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An Integrated approach for management of idiopathic recurrent acute pancreatitis (IRAP) with persistently increased serum amylase in sphincter of oddi dysfunction

A Case Report

##article.authors##

  • Soumya MS Amrita School of Ayurveda
  • Swathy S Amrita School of Ayurveda
  • Jwala Jayaram Amrita School of Ayurveda
  • Rajeshwari Nanaiah Amrita School of Ayurveda

DOI:

https://doi.org/10.53721/aca.11

Keywords:

Idiopathic Recurrent Acute Pancreatitis (IRAP), Avipatti curṇam, Yaṣṭimadhukṣīrapāka, Amlapitta, Case Report

Abstract

Idiopathic Recurrent Acute Pancreatitis (IRAP) is a clinical entity portraying episodes of acute pancreatitis which occurs more than one occasion after the initial attack. The prevalence of Idiopathic Acute recurrent pancreatitis on acute pancreatitis varied from 10-30% depends on etiological factors. The cardinal symptoms include epigastric pain which may radiates to back, with nausea or vomiting. Careful review of patient’s history and appropriate laboratory findings including raised serum amylase or lipase with radiological evidence confirms the diagnosis. The present case report highlights the efficacy of Ayurvedic treatment in, reducing the signs and symptoms of IRAP with significant changes in raised serum amylase and lipase. A 13year old girl, known case of Idiopathic Recurrent Acute pancreatitis after Acute pancreatitis management came to opd of Amrita School of Ayurveda with complaints of abdominal pain and nausea. On further evaluation Serum Amylase and Lipase were raised with USG showing bulky and hypoechoic uncinated process and head of pancreas. She was managed with internal medications like Yaṣṭimadhu kṣīra pÄÂka (Licorice milk) and Avipatti curṇam for four months, by considering the treatment principles for Amla Pitta (Acid Reflux). In this case the combination of Yaṣṭimadhu kṣīra pÄÂka and Avipatti curṇam, has shown a remarkable recovery from clinical symptoms and reduction in serum amylase and lipase. It may open a new path to the clinicians and researchers for finding the medicinal option for the treatment of this challenging disorder. This case report indicates the potential of Ayurveda for safe and effective management of Post IRAP symptoms

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References

Safari et al. Comparing the Roles of EUS, ERCP and MRCP in Idiopathic Acute Recurrent Pancreatitis. Clinical Medicine Insights: Gastroenterology 2016:9 35–39 doi:10.4137/CGast.S37927.

Kedia S, Dhingra R, Garg PK. Recurrent acute pancreatitis: an approach to diagnosis and management. Trop Gastroenterol. 2013;34(3):123-135. doi:10.7869/tg.116

Khurana V, Ganguly I. Recurrent acute pancreatitis. JOP. 2014;15(5):413-426. Published 2014 Sep 28. doi:10.6092/1590-8577/2417

Al-Haddad, M., & Wallace, M. B. (2008). Diagnostic approach to patients with acute idiopathic and recurrent pancreatitis, what should be done? World journal of gastroenterology, 14(7), 1007–1010. https://doi.org/10.3748/wjg.14.1007

Harish Kumar Singhal1, Radhey Shyam Sharma, Ayurvedic Management of Acute Pancreatitis- A Case Report, May - 2015 International Ayurvedic Medical Journal ISSN:2320 5091, Volume 3; Issue 5;

Rishi Vashishth Et Al: Clinical Study of Chronic Pancreatitis (Tikshnoshna Pitta) Treated with Some Ayurvedic Medicaments. International Ayurvedic Medical Journal {online} 2017

Moharana, Pritam & Roushan, Rakesh. (2018). A Critical Review of Samana Vayu in the Modern Perspective. 9. 188-197.

Ghosh K, Baghel MS. A clinical study to evaluate the role of Doshik predominance in the management of Amlapitta. Ayu. 2017;38(1-2):15-23. doi: 10.4103/ayu.AYU_75_14

Dr. Rajeshwari.P. N Dr. Jwala Jayaram et al: Open Label Single Arm Clinical Trial on Efficacy of Licorice Milk in GERD.

Anoop A S1, Lakshmiprasad L Jadhav and Sreelakshmi.P, An Open Label Single Arm Clinical Study on the Combined Effectiveness of Chitrakadi Vati and Avipathi Churnam in the Management of Hypothyroidism, Int J Ayu Pharm Chem 2019 Vol. 10 Issue 1 www.ijapc.com 192 [e ISSN 2350-0204]

Kotteswari, M & Prabhu, Kailash & Ram, Mudiganti & Ram Krishna Rao, Mudiganti & Ahamed, A & Balaji, Thotakura & Dinakar, Shruti & Sundaram, Raman. (2020). The gas chromatography-mass spectrometry study of one Ayurvedic formulation avipathi churnam. 2020.

Pragya Singhal. Effect of virechana karma (purgation) alone and with avipattikara choorna & shankha bhasma in treatment of pittajaparinama shoola (peptic ulcer). Ayurpharm Int J Ayur Alli Sci. 2016;5(10):128-136.

Gyawali, S., Khan, G. M., Lamichane, S., Gautam, J., Ghimire, S., Adhikari, R., & Lamsal, R. (2013). Evaluation of anti-secretory and anti-ulcerogenic activities of avipattikar churna on the peptic ulcers in experimental rats. Journal of clinical and diagnostic research: JCDR, 7(6), 1135–1139.

Integrated Management of Idiopathic Recurrent Acute Pancreatitis

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2020-11-12 — Updated on 2020-11-12