PCOS is a complex disorder or rather a spectral disorder with no uniform clinic or laboratory diagnostic criteria. Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disturbances affecting women all over the world.
Dr. Vidushi Jain, Dermatologist Trichologist, Medical head of Dermalinks says: "It has an unknown etiology and is recognized as a heterogeneous disorder that results in overproduction of male hormone primarily from the ovary, and is associated with insulin resistance."
The journey, the struggles and the treatment approach to each patient is different. As contrary to the popular belief, the manifestations are more severe in obese individuals with pcos but there is another phenotype known as lean PCOS.
"PCOS women can be sub grouped based on clinical features suggestive of endocrinological malfunctions and can be investigated accordingly for selection of appropriate treatment modalities," the doctor points out.
"The cornerstone to PCOS pathology is insulin resistance meaning that the body doesn't respond normally to insulin and thereby increasing insulin secretion from pancreas, which triggers inflammation and weight gain. High insulin level is both diagnostic criteria and also the underlying physiological driver. High insulin causes anovulation and also promotes testosterone secretion from ovaries (hyper androgenism)."
Dr Jain adds: "The skin features in PCOS sometimes present earlier as compared to irregular periods or investigations for infertility and a high degree of suspicion can help in early detection and prevention of disease progression."
Also, Read► PCOS and Fertility: What women can do about it?
She further explains:
Acanthosis nigricans is a skin disorder characterised by darkening and thickening of the skin, occurring mainly in the folds of the skin in the armpit (axilla), groin and back of the neck. Often treated as dirt, this condition is synonymous with insulin resistance and obesity. Sometimes it can be drug and malignancy induced too. The treatment approach is weight reduction and decreasing the insulin resistance with low glycemic diet and regular workouts. Skin lightening agents like retinoids, glycolic acid and treatments like TCA peels also play a role in cosmetic improvement.
Hirsutism or unwanted facial hair is a result of hyperandrogenism or excess male hormone secretion. Mostly affects chin, sidelocks, chest, thighs and even the nipple area . Treatment needs weight reduction to control the serum sex hormone binding globulin (SHBG) which in turn controls the free testosterone levels, androgen lowering medication like spironolactone, OCPs and laser hair reduction.
Also, Read► Polycystic Ovarian Syndrome: Causes, Symptoms and Ayurvedic Treatment
Acne or pimples: Females with persistent acne since teens or with acne presenting for the first time after 25 must be evaluated for PCOS. Acne in PCOS is generally resistant to standard acne treatments, affects mainly the lower one third of face , is associated with extremely tender eruptions suggesting more inflammation and shows premenstrual flare. Treatment results take longer to respond at least 3 months and best approach is to add combined oral contraceptives with anti androgen progesterone like drospirenone and cyproterone acetate as well as spironolactone to control the hyperandrogenic state. The role of supplements like inositol, magnesium, zinc and Vitamin D play an important role in controlling the inflammatory state.
Seborrhoeic dermatitis often presenting as oily scalp and dandruff, when severe can affect the oily areas of the skin like around nose, between eyebrows and behind ears. Associated with more androgens and hence more oil secretion promoting the growth of a fungus named malaseezia needs treatment and daily cleansing of the scalp with a salicylic acid or ketoconazole shampoo.
Female patterned hair loss or hair thinning presenting mainly in the crown and frontal area is often ignored until a major portion of the scalp becomes visible. Frequent changing of hairstyles to cover it up without seeking medical treatments leads to progression and greater damage. Starting minoxidil as a preventive therapy and doing platelet rich plasma sessions may be helpful. PCOS is a disorder which affects the body not only at a hormonal level thereby affecting metabolism and fertility but also it has far reaching effects on a person's confidence when it has negative influence on appearance. (Puja Gupta)
Read More► How to combat PCOS in the lockdown
Pain in the neck happens to be the fourth leading cause of disability globally, lagging behind ischemic heart disease, cerebrovascular disease, and lower respiratory infection. Neck pain can interfere with daily life, including the ability to feel productive, sleep, and enjoy time with family. It is a common occurrence among the working population usually engaged in tech jobs or desk jobs.
Srikanth H.S, Sr. Naturopath, Jindal Naturecure Institute, points out that there are several factors that can result in neck pain like stress, poor posture, obesity, muscle inflammation, arthritis, and injuries.
"The best way to deal with neck pain is to minimize it in the first place. Naturopathy offers safe and effective alternatives to deal with neck pain without falling prey to the side-effects of pharmaceutical drugs. Blending in the goodness of natural therapies like yoga, massage, herbs, and acupuncture, along with lifestyle modifications, naturopathy can bring huge relief from neck pain," he says.
