Customized Ayurvedic management of Agnyashaya shotha (Subacute Pancreatitis): An experience

Abstract

Subacute Pancreatitis (SAP), a rapidly developing inflammatory condition, is surgically manageable. Based on the clinical presentation and symptomatology, the manifestation of SAP can be termed as Agnyashaya Shotha (AS). The present case report is on a year-old manifestation of untreated SAP with severe gastro-duodenitis (~Agnyashaya shotha pradhana Grahani roga) in a young male. The previous Ultrasonography (USG) impression of the abdomen revealed “SAP” and the Upper Gastrointestinal (UGI) endoscopy report stated “severe gastroduodenitis.” The serum amylase and lipase levels were 141 U/L and 108 U/L, respectively. He was clinically treated with a customized and simple Ayurveda intervention for five days. The intervention involved oral proprietary polyherbal formulations along with the internal therapy of Matrabasti (~a form of unctuous enema) and Pathya (~wholesome dietary regimen), based on the treatment principles of Grahani roga (~disorders of lower gastrointestinal tract). He became asymptomatic and was discharged after five days of intervention. Furthermore, the USG impression of the abdomen revealed “no evidence of abnormalities” and his serum amylase was reduced to 59 U/L. Although at the time of discharge, the UGI endoscopy and serum lipase level could not be investigated due to the patient’s unwillingness, the case seemed to be worthy of reporting. Thus, the adoption of current therapeutic intervention along with proper Pathya based on Ayurveda principles might have managed the present case of SAP. Although the present case had its limitations, it significantly helped in understanding SAP, its pathogenesis, and management in the view of rationalized fundamental theories of Ayurveda.