Digestive tract problems in GP

Digestive Tract Problems in GP–

Part 1

Pain in Abdomen Presented By

• Prof.Dr.

• R.R.Deshpande

• 9226910630

7/19/2015 Prof.Dr.R.R.Deshpande 1


Digestive Tract Problems in GP

– Part 1 • Presented By –

• Prof.Dr.R.R.Deshpande (M.D in Ayurvdic

Medicine & M.D. in Ayurvedic Physiology)

• www.ayurvedicfriend.com

• Mobile – 922 68 10 630

• [email protected]

http://www.ayurvedicfriend.com/

mailto:[email protected]

Digestive Tract

7/19/2015 3 Prof.Dr.R.R.Deshpande


Digestive System Problems in GP -

Part 1 contains

• 1) Anorexia

• 2) Indigestion

• 3) Aerophagy(Gas)

• 4) Stomatitis

• 5) Hiccoup

• 6) Constipation

• 7) Diarrhoea

• 8) Vomiting


Digestive System Problems in GP

– Part 2 Contains --

• 9) Dysphagia

• 10) Pain In Abdomen

• 11) IBS

• 12) Jaundice

• 13) Peptic ulcer

Anorexia Symptom



Anorexia- Causes 1

• 1)Jaundice (Infective Hepatitis).

• 2) Fever.

• 3)Anemia.

• 4)Drugs -

(Biguanidees, Metronidazole, Digitalis,

Anti-hypertensive, Anti-diabetic)


Anorexia Causes 2

• 5) School going children -

(study related problems or psychological

reasons).

• 6) Adult male -

(Alcoholic, Tobacco, Mawa, Panparag,

Malignancy of Liver, Stomach).

Anorexia effects


Anorexia Effects



Anorexia causes 3

• 7) Pulmonary T.B.

• 8) Old patient (carcinoma of stomach).

• 9)Female patient (pregnant).

• 10)Sitophobia -

(fear of eating due to pain of oral ulcers

acute Gastritis).


Anorexia causes 4

• 11) Uraemia.

• 12) Psychogenic - Depression in females,

due to Domestic problems.

Diagnosis of Anorexia



Anorexia-Treatment 1

1. B plex – 1 OD.

2. Cipalactin or periactin - 4mg BD.

3. T.longiphen – 25mg BD.

4. Liv 52 – 2 TDS.

5. Cap Autrin – 1OD.

6. Digeplex or Unienzyme – 1 BD


Anorexia Treatment 2

Ayurvedic –

1. Arogyavardhini – 3 BD before food

2. Kumari Asav – 3 tsf with water BD

Lifestyle –

1. Fasting.

2. Regular walking exercise.

3. Happy Mind.

Vomiting



Nausea & Vomiting causes 1

• 1) Gastritis,peptic ulcer.

• 2) Female patient – early pregnancy

(amenorrhea)

• 3) Alcohol, Drugs

(asprin,NSAIDS,Flagyl,Chloroquin).

• 4) Vomiting with abdominal distension &

colicy pain – Intestinal obstructions.



• 5) Vomitus or patients breath – smell of

Kerosene or OP poison (Tik 20).

• 6) Vomiting with headache & high fever –

Meningitis.

• 7) Vomiting with loose motion –

Gastroenteritis (Gastro).



• 8) Vomiting with Right Hypochondric pain

– Hepatitis or Acute cholecystitis.

• 9)Vomiting & pain in right iliac fossa –

Acute Appendicitis.

• 10)Vomiting & pain in loin – acute

pyelonephritis.



• 11) Vomiting with severe phripheral vertigo

– Meniers disease or vestibular neuritis.

• 12) Vomiting & uncontrolled D.M –

Diabetic ketoacidosis.

• 13) Cyclical vomiting (Diagnosis of

Exclusion).

Vomiting

Sr. No. Associated symptoms with

vomiting

Diagnosis

1 With loose motion Gastro (gastro – interitis)

because of food poisoning in

epidemics.

