The first or proximal portion of the intestine is called duodenum. Approximately, it is 25 centimeter in length. The upper end of this organ is connected with the lower end of stomach. The pancreatic juice and bile are excreted into the duodenum through their respective ducts. This portion of the intestine, therefore plays a very important role in digestion of food.
In ayurveda this is called grahani. Ulcer in the duodenum causes colic pain. The pain usually starts after the food is digested. The peculiarity of this colic pain is that it occurs when the patient is hungry and subsides when he takes some food. There may be some exceptions in this rule.
The person suffering from the duodenal ulcer has impairment of the digestion and absorption of the food materials. This disease is commonly found in patient suffering from worry and anxiety. Because of the weakness produced by the colic pain, the patient becomes irritable and sensitive. At times, bleeding takes place from the ulcer and is passed through the stool. Because the blood has to pass through the remaining portion of the intestines, it is black in colour. It may also make black stool. The blood may come from mouth if the patient vomits but such condition is rare.
In ayurveda this colic pain caused by the duodenal ulcer is called parinam sula, which is mainly caused due to aggravation of vata. People having vatika type of physical constituent and psychic temperament are more prone to get this disease.
Treatment
Sukumara ghrita is the medicine of choice for this condition. The most important ingredient of this medicine are ghee and castor oil. This medicated ghee is to be given to the patient in a dose of two teaspoonfuls on empty stomach mixed with a cup of warm milk. If milk is not agreeable to the patient, then this medicated ghee can be given mixed well with a cup of hot water. The dose of this ghee is to be gradually increased. At times, the digestive power of the patient is affected by the intake of ghee. In that case the dose of the medicated ghee should be reduced. After taking this medicine for two or three days the digestive power of the patient improves automatically. Then he becomes capable of taking more and more of this ghee. The dose of the ghee should be increased half teaspoonful everyday. About six teaspoonful of ghee can be given to the patient in a gradually increased dosage and this will not cause any inconvenience or discomfort to the patient though he may feel laziness due to drowsiness and headache.
The medicine commonly used by the ayurvedic physicians for the treatment of any type of colic pain is sankha bhasma. Sankha is the skeleton of the animal living in sea which is called the conch shell. This shell is cut into pieces and bound with a piece of cloth and boiled in a vessel containing kanji. After boiling, the pieces of shell are cleaned carefully with hot water and triturated with lemon juice. Thereafter, they are put in two earthen pots and put in the oven. This procedure is repeated till the conch shell is reduced to the form of thin powder. Half a teaspoonful of this powder is given to the patient followed by a cup of hot water each time two or three times a day. When the patient is suffering from excessive pain then a preparation of sahkha bhasma commonly known as Maha Sankha Vati is to be given to the patient, usually in a dose of two tablets, two to four times a day depending upon the nature of the pain. After taking this medicine a cup of warm water is to be taken by the patient. This reduces the pain and prompts digestion.Maha sankha Vati is used by ayureveda physician for the treatment of duodenal ulcer in ayurveda.
The nature of this disease is such that with little treatment or without any treatment it may automatically subside. But, it may recur again when there is any disturbance in the intake of food or during psychic stress or strain. For the permanent cure of this disease, the medicated ghee described above is considered to be the best, and it should be taken for a sufficiently long time even after the colic pain is over. There are many other medicated ghee preparations like Amalaki ghrita and satavari ghrita which are also used in the treatment of this condition.
Diet
Articles of the food which produces dryness and roughness in the body are strictly contra-indicated. Pulses of all types and their preparations are also strictly prohibited. The patient should not take fried things. Spices and sour things are especially contra-indicated.
Other regimens
The patient should be kept free from mental stress and strain and also should avoid worry and anxiety. He should be given sufficient rest and should not stay on empty stomach. He should have sound sleep for sufficiently for a long time. A few hours of day sleep may be helpful for these patients. He should avoid constipation, so should have plenty of fibrous diet. If he is found to be constipated then a laxative should be administered. Castor oil is considered to be a good purgative. Husk of isafagul (Plantano ovate) may be given to the patient regularly at bed time. No strong purgative is given to the patient.
