Peptic Ulcer- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

PEPTIC ULCER Ayurvedic Treatment

A peptic ulcer is a sore that develops on the lining of stomach, small intestine or esophagus. A peptic ulcer in the stomach is called a gastric ulcer. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine (duodenum). An esophageal ulcer occurs in the lower part of your esophagus. Ulcers occur when stomach acid damages the lining of the digestive tract. Common causes include the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin. Upper abdominal pain is a common symptom. Treatment usually includes medication to decrease stomach acid production. If it is caused by bacteria, antibiotics may be required.

Signs & Symptoms

The most common symptom is a burning sensation or pain in the middle of the abdomen between your chest and belly button. Typically, the pain will be more intense when the stomach is empty, and it can last for a few minutes to several hours.

Other common signs and symptoms of ulcers include:

  • dull pain in the stomach
  • Trouble breathing.
  • Feeling faint.
  • Nausea or vomiting.
  • Unexplained weight loss.
  • Appetite changes.
  • Vomiting or vomiting blood — which may appear red or black.
  • Dark blood in stools, or stools that are black or tarry.

Nedenler

Stomach ulcers are almost always caused by one of the following:

  • H.pylori infection
  • long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
  • Zollinger-Ellison syndrome (a rare medical condition)

Patofizyoloji

Peptic ulcer disease (PUD) is characterized by discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in the stomach and proximal duodenum. Peptic ulcers are defects in the gastric or duodenal mucosa that extend through the muscularis mucosa.

Under normal conditions, a physiologic balance exists between gastric acid secretion and gastroduodenal mucosal defence. Mucosal injury and, thus, peptic ulcer occur when the balance between the aggressive factors and the defensive mechanisms is disrupted. Aggressive factors, such as nonsteroidal anti-inflammatory drugs (NSAIDs), H pylori infection, alcohol, bile salts, acid, and pepsin, can alter the mucosal defence by allowing back diffusion of hydrogen ions and subsequent epithelial cell injury. The defensive mechanisms include tight intercellular junctions, mucus, bicarbonate, mucosal blood flow, cellular restitution, and epithelial renewal.

H pylori can cause a major part of the pathology which includes acid and pepsin, that contributes to primary peptic ulcer disease. The unique microbiologic characteristics of H. pylori, such as urease production, allows it to alkalinize its microenvironment and survive for years in the hostile acidic environment of the stomach, where it causes mucosal inflammation and, in some individuals, worsens the severity of peptic ulcer disease.

When H pylori colonizes the gastric mucosa, inflammation usually results. In patients infected with H pylori, high levels of gastrin and pepsinogen and reduced levels of somatostatin have been measured. In infected patients, exposure of the duodenum to acid is increased. Virulence factors produced by H pylori, including urease, catalase, vacuolating cytotoxin, and lipopolysaccharide, are well described.

Most patients with duodenal ulcers have impaired duodenal bicarbonate secretion, which has also proven to be caused by H pylori because its eradication reverses the defect. The combination of increased gastric acid secretion and reduced duodenal bicarbonate secretion lowers the pH in the duodenum, which promotes the development of gastric metaplasia (i.e., the presence of gastric epithelium in the first portion of the duodenum). H pylori infection in areas of gastric metaplasia induces duodenitis and enhances the susceptibility to acid injury, thereby predisposing to duodenal ulcers.

Teşhis

  • Medical history
  • Blood test, stool test, or a breath test to rule out H.pylori infection.
  • Other tests and procedures used to diagnose stomach ulcers include:
  • Barium swallow test
  • Endoscopy (EGD)
  • Endoscopic biopsy

Treatments

It’s important to promptly treat an ulcer. Treatment will vary depending on the cause of the ulcer. Most ulcers can be treated with medicines but in rare cases, surgery may be required. In an actively bleeding ulcer, hospitalisation and intensive treatment including endoscopy, IV ulcer medications or blood transfusion is needed.

  • Nonsurgical treatment

Antibiotics and proton pump inhibitors (PPIs) are used to treat H. pylori infection. PPIs block the stomach cells that produce acid.

In addition to these following therapies are also advised in some cases:

  • H2 receptor blockers
  • stopping use of all NSAIDs
  • follow-up endoscopy
  • probiotics
  • bismuth supplement
  • Surgical treatment

In very rare cases, a non-healing or recurring and complicated stomach ulcer will require surgery.