2 With severe headache with high

fever

Meningitis or Encephilitis

3 With heart burn, stomach burn Acute Gastritis (alcohol abused

in large quantity) NSAID

overdose also

4 In elderly patient with sweating Acute myocardial infarction (dn't

treat immediately call

ambulance)


Vomiting


vomiting

Diagnosis

5 With history of amenorrhoea

(No M.C. is 6 months)

Hyperemesis gravidarum

6 With pain in right hypocho. Hepatitis / Colycystitis

7 Pain in right Iliac fossa Appendicitis

8 Pain in loin Pyelonephritis and due to

calculus


Vomiting


vomiting

Diagnosis

9 With abd. rigidity Intestinal Obstruction

10 With vertigo with Tinnitus Menier's disease, Vestibular

neuronitis

11 With uncontrolled D.M. Diabetic keto-acidosis

(ketone bodies)

12 Without any other specific

symptom but occur periodicity

Cyclical vomiting, idiopathic


Acid Indigestion Symptoms



Vomiting - Treatment

• 1) Inj.Reglan or Inj.Perinorum 10 mg stat (side effect – extra pyramidal symptoms – Then give, Inj.Calmpose 1 cc).

• 2) In pregnancy

Pregnidoxin – 12.5 mg TDS (meclizine hcl).

• 3) Severe Vomiting & Dehydration

- Tab or Inj.Ondansetron – 4 mg I/m stat

- I/v DNS & Ringer lactate.

Ayurvedic Anti Emetic Powder

• 1) Eladi Churna

• 2) Mayur piccha mashi


Ayurvedic Tablets for Acidity

• 1) Acidity with Indigestion ( Sama Pitta)

– Tab Sutshekhar

• 2) Acidity due to Spicy food & with

vomiting – Tab Laghu Sutshekhar


Ayurvedic Jam for Acidity

• Acidity,Burning ( Anti Pitta) –

• Gulkand ( Rose Jam)

• Moravala ( Amala Jam)

• Hyperacidity & Peptic ulcer – Shatavari

Ghruta ( Medicated Ghee)

•



Flatulence (Gas) or Belching

causes 1

• 1) Indigestion (unsatisfactory

bowel,Amoebiasis, Giardiasis).

• 2) Lack of Regular exercise (especially

abdominal exercise) – Less tone of

abdominal muscles.

• 3) Frequent aerated drinks, onions, peas,

beans, dals.

Indigestion


Pain in abdomen

due to Indigestion



Flatulence (Gas) or Belching

causes 2

• 4) Excessive eating.

• 5) Cholecystitis or Gall stones.

• 6) Fast eating Habits.

• 7) Swallowing air (sipping tea, chewing

Tobacco paan, chewing gums).


Belching- Treatment

• 1) Avoid above causes.

• 2) Gellucil MPS – 2 tsf TDS

(methyl polysiloxane)

3) Ayurvedic – Gasex ,Triphala vati

,Panchakolasav

4) Yoga -- Pavanmuktasan

Powders as

Appetiser, Digestant,Carminative

• 1) Hingwashtak Churna

• 2) Samudradi Churna

• 3) Ashtang lavan Churna

• 4) Bhaskar Lavan Churna

• 5) Panchasam Churna

• 6) Vadvanal Churna

• 7) Vaishvanar Churna

• 8) Chitrakadi Churna

• 9) Pippalyadi Churna

• 10) Lavangadi Churna


Ayurved for Indigestion

• Abdominal pain due to Indigestion,Gas etc –

• 1) Shankha vati

• 2) Lashunadi vati

• 3) Shulahara vati

• 4) Lashun Pak

• 5) Shatpal Ghruta

• 6) Eladi churna,

• 7) Lashunadi vati


Ayurved to improve abdominal muscle tone

• Colicy Pain & to improve tone of Muscle (

Nocturnal Eneresis) –

• Products of Kuchala or Nux vomica –

• 1) Agnitundi vati,

• 2) Vishatinduk vati

• 3) Tab Vatagajangkusha


Ayurvedic Liquids for Indigestion

• 1) Jeerakadyarishta – 4 tsf with equal

amount of water BD

• 2) Panchakolasav --- 4 tsf with equal

amount of water BD



Acute Constipation causes

• 1) Local pain at anus – painful fissure, perianal abscess.

