Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Dumping Syndrome – It’s a situation whereby the consumed meals strikes too shortly from the abdomen to duodenum – the primary a part of the small gut. One would expertise signs like diarrhea and cramps inside a couple of minutes to some hours of taking meals. It could additionally happen following abdomen surgical procedure whereby part of abdomen or complete abdomen has been eliminated or in those that have had abdomen bypass surgical procedure to shed pounds.
Dumping Syndrome is of two varieties. Early Dumping Syndrome is when the signs seem 10-Half-hour after taking meals and contains 75% of circumstances of dumping syndrome. Late Dumping Syndrome is when the emptying or dumping occurs 1-3 hours after consuming the meals and is present in much less variety of folks compared to early dumping syndrome.
Associated Studying – “Dumping Syndrome – that means, causes, signs, prevention, therapy”
Although there isn’t a one situation defined in Ayurveda which may be immediately correlated with Dumping Syndrome, this text makes an attempt to convey into focus many situations defined in several contexts which have comparable symptomatology and presentation as that of dumping syndrome. The mechanism of this situation taking place has additionally been defined from the angle of doshas governing the gastrointestinal tract.
Dumping Syndrome – Ayurveda Perspective
From Dosha Perspective
1. Early Dumping Syndrome – may be mentioned to be attributable to hyperactivity of samana vata and pachaka pitta. Pachaka pitta tries to digest the meals in a rush and samana vata pushes the meals shortly from abdomen into the gut. Improperly digested meals additionally stimulates the peristalsis in an exaggerated method. This may be correlated with excessive acids (pachaka pitta improve) excessively stimulating the nerves controlling the actions of the abdomen and gut muscle tissues (samana vata) in order to push the meals.
The capabilities of pachaka pitta embrace – anna grahana i.e. reception of meals, pachana – digestion of meals, vivechana – bifurcates the meals into helpful (diet) and undesirable (feces) parts and munchana – expulsion of digested meals into the small gut and undesirable parts from small gut to colon. If the coordination between these capabilities of pachaka pitta is just not correct, it may result in signs mimicking dumping syndrome.
2. Late Dumping Syndrome – could also be resulting from lazy (hypo-active) samana vata and pachaka pitta. Right here the meals is digested and pushed slowly from the abdomen into the gut. Initially the weak pitta digests the meals slowly. The partially digested meals will get stagnated for a very long time. This meals hinders the samana vata from pushing down the meals into the gut on the proper time and therefore delayed or late dumping happens.
Each these situations are referred to as dumping syndromes as a result of the abdomen dumps the partially digested meals into the gut. The phrase ‘dumping’ is vital right here. This phrase differentiates the traditional evacuation of digested meals (physiology) from irregular evacuation of undigested meals (pathology).
Ayurveda illnesses resembling with Dumping Syndrome and its subtypes
Early Dumping Syndrome – Wanting on the signs of Early Dumping Syndrome, it may be included underneath two situations defined in Ayurveda –
– Visuchika
– Adhmana
Late Dumping Syndrome – Although we can not get nearer situations defined in Ayurveda texts to match with Late Dumping Syndrome, among the signs carefully resemble that of Visuchika. Visuchika is a situation attributable to indigestion and is usually in comparison with cholera.
This situation will also be in comparison with yet one more situation named ‘Alasaka’ – a digestive dysfunction defined in Ayurveda attributable to indigestion. Alasaka means lazy. Right here the abdomen is lazy. The meals will get stagnated for a reasonably very long time within the abdomen and doesn’t get eradicated in an upward or downward path. The meals doesn’t get simply digested on this situation. This may be thought of as late dumping. In alasaka there happens distension and sounds within the stomach, there’s absolute constipation (feces and fart aren’t eradicated) which additionally causes thirst and belching. These signs aren’t evident in late dumping syndrome. However the signs evident in late dumping syndrome could also be thought of as after-effects of indigestion and absolute constipation.
Associated Studying – Alasaka
One other situation referred to as as Vilambika brought about resulting from indigestion of meals, attributable to contamination of meals by vitiated kapha and vata resembles late dumping syndrome from the angle of description of the illness. However Vilambika is claimed to be incurable and therefore doesn’t match into the comparability with late dumping syndrome.
