Abstract

AYURVEDIC MANAGEMENT OF DIABETIC GASTROPARESIS: FOCUSING ON AGNI, SODHANA, AND SHAMANA

Vaishali N.*, Suvendu Rout and Vijayarajaa P.

Abstract

Background: Gastroparesis (GP) is a disorder characterized by delayed gastric emptying without mechanical obstruction, causing nausea, vomiting, bloating, and pain. Its prevalence ranges from 13.8 to 267.7 per 100,000 adults, primarily affecting women. Diabetes is a major risk factor as Gastrointestinal complications are more common in Type 2 Diabetes Mellitus(T2DM), with delayed gastric emptying being a key contributor to disease burden and reduced quality of life. Symptoms vary from mild bloating to severe nausea and vomiting, often resulting in hospitalizations and frequent misdiagnosis as gastroesophageal reflux disease. As treatment options are limited, management of this condition focuses mainly on dietary modifications. The exact pathophysiology remains unclear, but potential mechanisms include vagal neuropathy, hyperglycemia-induced changes, disruptions in the interstitial cells of Cajal network, reduced neural nitric oxide synthase expression, and oxidative stress. In Ayurveda, GP does not have a direct equivalent but aligns with conditions such as Ama, Ajeerna, especially Alasaka. Alasaka- a severe form of delayed digestion, can lead to systemic toxicity due to undigested food (Ama). Associated symptoms include loss of appetite (Anannabhilasha), abdominal pain (Udarashoola), bloating (Adhmana), tastelessness (Arochaka), headache (Shiroruja), and vomiting (Chardhi). Insights into these Ayurvedic principles offer a novel perspective for developing effective, innovative and integrative management strategies. Methodology: Literature review was conducted using Ayurveda Samhitas and modern databases such as PubMed, Scopus, Google Scholar, AYUSH Research Portal, and Ayushdhara to integrate traditional Ayurvedic perspectives with contemporary research on Diabetic Gastroparesis. Discussion & Conclusion: Madhumeha and Alasaka are two distinct conditions that share a common underlying pathology-Agnimandyam. This impairment triggers a cascade of dosha imbalances and systemic dysfunctions. The Ayurvedic treatment approach for Diabetic Gastroparesis encompasses Amapachanam, Agnivardhana, and Nidana-Parivarjana Chikitsa. Additionally, Rasayana therapy is incorporated to strengthen gastric musculature, while a combination of Shodhana and Shamana Oushadhis ensures comprehensive disease management.

Keywords: Prameha; Madhumeha; Diabetes Mellitus; Rasayana; Panchakarma; Gastric hormones.