Risks of Neck Pain
The expert says: "The common causes of neck pain are muscle strain and nerve compression. However, the symptoms alone cannot indicate which one of these is occurring. Muscle strain usually results from poor posture, repeated lifting, sleep, stress, or anxiety. Nerve compression can occur when a disc in the spine slips out of its position and pinches or presses the nerves, or when the tissues in the neck get inflamed or swollen causing the nerves in the area to get squeezed. Whatever the cause, ongoing chronic neck pain shouldn't be neglected as it can lead to a lifetime of disability or even permanent damage."
Also, Read► How To Manage Your Neck Pain Better
He suggests naturopathy ways to treat neck pain:
The ancient art of yoga has been demonstrated to help people with chronic pain including neck pain. Studies have shown that yoga asanas help to reduce pain perception, improves mobility, and decrease inflammation. Even 15 to 20 minutes of yoga exercises a day can relax the body, stretch the muscles, increase blood circulation, and minimize the chances of neck pain. Some of the common yoga asanas which can be practiced for neck pain are Marjariasana (Cat Pose), Bitilasana (Cow Pose), Balasana (Child's Pose), Natarajasana (Reclining Twist Pose), Viparita Karani (Legs up the wall pose), and Savasana (Corpse Pose).
Also, Read► 6 Best Fitness Apps So You Can Exercise Anywhere
Several studies have pointed out that massage therapy can offer relief from neck pain and improve range of motion when performed by qualified professionals. Massage therapy usually involves the use of the hands to manipulate soft tissues, like the tendons and muscles, increase blood circulation, and reduce muscle tension. It helps to ease up the sore, numb and stiff muscles in the spinal area and neck region.
Also, Read► Had a hectic week? Just 10 minutes of massage will relax you
Herbal treatments have been used for ages to treat pains of different sorts. Herbal remedies can be sipped like tea, infused in the bathwater, used as an oil, or inhaled as aromatherapy. Devil's Claw is a popular herb that can substantially reduce neck pain and even improve physical functioning in osteoarthritis patients. Other than that, Lavender, Kudzu, and St. John's Wort are some of the most popular herbs that help relieve neck pain and lower back pain. For maximum effects, these herbs should be taken under the guidance of expert professionals.
Also, Read► 7 Ayurvedic Herbs for Insomnia
Acupuncture is a thousand of years old technique that involves pricks in the skin with needles at specific points on the body. The frequency and duration of acupuncture sessions may depend on how long the neck pain has already lasted, and also the severity of the symptoms. Some studies have revealed that acupuncture can stimulate biochemical changes both locally (where the needles are placed) and in the central nervous system. These biochemical changes may help to bring pain relief and other beneficial effects in some cases.
Also, Read► Acupuncture can be a safe option to treat migraines
Lifestyle modifications play a significant role in the management of neck aches and stiffness. Practicing good posture while at work or home should be a key priority for those suffering from neck pain. Getting good sleep and maintaining the spine in a comfortable position throughout the night, regular neck exercises, and taking breaks in between work and stretching are some of the ways to reduce strain on the neck and keep it relaxed. (Puja Gupta)
Read More► What Is Neck Pain And Its Symptoms And Cause
It is defined as inflammation of the mucous membrane lining in the nasal passage, presents as nasal congestion/sneezing/nasal and palatal itching/ rhinorrhea, and postnasal drainage and it includes allergic, nonallergic, and infectious.
In Ayurveda, Rhinitis is generally categorized in kaphaja and raktaja pratishyaya which is based on signs and symptoms that occur due to doshas.
Types of Rhinitis
1. Acute Rhinitis
2. Chronic Rhinitis
3. Hypertrophic Rhinitis
4. Allergic Rhinitis
5. Atrophic Rhinitis
6. Vasomotor Rhinitis
Acute Rhinitis can be viral/ bacterial. Commonly Rhinitis is known as Common cold (=coryza). The incubation period generally lasts for 1 - 3 days.
Rhinitis Symptoms & Signs
Burning sensation in the nasopharynx.
Sneezing/ coughing/ runny nose.
Itching in eyes / nose/ mouth/ throat/skin.
Pressure in the nose & cheeks.
Watery/ red/ swollen eyes.
Dark circles under eyes.
Recurrent nasal infection
Allergen such as pollen & spores.
House dust mites.
Climate/ air pollution.
Oversensitive immune system.