Associated Studying – Vilambika
Position of Vishamagni
The agni influenced by vata is known as vishamagni. Vishama means unpredictable or severely various. This digestive hearth behaves as weirdly as vata. Typically the individual experiences good starvation and typically completely nil. Typically this hearth digests the meals correctly and typically by no means. This additionally could affect how the bowel evacuates the wastes (feces). There could also be simple evacuation typically and typically troublesome. This conduct of vata would trigger a confused clearance within the intestine. Vishamagni, resulting from its unpredictable nature, causes each early and late dumping syndrome.
The Samana Vata perspective
Samana Vata is a subtype of vata which is positioned within the intestine, very near the agni – the digestive hearth. In its balanced state, it helps in preserving the agni in a state of stability. When it will get imbalanced it may disturb the agni to diverse proportions.
The capabilities of Samana Vata embrace –
Annam Grihnati (Anna Dharana– Vagbhata) – Samana Vayu is positioned within the abdomen, close to the seat of agni – digestive hearth and nearer to the pitta positioned therein i.e. pachaka pitta. The mixed motion of those doshas together with buffering and softening position of kledaka kapha permits simple digestion of meals and passage of digested meals to the subsequent a part of the digestive tract. Samana Vata initially receives the meals i.e. permits the entry of meals into the abdomen. So, the surroundings for reception of meals and drinks we devour is saved prepared by samana vata in a state of its stability. Prana Vata and Udana Vata participate on this course of and assist Samana Vata to obtain the meals. Samana Vayu additionally helps in retention of the meals within the abdomen till it’s digested to a specific extent. If this isn’t achieved as a result of sluggishness or hyperactive nature of samana vata, the meals will get propelled from the abdomen shortly into the loser intestines with out getting correctly digested. This results in the manifestation of many problems resulting from sluggish and improper / incomplete digestion of meals. This contains dumping syndrome.
Annam Pachati – Samana Vayu is claimed to be positioned within the proximity of Agni i.e. digestive hearth. The fireplace is represented within the physique by pitta. The pitta on this context is Pachaka Pitta – positioned within the abdomen and intestines. The Samana Vayu and Pachaka Pitta (Agni) are all the time interrelated and all the time work in coordination with one another and are concerned in correct digestion of meals. The chemistry between these two is essential. The coordination of samana vayu with the native doshas within the abdomen and intestines i.e. Pachaka Pitta and Kledaka Kapha and the stability between them is of utmost significance. Many pathological situations and purposeful imbalances like Dumping Syndrome can manifest when this chemistry, coordination and stability is disturbed.
Annam Vivechayati – Samana Vayu takes half in bifurcation of meals into sara bhaga i.e. digestible / digested half and kitta bhaga i.e. undigested or excretory half. Sara Bhaga is the a part of meals which is required for the constructing and functioning of physique and thoughts i.e. nutritive half and Kitta Bhaga is the undesirable portion or wastes / excreta of the meals. The segregation of meals into these elements is a primary inside intestine intelligence offered by Samana Vayu. With out this intelligence, the physique would throw or excrete every part that we eat or maintain throughout the abdomen and intestines. This may finally hurt the physique in some ways. After receiving, digesting and bifurcation of meals, Samana Vayu prepares the sara bhaga to get absorbed and to be distributed everywhere in the physique to all of the cells and organs of the physique via the center, with the assistance of Vyana Vayu. However, it prepares the undesirable / excretory elements i.e. kitta bhaga to get excreted from the physique. It additional bifurcates the kitta bhaga portion into pureesha – feces, mutra – urine and sweda – sweat. If this bifurcation is just not carried over correctly by Samana Vayu, the meals will shortly be dumped into the decrease small intestines and enormous intestines, which might be accountable for dumping syndrome and its signs.
Annam Munchati (Kitta Adho Nayana – Vagbhata) – Samana Vayu helps in propelling or pushing the kitta bhaga i.e. excretory wastes in downward path, in the direction of the big gut in order that they get excreted with the assistance of Apana Vayu. Although Apana Vayu is principally accountable for excreting the wastes out of the physique, Samana Vayu helps in getting ready the wastes and holding it till they’re expelled by Apana Vayu. Insufficient or hyper functioning of Samana Vayu may cause late and early dumping syndromes respectively.
Illnesses brought about resulting from vitiation or imbalance of Samana Vayu embrace
गुल्म अग्नि साद अतीसार प्रभृतीन् कुरुते गदान्।(सु.नि.१)
– Gulma – Stomach tumors
– Agnisada – Indigestion / sluggish digestion / anorexia
– Atisara – Diarrhea
– Prabhrtin Gadan – Different dreadful illnesses
A few of these situations are related to dumping syndrome.
