Ayurvedic Management of Recurrent Pancreatitis

Ayurvedic Management of Recurrent Pancreatitis

Recurrent pancreatitis involves repeated inflammation of the pancreas, which can lead to chronic pancreatic damage. From an Ayurvedic perspective, this condition involves deep-seated Agni dushti (digestive fire imbalance), Pitta dosha vitiation, and Rakta-Mamsa dhatu involvement with Āmavisha and Srotorodha (channel obstruction). The management aims at removing Āma, pacifying Pitta and Vāta, detoxifying the body, and strengthening digestion and pancreas function.

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1. Nidāna (Etiology) - Ayurvedic View

• Mithyā āhāra-vihāra (irregular or incompatible diet and lifestyle)

• Āma nirmiti (toxic undigested metabolic waste)

• Pitta-kopa (aggravation of Pitta by spicy, sour, or alcohol consumption)

• Stress (Chinta, Krodha) affecting digestion

• Viruddhāhāra (incompatible food combinations, e.g., milk + salt or fruit + milk)

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2. Samprāpti (Pathogenesis) - Ayurvedic Correlation

Modern View	Ayurvedic View
Recurrent inflammation of pancreas due to enzyme auto-digestion	Vitiation of Pitta-Vāta → Agni dushti → Āma formation → Srotorodha (obstruction in pancreatic ducts) → recurrent Urdhwagami Pitta janya Shoola & Daha
Exacerbated by alcohol, fatty food, stress	Nidānas like Madhya sevana (alcohol), Snigdha guru āhāra (heavy oily foods), and mental stress

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3. Clinical Correlation with Ayurveda

Symptom	Ayurvedic Term
Upper abdominal pain (epigastric)	Urdhwagami Pittaja Shoola
Nausea/vomiting	Chhardi
Loss of appetite	Aruchi
Loose stools	Atisāra or Grahani
Weight loss	Karshya
Fat malabsorption	Agnimandya with Pachaka Pitta dushti

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4. Chikitsā Sūtra (Treatment Principle)

“Āma-Pācana → Agni Deepana → Pitta-Vāta Shamana → Rasa-Rakta Shuddhi → Pancreatic rejuvenation”

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5. Ayurvedic Treatment Protocol

A. Āma Nirharana (Detoxification & Removal of toxins)

• Trikatu Churna + Shunthi + Guduchi – 3–5 g with warm water before food

• Agnitundi Vati / Ajamodadi Churna – for digestion

• Pippalyasava – after meals to stimulate digestion

B. Virechana (Therapeutic Purgation – esp. for Pitta Dushti)

• Trivrit Lehyam / Avipattikara Churna (mild purgation) for cleansing

• Gandharvahastadi Kashayam – when Vāta-Pitta both are involved

C. Deepana & Pachana (Strengthening Agni)

• Chitrakadi Vati

• Shankha Vati

• Hingwashtaka Churna

D. Pitta Shamana & Vata-Pitta Balance

• Guduchi (Tinospora cordifolia) – Rasayana, Deepana, Tridoshahara
  Classical Reference: Charaka Samhita – Tridoshaghna & Rasayana

• Yashtimadhu (Glycyrrhiza glabra) – anti-inflammatory, ulcer-protective
  Ref: Bhāvaprakāśa – Pitta-Vāta hara, Shothaghna

• Mustaka, Bilva, Amalaki, Haritaki – regulate digestion & control inflammation

E. Srotoshodhana & Liver-Pancreas Support

• Arogyavardhini Vati – for liver-pitta cleansing

• Katuki Churna / Patoladi Kashaya – for hepatopancreatic detoxification

• Bhunimba (Andrographis paniculata) – Pitta shamak, liver restorative

F. Rasayana Therapy (Rejuvenation)

• Amalaki Rasayana

• Ashwagandha / Shatavari / Yashtimadhu – for stress, tissue nourishment

• Guduchi Satva

• Chyavanaprasha (low dose) – post recovery

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6. Pathya-Apathya (Do’s and Don’ts)

Pathya (Recommended Diet)

• Light, warm, well-cooked food (Yavagu, Manda, gruel)

• Bitter and astringent vegetables (Neem, Patola, Lauki)

• Boiled water infused with Dry ginger or cumin

• Moong dal soup with Saindhava Lavana

• Small meals at regular intervals

Apathya (To Be Avoided)

• Spicy, sour, oily, fermented, packaged foods

• Alcohol, cold drinks, coffee

• Milk + salt/curd combinations

• Late-night meals and skipping meals

• Mental stress and overexertion

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7. Yoga & Lifestyle

Practice	Purpose
Yoga Asanas	Vajrasana, Pawanmuktasana, Bhujangasana – improves digestion
Pranayama	Anuloma Viloma, Sheetali – Pitta-Vata balance
Meditation	Reduces stress, stabilizes Agni
Daily routine (Dinacharya)	Regular wake/sleep & eating time – stabilizes hormones and metabolism

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8. Panchakarma Options (under supervision)

• Virechana – Best suited for recurrent Pitta-related inflammation

• Basti (Anuvasana & Niruha) – For chronic cases with Vāta dominance

• Lepa on abdomen – Amalaki + Yashtimadhu paste externally for burning sensation

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9. Prognosis & Recurrence Prevention

• Regular follow-up

• Maintenance of Pachana & Rasayana drugs

• Seasonal Virechana or mild detox once every 6 months

• Counseling and stress management

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10. Modern Research Support (Select Ayurvedic Herbs)

Herb	Effect
Guduchi	Immunomodulator, hepatoprotective
Yashtimadhu	Anti-inflammatory, supports GI mucosa
Amalaki	Antioxidant, restores pancreas function
Katuki	Bitter hepatoprotective, promotes bile flow
Bhunimba	Used in hepatobiliary disorders

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11. Sample Prescription (Under Clinical Supervision)

Time	Medicine	Dose
Before food	Trikatu Churna + Guduchi Churna	1–2g each with warm water
After food	Pippalyasava	15 ml with equal water
Night	Avipattikara Churna	5 g with warm water
After meals	Arogyavardhini Vati + Yashtimadhu Churna	1 tab + 2 g

Note: Dose may vary according to condition, patient strength, and physician’s discretion.

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Conclusion

Recurrent pancreatitis requires a comprehensive Ayurvedic approach that addresses root causes, strengthens digestion, eliminates toxins, and rejuvenates the pancreas and liver. Individualized treatment, dietary discipline, and regular detox are key to long-term recovery and relapse prevention.