Rhinitis Prevention & General Tips
Avoid touching your head/rubbing eyes/ nose
Close windows in-home/ car when pollen counts usually go high.
Enclose pillows/ mattresses in separate dust mite covers.
Keep pets off couches/beds
Wash your hands after touching/playing with pets.
Wear a hat/sunglasses to protect eyes from pollen and dust.
Avoid allergen exposure.
Use HEPA filters(high-efficiency particulate air) to reduce allergens in your home.
Probiotics may help improve symptoms of rhinitis.
Use of honey in dietary supplements
Use of vitamin-c to maintain histamine levels.
Use of some essential oils like peppermint/ eucalyptus, etc.
When to see your Doctor for Rhinitis Disease?
When signs and symptoms like occur and persist for a longer duration and when your allergies are causing symptoms such as chronic sinus infections/ nasal congestions/ difficulty breathing/ experience hay fever/ other allergy symptoms, then you should consult the doctor.
Risk Factors of Rhinitis
Allergic diseases (asthma/ eczema)
Exposure to pets/ parental smoking
High total serum (IgE)
Diagnosis for Rhinitis
Is represented by sneezing/ nasal congestion/nasal pruritus/rhinorrhea.
When an allergic disease is suspected=skin prick test can be performed for confirmation.
When skin testing is difficult to interpret / not feasible (ie, dermatographism), allergen-specific IgE serum testing based on the patient’s history can be useful for diagnosis.
WHAT TO AVOID IN RHINITIS?
Eliminate meat/ dairy products/ white flour foods/ sugar
Stop using nasal drops unnecessarily as they aggravate the condition by stopping the drainage & hardening the mucous.
Decongestants should be avoided as they can increase blood pressure too.
Avoid cold/ damp living/ working/ sleeping quarters.
Avoid gluten food
Avoid chocolate/ cheese/congestion food
WHAT TO EAT IN RHINITIS?
Ginger-treated water for drinking.
Decoction prepared from Dashamula & Trikatu with honey can be taken.
Neti pot use found effective
Drink a lot of fluids to thin your mucus.
Drink lots of water cause Good hydration helps keep the mucus thin and loose.
Vitamin c intake in your daily diet.
Question & Answers
Q.1 What is Hay Fever?
Ans. Hay fever, also known as allergic rhinitis, is an allergy-related inflammation of the nasal passages/ throat/ eye membranes usually caused by sensitivity to airborne pollens/molds/ some other reactions. It can have more adverse effects on a person with a family history of allergies.
Q.2 What are the differences between acute and chronic rhinitis?
Ans. Depending upon the duration with some signs and symptoms differences arise. Acute rhinitis usually lasts only for a few days/ up to 4 weeks with some signs and symptoms. But, in the case of chronic rhinitis, duration lasts for more than 4 consecutive weeks with signs and symptoms.
Q.3 What is a Skin prick test?
Ans. It is the most common skin allergy test. Firstly, you will get a series of tiny drops of allergens on the skin usually on the back surface/ area. After that, you will get a quick needle prick in the skin underneath each drop. If you are allergic to it, you will get a dime-sized hive that’s red and itchy at the needle prick site, if this happens then it is recommended to go for a follow-up to check the results.
Q.4 What is the role of histamine in rhinitis?
Ans. Histamine plays an important role in rhinitis more in allergic rhinitis. In susceptible individuals, allergen induces degranulation of mast cells of the nasal & release of histamine into the nasal mucosa. It has been detected after some controlled challenges with allergen & when administered into the nasal cavity too. Histamine receptors demonstrated in the nasal mucosa.
Q.5 What are the differences between sinusitis and rhinitis?
Ans. Allergic rhinitis (=hay fever) happens when someone breathes to allergic substances/ allergens and it results in inflammation and swelling occur inside the nose. On the other side, sinusitis is an inflammation of the lining of sinuses which can be acute/chronic depending on the causes.
Q.6 What are the impact of allergic rhinitis?
Ans. Impact of allergic rhinitis can influenced productivity, absent in work/school days / reduced activity/ comorbid diseases/ sinusitis/ asthma, etc.
Q.7 How allergens can cause allergic rhinitis?
Ans. Antigen-presenting cells, dendritic cells in the mucosal surface, process allergens & some peptides from allergens on the major histocompatibility complex(MHC) class 2 molecule. The MHC & antigen complex take a role as the ligand of T-cell receptors on naive CD4+ T cells, results in differentiation of naive CD4+ T cells to allergen-specific Th2 cells. Activated Th2 cells secret several cytokines, which induce isotype switching of B cells to produce specific IgE and proliferation of eosinophils, mast cells & neutrophils. Antigen-produced IgE binds to high-affinity IgE receptors on mast cells/ basophils usually.