Aushadha Sevana Kala for Samana Vata Balancing
Particular time of administration of medicines to result in stability of samana vata / to deal with illnesses attributable to imbalance of samana vata –
Madhyabhakta (in between the meals) – To result in stability of samana vata and in addition remedy the illnesses attributable to aggravated samana vata, medicines shall be administered in between the meals.
Methodology of administration of medicines – First, one has to devour half the amount of the meals. Then he has to take the medication. Later he shall devour the remaining half (half) of the meals. That is referred to as as madhyabhakta process of taking the medication.
This type of taking the medication will stability samana vata and remedy the illnesses attributable to the imbalance of the identical. This primarily stimulates samana vata and therefore enhances the digestive hearth (capability). Due to this fact, it’s a remedy for sluggish digestion and indigestion. It is usually a superb treatment for the illnesses of the stomach organs, illnesses of the colon, colic, stomach tumors and sprue / irritable bowel (inflammatory bowel illness).
Medicines antagonistic to aggravated vata and people which assist in kindling and balancing the digestive hearth shall be administered on this methodology to remedy dumping syndrome.
Position of Apana Vayu
As already mentioned, Apana Vayu is principally accountable for excretion of metabolic wastes. However the preliminary technique of getting ready mala – excreta from the meals and pushing it from the abdomen to the colon is the operate of Samana Vayu. When the coordination between these two Vayus is disturbed, many gastrointestinal situations like Dumping Syndrome could happen.
When Apana Vayu is hyperactive and situations like diarrhea, irritable bowel syndrome and many others. happen, the abdomen and higher intestines whereby Samana Vayu is operational is influenced, it causes early dumping syndrome as a result of suction exercise of Apana Vayu. On the identical time, hypo functioning of Apana Vayu could trigger situations like constipation and udavarta – upward motion of vata which in flip causes upward stress over the Samana Vayu zone and would possibly trigger late dumping syndrome.
Causative Components
Under talked about etiological components shall be thought of within the causation of dumping syndrome from Ayurveda viewpoint.
– Vata aggravating components and Pitta aggravating components – Early Dumping Syndrome
– Kapha aggravating components – Late Dumping Syndrome
– Particular person and relative imbalance between Samana Vayu, Pachaka Pitta and Kledaka Kapha
– Relative imbalance between Samana Vayu and Apana Vayu
– Causative components of Agnimandya, Ajirna
– Causative components of Udavarta, Anaha, Adhmana
– Causative components of Alasaka and Vilambika
– Causative components of Atisara and Grahani roga
– Vataja or Kaphaja Atisara or Grahani
– Extreme consumption of water or meals or irregular consumption of meals
– Extreme consumption of ‘heavy or arduous to digest’ meals
– Extreme consumption of Katu – pungent or Madhura – candy meals
Ayurveda Therapy Ideas of Dumping Syndrome
Nidana Parivarjana – The causative components of dumping syndrome shall be averted / saved away.
Managing Agni Vaishamya – The imbalances of Agni ought to be addressed and handled accordingly.
Immediate therapy of dosha imbalances – The doshas of the gastrointestinal tract accountable for causation of dumping syndrome ought to be balanced.
Vata Anulomana and Snehana – Vata ought to be pushed into its regular course and path with the assistance of Vata Anulomana herbs and formulations. Unctuous medicines and meals might be helpful.
Immediate therapy of accountable / causative illness situations – Illnesses together with agnimandya, ajirna, atisara, grahani, udavarta, visuchika, alasaka and vilambika and many others ought to be promptly handled.
Following meals self-discipline – One ought to take correct high quality and amount of meals and on the proper occasions. One ought to comply with Ahara Vidhi Vishesha Ayatanani – guidelines and laws of taking meals as described in Ayurveda.
Making correct life-style corrections – One ought to take pleasure in correct workout routines by way of high quality and amount, shouldn’t forcibly withhold the pure urges of the physique, shouldn’t create synthetic urges when not manifested, ought to have good management over stress and emotional swings and will stay away from viruddha ahara – incompatible and unwholesome meals combos and unsuitable habits and addictions.
Skillful use of Panchakarma procedures – Well timed and skillful administration of vamana, virechana or vasti as and when wanted, as per the conduct of the intestine will assist in resolving long-term dumping syndrome.
