3. INTRODUCTION
EPIDEMIOLOGY
ANATOMY , PHYSIOLOGY OF STOMACH & ACID SECRETION
CAUSES
CLASSIFICATION
HYPERACIDITY IN AYURVEDA
CHIKITSA
PATHYA-APATHYA
CHIKITSA ACCORDING TO CONDITION
PATENT FORMULATIONS
RESEARCH ACTIVITIES
SUMMARY
CONCLUSION
4. Acidity is the common term used by common people and it is
one of the most common symptom affecting the larger
population in the India
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.
5. It is the 4th ranking symptom presenting for the diagnosis to
gastroenterologists.
Nearly 25% of the population will have hyperacidity
symptoms at least 6 times yearly.
Hyperacidity is the most common symptom seen in 40% of
patients.
Hyperacidity prevalence has been found to range from 6.2%
to 40% with increase of prevalence with age male and
female
A few studies from India indicate a prevalence of 7.6–18.7%
6.
7.
8.
9. Acid is secreted by parietal cells
in the proximal two thirds (body)
of the stomach.
HCl is produced by the parietal
cells of the stomach. To begin
with, water (H2O) and carbon
dioxide (CO2) combine within
the parietal cell cytoplasm to
produce carbonic acid (H2CO3),
which is catalysed by carbonic
anhydrase.
Carbonic acid then
spontaneously dissociates into a
hydrogen ion (H+) and a
bicarbonate ion (HCO3
–).
10. The hydrogen ion that is formed is transported into the
stomach lumen via the H+– K+ ATPase ion pump. This
pump uses ATP as an energy source to exchange
potassium ions into the parietal cells of the stomach with
H+ ions.
The bicarbonate ion is transported out of the cell into the
blood via a transporter protein called anion
exchanger which transports the bicarbonate ion out the
cell in exchange for a chloride ion (Cl–). This chloride ion
is then transported into the stomach lumen via a chloride
channel.
This results in both hydrogen and chloride ions being
present within the stomach lumen. Their opposing
charges leads to them associating with each other to
form hydrochloric acid (HCl)
11. Comprised of two words i.e,
Hyper + Acidus which means
excess & Sour respectively,
The stomach secretes
hydrochloric acid, a digestive
juice that breaks down food
particle into the smallest form to
aid digestion.
Hyperacidity simply means an
increased level of acid in
stomach.
12. Hyperacidity can result from lifestyle or dietary habits, a medical
condition, or the use of medications, stress etc,
Common causes of Hyperacidity:
1. dietary factors (Fatty, oily or spicy foods. )
2. Faulty eating habits/ Fast Food (Overeating or eating too
quickly)
3. Too much caffeine, alcohol, chocolate or carbonated
beverages, smoking, Tobacco
13. WIDE RANGE OF HEALTH CONDITIONS, INCLUDING:
1. GERD
2. Peptic ulcer disease – a) Acute b) Chronic a)Stomach/Gastric
Ulcer b)Duodenal Ulcer
3. Gastritis – a) Acute b) Chronic
4. Infection, specially with H. Pylori
5. Oesophagitis – a) Reflux esophagitis
b) Infective esophagitis
7. Dyspepsia – a) Functional b) Organic dyspepsia
8. Hiatus hernia
14. DISEASE CONDITIONS OTHER THAN GASTRO
INTESTINAL TRACT:
1. Thyroid disease - Hypothyroidism
2. Diabetes (Gastroparesis)
3. Obesity
4. Depression
5. Stress
IN PREGNANCY :
Hyper acidity is common during pregnancy, especially in the last
trimester. This is due to the way the fetus presses against the
stomach.
16. Reduced LOS pressure
Reduced esophageal clearance mechanism
Delayed gastric emptying
Impaired gastric acid secretion
Inflammation of the gastric mucosa
17. HYPERACIDITY AS SYMPTOM AND
ASSOCIATED DISEASES
Diseases associated with GIT System
Disease associated with other System
18. HYPERACIDITY AS SYMPTOM ASSOCIATED
WITH GIT
CAUSES DISEASES
1.Muscular dysfunction Achalasia
Hiatus hernia
GERD
2. Inflammatory Oesophagitis
Gastritis
Peptic ulcers
Infection with H pylori
3. Malignancy Oesophageal Carcinoma
Gastric Carcinoma
19. HYPERACIDITY AS SYMPTOM ASSOCIATED
WITH OTHER SYSTEM
1. Cardio vascular disease Coronary heart disease
2. Endocrine disease Hypothyroidism
Diabetes mellitus
3. Psychological Stress
Depression
3. Others Pregnancy
Faulty dietary habits
Addictions
20. A burning pain in the chest that usually occurs after
eating (retrosternal burning)
Pain that worsens when lying down or bending over
Bitter or acidic taste in the mouth
Sour or bitter belching
Nausea.
