Published online in http://ijam.co.

in ISSN No: 0976-5921

International Journal of Ayurvedic Medicine, Vol 14 (1), 2023; 297-301

Management of Amlapitta (Hyperacidity) with Patoladi kwath: A Case Study

Case Report

Seema H Thakare1*, Prashil P Jumade2, Sneha Vidhate3

1. Assistant Professor, Department of Rognidan & Vikruti Vigyana,
3. Assistant Professor, Department of Dravyaguna,
Mahatma Gandhi Ayurvedic College, Hospital & Research Centre, Salod (H), Wardha.
Datta Meghe Institute of Medical Sciences (Deemed to be University), Nagpur. Maharashtra. India.
2. Associate Professor, Department of Community Medicine, Karpagam Medical College, Coimbatore, Tamil Nadu. India.

Abstract
Amlapitta (Hyperacidity) is one of the gastrointestinal disorders. It is closely related with food habits,
behavioral pattern & life style. It is not described in basic compendium of Ayurveda like Charak samhita, Sushruta
samhita & Ashtang hridaya. Its detail description is available in Madhavnidan, Kashyap samhita, Yogratnakar etc.
Consumption of etiological factors leads to provocation of tridoshas & causes Agnimandya. Vitiated Agni unable to
digest the food properly & leads to fermentation of food. In Amlapitta (Hyperacidity) pachak pitta is increases in its
quantity & its normal bitter taste (katu) gets converted to sour (amla) taste due to fermentation of food. Tikta-Katu
rasatmak drugs are mainly used for treatment as they have Aampachan & Agnideepan properties. Patoladi Kwath
was used for shaman chikitsa in present case. A 42 years male patient having chief complaints of Udar-uro daha
(burning sensation in abdomen & chest region), Amlodgar (Sour belching), Aruchi (Anorexia), Hrillas (feeling of
Nausea), Chardi (episodes of vomiting occasionally), Udarshula (Abdonimal pain), Klama (Fatigue) & Bhrama
(Vertigo) was treated with Patoladi Kwath for 15 days. Follow-up of patient was taken after each 7 days. This Kwath
(Decoction) is an excellent combination of pittashamak dravyas, performs functions like Agnideepana, pachana &
helps to improve digestion. After 15 days treatment, symptoms like Udar-uro daha, Amlodgar, Hrillas, Chardi,
Udarshula & Bhrama got complete relief while in symptoms like Aruchi & klama relief was 80% & 75%
respectively. Overall percentage of relief was found to be 90%.
Key Words: Amlapitta, Ayurveda, Deepan, Pachan, Patoladi Kwath.

Introduction metabolism of body. (2) Even after advancement in the

Present era is full of stress & strain due to field of science & technology human beings are facing
competitive life style. Everyone is trying to follow the many health issues. Majority of the diseases are due to
western culture to maintain their status in high class faulty dietary habits & counts nearly 80 % among the
society. Basic Needs of human are increasing but the top ten killing diseases. (3) The process of digestion
resources to fulfill these needs are limited. Everyone is gets disturbed because of wrong life style & food habits
struggling to survive in the age of competition and leading to production of symptoms like hyperacidity,
while doing all this peoples are neglecting their own dyspepsia, indigestion & 50 % of gastrointestinal
health. Because of changing life style, food habits, disorders. (4)
behavioral pattern etc. they are facing various Amlapitta is one of the vyadhi of gastrointestinal
functional or psychological diseases. Gastrointestinal system. The basic compendium of Ayurveda like
disorders are one of them. Acharya Suhruta also Charak samhita, Sushruta samhita & Ashtang hridaya
mentioned that, food taken by the person with disturbed has not described the disease. The detail description of
psyche does not digested properly even it is wholesome Amlapitta is available in Madhavnidan, Kashyap
& consumed in proper quantity. (1) Proper intake of samhita, Yogratnakar etc. According to Kashyap
food is important for the maintenance of digestive samhita, Amlapitta is closely related to the factors like
power and therefore for maintaining strength, health & type of food we consumed, Food habits & timing of
taking food, life style, nature of work etc. (5) In
Amlapitta, quantity of Pachak pitta is increased & its
* Corresponding Author: normal bitter taste gets changed & it becomes excess
Seema H Thakare sour. (6) Excess consumption of viruddha ahaar
Assistant Professor, Department of Rognidan & (incompatible food), dushta (rotten), ati-amla (sour) &
Vikruti Vigyana, Mahatma Gandhi Ayurvedic College, vidahi aahar (spicy food), pittakarak aahar ( pitta
Hospital & Research Centre, Salod (H), Wardha, Datta aggravating diet & drinks), guru aahar ( food which is
Meghe Institute of Medical Sciences (Deemed to be heavy to digest), Abhishyandi aahar (unctuous diet),
University), Nagpur, Maharashtra, India. Atidrava aahar (excess liquid diet), vegdharan
Email Id: [email protected] (suppression of natural urges), atimadhyapana (excess