• 2) Elderly bed ridden patient.

• 3) Pregnancy.

• 4) Constipation with colicky pain in abdomen,Board like rigidity, abdominal distention or vomiting- Intestinal obstruction. (hyper peristalsis) or paralytic ileus (No peristalsis) or Acute Abdomen.

• 5) Idiopathic functional constipation.

Anal Fissure



Acute Constipation- Treatment 1

• 1) For perianal abscess – Incision & drainage.

• 2) For fissure in Ano –

- Local – Xylocaine oint.

- Cap Mox – 500 mg TDS.

- Tab Tini – 300 mg – 1 BD.

- Tab Voveron – 100 mg – 1 BD.

- Tab Triphala vati – 2 H.S.


Acute Constipation- Treatment 2

• 3) For idiopathic constipation –

- Tab Herbolax (Himalaya) 3 H.S or

Abhayaristha – 3 tsf with equal quantity of

water-BD.

• 4) For Acute Abdomen –

- Admit Immediately.


Chronic Constipation – causes 1

(Habitual Constipation)

• Lack of exercise (especially abdominal

muscle exercises – poor abdominal

muscle tone.)

• Lack of roughage (Green vegetables,

fruits, raw bananas) in Diet.


Chronic Constipation causes 2


• Drinking Less water or beverages.

• Tobacco, Mawa, smoking.

• Drugs (Anti-hypertensives, antacids, Iron,

NSAIDS).




• 1) Insulting Natural calls.

• 2) Pain at anus (Fissure, anal stricture,

Growth).

• 3) Bed ridden patients




• 4) In Elderly alternate constipation &

Diarrhoea or Constipation with P /R

bleeding ---- R / O -- Malignancy of colon

or rectum .

• 5) Long term use of Laxatives or Enema(

Loss of Muscle Tone)

Types of stool


Chronic Constipation


Constipation


Constpation



Chronic Constipation- Treatment

• 1) Treat above said causes & Regular abdominal massage on empty stomach with warm sesame oil & fomentation.Regular 45 min walk,Pavanmuktasan,Naukasan

• 2) Intermittent ayurvedic oil Enemata (Anuvasan Basti).

Caution

Elderly patient – alternate constipation & Diarrhea, with P/R bleeding – Rule out Rectal or colonic cancer.

Stress & Constipation


Constpation misunderstanding


Ayurvedic Medicines –

Laxative Powders • 1) Avipattikar churna

• 2) Amalakyadi churna

• 3) Swadishta Virechan churna

• 4) Sukhasarak churna

• 5) Gandharva Haritaki churna

• 6) Narayan churna

• 7) Triphala churna

• 8) Gomuta Haritaki churna

• 9) Isabgol churna


Ayurvedic Strong Purgatives

( Virechak) • Products of Jaypal ( Croton tiglium) –

• Tab Ashwakanchki

• Tab Icchabhedi

• Tab Naracha rasa

• Note – mainly used as Detox process in

Ascites, Skin Diseases, Hemiplegia


Ayurvedic Liquid for Constipation

• Laxative ( Useful in Constipation, Acidity,

Jaundice, Ascites, Oedema) –

• Liq Abhayarishta – 4 tsf with equal amount

of water BD



Stomatitis causes 1

• If Recurrent – Apthous stomatitis (spicy

food, Non veg, alcohol-Heat).

• Diffuse Inflammation –

a) Fiery red tongue – B.complex deficiency.

b) White depapillated & smooth, bald tongue

– Iron deficiency.

c) White exudates, easily removed-oral

candidiasis (Thrush), with HIV or D.M.