Throat burn.
Regurgitation of food or sour substance.
Gaseous distention of abdomen.
Heaviness in abdomen.
21. The main factors involving are:
1. Ahara 2. Pranavayu
3. Saman Vayu 4. Apana vayu
5. Pachaka Pitta 6. Bodhaka Kapha
7. Kledaka Kapha 8. Agni.
Any Vikruti among these may leads to
Hyperacidity
22. In Ayurveda Hyper acidity can be explained under
1. Urdwaga Amlapitta
2. Vidagdhajeerna
3. Saamapitta Laxana
4. Pittaja Grahani Laxana
23. दुर्गन्धि हरितं श्यावं पित्तंमाम्लं घनं र्ुरु
आन्म्लकाकण्टह्रद्िाहकिं सामं पवननर्दगशेत|A.S.Su
21/33
When pitta dosha combines with Ama it produces
Sama pitta lakshanas among which he explained
amleeya pitta and hrut daha which can be
considered as hyper acidity.
24. आम्लपित्तं चेनत आम्लोद्र्ुणोर्िक्तं पित्तं | Chakrapani
पवदाहादाम्लर्ुणोर्िक्तं पित्तं आम्लपित्तं | Vijaya rakshita
Amlapitta is a condition where amlaguna
increases due to samata.
Due to increase in amla guna and vidaaha guna of
pachaka pitta leading to kanta, hrut daaha,
Avipaka, Amoldgara, Tiktodgara, Prasek.
25. पवदग्िे भ्रमतृण्मूर्च्ाग: पित्तार्चच पवपविारुाा: |
उद्र्ािश्च सिूमाम्ल : स्वेदो दहश्च ाायते | Ma.ni
6/11
caused due to vitiation of pitta dosha ( Pachaka
Pitta)
It is characterised by bhrama, daha, trushna,
murcha, Amlodgaara, sweda pravrutti.
26. While explaining pittaja grahani Acharyas
explained lakshanas as Amlodgara and Hrut
kanta daha.
27. Ama chikitsa:
आम प्रदोषाानां िुनपवगकािनाम् अितिगणेनैवो ििमो भवनत।
Cha.vi 2/13
Vidagdhajeerna:
तत्रामे वमनं कायं पवदग्िे लङ्र्नं र्हतम् पवष्टब्िे स्वेदनं
िथ्यं िसशेषे शयीत च | Su. Su 46
लङ्घनं कायगमामे तु, पवष्टब्िे स्वेदनं भृशम् पवदग्िे वमनं ,
यद्वा यथास्वस्थं र्हत ्ं भवेत | A. H .Su 8/27
29. Chikitsa of hyperacidity in Ayurveda can be
considered as
1. Nidana Parivarjana
2. Yukti vyapashrya Chikitsa
3. Satvavajaya Chikitsa
4. Rasayana
5. Yoga and pranayama
30. Is 1st step in treating any disease
Avoding ahaaraja, viharaja, manasika
karanas
31. Involves - Shodana and Shamana
Shodana - Vamana and Virechana
32. Vamana therapy has substantial role in treating
Urdhvaga Amlapitta.
It is conducted when there is vitiation of Apakwa
pitta and Kapha.
Kapha Dosha Prakopa : Pippali, Madanaphala ,
Saindava Lavana with Ushna Jala
Pitta Dosha Prakopa : Patola , Vasa, Nimba
33. Snehana dissolution of toxic material into oil
( Abhyantara Snehana helps to dissolve the Dosha and to increase
the volume and makes the Dosha free from their adherence.)