Q.8 What is a pollen allergy?
Ans. Pollen= is a very fine powder produced by trees/ flowers/ grasses/ weeds to fertilize other plants of the same species. In many people, pollen can cause adverse immune responses. People who get pollen allergies have an immune system that identifies the harmless pollen as a dangerous intruder, and begins to produce chemicals to fight against the pollen causes allergy. It is known as an allergic reaction,& the specific type of pollen that causes is known as an allergen. Reaction leads to numerous irritating symptoms, such as sneezing/ stuffy nose/ watery eyes, etc.
Q.9 What is Rhinitis according to the Ayurveda concept?
Ans. In Ayurveda, Rhinitis is generally categorized in kaphaja and raktaja pratishyaya which is based on signs and symptoms occur due to doshas.
Q.10 How Ayurveda treatment works on Allergic Rhinitis?
Ans. Treatment is basically done on shamana and shodhana chiktsa with some classical formulations of Laxmi Vilas rasa/godanti bhasma etc. by Ayurveda physician after examining the patient carefully. It is recommended that to consult the doctor before taking any kind of medications.
1. Abhinava Shalakya Vigyan 2nd edition (2019) by Dr. Aparna Sharma, Nasa Roga.
2. Sushruta Samhita by Dr. Ambikadatta Shastri
3. Diseases of Ear, Nose and Throat & Head and Neck Surgery 6th edition by PL Dhingra and Shruti Dhingra.
4. Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
5. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition.
What is Cervical Spondylosis?
Cervical spondylosis is a disorder in which there is abnormal wear on the cartilage and/bones of the neck (cervical vertebrae) and it is a common cause of chronic neck pain. It is a degenerative condition of the cervical spine affecting the middle and old age group of both sexes leads to pain and stiffness in the neck, radiating pain to the arm, paraesthesia, numbness, headache, giddiness, etc.
In Ayurveda, Cervical spondylosis is caused by a Vata dosha aggravation and it’s mainly a Vata problem. Its clinical presentation is similar to Vishwachi in which degenerative condition of the cervical spine is common. It’s a disease that mainly affects the neck and upper extremities having signs and symptoms similar to that of cervical spondylosis. Vishwachi is a vataja nanatmaja vikara. The involvement of Vata in the clinical manifestation of vishwachi is of prime importance.
Cervical Spondylosis Symptoms & Signs
Often develop slowly over time, but they get worse suddenly
Pain may be mild/it can be deep and so severe that affected movements
After standing/sitting at night, the pain gets worsen
Pain over the shoulder blade/it may spread to the upper arm, forearm, fingers
Pain gets worse at night/sneezing/coughing/laughing/bending the neck backward/walking more than a few yards
Neck stiffness that gets worsen
Abnormal sensation/numbness in the shoulders/arms/legs
Headache (especially back of the head)
If pressure occurs on the spinal cord then, loss of control occurs over the bladder/bowels
Moving the head may make the pain worse and after sleeping neck stiffness is more common
Sometimes, these all changes result in a compression of the blood vessels, it can affect the blood supply to the brain and results in dizziness and blackouts
Dysphagia can occur rarely
Cervical Spondylosis Causes
It is caused by chronic wear on the cervical spine, includes the discs/cushions between the neck vertebrae and the joints b/w the bones of the cervical spine, there may be abnormal growths/spurs on the bones of the spine (vertebrae)
The major risk factor is aging. At the age of 60, most persons show signs of cervical spondylosis
Other factors include
Being overweight/not exercising
Having a job that requires heavy lifting/lot of bending/twisting
Past neck injury
Past spine surgery
Severe arthritis/small fractures/osteoporosis
When to See Your Doctor for Cervical Spondylosis Disease?
When pain and stiffness around the neck occur for long days and found unable to move properly your neck and facing difficulty and pain while bending, along with signs and symptoms that affect your daily routine, then you should consult the doctor.