Apthous stomatitis


Apthous ulcer



Stomatitis causes 2

d) White patches, can not be removed –

Leukoplakia (pre-malignancy condition)

e) White palate, with difficulty in opening the

mouth - sub mucous fibrosis ( Manikchand

or beetelnut chewing).


Stomatitis causes 3

• Non recurrent Ulcers –

a)Infection – Herpangina, syphilis.

b) Traumatic – Sharp tooth.

c) Chemical burn – Aspirin for toothache.

d) Skin – Lichen planus,pemphigus,drug reaction.

e) Carcinoma of tongue or cheek.


Stomatitis Treatment 1

• 1) Avoid – spicy food, hot drinks & tobacco.

• 2) Local – Gelora cream / Glycerine or Kailas Jeevan.

• 3) Rines – Betadine oral wash ,Milk gurgaling

• 4) Kenacort oral paste (Triamcinolone),Kailas Jeevan

• 5) Gairik & Paraval Pisti with cream of milk

• 5) Beclate (Betamaethasone) inhalar spray on ulcers.


Stomatitis Treatment 2

• 1) Red magenta tongue – High doses of B.complex.

• 2) T.B.plex & T. Celin – 1 BD.

• 3) Bald tongue – Cap Autrin 1 OD.

• 4) Oral thrush – Candid oral paint & T Zocon

(Fluconazole) 150 mg – stat.

• 5) Submucous fibrosis – Refer to ENT.


Hiccup causes

• Involuntary Spasm of Inspiratory muscles, followed by abrupt closure of glottis

• Precipitated by – Irritation of Diaphragm due to distention of stomach.

• Rare causes –

1) Pleurisy or Mediastinal mass. – X ray chest

2) Uraemia. ----------------------------- Sr.Urea & Creatinine

3) Sub. Diaphragmatic abssess.--- USG Abdomen

4) Gastritis or ulcer.-------------------- Gastro duodenoscopy

Hiccup



Hiccoup Treatment

• 1) Breathing in & out in a plastic Bag.

• 2) Breath holding – as long as possible.

• 3) Pressure on eye balls.

• 4) Drink ice cold water

• 5) Mucaine Gel (Antacid with Xylocaine) 2 tsf - 2

tds.

• 6) T.cyclopam (Anti.spasmodic) 1 stat & repeat

after 2 hrs.

• 7) T.Largactil 50mg stat & repeat after 6 hrs.


Investigation in Hiccup

• 1) X ray chest --- Pleurisy,Mediastinal

mass

• 2) Sr.Urea & Creatinine – Uraemia

• 3) USG Abd – Sub diaphragmatic abscess

• 4) Gastroscopy -- Ulcer


Acute Diarrhoea causes

• 1) Viral.

• 2) Bacterial.

• 3) Amoebic.

• 4) Drug Induced.

• ( Amoxycilline,Iron,Antacid with Mg)

Spread of Diarrhoea


Diarrhoea


Diarrhoea 2


E coli


Grades of Dehydration

• 1) All times irritable (crying children)

excess thirsty, oliguria.

• 2) Cries vigorously, sunken eyeballs,

sunken fontanels, drowsiness.

• 3) Child becomes quiet, total anuria,

inelastic skin, feeble but fast.

•


Signs of Dehydration


ORS ( Oral Rehydration solution)


Which Diarrhoea Patients should be

Admitted ?

• 1) Dehydration grade III.

• 2) Child below 6 months

• 3) Acidosis (deep rapid and harsh

breathing)

• 4) severe abdominal distension.

