Aug 5, 2019

Udarashoola treatment

A case of udarashoola

Dr.Rekha Hegde:
Namaste Vaidyas,, here is a case of Udarashula since 5_6 yrs.    61 yrs. Male. Pittavata nature,,  Shula time__ immediately after night food. Continues till morning. Site__ around Nabhi.,Udara. Anubandha laxanas__ severe hunger feeling for every 3 hrs.   Upashaya__ after anulomana 10 percentage,, initially he feels better when he does mushtihata around Udara. Anupashaya__ Guru, snigdha .vishtambhi aahara.                 ..           motion _ morning normal,, urges to pass bowel after dinner and at midnight.ghana, sometime semisolid.                               No urodaha,, chardi,, udgarabahulya.                      Nidra_ good ,only he get up for bowel in midnight.  No DM.HTN. . Tests__ Hb.ESR. LFT normal.

Done Endoscopy.colonoscopy 6 yrs back, no copy stored,, slight mucosal  errossion in gastrum... Given treatment 2 yrs back with pittanulomana. , Ropana like Avipattikara, kamaduga mukta,, Dhatriloha,, Tiktaka ghrita,, Dadimadhtaka.shankhavati. LSS. .. Food ___ avoided all pittakara , guru aahara..  # earlier pain comes during daytime whenever he takes sweets , aggravating food.# now only after dinner. ## stress __ medium. His family members says it's phscycological.   Thinking in line with Pittavata pradhana Grahani. Planning to advise Takra, karanjapallava,. Dadima Guruchyadi kashaya ,parushakadi lehya, kutajaparpativati. Pp vati ,then dadimadi ghrita... . I am looking forward for your valuable suggestions.line of treatment .

Jayakrishna Kulamarva:
Try using pippalyasava and bilagyl

Dr.Rekha Hegde:
Thanks for responding sir.pippalyasav will not increase hunger?

Dr.pradp Noori:
Good analsis and also medicines . You need to do what you understand .
Some clarification required about food habitat lifestyle job and physic .
Genrally what i do in my practice initially
We can analyse this case as
Age wise it is VATA
Prakruti (? Weight/hair /activity)pittavayaha
Shoola is vata
Hungry frequently is vata pitta
Pain sthana vata pitta( Nabhi Pradesh and not towords amashaya)
So tackle it as both grahani vikara +parinamashoola or annadrava shoola  (pitta vata treatment)
1.Amlaki 1gm +yestimadh1gm+swarnamakhikabhasma 65mg with go ghrutam or sukumaram ghrutam  half an hour before food twice .
2. Kutajavaleham 10 gms  morning
3. Swadistavirachan choorna bedtime
Is my choice for 15 days.
Q to think of .
▶️ why pain only in the night?
▶️ fatty live and prostrate are they linked to the disease or not ?
▶️ pain immidiatly after food is  kapha kala .
▶️ is galbladder involved
▶️ does inactivity in night triggering the pain .
▶️ can we expect amoebiasis ect
Thank you for presenting the case and please post the proceedings .

Jayakrishna Kulamarva:
Severe hunger can be a vagal response to the lack of nourishment to the cells and the root cause is malabsorption

If you rectify the absorption hunger response will go down

If the increased hunger is due to pitta adhikya you will see other pitta lakshana such as bhrama and daha(Pani paada,hrud)

In that case you will have to manage with yeshti,sariva combo with praval pishti


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