Achalasia Ayurvedic Treatment: Panchakarma, Medicines, and Diet Protocol

Achalasia is an esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absence of normal peristalsis, leading to dysphagia, regurgitation, chest pain, and sometimes weight loss. From an Ayurvedic perspective, it can be correlated with Annāhāra-vaha Srotas Dushti (disorder of food-carrying channels), mainly due to Vāta-kapha vitiation obstructing the normal passage of food.

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Ayurvedic Understanding of Achalasia

• Doṣa involvement:

  • Vāta (esp. Apāna & Udāna Vāta) – impaired downward and upward movement.

  • Kapha – obstruction due to stiffness and unctuousness in the channels.

  • Pitta may be secondarily aggravated due to indigestion and reflux.

• Srotas: Annavaha Srotas (gastrointestinal tract).

• Samprapti: Vāta-kapha prakopa → Obstruction at LES → Stambhana (stasis of food) → Annavaha Srotas Dushti.

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Management Principles

1. Āma-Pācana & Agni Dīpana – to reduce undigested toxic material and improve digestion.

2. Vāta-Kapha Shamana – pacification of obstructed vāta and kapha.

3. Srotoshodhana – clearing the obstruction in the channels.

4. Rasāyana – rejuvenation of esophageal motility and mucosal health.

5. Psychological care – as stress worsens symptoms, Satvāvajaya Chikitsā may be needed.

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Treatment Protocol

1. Panchakarma Therapies

• Snehapāna (internal oleation): Use of medicated ghṛtas like Sukumāra Ghṛta or Kalyānaka Ghṛta.

• Mridu Virechana (mild purgation): With Trivṛt Lehya, Avipattikara Chūrṇa to balance Pitta and improve Agni.

• Vasti Chikitsa (enema therapy):

  • Mātrā Basti with Kṣīrabala Taila, Anuvasana Basti with Sahacharādi Taila to control Vāta.

  • Nirūha Basti with Dashamoola Kwātha for Vāta-kapha balance.

• Nasya: Ksheerabala Taila or Anu Taila for neurological regulation of swallowing reflex.

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2. Oral Medications

• Agni Deepana & Āma Pācana:

  • Trikatu Chūrṇa (Pippali, Maricha, Shunthi)

  • Hingu Ashtaka Chūrṇa before meals

• Vāta-Kapha Shamana & Srotoshodhana:

  • Dasamoola Kwātha

  • Pippalyasava / Ardrakāsava

• Mucosal protection & Rasāyana:

  • Yashtimadhu Chūrṇa (Glycyrrhiza glabra) with honey/milk

  • Amalaki Rasāyana

  • Guduchi Satva

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3. Pathya-Apathya (Diet & Lifestyle)

• Pathya:

  • Warm, semi-solid, easily digestible food (yusha, gruel, moong dal soup).

  • Milk with Trikatu or Yashtimadhu.

  • Small frequent meals.

• Apathya:

  • Avoid very dry, hard-to-swallow, fried, and refrigerated food.

  • Excess spicy, sour, and heavy-to-digest items.

  • Mental stress, late-night eating.

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4. Supportive Yogic Practices

• Prāṇāyāma: Anuloma-Viloma, Bhramari (to balance Vāta and calm mind).

• Āsanas: Vajrāsana after meals, Bhujangāsana, Matsyendrāsana (improves digestion & esophageal motility).

• Meditation: To reduce stress-related worsening of symptoms.

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Sample Protocol (Practical Outline)

Initial Phase (2 weeks):

• Light diet + Deepana-Pachana with Trikatu, Hingvastaka.

• Snehapāna with Sukumara Ghrita.

• Mild Virechana.

Main Phase (4–6 weeks):

• Dashamoola Kwatha + Yashtimadhu regularly.

• Vasti chikitsa (alternate Anuvasana & Niruha) for 8–12 days.

• Nasya with Ksheerabala Taila.

Maintenance Phase:

• Pippalyasava 10 ml bd after meals.

• Yashtimadhu with honey.

• Pathya ahara & yoga.

• Rasāyana: Guduchi, Amalaki, Ashwagandha as required.