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Line 55: − + + + + − + + + − • Serous & mucous secretions of salivary glands & oesophagus+ − • Mucous secreted by mucous glands of surface mucous cells and mucous neck cells of the stomach+ − • Mucous and bicarbonate ions secreted from bruner's gland of the small intestine + − • Bicarbonate ions secreted from the duct of pancreas+ − • Alkaline mucous secretion by Brunner's glands in the duodenum + − • Mucous secreted by goblet cells that lubricate the intestinal surface+ − • Water & electrolytes secreted by enterocytes of the small intestine+ − • Mucous secreted by epithelial cells of crypt's of Liberkuhn of the large intestine + + + + + + + + + + + − The third most important component of the digestive process is “samana vayu” which represents the regulation of the enteric nervous system, the sympathetic and parasympathetic supply of the autonomic nervous system. − The action of "samana vayu" can be partially understood by the regulation of the secretion of HCL by parietal cells. The activities of the vagus nerve, the amount of gastrin from G cells and somatostatin from D cells, and the level of histamine play a vital role in this process. + +
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<big>'''Principles of Diagnosis and Management of acid peptic diseases in Ayurveda'''</big>
<big>'''Principles of Diagnosis and Management of acid peptic diseases in Ayurveda'''</big>
<div style = "text-align:justify;">
<div style = "text-align:justify;">
Acharya Sushruta’s definition of a “healthy person” (swastha) is the most widely accepted one in [[Ayurveda]].[Su. Sa. Sutra Sthana 15/41]
Acharya Sushruta’s definition of a “healthy person” (swastha) is the most widely accepted one in [[Ayurveda]].[Su. Sa. Sutra Sthana 15/41]
The physical components of health are listed as the three ([[doshas]] - [[vata]], [[pitta]] and [[kapha]]); the seven body tissues ([[dhatus]]); and the excretory functions([[mala]]). Digestive power([[agni]] is also added with due importance. It indicates that all kinds of “transformation processes”, essential for the maintenance of health are facilitated by the [[agni]] from gross to minute level.
The physical components of health are listed as the three ([[doshas]] - [[vata]], [[pitta]] and [[kapha]]); the seven body tissues ([[dhatus]]); and the excretory functions([[mala]]). Digestive power([[agni]] is also added with due importance. It indicates that all kinds of “transformation processes”, essential for the maintenance of health are facilitated by the [[agni]] from gross to minute level.
===Agni and patterns of digestion ===
===Agni and patterns of digestion ===
When the [[agni]] is in the balanced state, it is known as “samagni”. But when it is affected by three [[dosha]], it shows three pathological variations. If there is an excess of [[kapha]] [[dosha]], it lowers the power of [[agni]] and the condition is known as “mandagni” (slow digestion). When [[pitta]] is in excess form, the [[agni]] becomes “teekshnagni” (fast/quick digestion). It can digest anything and everything and when the food is not available, it starts digesting the tissue elements ([[dhatus]]). For example, in thyrotoxicosis the hyperactivity of the thyroid gland causes high basic metabolic rate (BMR) and cachexia develops. When the [[agni]] is affected by vitiated [[vata]], it becomes “vishamagni” (irregular digestion). As [[vata]] has catalytic action (“yogavahi”), if it interacts with [[kapha]], it will enhance the activity of [[kapha]] and if it interacts with [[pitta]], it enhances the activities of [[pitta]].
When the [[agni]] is in the balanced state, it is known as “samagni”. But when it is affected by three [[dosha]], it shows three pathological variations. If there is an excess of [[kapha]] [[dosha]], it lowers the power of [[agni]] and the condition is known as “mandagni” (slow digestion). When [[pitta]] is in excess form, the [[agni]] becomes “teekshnagni” (fast/quick digestion). It can digest anything and everything and when the food is not available, it starts digesting the tissue elements ([[dhatus]]). For example, in thyrotoxicosis the hyperactivity of the thyroid gland causes high basic metabolic rate (BMR) and cachexia develops.
When the [[agni]] is affected by vitiated [[vata]], it becomes “vishamagni” (irregular digestion). As [[vata]] has catalytic action (“yogavahi”), if it interacts with [[kapha]], it will enhance the activity of [[kapha]] and if it interacts with [[pitta]], it enhances the activities of [[pitta]].
Ultimately, the impairment of [[agni]] leads to improper digestion leading to the process of fermentation and putrefaction, and then, there is the production of toxic metabolites called "ama". These toxic metabolites are the main cause of all the disease conditions. All diseases arise from the lowered activity of [[agni]].i.e “mandagni” [A.Hr. Chikitsa Sthana 12/1].
Ultimately, the impairment of [[agni]] leads to improper digestion leading to the process of fermentation and putrefaction, and then, there is the production of toxic metabolites called "ama". These toxic metabolites are the main cause of all the disease conditions. All diseases arise from the lowered activity of [[agni]].i.e “mandagni” [A.Hr. Chikitsa Sthana 12/1].
So, good or bad health begins in the gut and the treatment is focused on the measures for maintaining the heath of digestive power (kayagni), thereby eliminating all the diseases of the whole body. This is the first branch of Ayurveda called “Kayachikitsa’.
So, good or bad health begins in the gut and the treatment is focused on the measures for maintaining the heath of digestive power (kayagni), thereby eliminating all the diseases of the whole body. This is the first branch of Ayurveda called “Kayachikitsa’.