Surgery may include:

  • removal of the entire ulcer
  • taking tissue from another part of the intestines and patching it over the ulcer site
  • repairing a bleeding artery
  • cutting off the nerve supply to the stomach to reduce the production of stomach acid

Prognoz

When the underlying cause of peptic ulcer disease is addressed, the prognosis is excellent. Most patients are treated successfully with the eradication of H pylori infection, avoidance of nonsteroidal anti-inflammatory agents (NSAIDs), and the appropriate use of antisecretory therapy.

Komplikasyonlar

If left untreated, peptic ulcers can result in:

  • Internal bleeding
  • A hole (perforation) in the stomach wall
  • Obstruction in the digestive tract
  • Gastric cancer

Disease & Ayurveda

In Ayurveda, abdominal pain and colic comes uder shola and peptic ulcer can be compared with parinama soola or annadravasoola in chronic stage. The word parinama means transformation and here it implies digestion. Abdominal pain which is related with the stages of digestion is called parinaama soola. Anna means solid foods and drava means liquids. Abdominal pain developing while the intake of solid or liquid diet (regardless of food intake) is called annadravasoolawhich is said to be incurable.

Nidana

  • Causative factors for the vitiation of Vaata dosha
  • Unwholesome diet
  • Untimely diet
  • Unhealthy eating habits
  • Sleeping disorders

Purvaaroopa

                Belirtilmemiş

Samprapti

        Due to the causative factors, gets covered with the misplaced or aggravated Kapha or Pitta or both and produce pain in the abdomen. When the Kapha is moved from its normal site, along with Pitta blocks the Vaayu and causes pain during the digestion process.

Lakshana

  • Pain during the digestion of the food
  • Pain in the abdomen
  • Pain in the flanks and sides of abdomen
  • Pain in the navel region
  • Pain in the area of urinary bladder
  • Pain in between the breasts
  • Pain in the sacral area

Bölümler

  • Parinaama soola
  • Annadrava soola

Prognoz

Kashtasaadhya/Asaadhya when 3 doshas are involved, with complications or when the strength, muscles and digestive power of individual is deteriorated.

Chikithsa

The Ayurveda treatment of this disease is primarily langhanam(weight reducing therapies like fasting). Also vamana(therapeutic emesis), virechana(therapeutic purgation)and vasti(therapeutic medicated enema) are recommended for a detoxified body and a well-balanced agni(metabolism)

Samana

  • Aamapaachanam
  • Agnideepanam
  • Pathya aaharam

Sodhana

  • Vamana
  • Virechana
  • Vasti

Commonly used Medicines

Mevcut Markalar

  • AVS Kottakal
  • AVP Coimbatore
  • SNA oushadhasala
  • Vaidyaratnam oushadhasala

Ev ilaçları

There is no proven home cure for peptic ulcer but as it is directly related with digestion, some changes in diet regimen are believed to be beneficial like including the following into daily diet:

  • Coconut
  • Virgin coconut oil
  • Zerdeçal
  • Tulsi leaves
  • Carrot juice
  • Kuru Üzüm
  • Bananas

Diyet

  • Kaçınılması gerekenler

Heavy meals and difficult to digest foods – cause indigestion.

Hot, spicy and pungent items like pickle

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products – increase kapha, cause obstruction in channels and obesity

Curd – causes vidaaha and thereby many other diseases

  • Eklenecek

Hafif yemekler ve kolay sindirilebilir gıdalar

Green gram, soups, fresh vegetables and fruits, raisins, pome granate

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Davranışlar:

  • Protect yourself from cold climate.
  • Aşırı güneş ışığı, rüzgar, yağmur veya toza maruz kalmaktan kaçınmak daha iyidir.
  • Maintain a regular food and sleep schedule.
  • İdrar, dışkı, öksürük, hapşırık vb. dürtüleri tutmaktan veya zorlamaktan kaçının.
  • Avoid sedentary lifestyle.

Yoga

Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

Yoga, vücut içinde ve çevredeki sistemle uyumu koruyabilir.

Pavanamuktasana

Nadisudhi pranayama

Bhujangasana

Simple exercises for lungs and heart health

Tüm egzersizler ve fiziksel eforlar sadece bir tıp uzmanının gözetimi altında kararlaştırılmalı ve yapılmalıdır.

Araştırma makaleleri

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140150/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952291/

 

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