Risk Factors of Cervical Spondylosis
Age- it’s a normal part of aging, occurs more commonly in old age persons
Occupation- Overhead work put extra stress on your neck
Genetic factors inherent
Repeated occupational trauma: carrying axial loads/professional dancing/gymnastics
Some conditions that contribute to segmental instability and excessive segmental motion like congenitally fused spine/cerebral palsy/down syndrome
Some myelopathy causes
Smoking also a risk factor
Cervical Spondylosis Prevention
Regular exercise for the speedy recovery
A heated pad/cold pack can provide pain relief when the neck muscles become sore
A soft neck brace can temporarily relieve pain if a person wears them for short periods
Maintain neck muscle strength, especially neck extensor strength for prevention in general
Avoid holding the head in 1 position (for long duration)
Avoid prolonged head extension
Be careful while performing physical activities
Hot shower in the morning can help
Headrest & seatbelt also may reduce the risk of developing this condition
Yoga Therapy: balasana, natarajasana, bitilasana, marjaryasana, viparitakaranai asana, utthita trikonasana, shavasana can help to reduce the effect of cervical spondylosis
Diagnosis of Cervical Spondylosis
EMG & nerve conduction velocity test may be done to examine nerve root function
The doctor will check the range of motion in your neck for proper identification and location of pain
Reflexes and muscle strength will be tested to find out if there’s pressure on your spinal nerves/spinal cord
Nerve conduction study
What to avoid in Cervical Spondylosis?
Potato/cucumber/cold drinks/ice-cream/rajma/dry meat, etc. Avoided
Bending/sudden stretching/weight lifting to be avoided for making it more severe
Long journey on two-wheeler/sitting in abnormal posture/sitting for a long time to be avoided
Avoid holding the head in 1 position ( for longer duration)
Avoid prolonged head extension
Be careful while performing physical activities
Consumption of high-fat dairy products can lead to inflammation
Avoid processed food completely
Avoid meat and dairy products which contain saturated foods & arachidonic acids
Avoid more caffeine consumption
Avoid red meat
Avoid foods that lead to more production of acidity
Avoid spicy/hot/salty/oily foods
What to eat in Cervical Spondylosis?
Black gram/horse gram/wheat/rice
Gingili oil/mustard oil/milk/butter/soar fruits
Drumstick fruits & leaves
Consume a diet that is rich in anti-inflammatory food substances
Fish/nuts/oilseeds/omega 3 fatty acids and Vitamin- E rich foods
Diet rich in monounsaturated fatty acids
Replace rice with wheat
Bitter gaud/drumstick bitter vegetables
Questions & Answers
Q1. Why Cervical Spondylosis occur in old-age people?
Ans. Older age is a risk factor as in addition to age, people often get more likely to experience neck pain. It is the general term for age-related wear & tear affecting the spinal discs in the neck region. Also, it is caused due to disks dehydration and shrinking. In most people age > 50, discs between the vertebrae become less spongy & provide less of a cushion. Bones & ligaments get thicker and encroached the space of the spinal canal.
Q2. If myelopathy occurs with cervical spondylosis, then what will be the symptoms like?
Ans. Symptoms of cervical spondylosis with myelopathy include tingling/numbness/weakness in the arms, hands, legs, feet/lack of coordination & difficulty walking/abnormal reflexes/muscle spasms/loss of control over bladder/bowel incontinence.
Q3. How is Cervical Spondylosis diagnosed properly?
Ans. By taking a medical history with signs and symptoms appearing, it will be followed by a physical exam of the body by focussing on the neck/back/shoulders. The strength of hands and arms/reflexes test/loss of sensation checkups/walk/equilibrium can be tested. Other tests also can be done include x-ray/computed tomography/magnetic resonance imaging( MRI), EMV tests, etc.
Q4. According to Ayurveda, which disease is similar to that of cervical spondylosis?
Ans. In Ayurveda, Cervical spondylosis is caused by a Vata dosha aggravation and it’s mainly a Vata problem. Its clinical presentation is similar to Vishwachi in which degenerative condition of the cervical spine is common. It’s a disease that mainly affects the neck and upper extremities having signs and symptoms similar to cervical spondylosis. Vishwachi is a vataja nanatmaja vikara. The involvement of Vata in the clinical manifestation of vishwachi is of prime importance.
Q5. What exactly is the meaning of the term ‘Spondylosis’?
Ans. Spondylosis is basically a painful condition and situation of the spine which results from the degeneration of the intervertebral discs. Often, it is considered a general term for age-related wear & tear of the spinal discs. It affects the vertebral discs and facet joints that gradually develop with age. This condition can narrow the spinal canal that further results in the compression of the spinal cord & nerve roots. Chronic compression can lead to damage to the spinal cord/can cause radicular arm pain further.
Q6. What are the complications of Cervical Spondylosis?
