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
• mailme.drrrdeshpande@rediffmail.com

Digestive Tract
7/19/2015 3Prof.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)
•7/19/2015 Prof.Dr.R.R.Deshpande 28

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.
•7/19/2015 Prof.Dr.R.R.Deshpande 73

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/

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

Prof.Dr.R.R.Deshpande
• Sharing of Knowledge
• FOR
• Propagating Ayurved

Digestive tract problems in GP

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Digestive tract problems in GP

Similar to Digestive tract problems in GP (20)

More from rajendra deshpande

More from rajendra deshpande (20)

Recently uploaded

Recently uploaded (20)

Digestive tract problems in GP