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Seema H Thakare et.al., Management of Amlapitta (Hyperacidity) with Patoladi kwath: A Case Study
alcohol consumption), diwaswap (Day sleep) etc. are Examination
the different causes of Amlapitta given in Ayurveda On examination, the vitals of the patients were
classics. These factors cause vitiation of all three doshas within the normal limits. No any abnormal finding was
but predominantly pitta dosha is vitiated. These vitiated noted in systemic examination. The findings of
doshas lowers the functioning of Agni (digestive Ashtavida pariksha (Eight fold examination) are given
power). Impairment of agni leads to improper digestion in Table no. 1.
& metabolism which further leads to manifestation of
Amlapitta. (7)(8) Agnimandya & formation of aam Subjective Criteria
(undigested food) are the root cause of Amlapitta. So, The assessment of subjective features was done
while treating the disease with shaman chikitsa drugs on the basis of gradation of symptoms given in Table
having Aampachan & Agnideepan properties are mainly no. 2.
used. Katu & Tikta rasatmak dravyas mainly possess
Aampachan & Agnideepan properties. Patoladi Kwath Diagnosis
is combination of mainly tikta rasatmak dravyas which On the basis of history, clinical symptoms &
is useful in treatment of Amlapitta. It helps to relieve examination the patient was diagnosed as Amlapitta.
the symptoms like Shula (pain), Bhrama (Vertigo),
Aruchi (anorexia), Agnimandya (loss of appetite), Daha Treatment given
(burning sensation), Jwara (fever) & Chardi (vomiting). Tikta rasapradhan dravyas are mainly preferred
(9) In the present case study, the patient is treated with in the treatment of Amlapitta. (10) In this case Patoladi
using the Patoladi Kwath. Kwath 15 ml in BID dose was given to the patient
internally before one hour of each meal with lukewarm
Case Presentation water for 15 days. Follow up of patient was planned
A 42 years male patient having chief complaints after 7 days for the assessment of symptoms. Patient
of Udar-uro daha (burning sensation in abdomen & was advised to take simple diet & avoid heavy, spicy &
chest region), Amlodgar (Sour belching), Aruchi oily food. He was also advised to avoid alcohol &
(Anorexia), Hrillas (feeling of Nausea), Chardi tobacco chewing.
(episodes of vomiting occasionally), Udarshula
(Abdonimal pain), Klama (Fatigue) & Bhrama (Vertigo) Table No. 1 Ashtavidha Pariksha
came to OPD at Naliniprakash clinic, Sainagar Wardha. Nadi (Pulse) 76/min, Regular
The patient was suffering with above symptoms since Mutra (Urine) Samyak (Normal)
last 3-4 months. The patient was farmer by occupation Mala (stool) Samyak (sometimes hard stool)
& having habit of alcohol consumption (1-2 times / Jivha (Tongue) Sama (Coated)
week) & tobacco chewing (2-3 times /day) since last Shabda (Speech) Spashta (Clear)
10-12 years. He had taken modern treatment for few Sparsha (Touch) Ushna (hot)
days but has got only temporary relief. He had no Druka (Vision) Samyak
history of Hypertension, Diabetes or any major illness Akriti (Built) Madhyam (Medium)
in past.

Table. No. 2 Subjective Criteria (11)

S. N Features Gradation Parameter
0 No Daha in any area
Daha occurs in one of the area i.e Ura, Udara, Kukshi / for more than half an hour
1 occasionally.
2 Daha occurs in any two area or occurs daily for half an hour to one hour
1 Daha Daha occurs in more than two area occurs daily for one hour or more and relieves after
3 vomiting or digestion of food
Daha occurs in most of the areas so that patient may not sleep at night and does not get
4 relieve by any measure.
Severe daha occurs in whole body areas like hands, feet or Sarvanga and does not get
5 relieves by any measure.
0 No Amlodgara
Occasionally occurs during day or night time & lasts for less than half hour after each
1 meal.
Amlodgara occurs daily for two to three times for ½ - 1 hrs. and relieved by sweets, water
2 and antacids
2 Amlodgara Amlodgara occurs after intake of each meal or any food substance for period of half to
3 one hour, and get relieved by digestion of food or vomiting
4 Amlodgara occurs for more than one hour not relieved by any measure
Amlodgara causing disturb to the patient’s even small quantity of fluid regurgitate to
5 patients mouth

