Hyperacidity (Amlapitta) is one of the most common diseases seen in society. It is seen in all ages, all classes, and all communities. Hyperacidity refers to a set of symptoms caused by an imbalance between the acid-secreting mechanism of the stomach and proximal intestine and the protective mechanisms that ensure their safety. The stomach normally secretes acid that is essential in the digestive process. When there is excess production of acid in the stomach, it results in the condition known as acidity or amlapitta.
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Causes of Amlapitta
‘Hurry’, ‘Worry’, and ‘Curry’ are the three main reasons for the disease.
Diet (Ahara) responsible for Amlapitta
- Spicy food habits like eating samosa, burger, pizza, Chinese food. Excessive use of chilly, Cinnamon, clove, mustard, garam masala powder (spice mixture), garlic, etc. in diet.
- Salty and sour foods like chips,
- Eating of stale, fermented foods (dosa, uttapam,idli, etc. bakery food items).
- Excessive intake of fast food
- Excessive intake of Oily foods, pickles
- Intake of food and beverages in its hot condition like soups
- Excessive intake of tea/coffee.
- Lesser intake of water, dry food
- Irregular meal times
- Repeated food intake (before the digestion of the previously taken food)
- Incompatible food like taking non-veg., pizza followed by a milkshake.
- Skipping meals.
- Eating too late at night
Regimens (Vihara) causing Amlapitta
- Lack of rest, fast-moving lifestyle.
- Insufficient sleep at night.
- Sleeping immediately after meals.
- Suppression of natural urges.
- Excessive exposure to sun and fire
Mental factors responsible for Amlapitta
- Stressful lifestyle
- Excessive anxiety, worry, jealousy, anger, fear
- Job dissatisfaction
Other causes
- Living in anoopadesha i.e Assam, Bengal and coastal region.
- Sharad ritu (Autumn season)
- Addiction of alcohol, smoking, tobacco chewing
- Prolonged intake of NSAIDS (pain killers)
- Helicobacter pylori infection
All the above factors result in excessive increase of ‘Pitta dosha’ in body and exhibits symptoms of amlapitta.
Signs and Symptoms of Amlapitta
- Heart & chest burn (retrosternal burning),
- Sour or bitter belching.
- Nausea,
- Throat burn.
- Regurgitation of food or sour substance
- Vomiting
- Gaseous distention of abdomen
- Heaviness in abdomen
- Indigestion.
- Aversion towards food.
- Pain in the abdomen.
- Chest pain.
- Headache.
- Bad breath.
- Foul-smelling loose motions.
- Severe burning sensation over feet, hands
- Thirst,
- Mouth ulcer,
- Fatigue (especially in legs)
- Tiredness
- Fainting.
- Giddiness.
- Itching all over the body
Investigations for Amlapitta
- Gastroscopy (Upper Gastrointestinal Endoscopy)
- Esophageal pH monitoring
- Gastrin levels in the blood
- Barium Meal x-ray
- Serology + histology for H. Pylori
- Stool routine examinations
Complications
If not treated timely or if unwholesome diet, regimen, and habits continued, it may lead to
- Gastric Ulcer
- Chronic Gastritis
- Duodenitis
- Irritable Bowel Syndrome
- Mal-absorption
- Anemia
- Peptic Stenosis
Medical Management
1. Avoid causative factors
2. Palliative treatment As the disease is of Pitta origin, all measures are undertaken to pacify pitta.
3. Panchakarma treatment When a patient cannot be well managed with oral medications ‘Panchakarma procedures’ like Vamana (emesis) or virechana (purgation) whichever is needed should be administered. In chronic cases, Asthapanavasti (medicated enema) is indicated.
Some important single drugs useful in Amlapitta
- Shatavari – 3 gm twice a day with milk
- Yashtimadhu – 3 gm twice a day with milk
- Amalaki (Indian gooseberry) – 3 gm twice a day with water
- Sunthi (dry ginger) – 1- 3 gm twice a daywith water
Some important Pharmacopial Preparations
- Kamdudha Rasa – 250-500 mg twice a day with Honey
- Sutashekhar Rasa – 250 mg with Honey twice a day
- PrawalPishti – 125 to 250 mg with Amalki Juice
- PrawalPanchamrit Rasa – 250-500 mg twice a day
- DhatriLauha – 1/2-1 gm BD with Ghee