breakdown. Restriction of water, sour and salty foods, fast foods are very crucial for the treatment outcome as it create Ama. More research on Pathya (Ayurveda diet) in Yakritkshaya (Liver cirrhosis) is encouraged.
Downloads
References
Panda Ashok Kumar & Tripathy Rabi, The concept of Sopha : Critical Review. Inter J Res: Granthalaya August 2020;8(8):15- 23.
Stephanie Peltz, The Digestive Fire: Ayurvedic approach to healthy digestion through the Season, Chiro-practice Wellness, 2019 March issue: Volume-1, 20-1.
Sevastianos VA, Drurakis P, Malnutrition and Sarcopenia in advanced Liver diseases, J. Nutr Food Sci 2016;6:487.
Hulsman EJ entitled Protein Energy Malnutrition Predicts complications in Liver cirrhosis, Eur J. Gastroenterol Heptol 2011;23:982-989.
Ashok Kumar Panda & K.K. Rath. Ayurvedic treatment outcome for Chronic Liver diseases. J Ayurveda Integr Med Sci 2019;6:190-193
Acharya YT, Charaka Samhita, Chikitsasthana, Udara chikitsa, 13/61, Reprint edition Chaukhambha Orientalia, Varanasi, 2007; 493.
Ashok Kumar Panda et al., Role of Meda (Adipocyte) in Liver diseases: Ayurveda Prospective, J Ayurveda Integr Med Sci 2020;2:141-47.
Parvin Mirmiran entitled Relationship between Diet and Non Alcholic Fatty Liver diseases : A review, Iran J public Health August 2017, 26;8:1007-1017.
Banerjee S, Debnath P, Debnath PK. Ayurnutrigenomics: Ayurveda-inspired personalized nutrition from inception to evidence. J Tradit Complement Med. 2015;5(4):228-233. Published 2015 Mar 24. doi:10.1016/j.jtcme.2014.12.009
Agnivesha, Charaka, Dradhabala, Charaka Samhita, Sutrasthana, edited by Pt. Kashinath Shastri, reprint edition, Chaukhamba Bharati Academy, Varanasi, Adhyaya, 2003; 25/45: 478.
Park BJ, Lee YJ, Lee HR. Chronic liver inflammation: clinical implications beyond alcoholic liver disease. World J Gastroenterol. 2014;20(9):2168-2175. doi:10.3748/wjg.v20.i9.2168.
Panda A.K entitled, A Consensus driven statement for Ayurvedic Nomenclature of Various liver diseases (Yakritroga) under publication.
St George A, Bauman A, Johnet A, Farrel G, Chey T, George J. Independent effects of physical activity in Patients with non alcoholic fatty liver diseases,Hepatology 2009;50:68-76.
Cheung K, Lee SS, Raman M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clin Gastroenterol Hepatol 2012;
:117-125 [PMID: 21893127 DOI: 10.1016/j.cgh.2011.08.016]
Bengtsson M, Björnsson E. Gastrointestinal symptoms in patients with liver cirrhosis: associations with nutritional status and health related quality of life. Scand J Gastroenterol 2006; 41: 1464-1472 [PMID: 17101578 DOI: 10.1080/00365520600825117]
Figueiredo FA, Perez RM, Freitas MM, Kondo M. Comparison of three methods of nutritional assessment in liver cirrhosis: subjective global assessment, traditional nutritional parameters, and body composition analysis. J Gastroenterol 2006; 41: 476-482 [PMID: 16799890 DOI: 10.1007/s00535- 006-1794-1]
Sharma KK, Kumar KP, Effect of Yogic practices on liver functions parameters. Yoga International Journal of Yoga and Allied Sciences 2017; 6 (Suppl): 242
Shergill R, Syed W, Rizvi SA, Singh I. Nutritional support in chronic liver disease and cirrhotic. World J Hepatol 2018; 10(10): 685-694 Available from: URL: http://www.wjgnet. com/1948-5182/full/v10/i10/685.htm DOI: http://dx.doi. org/10.4254/wjh.v10.i10.685
Agnivesha. Charaka Samhita, Agnivesha treatise refined and annoted by Charaka, redacted by Dridhabala Ayurveda Deepika commentary by Chakrapanidatta, edited by Yadavji
Trikamji Acharya . Varanasi: Chaukhamba Prakashana; reprint 2011, p.484. Tpg:738
Sushrutha. Sushruta Samhita with Nibandha Sangraha Vyakhya by Dalhanacharya and Nyayachandrikakhyapanjikavyakhya by Gayadasa, edited by Vaidya Yadavaji Trikamji, 8th ed Varanasi: Chaukambha Krishnadas Academy; 2013. p.458.tpg
Journal of Ayurveda and Integrated Medical Sciences (JAIMS) retains the copyright of the contents of this journal but grant the readers the right to use the contents with terms and conditions under a creative common attribution licenses 4 of Attribution, Share Alike and Non-commercial type (CC BY-NC-SA) that allows copy, distribute, display, and perform the work and make derivative works based on it only for non-commercial purposes.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