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International Journal of Ayurvedic Medicine, Vol 14 (1), 2023; 297-301

0 No vomiting at all
1 Frequency of salivation on every day
2 Feels sense of nauseating and vomiting occasionally
3 Chardi & Hrillas Frequency of vomiting is two to three times or more per weeks and comes whenever
3 Daha or pain is aggravated
4 Frequency of vomiting daily
5 Frequency of vomiting after every meal or even without meals
0 No pain at all
1 Mild/ occasional pain which need no medication
Pain (abdomen) for less than half an hour and relieved after intake of sweets cold drinks
2 food antacid milk etc.
4 Udarshula Abdominal pain due to ingestion of food and relieves after digestion of food or by
3 vomiting.
Severe unbearable pain which does not subside by any measure and the patient awake in
4 the night
5 Unbearable pain associated with frequent vomiting and hematemesis
0 Willing for all edible food
1 Unwilling for some specific diet but less than normal
2 Unwilling for any specific Rasa i.e. Madhura /Katu/ Amla/ food
5 Aruchi
3 Unwilling towards food but could take the meal
4 Unwilling towards disliked foods but not to the other
5 completely unwilling towards meal
0 No Klama at all
Occasionally feels lassitude without Shrama which remains for sometimes and then
1 vanish
6 Klama
2 Feeling of Lassitude without Shrama daily for sometimes
3 Feeling of Lassitude without Shrama daily for long duration
4 Always feels tired and have no enthusiasms
0 No Reeling of head/ Bhrama at all
1 occasionally feeling of reeling head/ Bhrama
7 Brama 2 Frequency of Feeling of reeling head/ Bhrama < 3 times a day
3 Frequency of Feeling of reeling head/ Bhrama > 3 times a day
4 Frequently feeling of reeling head change of posture causes the severe problem

Observation & Result Table No. 3 Assessment after each follow-up:

The assessment of patient was done before & After
Before Follow up treatment
after treatment on the basis relief of symptoms given in Follow up
treatment after 7
Table no. 3. Patient has 63% relief at first follow up (i.e Symptoms (AT) (after
(BT) days 15 days)
after 7 days). After 15 days treatment, it was observed
that patient has 100 % relief in symptoms like Udar-uro Udar-uro daha 3 1 0
daha (burning sensation in abdomen & chest region), Amlodgar 4 2 0
Amlodgar (Sour belching), Hrillas (Nausea), Chardi Aruchi 5 2 1
(vomiting), Udarshula (Abdonimal pain) & Bhrama Hrillas & Chardi 2 0 0
(Vertigo). In symptoms like Aruchi & klama the relief Udarshula 2 1 0
was 80% & 75% respectively. The overall percentage of Klama 4 2 1
relief was found to be 90 %. Bhrama 2 0 0

Diagram No. 1 (Presentation of symptoms before &

after treatment): Discussion
Amlapitta is most common vyadhi of annavaha
srotas (Gastrointestinal system). Abnormal functioning
of Agni (digestive power) is the main reason for
manifestation of most of gastrointestinal disorders. The
factors like faulty dietary habits, irregular timing of
diet, consumption of spicy, heavy, unctuous, pungent
food in excess, Faulty behavioral habits, Excess stress
& habits like Alcohol consumption, smoking etc. all
these are responsible for abnormal functioning of Agni.
Vitiated Agni is unable to digest the ingested food
properly which leads to formation of Aam & due to this

