Salient features of Amlapitta

Salient features of amlapitta ; The acid environment within the stomach leads to cleavage of the inactive precursor to pepsin and provides the low pH (<2) required for pepsin activity. Pepsin activity is significantly diminished at a pH of 4 and irreversibly inactivated and denatured at a pH of >7. Achlorhydria leads to hypergastrinaemia. Enterochromaffin- like (ECL) cell hyperplasia with frank development of gastric carcinoid tumors may result from gastrin trophic effects. Hypergastrinaemia and achlorhydria may also be seen in non pernicious anaemia- associated type A gastritis. Drugs containing katu rasa maintain required pH to activate pepsin for its action on protein digestion..therefore its known as deepaniya .. Proton pump inhibitors can develop mild to moderate hypergastrinaemia and in turn carcinoid tumors in some experimental animals.. ayurveda drugs effective in amlapitta never develop such side effects , only because of katu and tikta rasa.. katu rasa produces achchha pitta not vidagdha pitta... Heart burn and regurgitation are common symptoms of GERD (urdhvaga amlapitta). Inherent in pathophysiologic model of GERD is that gastric juice is harmful to esophageal epithelium. However , gastric acid hypersecretion is usually not a dominant factor in development of esophagitis. One caveat is with chronic H.pylori gastritis, which may have a protective effect by inducing atrophic gastritis with concomitant hypoacidity. Pepsin, bile and pancreatic enzymes within gastric secretion can also injure esophageal epithelium. Bile warrants attention because it persists in refluxate despite acid suppressing medications. Bile can transverse cell membrane , imparting severe cellular injury in a weakly acidic environment, and has also been invoked as a cofactor in pathogenesis of Barrett's metaplasia and adenocarcinoma. Hence, the causticity of gastric refluxate extends beyond hydrochloric acid.. kutaki , amrita , kiraatatikta , shataavari , aamalaki ,avipattikara churna , bhoonimbaadi kvaatha, daadimaadi ghrita , kushmaanda avaleha ,etc drugs are best options in urdhvaga amlapitta and to prevent metaplasia...

.Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com - See more at: http://infoayushdarpan.blogspot.in/#sthash.6O6eCEsw.dpuf