Waram-e- Mi’da (Gastritis)

Introduction

Waram-e- Mi’da (Gastritis) is a disorder affecting all age groups and both sexes, but it is more common amongst adolescents (12-17 years). It is the commonest GIT (Gastrointestinal tract) disorder in all cultures and civilizations. The term "Gastritis" refers usually to inflammation, erosive state to the stomach lining tissue which may occur either instantly (acute) or gradually (chronic).

It occurs when there is an imbalance between the acid production, resulting in swelling and damage of the stomach lining. In fact there is excess secretion of acid by the gastric glands of the stomach.

Various factors like spicy food, medicines, tobacco, alcohol etc. can cause increase in gastric acid production and disturb, weaken or damage the normal stomach lining.

If anyone have upper abdominal pain or discomfort , nauseatic feeling, stomach fullness, heartburn, vomiting, indigestion, burning sensation, belching, water brash or irregular bowel movement, we need to rule out whether he or she is suffering from acidity or gastritis or these symptoms are appearing due to some other reasons. Waram-e- Mi’da (Gastritis) can lead to many other illnesses in the body if ignored.

Waram-e- Mi’da (Gastritis) becomes worse when an individual has poor eating habits and living improper lifestyle.

Symptoms of Gastritis (Waram-e- Me’da):

Symptoms of gastritis vary among individuals, and in many people even there are no symptoms. It also depends on the duration of disease, whether it is of acute or chronic type.

The most common symptoms of acute gastritis include:

  • Abdominal bloating or stomach fullness
  • Belching (expelling air from the stomach through the mouth)
  • Waterbrashes (sudden filling of the mouth with dilute saliva)
  • Upper abdominal pain, discomfort or heaviness
  • Nausea/vomiting feeling
  • Irregular bowel movement
  • Recurrent indigestion
  • Chest burn or gnawing feeling between meals (heartburn)
  • Hiccups
  • In addition to these symptoms, chronic gastritis may include weight loss, continuous flatulence, black stool, loss of appetite and even anaemia.

Causes and Factors responsible for Waram-e- Mi’da (Gastritis):

Common causes of gastritis are many like, Ingesion of fatty and spicy food, intake of bitter or sweetish things, smoking, emotional disturbance, continued use of alcoholic beverages, long duration intake of NSAIDS, aspirin use for rheumatoid and osteoarthritis patients, autoimmunity (body loses its own immunity and attacks itself) etc.

Sometimes overeating may be responsible for acute gastritis. In some cases, however drinking of hot water may also cause inflammation of mucous membrane of stomach. Other factors like chronic bile reflux, psychological stress, autoimmune disorders and HP (Helicobacter pylori) infection are responsible for chronic gastritis.

These factors in the long term may even cause an ulcer (permanent breakage of the stomach lining), acid reflux disorder (food coming back to mouth after swallowing) and stomach cancer.

If acute gastritis (Warm-e- mi’da haad) persists for long periods, it can lead to chronic gastritis (Waram-e- mi’da muzmin).

Unani Perspective of Waram-e- Mi’da (Gastritis)

Unani physicians have mentioned the disease by different names e.g Waram-e- Me’da, Sozish-e- Me’da, Hurqat-e- Me’da, and Iltehab-e- Me’da.

As per Unani Philosophy Waram-e- Mi’da (Gastritis) is caused by Su’-e- Mizaj- Mi’da Haar (Hot temperament of stomach) or Su’-e- Mizaj- Me’da Baarid (Cold temperament of stomach),.

In other words it is caused by the accumulation of Dam (Samguine), Safra (Yellow bile), Balgham (Phlegm) or Sauda (Black bile) in the stomach, leading to the inflammation of gastric mucosa. It may also be elaborated as retention of humours (Akhlaat) within the stomach is main cause of Waram-e- Mi’da (Gastritis).

It is characterized by abdominal heaviness and distention, Humma (Fever), Qai (Vomitting), Shiddat-e- pyas (Excessive thirst), restlessness and decreased appetite in case of Waram-e- haar (Hot type ofWaram-e- Mi’da (Gastritis).

In case of waram-e- baarid (Cold type of Waram-e- Mi’da (Gastritis) of soft consistency caused by Blgham, there will be Humma-e- layyinah (Mild fever), excessive appetite, decreased appetite, distended stomach, whitish tongue and puffiness of face.

While in case of hard consistency caused by sauda (Black bile), there will be hardness on palpation, but no history of fever.

