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TITLE OF CASE

Standalone successful ayurvedic management of hyperacidity- A case report.

Dr Partap Chauhan

ABSTRACT

A 39-year-old female patient presented with burning sensation, heaviness in the chest associated with occasional headache, constipation and hyper pigmentation of skin since 2 years. Even with antacids, for 2 years, she could not get relief from her symptoms. The associated symptoms were a sense of chocking while swallowing something, a constant dryness in the throat, a repeated urge to drink water to soothe the irritated food tract. Patient opted for Ayurvedic treatment and approached Dr Partap Chauhan. Based on the clinical evaluation, he made the biomedical diagnosis as Hyperacidity and the Ayurvedic diagnosis as Amlapitta- Vatapitta vriddhi. The line of treatment followed was Vatapitta shamana and Pitta shamana, sroto shodhana and rakta shodhana. Dravyas chosen were balya, rasayana, dipana and pacana in nature. In 1 year and 8 months, the patient got complete relief from all the symptoms. This case report demonstrates the successful standalone ayurvedic management of chronic hyperacidity in a patient who did not get relief with antacids. 

KEYWORDS

Hyperacidity, Amlapitta, Ayurveda, Case report, Standalone

INTRODUCTION

The hydrochloric acid in our stomach is needed for the digestion and breakdown of food. When there is an increase in the secretion of hydrochloric acid by the cells in the lining of our stomach, it is known as hyperacidity. These increased acid levels can cause many hyperacidity symptoms.

Causes of hyperacidity: 

Hydrochloric acid is constantly present in our bodies. Its secretion increases when there is food to be digested. Hyperacidity is a pathological increase of the acid level in our stomach. This can happen in cases of:

Some infection that causes the stomach to secrete more acid to destroy the bacteria or virus.

Inadequate food or infrequent meal timings, which cause the acid to be underutilised.

Certain genetic conditions where the stomach secretes more acid than required.

Stress of the mental and physical type.

Smoking

Increased intake of hot liquids and stimulants such as tea and coffee

Increased alcohol intake

Foods that upset the stomach and don’t suit the person, including those who are lactose intolerant or gluten intolerant.                             

Signs & Symptoms: Although hyperacidity symptoms are predominantly associated with burning, there are other symptoms too. Some other hyperacidity symptoms are described below:

Burning in the heart and chest region, above the stomach.

A burning sensation may sometimes be felt in the throat

A sour or bitter taste in the mouth that lasts for a while.

Sometimes, the hyperacidity symptoms can cause chest pain.

Due to burning in the throat, there can be a dry cough.

Asthma is also known to be a hyperacidity symptom.

Chronic sinusitis due to acid reflux.

Ear pain due to sinusitis caused by the reflux. 

Diagnosis & Treatment:  The primary diagnostic criteria for hyperacidity is medical history and clinical evaluation by the physician. 

The cause is identified, and then the apt treatment is given. Mostly the treatment of choice is antacids, and pain killers to address the pain. Diet and lifestyle plays an important role in the management of the condition. 

Prognosis: Hyperacidity is a mild condition, that can be managed well with medicine, diet and lifestyle. But if left untreated, this can become severe. Chronic (longterm) hyperacidity can result in ulcers and if the ulcers are not taken care of, it can result in perforation, which is a surgical emergency. Chronic ulcers can also become a malignancy. Prevention is better than cure.

PATIENT INFORMATION

A 39-year-old female patient presented with burning sensation, heaviness in the chest associated with occasional headache, constipation and hyper pigmentation of skin since 2 years. Even with antacids, for 2 years, she could not get relief from her symptoms. The associated symptoms were a sense of chocking while swallowing something, a constant dryness in the throat, a repeated urge to drink water to soothe the irritated food tract. Patient opted for Ayurvedic treatment and approached Dr Partap Chauhan. Based on the clinical evaluation, he made the biomedical diagnosis as Hyperacidity and the Ayurvedic diagnosis as Amlapitta- Vatapitta vriddhi.

No relevant family/genetic/surgical history. 

Psychosocial history- Job stress, Disturbed sleep

CLINICAL FINDINGS

General examination was done. 

Vitals- Normal                                                                                                                              

Dosha- Vata Pitta

Dushya- Rasa dhatu

Srotos- :Anna vaha, Rasa vaha

Adhisthana- : Amashaya

TIMELINE

Image 1. Timeline of events added below

DIAGNOSTIC ASSESSMENT

Modern Diagnostic parameter; The biomedical diagnosis was confirmed by the Ayurvedic physician based on the clinical evaluation. The patient was on regular antacids since 2 year. 

