Panchakarma in Parinaama Shoola - A Review Article

Abstract

Parinama Shoola is a chronic, recurrent, and non-fatal gastrointestinal (GIT) condition, accounting for 25% of patient visits to clinics and hospitals in India.^[1] In Ayurveda, Madhavakara was the first to describe Parinama Shoola, characterizing it as pain during digestion, and categorizing it as a Vata-Pradhana Tridoshaja Vyadhi.^[2] Samprapti: The development of Shoola begins with the consumption of incompatible foods (Viruddhahara), such as hot and spicy rich fatty diets, junk foods, and habits like tobacco chewing, smoking, and alcohol consumption. Physical inactivity and mental stress further exacerbate the condition, leading to digestive impairment (Agnimandya) and the formation of toxins (Ama). This sequence of events progresses through stages of:  Ajeerna (indigestion), Amlapitta (hyperacidity), finally culminating into Shoola (pain).^[3] The causes, progression, and symptoms of Parinama Shoola are remarkably similar to those of duodenal ulcers in modern medical science. Management of duodenal ulcers typically involves: Educating the patient, Avoiding known causative factors, Prescribing bland diets, Using antacids and acid-blocking medications, Administering antibiotics for H. pylori infection. Despite these treatments, high recurrence rates and unwanted side effects are common. In Ayurvedic treatment for Parinama Shoola includes: Samshodhana (purification), Samshamana (pacification), Nidana Parivarjana (avoidance of causative factors), Pathya-Apathya (dietary and lifestyle modifications) and Prevention of recurrences. Ayurvedic medicines are noted for being cost-effective, easily available, and safe for long-term use.