Avicenna describes in his book “Canon of Medicine”, the diseases of internal organs, in particular to detailed description of symptoms of gastritis and gastric ulcer. He also provides data on diseases of the stomach and intestines as a reaction of the organism to changing environmental conditions and violation of specific forms of adaptability of the organism.  

Unani classification of Waram-e- Mi’da (Gastritis):

  1. Unani scholars have described Waram-e- Mi’da (Gastritis) on the basis of clinical features. It is of two types
    1. Waram-e- Mi’da har (Hot type of gastritis)
    2. Waram-e- Mi’da barid (Cold type of gastritis)

        Hot (Haar) type of Waram-e- Mi’da (Gastritis): It is of two types

  • Damwi (Sanguine) type of Waram-e- Mi’da (Gastritis)
  • Safrawi (Billious) type of Waram-e- Mi’da (Gastritis)

        Cold (Baarid) type Waram-e- Mi’da (Gastritis): It is of two types

  • Balghami (Phalegmatic) e.g. Waram-e- Mi’da Rakhw
  • Saudawi (Melancholic) type e.g Waram-e- Mi’da Sulb
  1. Unani scholars have also described Waram-e- Mi’da (Gastritis) on the basis of Causative factors and humours. In this category it is of four types
  1. Waram-e- Mi’da damvi (Sanguine)
  2. Waram-e- Mi’da safravi (Billious)
  3. Waram-e- Mi’da balghami (Phlegmatic)
  4. Waram-e- Mi’da saudavi) (Melancholic)
  1. Unani scholars have also described Waram-e- Mi’da (Gastritis) on the basis of duration of the disease. In this category it is of four types
  1. Waram-e- Mi’da Falghamuni
  2. Waram-e- Mi’da Hamrate me’di
  3. Waram-e- Mi’da Rakhw
  4. Waram-e- Mi’da Sulb
  1. Scholars have also described Waram-e- Mi’da (Gastritis) on the basis of gross pathological changes. In this category it is of two types
  1. Waram-e- Mi’da Ha’ad (acute gastritis): which occur suddenly
  2. Waram-e- Mi’da Muzmin (chronic gastritis): which develops over a period of time

Principles of treatment (Usool-e- Ilaj)

  1. Taqleel-e- ghiza (Dietary restriction)
  2. Islah-e- Mizaj-e- Me’da (correction of gastric temperament) wa Taqwiyat-e- Me’da (Toning up of stomach)
  3. Tahleel-e- waram (Resolution of swelling) in case of Waram-e- haar (Hot swelling)
  4. Ishaal (Purgation) through enema in case of Waram-e- haar (Hot swelling)
  5. Rad’e mawaad (Replellence of causative matter) in case of Waram-e- haar (Hot swelling)
  6. Istifraagh (Evacuation) by mushil-e- sauda drugs in case of waram-e- sulb (hard nature swelling)

Management of Gastritis (Waram-e- Me’da)

Stomach (Me’da) is the prime concern in Unani medicine and Unani physicians emphasized on better functioning of stomach (mi’da). An appreciable number of Unani mufrad (single) and murakkab (compound) drugs are used to treat the disease. Efficacy of the drugs against gastritis has been tested by in vivo and in vitro studies. In Unani system of medicine plants, animals as well as mineral origin drugs are being used for the treatment of gastritis without any known side effects.

Single drugs (Mufrad advia): Some of the Unani drugs used since ancient times for the treatment of gastritis found to be highly effective.

  • Althaea officinalis Linn.                                              (Khatmi)
  • Alpinia galanga (Linn.)Willd.                                      (Khulanjan)
  • Aloe barbadensis Mill.                                                (Elva)
  • Onosma bracteatum                                                   (Gaozaban)
  • Glycyrrhiza glabra Linn.                                             (Asl-us-soos)
  • Withania somnifera (Linn.) Dun.                                (Asgand)
  • Zingiber officinale Roscoe                                          (Adrak)
  • Andrographis paniculata wall                        (Bhui neem)
  • Phyllanthus emblica Linn./ Emblica officinalis Gaertn.    (Amla)
  • Picrorhiza kurroa                                                        (Kutki)
  • Nigella sativa Linn.                                                     (Kalonji)
  • Curcuma longa                                                           (Haldi)
  • Berberis aristata DC. Syn.: B. chitria Lindl.               (Dar hald)
  • Momordica charantia Linn.                                        (Karela)
  • Aegle marmelos Correa ex Roxb.                              (Bael)
  • Asparagus racemosus Willd.                                      (Satawar)
  • Acacia arabica/nillotica Willd.                                    (Samagh-e-arabi)
  • Myristica fragrans Houtt.                                            (Jaiphal)
  • Plantago ovata Forsk.                                                (Aspghol)
  • Bambusa arundinacea (Retz.) Roxb. Syn.: B. bambos Voss   (Tabasheer)
  • Pistacia lentiscus Linn.                                               (Mastagi)

