Introduction

Ayurveda is said to be the most ancient of medical sciences. Ayurveda stands apart from the rest of medical fraternity with its holistic approach to disease management on basis of Nidana Panchaka. It is believed that everything in this universe is composed of five Elements, Panchabhootas, then they constitute the three Doshas or bio energetic forces that govern our health. The first and foremost task in Ayurvedic disease management is a proper understanding and description of its Etiopathogenesis. Ayurvedic treatment is based on restoring balance of three Doshas Vata Pitta Kapha. In Ayurveda, mind and body are manifestations of consciousness. Amlapitta is a type of GI disorders that effect on almost all the human beings. Amlapitta is one of burning problem of our society. It’s a disease of Annavah Srotas .this disease is not mentioned in the Brihatrayee but in Charak Samhita this terminology has been used in nine places. Acharya Kashyap was first to give detailed description of the disease. The term Amlapitta is composed of words Amla and Pitta. Describing the pathogenesis Acharya Charak has mentioned that the Amavisha gets mixed with the Pitta, the disease Amlapitta is developed. Whereas Acharya Kashyap believed that the disease is caused by vitiation of Doshas causing Mandaagni leading to Vidagdhajirna manifesting as Amlapitta. There is an increase in Amla Guna of Pachaka Pitta and this Amlibhuta Pitta does not perform its main digestive functions. The first and foremost group of etiological factors of Amlapitta are dietary factors, as intake of food against code of Dietics i.e. Ahara Vidhi Vidhaana and Visheshaayatana. Excessive use of Pitta aggravating factors like Katu, Amla , Vidahi etc and irregular time of consumption of food. Indiscriminate use of several drugs like Steroids, NSAIDS. To maintain sound and good health one has to follow code of habits. Regular habits of Defecation, Eating and Sleeping in time. Some habits like not to suppress the natural calls and maintain the equilibrium of body constituents, by this good health and proper functioning of body is maintained. If this is not followed than whole body functioning gets disturbed and will cause disturbances of equilibrium of Pitta and digestion that will finally lead to AMLAPITTA. Psychology also play a great role in maintaining health of a person. Psychological factors like Anger, Fear, and Anxiety are also identified as main factors that will affect physiology of digestion. These factors tends to affect the secretion of Gastric Juice which will disturb the Haemostasis and will further cause Amlapitta. Ushna and Tikshana drugs if used excessively without proper assessment for a long period Panchakarma and Heenayoga, Mithyayoga and Atiyoga by attacking on seat of Agni i.e. Amashya and Upadrava of some diseases like chronic Vibandha, Arsha , Ajirna and Pandu. Sight and smell of certain food items provoke a strong reflex vomiting in which stomach is powerfully irritated. Desha, Kala, Ritu takes a great extent in causation of Amlapitta. Excessive consumption of Alcohol, Tobacco, Beverages, smoking or irritant substances these can cause a local irritation in stomach which can cause more Gastric Juice. According to modern literature, Hyperacidity simply means increased level of acid in stomach. Stomach secretes hydrochloric acid, a digestive juice that breaks down food particles into their smallest form to acid for digestion. Hyperacidity in all is subjected as gastric discomfort by most of the patients. Symptoms like heart burn, chest pain, gastric discomfort, abdominal distention, sour belching, nausea and loss of appetite, reflexes of food taken all these together make disease hyperacidity. Vagal affects, hormonal effect, insufficient circulation, shock, age, sex, temperature, family history, social class, occupation are some of the factors that cause Hyperacidity. Some aggressive factors like Hydrochloric Acid, Pepsin, Refluxed Bile, Alcohol, Bacterial, Toxins Psychological Trauma and some defensive factors are responsible for enhancement of Mucosal Protection. Hyperacidity can be caused due to prolonged intake of various Medications. Some Anti-Inflammatory for long period, Drinking Alcohol, Heavy Smoking, these are important cause of Hyperacidity. Eating Habits, Stress, Pregnancy, Obesity, Ageing, Fasting, Eating Junk Food these can cause hyperacidity.                        

Aims And Objectives

• To compile the literature concerned.
• To study the Aetiology, Pathogenesis, and Symptomatology of the disease according to Ayurveda as well as modern science.
• To study the efficacy of Amalaki Rasayana in the management of Amlapitta.

Material Methods

A total of 30 patients presenting with the classical features of Amlapitta were selected from Jammu institute of Ayurveda and Research.

Inclusion Criteria

• According to classical texts the signs and symptoms of Amlapitta will be included.
• Patients of both sexes in the age group of 20-60yrs will be included.

Exclusion Criteria

• Patients suffering from Peptic Ulcer, Duodenal Ulcer, and Melena were excluded.
• Patients below 20yrs and above 60yrs of age.

