Ayurvedic Management of Achalasia

Achalasia Cardia is a motility disorder of the Gastro-Intestinal Tract. Here, the person feels difficulty in swallowing food. Achalasia Cardia is a condition, where the fibers of the lower sphincter of the esophagus are constricted, and lacks in relaxation of a lower sphincter in response to swallowing. In Ayurveda Chal guna which means – “to move” is the quality of Vata Dosha. So, whatever the movements are taken inside our body are under control of Vata Dosha. For example – swallowing, passing food from one organ to other, blood circulation, elimination etc. All these movements are monitored by Vata itself. So, if there is any difficulty in these movements, that shows the impaired functioning of Vata Dosha. So, Achalasia is a VATA Pradhan Tridoshaj Vyadhi.

What are the Causes of Achalasia?

  • As stated earlier, it is a vata pradhan tridoshaj vyadhi, definitely there is involvement of pitta and kapha dosha along with prime dosha i.e Vata.
  • Aahaar karana’s (Diet habits) – Indulging more in foodstuffs which are dry, rough, heavy in nature like- Junk foods, white flour, dry fruits etc.
  • Viharaj karana’s (Lifestyle behavior) – Involving more in heavy exercises, living a sedentary lifestyle, awakening at night. etc
  • Mansik karana’s (Mental status) – Emotional concerns impacts this condition, infact trigger this condition.
  • Vanshik karana’s (Hereditary) – Few cases of Muscular Dystrophy are inherited in nature which will affects the generations. This condition is also one among them.

Other factors – There are some triggering factors which imparts a role in provoking this condition. They are –

  1. Age – In old age, Vata is a dominant dosha. So, if there is any abnormality in the functioning of the Vata dosha, our nervous system which controls all the motor functions also gets affected.
  2. Smoking – Smoking and tobacco lead to the destruction of muscle fibers.
  3. Alcohol – It affects the neurons, which conveys the motor signals to esophageal sphincter – to relax while swallowing.
  4. Anatomical lesion – If there is any stenosis at the cardiac esophageal end then that will represent the symptoms of Achalasia. 


Pathogenesis According to Ayurveda

According to Ayurveda, mostly for every disease of Gastro-Intestinal-Tract we consider AAHAR and AGNI are the definite vitiated factors.

                                CAUSE

                ↓

           Leads to vitiation of Vata Pradhan Tridoshas

           (especially udana, prana and saman Vata along with Agni)

                ↓

vitiated doshas get localized in Mamsa dhatu and impair the functioning of esophageal muscles and motor neurons.

                ↓

       and produces symptoms like, dysphagia, odynophagia etc.

                ↓

              ACHALASIA

What are the Symptoms of Achalasia?

  • Dysphagia (Person feels difficulty to swallow)
  • Odynophagia (Pain while swallowing)
  • Heartburn (occurs due to delayed digestion)
  • Sensation of food been stuck in the neck.
  • Regurgitation

How We Can Manage Achalasia with The Help of Ayurveda?

 Management criteria include –

  1. Nidana Parivarjana – Avoiding the root cause.
  2. Measures to relax muscle fibers of the oesophageal sphincter.
  3. Maintaining motor functions. (As we know Vagus nerve gives the parasympathetic signal to esophageal sphincters.)

“By maintaining the equilibrium of Tridoshas”.

    4) Rasayan therapy – To treat neuron-degenerative changes.

Treatment Aspect in Ayurveda

1. Nidana Parivarjana

For treating any disease, we have to avoid the root cause of the disease.

2. Shodhana Chikitsa (Purification Measures)

Shodhana chikitsa is a therapy, by which we eliminate the vitiated doshas from the body through the nearer external orifice.

A) UroVasti

We can advise Urovasti as it does local swedana (sudation), and helps in relieving rigidity of esophageal muscles, thus, pacifies the Vata

B) Vamana (Emesis)

Vaman helps to evacuate the accumulated ama, which causes obstruction in the movement of vata.

C) Snehapana (Internal Oleation)

Can be effective in releasing the pressure and softens the srotas, and it also lubricates the esophageal tract which helps in easy swallowing.

3. Shamana Chikitsa (Palliative Care)

Internal medications which are helpful in this condition, they are

A) Vata Anulomana

The medicines which will help to correct the downward movement of Vata dosha and also eliminates the toxins from the body. For example – Avipatikar Churna, Haritaki Churana, Triphala Churana and Eranda taila (Castor oil) can be used.

B) Calcium Compounds

Shankha bhasma and Prawal panchamrit helps to manage heartburn.

C) Deepana– Pachana Medicines

Agni is also vitiated in this condition, So, maintain this with the help of deepana – pachana herbs like – Hingwadi vati, Hingwadi Churan, Chitrakadi Vati etc.

4. Rasayan therapy (Rejuvenation therapy)

Achalasia may arise due to degenerative changes in neurons. So, to revitalizing them rasayanas are required. For example,

  • Brahmi Vati (Nourishes the nervous tissues, and also alleviates stress)
    • Yashtimadhu Churana ( Glycyrrhiza glabra) – Yashtimadhu is one of the Medhya herbs explained in our classics. Along with rejuvenation, it also helps to manage throat problems.
    • Amalaki Rasayan – Amla is an antioxidant – rich fruit, which helps to repair neurons.
    • Arogyavardhani Vati – As the name of this medicine itself defines – Arogya (which means leading a disease free). Thus, this medicine supports healthy and disease-free life.

5. Giloy (Tinospora cordifolia)

Giloy (Tinospora cordifolia), Tulsi (Holy basil) and Haldi (Turmeric) can be used, as they have antibacterial, anti-inflammatory and immune-boosting properties.

6. Shalya Karma (Surgery)

Last but not the least, surgery can be advised if the cause is stenosis.

What are the Home Remedies for Achalasia?

  • Prefer lukewarm decoctions which are prepared with the herbs like – tulsi and giloy.
  • Add Ghrita (Cow ghee) in your daily diet, as it will lubricate the food pipe.
  • Take cow milk on daily basis as it rejuvenates the body.
  • Prefer to sleep and wake up early.
  • Gargles are advised by adding pinch of salt in lukewarm water.
  • Perform YOGA – As discussed earlier, emotional distress is one of the provoking factors, so manage them with the help of Meditation. Some supportive Asanas (Body poses) may be helpful in this condition like – Bhramri pranayam, Bhujangasana etc.
  • Dhoti – It is one of a procedure among Shadkarmas, explained in Ayurveda – which will help to relax the sphincter. Here, one has to drink sufficient amount of water (quantity depend upon individuals’ capacity) afterwards emit it out.

What are the Precautions to Be Taken While Taking Medications?

  • Avoid the use alcohol and smoking.
  • Prefer liquid and lukewarm stuffs.
  • Avoid non-vegetarian diet, dry, junk and spicy foodstuffs.