• 5) Toxicity


Amoeba


DD OF Dysentery - 1

Bacillary Dysentery Amoebic Dysentery

1. Organism E. Coli, Ftexnor, shigella flexnor Amoeba, EH – Entymoeba

hystolytico, Giordia lamlia

2. Onset Very sudden / acute Less acute

3. Fever yes No

4. Toximia present Absent

5. No. of stools More (12 – 15 /day) Less (7 – 8/day)

6. Tenesmus more Less


DD OF Dysentery - 2

Bacillary Dysentery Amoebic Dysentery

7.Pain in

abdomen

Diffuse pain and mild Mainly on caecum and

pelvic colon

8. Dehydration Severe Absent

9. Stool Less faecal matter, but some

times blood and mucus

Less faecal matter plus lot

of mucus

10. Straining less Present

11. B. P. hypotension B.P. normal

12. stool exam Pus cells+++ and RBC++ Mucus+++, blood+ & EH

cysts seen


DD OF Dysentery - 3

Bacillary Dysentery Amoebic

Dysentery

13.

prognosis

May be bad due to

complications like

dehydration (sp < 2 & >

60 yrs)

Good, but

recurrence is always

possible.

14.

treatment

ORT & Antibiotics as

Ciplox – 500 mg, B.P.

Antiamoetic

treatment, Tiniba –

500 mg, B.D.



Acute Diarrhoea Treatment 1

• O.R.T, Buttermilk, black tea, Coconut

water, Fruit juice.

• Soft rice, Mung dal, Over ripe banana

(pectin), curds.

• Cap. Imosec (Loperamide) – 2 cap. State

& 1 cap after each loose motion (Max. 8

cap/day)



• Tab cyclopam 1 TDS.

• Inj. Reglan (Metochloropromide) – 2 cc I/m

stat.

Caution

Metochloropromide & Loperamide – do not

use together.( Replace Loperamide by

Codeine 30 mg tds)



• If fever with Diarrhoea (Infection).

• Ciplox (cipro floxacin) 500 mg BD.

• Norflox (Nor floxacin) 400 mg BD.

• Tab.Tini – 500 mg BD

• Tab Norflox TZ – 1BD



Hypotension or Dehydration

- Fast I/V drip, with Ringer lactate & DNS.

- Inj. Mephentin 1-2 cc I/V stat.

- Inj. Efcorlin 100-200 mg I/V stat.

- Inj. Gentamicin 80 mg I/V stat.

Shift patient to Hospital( Fear of

Septicaemic shock)

Diarrhoea – My favorites Tab

• Tab Dyrade M – 1TDS OR

• Tab Dependal M – 1 TDS

• Kutaja Parpati Vati /Kutajarishta/Kutaja

Ghana vati

• Previously DIQ & Furoxone

• Yellow coloured urine with Furazolidine

• Mettalic Taste with Flgyl


Ayurvedic Powders to stop loose motions ( Stambhak)

• 1) Jatiphaladi Churna

• 2) Gangadhar Churna

• 3) Bruhat Gangadhar Churna

• 4) Samasharkar Churna


Ayurvedic Tablets for Diarrhoea with fever

• 1) Tab Sanjivani

• 2) Tab Shankhodar


Ayurvedic Medicines for Diarrhoea

• Diarrhoea,Dysentry,Colitis –

• Liq Kutajarishta – 4 tsf with equal amount

of water BD

• Liq Babbuladyarishta -- 4 tsf with equal

amount of water BD



Chronic diarrhoea causes

• 1) Ulcerative colitis.

• 2) Opportunistic Infections, associated with HIV.

• 3) Chronic pancreatitis.

• 4) Sprue.

• 5) Laxative abuse.

• 6) Lactose Intolerance.

• 7) Hyperthyroidism.

• 8) D.M

• 9) IBS (Irritable Bowel syndrome)

• 10) Drugs

• 11) Intestinal T.B.


Chronic diarrhoea Treatment 1

• 1) Cap. Imosec (Loperamide) – 1 TDS.

• 2) Tini – 500 mg – 1 BD

• 3) T. Zentel (Albendazole) 400 mg – 1 stat

• 4) T. Ciplin DS – TDS x 7 days.