Ans. Complications of cervical spondylosis include: cervical myelopathy/paraplegia/tetraplegia/recurrent chest infection/pressure sores/recurrent urinary tract infection/progressive neurologic deficits/documented compression of the cervical nerve root/or spinal cord/intractable pain.
Q7. What is the role of psychosocial support in the treatment of cervical spondylosis?
Ans. Some patients with significant disabilities often react with fear/anxiety/depression. Postoperative depression is significantly associated with pain intensity/pain interference/pain-related disability. After surgery, results of one study of depression/negative affect among spinal surgery patients suggest postoperative screening for depression and treating depression to improve functional outcomes after spine surgery.
Q8. What are the various exercises and therapies recommended for cervical spondylosis?
Ans. Various exercises recommended to ease the symptoms of cervical spondylosis are neck stretch/neck tilt/side-to-side neck tilt/neck turn with 5 repetitions. In Ayurveda, some yoga therapies are there like, balasana, natarajasana, bitilasana, marjaryasana, viparitakaranai asana, utthita trikonasana, shavasana can help to reduce the effect of cervical spondylosis.
Q9. What is the role of physical therapy in the treatment of cervical spondylosis?
Ans. Usually, immobilization of the cervical spine occurs with severe cervical spondylosis with evidence of myelopathy. It limits the motion of the neck. Soft cervical collars are recommended for daytime use only. Patient’s tolerance and compliance are considered when any braces used. Isometric cervical exercises may help to limit the loss of muscle tone. Molded cervical pillows can better align the spine during sleep & provide symptomatic relief for some patients. Neck & upper back exercises are recommended. Yoga therapies also play an important role to reduce the inflammation and pain in cervical spondylosis.
Q10. How cervical spondylosis is cured through the Ayurveda line of treatment?
Ans. During the acute phase (about a week), usually complete bed rest & use of a thin pillow & hard bed is recommended. After acute phase, some panchakarma procedures like sadyovirechana, greevabasti, abhyanga, patra pinda sveda, nasya should be done.
Podikkizhi, ilakikizhi, greeva pichu, tailadhara, panchatikta & ksheera basti, shalishastic pinda sweda is also recommend. Mainly, all the above procedures done after examine the bala and prakriti of the patients. Along with these procedures, shamana chikitsa with recommend classical formulations should be given to the patient.
1. Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition
2. Kayachikitsa Volume-3by Prof. Ajay Kumar Sharma (2017)
3. Charak Samhita, Chikitsa Sthana- ch-28
4. J.Alastair Innes, Davidson’s Essential of Medicine 2nd edition
5. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition
What is Diarrhea?
Diarrhoea is the passage of three/ more loose/ liquid stools per day/more frequently than normal for an individual. From the clinical point of view, diarrhea means increased stool water, and this increases stool frequency and the passage of liquid stool.
Diarrhea in Ayurveda
According to Ayurveda, Diarrhoea is commonly known as Atisara. It occurs due to intake of causing factors which results in agnimandya mainly jathragni due to which ama dosha (Kapha) increases and vata prakopa occurs due to which strotodushti in poorishvaha and udakavaha occurs and increase of more loose or liquid stools comes out.
Types of Atisara - According to Acharya Charak
Blood/ mucus in the stool
Frequent bowel movements
Food intolerance/lactose intolerance
Adverse reaction to a medication
Viral/ bacterial infection
Childhood cause - Rotavirus
Bacterial infection - salmonella/E.coli
Stress/indigestion due to mal-absorption
Acc. To Ayurveda- ajirnashana, adhyashana, ati-drava, ati ruksha ahara, dushita anna, etc.
Prevention of Diarrhoea
Safe drinking water
Hand washes with antiseptic soap/solutions
Good personal hygiene/food hygiene
Health education about the spread of infections
Use of ORS (Oral Rehydration Solution)
Nutrient-rich foods in case of malnutrition
Consult a doctor in case of persistent diarrhea
When to See Your Doctor for Diarrhoea Disease?
When diarrhea persists beyond a few days and the body starts dehydrating with severe abdominal/ rectal pain/bloody/black stools/weight loss/fever above 102 degrees F, then you should consult the doctor immediately.