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Seema H Thakare et.al., Management of Amlapitta (Hyperacidity) with Patoladi kwath: A Case Study
food gets fermented. In Amlapitta, pachak pitta is exposure to sun, habits like tobacco chewing & alcohol
increases in its quantity. It’s normal bitter taste (katu) consumption etc. All these factors are causing
gets converted to sour (amla) taste due to fermentation provocation of pitta dosha. Katu- tikta rasatmak &
of food. Improving the functions of Jatharagni is anuloman dravyas are useful here to break the
important part of treatment of this disease. Also samprapti (pathogenesis) of disease. Patoladi Kwath a
nidanparivarjan (avoidance of etiological factors) is simple combination of herbal drugs was given to patient
advised in Ayurveda to treat the disease from its root along with pathya-apathya chart (proper diet chart). It is
cause. So along with symptomatic management it is excellent combination of pittashamak dravyas and also
important correct dietetic factors, improve life style, performs the functions like Agni deepana, pachana &
avoid excess stress etc. Mostly pitta shamak aahar i.e helps to improve the digestion. It contains four
tikta, kashay rasatmak & laghu gunatmak aahar is ingredients namely Patola (Sespadula), Shunthi
advised to the patient. (Ginger), Guduchi (Gulancha Tinospora) & Katuki
Here in the present case, etiological factors (Hellebore). The properties of individual dravyas are
observed includes irregular meal timing, excess given in Table No.4.
consumption of tea, consumption of spicy food, excess

Table No. 4 Properties of each ingredient of Patoladi Kwath

Drug Latin Name Family Rasapanchak Karma
Rasa – Tikta
Trichosanthes Vipaka - Katu Deepana, Rochana, Pachana,
Patol Cucurbitaceae
dioica Roxb. Veerya - ushna Anulomana, Rechana, Pittasaraka (12)
Guna – Ruksha, Laghu
Rasa – Katu
Zingiber officinale Veerya – usnha Rochana, Deepana, Pachana,
Shunthi Zingiberaceae
Roscoe. Vipaka – Madhura Vatanulomana, Shulaprashamana (13)
Guna – Laghu, Snigdha
Rasa–Tikta, Kashay
Tinospora Cordifolia Veerya – Ushna Chhardinigrahana, Deepan, Pachan,
Guduchi Menispermaceae
Miers. Vipaka – Madhura Pittasarak, Anulomana (14)
Guna – Guru, Snigdha
Rasa –Tikta
Picrorhiza kurroa Veerya – sheeta Rochana, Deepana, Yakriduttejaka,
Katuki Scrophulariacace
Royle ex Benth. Vipaka –katu Rechana, Pittasarak (15)
Guna – Laghu, Ruksha

Patol acts as deepan & pachan because of tikta factors responsible for its manifestation. To treat the
rasa, katu vipak & ushna virya and hence effective in disease from its root cause, one must follow the pathya-
agnimandya & arochaka. It also shows anti-ulcerous & apthya described in Ayurveda. Both Shodhan & Shaman
gastro-protective effect. (16) Shunthi acts as chikitsa are given in Ayurveda classics for treatment of
gastrointestinal stimulant. Because of its Rochana, Amlapitta. Mostly tikta rasa food & drinks should be
Deepana, Pachana properties it helps to relieves the advised to the patient. Patoladi Kwath is very simple &
symptoms like Ajirna, agnimadya. It also acts as cost-effective herbal formulation. It contents four
shulaghna. It inhibits gastric acid secretion, acts as dravyas which are mostly tikta rasapradhan,
antioxidant & protects the gastric damage. (17) Guduchi pittashamak & having deepan, pachan, rochan
also acts as Chhardinigrahana, Deepan, Pachan. It is properties & hence it is useful in Amlapitta. However
pittahara due to its madhur vipak & tikta kashay Rasa. further research may be carried out in large sample size
It improves digestion and hence used in many intestinal to rule out the efficacy of patoladi Kwath in Amlapitta.
problems. (18) Katuki acts as pittashamak because of its
tikta rasa & sheeta virya. It also shows Rochana, Acknowledgement
Deepana, pittasarak properties & helps to relive aruchi, Authors are thankful to Dr. Vaishali Kuchewar,
agnimadya etc. Overall ingredients of the Patoladi Dean MGACH & RC for providing such opportunity
Kwath are mostly Tikta & katu rasapradhan & shows and also thankful to Dr. Prashil Jumade and all other
agnimandyahara effect, digest aam, pacify the peoples who knowingly and unknowingly help in
vidagdha pitta & helps in relieving symptoms of writing manuscript.
Amlapitta.
Conflict of Interest:
Conclusion No conflict of interest.
Diet & life style plays as important role in both
pathogenesis & treatment of Amlapitta. It is common Funding Support:
disease mostly observed in general practice. No any source of funding.
Agnimandya & aam formation are two most important

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International Journal of Ayurvedic Medicine, Vol 14 (1), 2023; 297-301

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