The toxin present in cytoplasm become
membrane bound
Swedana Cell membrane permeability changes
Excreation of fat soluble protein bound
toxin in to circulation
(Swedana help the Dosha to liquefy and disintegrate, and helps to
mobilize the Dosha from Shakha to Koshta. )
34. Vamaka drug Irritates the gastric mucosa and stimultes the
vagus nerve
Vagus nerve immidiately activate vomiting
center via CTZ
impulses go to the skeletal muscle of abdominal wall,
smooth muscle of stomach and muscle of diaphragm
Contraction of abdominal muscle may rise of intra
abdominal pressure and pressure of stomach also.
lower oesophageal spincter get relax & there by
leading to initiation of bouts.
vitiated pitta and Kapha get expelled out by Vamana
35. The symptoms of Urdwaga Amlapitta are due to
disturbance in Dravata and Ushnata of Pachaka pitta
& Snighdhata of Kledaka Kapha. (Vamana is
indicated in Apakwa pitta & Kapha )
Deepana and Pachana help to digest the Ama,
makes the Dosha Nirama and increases the Agni
It is told that doshas should be removed through
nearest root, as Amlapitta is a disease of Amashaya
Samudbhava, Hence vamana is 1st line of treatment
36. In Amlapitta manasika doshas ( raja and tama ) has
been affected.
Vamana does indriya shudhhi and mana prasadana.
The symptoms like Chaardi , amlodgara, kanthdaha ,
hrutdaha , utklesh , avipaka may get reduced due to
apakwa pitta & kapha nirharana, ashaya shudhhi,
ama dosh nirharan, shuktata nash, vidagdhtanash
done by Vaman.
37. Virechana is best measure for Pittaja disorders and
when pitta associated with Vata and Kapha as
Shodana.
The main pathological factors assosiated with
Amlapitta are Pachaka pitta , kledaka Kapha,
Samana vayu , Ama and vitiated Agni
Deepana Pachana Snehana & Swedana
Virechana
38. Effect at Dosha level - Virechana helps to expel the
excessive Dravata of Pitta , Snigdhta kapha & even it
acts as vatanulomana.
Effect at Ama & Agni – Due to Ushna, Tikshan,
Sukshma, Vyavayi, Vikasi, of virechana dravya they
clears Ama & helps in Agni dushti
At level of Srotas – acts as Srotoshodana
Mana indriya prasadana property of Virechana helps
in rectyfying the psychological factors involved.
43. Satvavajaya Chikitsa is a nonpharmacological
approach aimed at control of mind and restraining it
from unwholesome Arthas ( objects ) or Stressors.
Restraining the mind from unwholesome objects
Directing the mind towards wholesome objects
52. Efficacy of Chatuhsama in Amlapitta W.S.R. To
hyperchlorhydria (World Journal of Pharmaceutical
Research - 2018)
Clinical efficacy of Baladi Manduram in the management
of Amlapitta
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153916/
- 2017)
A clinico-comparative study on the role of Vaman Karma
and Patoladi kashayam in the management of Amlapitta
(International Ayurvedic Medical Journal – 2016)
53. Clinical evaluation of Eladi churna & Yavadi kwath
in amlapitta (International Ayurvedic Medical
Journal – 2017)
A Randomized Comparative clinical study to
evaluate the efficacy of Triphala Mandoora over
Kamadugha Rasa in Urdwaga Amlapitta W.S.R to
Dyspepsia.
54. 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.
Hyperacidity can result from lifestyle or dietary habits, a
medical condition, or the use of some drugs, stress etc,
When compared with Ayurveda vikruti in Ahara Saman,
Apana vayu, Pachaka Pitta, Bodhaka Kledaka Kapha &
Agni may leads to Hyperacidity
55. Probable chikitsa of Hyperacidity in Ayurveda
incldes Nidana Parivarjana, Shodana, Shamana,
Rasayana, Yoga and pranayama.
The cause of the hyperacidity is properly
understood and accordingly treat the disease.
56. Treatment of Hyperacidity is based on, Rogi bala,
Roga bala, Prakruti, Vikruti, Ahara, Desha, Kala
Pathyapathya has great role in treating Hyperacidity
“Kashyapa explained as milk is poured into curd pot
immediately attains sourness , in the same way ,
repeatedly eaten food gets improperly digested and
attains vidagdhata”
With time hyperacidity gets complicated , thus
Arresting the progress of disease is one of the
important step achieved through pathya apathya.
57. Satvavajaya chikitsa empowers the patient to deal
with stress : one of the common triggers
Shodhan Chikitsa facilitates the expulsion of vitiated
Dosha from the body, there by cures the disease from
root and is conducted on the basis of Roga bala And
Rogi bala
Hence selective combination of Pathyapathya,
Shodana & Shamana plays effective role in treating
Hyperacidity