Diagnosis of Diarrhoea
Physical examination of the abdomen
Some general questions for the diagnosis will ask by the doctor like current medications/past medical history/family history/travel history/any other medical conditions
Signs of dehydration
Tests for diarrhoea include-CBC/liver function test/tests for malabsorption/ ESR/C-reactive protein/antibodies test/stool tests
X-Ray/CT- scan- to rule out structural abnormalities associated
Diarrhoea Prevention Tips
Drink clear liquids - water/broth/fruit juice
Replenishing water loss is important
Avoid milk, it can make diarrhea worsen
Intake of ORS ( Oral Rehydration Solution)/Electrolytes fluid
Consume (Sugar+salt+water )
BRAT diet -( banana/ rice/applesauce/toast) can be taken
Avoid junk foods/alcoholic beverages
Avoid strenuous exercises
What to avoid in Diarrhea?
Heavy/hard/cold/hot/spicy and oily foods
Raw fruits and vegetables
Avoid junk foods
Avoid strenuous exercises
Greasy foods/spicy foods
Artificial sweeteners/high levels of fructose foods
What to eat in Diarrhea?
Vilepi ( rice gruel), laaja manda, rice washed water ( avoid contamination with pesticides)
Rice+curd/rice + buttermilk
Masoor/ aadhaki yoosha
Coconut water frequent drinking
Deepana and laghu guna diets
Pectin rich foods such as fruit
Electrolytes food- miso-soup, sports drinks
Cooked/ soft vegetables
BRAT( banana/rice/applesauce/toast) diet
Drink plenty of fluids to avoid dehydration
Question & Answer
Q.1 How much serious is Diarrhoea disease in children?
Ans. Diarrhoeal disease is the second leading cause of death in children under 5 years, also kills around 525000 children under five. Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year according to data collected.
Q.2 What are the different types of Diarrhoea?
Ans. Different types of Diarrhoea include -
1) On the basis of duration:- Acute Diarrhoea, Chronic Diarrhoea.
2) On the basis of clinical presentation:- Acute watery diarrhea, Acute Bloody Diarrhoea.
3) On the basis of Physiology:- secretory diarrhea, osmotic diarrhea, exudative diarrhea, motility related, inflammatory diarrhea.
Q.3 How does Diarrhea cause dehydration?
Ans. Body intakes water and salt through drinks/food/fluid. Normally, it loses water and salt through stools/urine/sweat/breathing. When the bowel is healthy, water and salt pass from the bowel into the blood and when diarrhea occurs, the bowel doesn’t work normally. As a result of this, less water and salt pass into the blood, and more pass from the blood into the bowel. Thus, the amount of water and salt passed in the stools is greater than the normal.
Larger than normal loss of water and salt from the body results in dehydration. It usually occurs when the output of water and salt is greater than the input. Repeated vomiting, which often accompanies diarrhea can also contribute to dehydration.
Q.4 Why is Diarrhea dangerous?
Ans. Mainly due to diarrhea two main dangers, death and malnutrition occur. Death from acute diarrhea is most often caused by loss of a large amount of water and salt from the body, loss is called dehydration. Severe diarrhea with complications is most common in people with malnutrition and can also cause malnutrition and can make existing malnutrition worse because nutrients are continuously lost from the body and nutrients repair damaged tissue rather than for growth.
Q.5 Why Diarrhoea has become a major cause of death in many countries?
Ans. Diarrhea is a leading cause of death during complex emergencies and natural disasters. Displacement of populations into temporary, overcrowded shelters is often associated with polluted water sources, inadequate sanitation, poor hygiene practices, contaminated food, and malnutrition - all of which affect the spread and severity of diarrhea. At the same time, the lack of adequate health services and transport reduces the appropriate treatment of diarrhea cases which also considered a major issue in public health.
Q.6 What is the importance of Oral Rehydration Solution (ORS) in children?
Ans. A solution of oral rehydration solution salts (ORS) is a simple, inexpensive, and life-saving remedy that prevents dehydration among children with diarrhea. In a healthy child, the small intestines absorb water and electrolytes from the digestive tract so that these nutrient-rich fluids may be transported to other parts of the body through the bloodstream.
In a sick child, diarrhea-causing pathogens damage the intestines- causing an excessive amount of water and electrolytes to be secreted rather than being absorbed. When the ORS solution reaches the small intestines, then the sodium (Na) and glucose in the mixture are transported together across the lining of the intestines, sodium, which is now in higher concentrations in the intestines, promotes water absorption back into the body from the gut.
Q.7 What are the causing factors for Diarrhoea ( Atisara ) according to Ayurveda in general?