Table 1. Symptoms tabulated at baseline

 

Symptoms	Feb 19
Burning in chest/heaviness	++++
Acidity	+++
Headache	+++
Bowel	Incomplete 3-4 times / day
Skin hyper pigmentation	++++

Ayurvedic Assessment was done based on the presenting complaints and clinical evaluation. The treating physician confirmed the Ayurvedic diagnosis as Amlapitta- Vatapitta vruddhi.

Differential Diagnosis- 

Coronary artery disease

Achalasia

Eosinophilic esophagitis (EoE)

Non-ulcer dyspepsia

Rumination syndrome

Esophageal diverticula

Gastroparesis

Esophageal and gastric neoplasm

Peptic ulcer disease (PUD)

On the basis of the clinical evaluation the physician diagnosed the condition as hyperacidity.                               

Prognosis- Hyperacidity is a mild condition, that can be managed well with medicine, diet and lifestyle. But if left untreated, this can become severe. Chronic (longterm) hyperacidity can result in ulcers and if the ulcers are not taken care of, it can result in perforation, which is a surgical emergency. Chronic ulcers can also become a malignancy. Prevention is better than cure.

THERAPEUTIC INTERVENTION

Refer the tab ‘Treatment’ in the Portal. 

FOLLOW-UP AND OUTCOMES

The patient had 6 follow ups in total over a time period of 1 year and 8 months. The last follow up done was in December 2020.

Clinician-based assessment; After 2 months of treatment, headache, burning sensation and heaviness of chest reduced. With 1 year of treatment, patient was relieved from all the primary symptoms except the hyperpigmentation of skin. In 1 year and 8 months, the patient got complete relief from all the symptoms. 

Table 2. Symptoms tabulated from baseline throughout the treatment date wise

 

Symptoms	Feb 19	April 2019	July 2019	Oct 19	Jan 20	Aug 20	Dec 20
Burning in chest/heaviness	++++	++	++	+	Absent	Absent	Absent
Acidity	+++	+	++	++	Absent	Absent	Absent
Headache	+++	++	+	+	Absent	+++	Absent
Bowel	Incomplete 3-4 times / day	Incomplete 3-4 times / day	Hard bowel - 1 time/ day	Normal - 1 /day	Normal	Normal	Normal
Skin hyper pigmentation	++++	++++	++++	++++	+++	Absent	Absent

Patient- based assessment: Not relevant

Intervention adherence and tolerability – The patient adhered to the prescribed treatments and tolerated the treatments well. 

Method of assessment- Subjective parameters were the main assessment tools. 

Adverse and unanticipated events; None reported

 DISCUSSION: 

Hyperacidity is a mild condition, that can be managed well with medicine, diet and lifestyle. But if left untreated, this can become severe. Chronic (longterm) hyperacidity can result in ulcers and if the ulcers are not taken care of, it can result in perforation, which is a surgical emergency. Chronic ulcers can also become a malignancy. Prevention is better than cure. In this case report, the had been trying antacids since 2 years, but there was no relief. Moreover, new symptoms started to manifest. The ayurvedic diagnosis was Amlapitta- Vatapitta Vruddhi, and the line of treatment followed was basically Vata-pitta shamana and pitta shamana, sroto shodhna and rakta shodhana. The dravya used were balya, rasayana, dipana and pacana. 

PATIENT’S PERSPECTIVE

Not available. 

LEARNING POINTS/TAKE HOME MESSAGES 

This case highlights the efficacy of ayurveda in managing hyperacidity condition in a patient who had been suffering with its  symptoms since 2 years has achieved complete relief within 2 years. 

INFORMED CONSENT

Written consent obtained from patient for publishing of the case report in the Portal 

ACKNOWLEDGEMENTS

None 

CONFLICT OF INTEREST

None declared.

 FUNDING

None

 REFERENCE

1. https://manmatters.com/blog/hyperacidity/
2. https://www.thehealthsite.com/diseases-conditions/hyperacidity-or-acid-dyspepsia-what-causes-it-and-how-to-avoid-it-786412/
3. Madhava Nidana. Chapter 51. Amlapitta Nidana.
4. https://www.easyayurveda.com/2021/03/10/amlapitta/