Compound drugs (Murakkab advia): Compound Unani drugs highly effective in gastritis are, Majoon Zanjabeel, Jawarish Anarain, Jawarish Mastagi, Majoon Dabeedulward, Qurs Satawari, Qurs Tabasheer, Jawarish Tabasheer, Khameera Sandal, Itrifal Aftimoon, Sharbat Neelofar, Sharbat-e- Anar, Sharbat-e- Unnab.

A part from above mentioned Unani compound drugs (when used alone) some other compound drugs are also very effective if they are used in combination e.g.

  • Murabba Zanjabeel 07- 10 gms with Arq-e- Baadiyan 125 ml BD
  • Jawarish Kamooni 05- 07 gms after meal
  • Jawarish Mastagi 05- 07 gms with Arq-e- Baadiyan 125ml BD
  • Jawarish Ood-e- Shirin 05- 07 gms after meal
  • Jawarish Ood-e- Tursh 05-07 gms after meal
  • Habb-e- Pachlauna (2 in number) after meal with water
  • Habb-e- Tursh (2 in number) after meal with water
  • Habb-e- Hilteet (2 in number) one hour after meal with water
  • Safoof Hazim 3-5 gms after meal with lukewarm water

Regimental therapy (Ilaj Bil Tadbeer)

  • Bloodletting through Akhal (Fasd-e- Wareed-e- akhal) in case of Waram-e- haar (Hot swelling) of stomach.
  • Light exercise is also advised in case of Waram-e- baarid rakhw (Phlegmatic swelling).
  • Long duration sleep is advised in such cases.
  • Massage with oil and vinegar in case of Waram-e- baarid rakhw (Phlegmatic swelling).
  • Qai (Emesis) is also advisable to make stomach empty

Dietary recommendations

  • Aghziya Lateefa (Easily digestible light diets) like nashpati and safarjal in case of waram-e- haar (Hot swelling) and aab-e- anar tursh in case of Waram-e- baarid (Cold swelling)

Dietary restrictions

  • Chilled water to be avoided in case of waram-e- rakhw (Phlegmatic swelling)
  • Spicy and oily diet to be avoided in all types og gastritis (waram-e-me’da)

Pharmacotherapy (Ilaj Bil Dawa)

  • Ma-ul- sha’ir (Barley water) is very useful in Waram-e- haar (Hot swelling) of stomach when used orally.
  • Ma-ul- Usool (A compound Unani preparation made up of certain roots of plants) is very effective in case of waram-e- rakhw (Phlegmatic swelling).
  • Similarly Ma-ul- Usool mixed with Gulqand (Compound Unani drug) is also very effective in case of waram-e- rakhw (Phlegmatic swelling).
  • Ma-ul- Usool mixed with Dawa-ul- kurkum is very effective in case of waram-e- rakhw (Phlegmatic swelling).
  • Arq-e- Badiyan 2.25 ml, Arq-e- Karafs 2.25 ml with fruit pulp of Cassia fistula, Linn. (Fuloos-e- khyar shambar) in very beneficial in case of waram-e- sulb (Phlegmatic swelling).
  • Massage of castor oil over the abdomen in case of Phlegmatic swelling (waram-e- sulb).
  • Make powder of Ja’ifal (Myristica fragrans, Houtt.) and use ½- 1 gm BD.
  • Make powder of Filfil Siyah (Piper nigrum, Linn.) Use it in 1 gm dose TDS (just after meal).
  • Make powder of Gul-e- surkh (Rosa damascena, Mill.) 10 part, Tabaasheer (Bambusa bambus, Druce.) 3 part, Kishniz Khushk (Coriandrum sativum, Linn.) 5 part. Use it in the dose of 7 gms BD.
  • Make powder of Pudina (Mentha piperita, Linn.). Use it in 2- 3 gms dose with ‘Arq-e- ilaichi BD.

References:

 

 

  • PUBLISHED DATE : Mar 04, 2019
  • PUBLISHED BY : NHP Admin
  • CREATED / VALIDATED BY : Dr. Mahtab Alam Khan
  • LAST UPDATED ON : Mar 04, 2019

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