(for Diarrhoea with HIV)


Chronic diarrhoea Treatment 2

• Cap. Doxy 1 (Doxycycline) –

100mg – BD x 10days (for sprue)

• Cap.Neutrolin B TDS x 7 days

• T.Alprazolam 0-25mg – BD (In IBS).

• T.Folvite (folic acid) – 5mg BD x 10 days.

• Avoid – fatty foods, raw vegetables,

uncooked meat.

Ayurvedic Medicines for Chronic Diarrhoea

• Diarrhoea,Dysentry,Colitis –

• 1) Kutajavaleha,

• 2) Bilvavleha

• 3) Dadimavleha



Ayurved for General Practioner

• Very very popular

Book in Medical

Practioners

• 100 common

symptoms of General

Practice with

causes,Investigations

& Ayurvedic

Treatments


Clinical Examination

• Systemic Examination

of 8 systems

• Ayurvedic Srotas

Examination

• Clinical significance of

Lab Tests &

Radiology,USG,2D

Echo


Notes on Medicine Part 1

• Very very useful Book

for all Medical

Practioners

• Guidelines with

causes,symptoms,Ay

urvedic & Modern

Treatments to treat

Fever,Pain in

Abdomen & Arthritis


Best Book for

Medical Students & Practioners


Preventive Cardiology

& Ayurvedic Management

• Best Book for GP

• All cardiac problems

like

Hypertention,CCF,

Angina,Myocardial

Infarct are discussed

with Ayurvedic

Management

Contact -922 68 10 630


Digestive Problems

& Ayurvedic Management


• All Digestive

problems like

Acidity,Pain in

abdomen,

• Constipation ,colitis

are discussed with

Ayurvedic

Management

Contact -922 68 10 630


Gynaecological Problems &

Ayurvedic Management


• All Gynaecological

problems like Heavy

bleeding,White

discharge,Infertility,ca

ncer are discussed

with Ayurvedic

Management

Contact -922 68 10 630


Arthritis,Backache &

Ayurvedic Management


• All Joint problems

like Rheumatoid

Arthritis,Osteoarthritis

,Backache are

discussed with

Ayurvedic

Management

Contact -922 68 10 630


Neurological Problems & Ayurvedic

Management


• All Neurological

problems like

Headache,Epilepsy,Al

zeimer’s Disease are

discussed with

Ayurvedic

Management

Contact -922 68 10 630


Ayurvedic Concept of Diet

& Nutrition


• Dietary Advice

according to Prakruti

,Dietary prescriptions

for many diseases are

given

• Contact -922 68 10

630


Health Tips for 365 Days


• This Book is very

useful from Common

man to Doctors

• It covers all imp

aspects mentioned in

Ayurveda

• Open as per date &

complete reading of

one page only

Prof.Dr.Deshpande’s

Popular Links on Internet

• Just Start Internet on Desk top or Lap top

or on your mobile . Copy Following Link &

Paste as Web address –URL

• http://www.youtube.com/user/deshpande1

959

• http://www.slideshare.net/rajendra9a/

• http://www.mixcloud.com/jamdadey/


http://www.youtube.com/user/deshpande1959

http://www.youtube.com/user/deshpande1959

http://www.slideshare.net/rajendra9a/

http://www.mixcloud.com/jamdadey/

Prof.Dr.Deshpande’s

Popular Links on Internet

• Just Start Internet on Desk top or Lap top or on your mobile . Copy Following Link & Paste as Web address –URL

• http://professordeshpande.blogspot.in

• http://professordrdeshpande.blogspot.in/

• http://www.mixcloud.com/rajendra-deshpande

• https://soundcloud.com/professor-deshpande


http://professordeshpande.blogspot.in/

http://professordrdeshpande.blogspot.in/

http://www.mixcloud.com/rajendra-deshpande



https://soundcloud.com/professor-deshpande



Prof.Dr.R.R.Deshpande

• Sharing of Knowledge

• FOR

• Propagating Ayurved


Digestive tract problems in GP

Education

Transcript of Digestive tract problems in GP