Ans. By intake of too cold/unctuous/rough/heavy/coarse/hard things, irregular meals/intake of incompatible and unsuitable things/fasting/delayed meals/drinking defective wine and water/overdrinking/avoiding evacuation/irregular application/mismanagement of remedial measure/excessive exposure to fire, sun, wind & water, sleep/oversleep/suppression of urges/seasonal perversions, excessive fear/grief/mental agitation/, intestinal worms, phthisis, fever, piles, in a person having deranged agni all the three doshas get vitiated and damaged the agni and further reach the colon and cause atisara (=diarrhoea) with symptoms of all the doshas.
Q.8 How Diarrhoea occurs according to Ayurveda?
Ans. According to Ayurveda, Diarrhoea is commonly known as Atisara. It occurs due to intake of causing factors which results in agnimandya mainly jathragni due to which ama dosha (kapha) increases and vata prakopa occurs due to which strotodushti in poorishvaha and udakavaha occurs and increase of more loose or liquid stools comes out.
Q.9 What is Traveler’s Diarrhoea?
Ans. It is a digestive tract disorder that commonly causes loose stools and abdominal cramps. Mainly caused by eating contaminated food and water while travelling to different places. Common signs and symptoms include abrupt onset of passage of three/more stools in a day, urgency for defecation, cramps, nausea/vomiting/ fever can occur.
Q.10 How Ayurveda treatment helps in managing Diarrhoea?
Ans. Mainly Ayurveda principle works on the principle of Chikitsa sutra which includes proper treatment of ama dosha/ langhana/uses of stambhak aushadh/ (deepana-pachana dravya) use &treatment according to bhedanusara lakshana, & use of various ayurvedic formulations in shamana chikitsa helps in managing Diarrhoea acc. To Ayurveda.
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2. Kayachikitsa Volume-2 by Prof. Ajay Kumar Sharma (2017)
3. Charak Samhita, Chikitsa Sthana-ch-19
4. Madhava Nidana, Ch-3
5. Sushruta Samhita Uttaratantra, Ch-3
6. Ashtanga Hridaya, Nidana Sthana, Ch-8
7. Ashtanga Hridyaya, Chikitsa Sthana, Ch-9
8. J.Alastair Innes, Davidson’s Essential of Medicine 2nd edition
9. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition
Staying at home has resulted in a lot of stress for people of being stuck indoors for the week on end; the uncertainty has taken a toll on people's mental well-being. Stress cannot be hidden; it shows on your face. The first tell-tale signs reflect on your face as pale skin and mild eruptions on the surface.
Stress causes hormonal imbalance which leads to acne, rashes, hair thinning and fall, and various other skin break-outs. It is imperative that people follow a good skincare routine while they're indoors. Staying inside does not necessarily mean you can forego or overlook skin and hair care. These are prone to more damage owing to stress. One should follow a strict, if not elaborate, skincare routine, which involves cleansing, toning, and moisturizing.
Geetanjali Shetty, Consultant Dermatologist, and Cosmetologist on behalf of Cetaphil India shares most important of all keep yourself hydrated with water and lots of liquid!
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Side Effects of Stress Oily Skin & Acne
Acne and oily skin are the most common side effects of stress. When our body is stressed it releases cortisol which is our fight or flight hormone. The cortisol (stress hormone) weakens the skin's immune system, leading to oxidative (free radicals) stress, which manifests itself as wrinkles, lines, and lackluster skin. It also increases inflammation in the body and conditions like eczema, rosacea, and psoriasis can flare-up.
For skin, stress is quite evident in various forms like redness of the skin, acne, etc. If there are skin breakouts and eruptions -- it is better to avoid exfoliation and stick to cleansing your face thrice daily. Similarly, those with skin on the drier side should aim to wash their face only twice a day with a foaming cleanser. Should your skin need a little boost, indulging in Vitamin C to help combat the loss?
If you know you're about to enter a stressful period, try to make time for the activities that will help you feel calm and rested -- your skin will thank you.
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Home Remedies to Fight Acne
It is highly imperative to discover what one is getting exposed to and when. Stick to your skincare routine - cleansing, exfoliating, and moisturizing, and keep sunscreen handy for the times that you may have to make a quick dash to the grocers. Even if you're not wearing makeup, your face still gathers sweat, sebum, and dirt build-up throughout the day.
Lastly, it's important that to stay away from fried and spicy food. Vitamin E is a superfood for your skin you can apply it topically or you can choose to consume it through vitamin E-rich foods like almonds, corn oil, cod-liver oil, hazelnuts, lobster, peanut butter, safflower oil, salmon steak, and sunflower seeds. The most essential thing to bear in mind is to keep yourself hydrated drink lots of water, juices, and liquids.
(N. Lothungbeni Humtsoe)
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