Investigations

• BLOOD : Hb gram%  , TLC , DLC , ESR
• URINE : Routine and Microscopic examination
• STOOL: Routine and Microscopic examination

Drug Review

Amalaki Rasayana

• Fine powder of Amalaki
• Amalaki swarasa
• Madhu ( Honey)
• Ghritta  
• Pippali
• Sugar 

Bhavna: 21 Times

Amalaki

 (Emblica Officinalis)

Parts Used

Root Bark, Stem Bark, Leaf, Fruit, Seed.

        Properties

• Rasa – Amala , Madhura , Kashaya , Tikta , Katu
• Guna – Guru , Ruksha , Sheeta
• Virya – Sheeta
• Vipaka – Madhura

Doshaghanta

                          Tridosha Shamaka [ Especially Pitta Shamaka ]

Probable Mode Of Drug Action

Effect Of Drug On Cardinal Signs And Symptoms:

 Amalaki rasayana due to its properties like Deepana Pachana and properties like Kashaya Rasa govern Sheet Virya. The chronic effect of Agni Dushti and Grahani Roga leads to the organic lesions in Amashaya. In this Amalaki is helpful by its property of Rasayana. It is scientifically proved that ascorbic acid is best as antioxidant property. Vitamin C can prevent the formation of such Nitrosamines in food and GI tract. Kashaya rasa tones up the tissues and hastens healing of ulcers. Amalaki being Kashaya Rasa might be rapidly healing the Ulcers and toning up the gastric and Duodenal Mucosa making them more resistant against action of acid.[i] Besides giving relief from symptoms the drug had also imparted Rasayana effects. Whether the phenomenon is due to correction of the pathology or due to claimed Rasayana effect of the drug. Amalaki has been considered as one of the foremost Rasayana drugs imparting a long healthy life.

Observations And Results

• Tikta Amlaodgara: 80% Improvement Was Found In Patients.
• Hritkanthadaha: This Drug Showed 75% Relief In Patients
• Aruchi: 70% Relief In Aruchi Was Seen
• Adhmana: 85% Relief Was Seen.
• Gaurava: 75% Relief Was Seen.
• Agnimandya: 70% Relief Was seen.

Discussion

Amlapitta is a disorder occurring in Amashaya and clinical features are related with upper part of GI tract. The major causative factor are mainly vitiating the Agni and its functions related with digestion and Metabolisim. The problem is very common due to changing lifestyle. The present study is to study the efficacy of Amalaki Rasayana in management of Amlapitta. Amlapitta is foremost disease at OPD level people are suffering due to changing diet habits, social structures, life styles, and mental stress and strain.Factors responsible for manifestation of the disease of G.I.T. are almost similar. Diet which is against Ashtavidha Ahara Vidhi Vishesayatana, dietetic code and conduct are mostly responsible for most of the disease. Mandagni or Agnidushti caused by any Nidana is responsible for such diseases. This first vitiate the Doshas and further Dushya and pathogenesis progresses. Amalaki is one of the most effective remedy in Paittika disorders. It neutralises the Vata and Kapha Doshas but its main action is Pittashamaka. So it acts like a good agent in Amlapitta. It has Antioxidant property, Antisecretory due to its rich source of Vitamin C, Tannins, and Flavonoids. So, it may act as Anti –Ulcer and Anti Secretory drug.Due to uncontrolled intake of factors affecting Agni and leads to Agnidushti and symptoms appear and Amadosha leading to Amlapitta. Amalaki here is said to be antagonist to properties of Deepana Pachana it is helpful in all levels of Samprapti.In this study, the efficacy of trial drug is seen. Aetiopathogenesis, symptomatology of Amlapitta is studied. Amlapitta is a result of Agni Dushti and is chronic in nature. Dushya, Rasa, And Rakta, Srotas, Annavaha, Purishvaha Srotas are involved. It was observed that patients taking Amalaki Rasayana were relieved of their symptoms in 3-4 weeks. The drug is especially effective in early cases Of Amlapitta. The effect of trial may be due to its Pittashamaka property.

Conclusion

Thus, it can be concluded that Amlapitta, being a common lifestyle-related gastrointestinal disorder primarily caused by Agnidushti, responds effectively to Amalaki Rasayana therapy. The drug, owing to its Pittashamaka, antioxidant, antisecretory, and anti-ulcer properties, not only alleviates the symptoms but also helps in correcting the underlying pathogenesis by restoring Agni. The study highlights that Amalaki Rasayana is especially beneficial in early and uncomplicated cases of Amlapitta, offering a safe, natural, and holistic management approach in Ayurveda.