By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Pancreatitis is an inflammation of pancreas, a large gland situated behind the stomach and next to the small intestine. 2 main functions of Pancreas –
Releases powerful digestive enzymes into the small intestine to help digest food.
Releases insulin and glucagon into the bloodstream. These hormones help your body control how it uses food for energy.
Read more about Pancreatitis – Modern view
Types of Pancreatitis
Acute pancreatitis is sudden inflammation that lasts a short time.
Chronic pancreatitis is long-lasting inflammation.
Causes and pathology
Pancreatitis occurs when digestive enzymes become activated within pancreas, irritating the cells of pancreas and causing inflammation. Repeated bouts of acute pancreatitis cause damage to the pancreas and lead to chronic pancreatitis. Scar tissue may form in the pancreas, causing loss of function.
Conditions that can lead to pancreatitis include:
High calcium levels in the blood
High triglyceride levels in the blood
Injury to the abdomen
Endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to treat gallstones, also can lead to pancreatitis. Sometimes, a cause for pancreatitis is never found.
Symptoms of acute pancreatitis
Higher heart rate
Nausea and vomiting
Swollen and tender belly
Pain in the upper part of your belly that goes into the back. Eating may make it worse, especially foods high in fat.
Symptoms of chronic pancreatitis
The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. But you may also have:
Constant pain in the upper belly that radiates to your back. This pain may be disabling.
Diarrhea and weight loss because pancreas isn’t releasing enough enzymes to break down food
Upset stomach and vomiting
Treatment for acute pancreatitis
Intravenous (IV) fluids
Low-fat diet or fasting.
Severe cases –
ERCP to take out gallstones if they’re blocking your bile or pancreatic ducts
Treatment for chronic pancreatitis
Insulin to treat diabetes
Pancreatic enzymes to help your body get enough nutrients from your food
Surgery or procedures to relieve pain, help with drainage, or treat blockages
Read more about Causes, Risk factors and Complications of Pancreatitis
Pancreatitis In Ayurveda
Probable Ayurvedic correlation
Agnyashaya Shotha – Pancreas is one organ which has not been anatomically elaborated in Ayurveda. Among the list of visceral organs, agnyashaya i.e. organ where agni or digestive fire is located has been mentioned. This seems to be an explanation of pancreas. The digestive juices and hormones it produces, which participate in digestion of food and other body functions can be compared to the fire in pancreas. A term called kloma too has been correlated to pancreas. The line of treatment of shotha i.e. inflammation should be followed in this context.
Pittaja Shotha – Pancreatitis shall be treated on the basis of pittaja shotha or inflammation caused by increased pitta. Fire and pitta have a residence and resident relationship. Pitta is chiefly involved in causing inflammation. If the fire in the pancreas is considered to be pitta, excessive pitta in the pancreas will tend to damage its abode.
Pittaja Shula – Pain or colic caused by aggravated pitta includes pain having origin in many digestive organs, mainly pancreas.
Teekshnagni and Vidagdhajirna – Tikshnagni is a condition in which the digestive fire governed by vitiated pitta causes burnout of food, inflammation and destruction of digestive apparatus, pancreas in this condition. This condition will lead to a pitta type of indigestion wherein the consumed food is burnt out and depletes the body of its nutrition.
Samprapti – pathogenesis
Dosha – Pitta predominant
Agni – Tikshnagni
Srotas – Annavaha, Udakavaha,
Sroto dushti Lakshana – ati pravritti (excessive discharge, hyperactivity)
Vyadhi Marga – Abhyantara (visceral organ)
Sadhya Asadhyata – acute pancreatitis – curable, chronic pancreatitis – curable with difficulty
Read – How To Make Prognosis Of Disease According To Ayurveda?
Shula Chikitsa – treatment of colic, mainly pittaja type of colic
Shotha Chikitsa – treatment of swelling and inflammation, mainly pittaja type of swelling
Teekshnagni and Vidagdhajirna – treatment of intense digestive fire and subsequent burnout of food should be adopted. Both these are caused by highly vitiated pitta.
Other treatment strategies –
Krimi Chikitsa – when infection is suspected as causal of pancreatitis.
Ashmari Chikitsa / pittashmari chikitsa – treatment for gall stones or calculi, when it is suspected to be causal.
Sthoulya and Medo Roga Chikitsa – when obesity and high triglycerides are responsible for pancreatitis
Arbuda Chikitsa – when pancreatic cancer is causing inflammation of the pancreas.
Jwara Chikitsa – treatment of fever, when fever and pain are associated
Chardi, Atisara, Ajirna Chikitsa – treatment of vomiting, diarrhea and indigestion when these symptoms are predominant in pancreatitis
Role of Panchakarma
Virechana is the best treatment for pancreatitis since there is involvement of the digestive part of pancreas, involvement of high pitta and inflammation. Guggulutiktaka Ghrita for oleation and Trivrit lehya for purgation are preferable. Small doses of Avipattikara Churna, Trivrit lehya, Drakshadi Lehya, Sukumara Ghrita, Kalyanaka Ghrita and Indukanta Ghrita in small doses calms pitta and relieve inflammation associated with pancreatitis apart from causing mild purging. These remedies shall be tried in case of mild to moderate pancreatitis.
Enema with Dashamula Ksheera Vasti or Yashtimadhu siddha Ksheera Vasti, matra or anuvasana vasti with yashtimadhu taila and pittahara vastis are highly useful.
Sukumara Kashayam / Ghrita
Tiktaka Kashayam / Ghrita
Milk boiled with Licorice
Guggulutiktakam Kashayam / Ghritam
Kutaja Ghana vati
Medohara Vidangadi Lauha
Varanadi Ghritam / Kashayam
Punarnavadi Kashayam / Punarnava Mandura
Krimi kutara ras
Dashamula Haritaki Rasayana
Ghee fried asafetida
Dashamula – ten roots
Yava Kshara – alkali of barley
Ash of conch
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