==The concept of digestion in Ayurveda==
==The concept of digestion in Ayurveda==
The whole digestive process in the gut starts right from the mouth, where there is the action of “bodhaka kapha” to start the process of digestion. Then it goes to the stomach (amashaya) where it is subjected to the action of "kledaka kapha" for adding the moisture content (kleda) to the food material. Subsequently, from the stomach (amashaya) it goes into the portion of the small intestine called "grahani" which is the seat of "pachaka pitta". The 6th internal layer called "pittadhara kala" is also situated there. The main process of digestion occurs in this portion of the gut. It is followed by caecum (unduka) and large intestine (pakwashaya) where the separation of essence (sara) and excretory materials (kitta) occurs with the help of “samana vayu” which leads to the absorption and assimilation of nutrient portion and excretion of the waste products in the form of faeces (purisha) and urine (mutra) with the help of “apana vayu”.
The whole digestive process in the gut starts right from the mouth, where there is the action of “bodhaka kapha” to start the process of digestion. Then it goes to the stomach (amashaya) where it is subjected to the action of "kledaka kapha" for adding the moisture content (kleda) to the food material. Subsequently, from the stomach (amashaya) it goes into the portion of the small intestine called "grahani" which is the seat of "pachaka [[pitta]]". The 6th internal layer called "pittadhara kala" is also situated there. The main process of digestion occurs in this portion of the gut. It is followed by caecum (unduka) and large intestine (pakwashaya) where the separation of essence (sara) and excretory materials (kitta) occurs with the help of “samana [[vayu]]” which leads to the absorption and assimilation of nutrient portion and excretion of the waste products in the form of faeces ([[purisha]]) and urine ([[mutra]]) with the help of “apana vayu”.
Here, the “kledaka kapha” can be represented in the form of mucin, which moistens the food materials and loosens its molecules. It buffers the action of the strong acid and inhibits the action of pepsin. It provides a protective layer to the stomach wall to prevent the corrosive effect and its digestion by pepsin. So, the functions of “kledaka kapha” are reflected mainly through the functions of mucin.
Here, the “kledaka kapha” can be represented in the form of mucin, which moistens the food materials and loosens its molecules. It buffers the action of the strong acid and inhibits the action of pepsin. It provides a protective layer to the stomach wall to prevent the corrosive effect and its digestion by pepsin. So, the functions of “kledaka kapha” are reflected mainly through the functions of mucin.
The action of kledaka kapha is also executed by the following secretions in the gut.
The action of kledaka kapha is also executed by the following secretions in the gut.
*Serous & mucous secretions of salivary glands & oesophagus.
*Mucous secreted by mucous glands of surface mucous cells and mucous neck cells of the stomach.
*Mucous and bicarbonate ions secreted from bruner's gland of the small intestine.
*Bicarbonate ions secreted from the duct of pancreas.
*Alkaline mucous secretion by Brunner's glands in the duodenum.
*Mucous secreted by goblet cells that lubricate the intestinal surface.
*Water & electrolytes secreted by enterocytes of the small intestine.
*Mucous secreted by epithelial cells of crypt's of Liberkuhn of the large intestine.
“Pachaka pitta” represents the digestives enzymes like trypsin, chymotrypsin, carboxypolypeptidase, pancreatic amylase, pancreatic lipase, cholesterol esterase, phospholipase, salivary amylase, maltase, lingual lipase, pepsin, gastric lipase, gastric amylase, gelatinase, urase, etc.
“Pachaka pitta” represents the digestives enzymes like trypsin, chymotrypsin, carboxypolypeptidase, pancreatic amylase, pancreatic lipase, cholesterol esterase, phospholipase, salivary amylase, maltase, lingual lipase, pepsin, gastric lipase, gastric amylase, gelatinase, urase, etc.
It digests the food, separates the waste and nutrients from it, and supports the other forms of [[pitta]] located in different parts of the body.
It digests the food, separates the waste and nutrients from it, and supports the other forms of [[pitta]] located in different parts of the body.
The third most important component of the digestive process is “samana [[vayu]]” which represents the regulation of the enteric nervous system, the sympathetic and parasympathetic supply of the autonomic nervous system.
The action of "samana [[vayu]]" can be partially understood by the regulation of the secretion of HCL by parietal cells. The activities of the vagus nerve, the amount of gastrin from G cells and somatostatin from D cells, and the level of histamine play a vital role in this process.
==Acid-Peptic Diseases==
==Acid-Peptic Diseases==
Acid peptic disorders include many conditions whose pathophysiology is directly related to the damage caused by acid and peptic activity of gastric secretions. It includes gastroesophageal reflux disease, peptic ulcer (gastric and duodenal), and stress-related mucosal injury. In all these conditions, mucosal erosions or ulcerations arise when the caustic effects of aggressive factors overwhelm the defensive factors of the gastrointestinal mucosa.
Acid peptic disorders include many conditions whose pathophysiology is directly related to the damage caused by acid and peptic activity of gastric secretions. It includes gastroesophageal reflux disease, peptic ulcer (gastric and duodenal), and stress-related mucosal injury. In all these conditions, mucosal erosions or ulcerations arise when the caustic effects of aggressive factors overwhelm the defensive factors of the gastrointestinal mucosa.