Amlapitta – Meaning, Symptoms, Types, Prognosis

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

The pitta which is sour or has developed sour taste due to it being burnt is called as amlapitta. The word amlapitta can be split into 2 components – Amla = sour; Pitta = pitta

Types of Pitta

Pitta is of two types.
Prakrita / Avikrta Pitta – means normal pitta, pitta which is in a state of qualitative and quantitative balance.
Vidagdha / Vikrta Pitta – means burnt or contaminated pitta.

According to Master Sushruta – the taste of prakrta pitta is pungent / bitter. The taste of vidagdha pitta is sour. This means to tell that if pitta gets burnt due to certain etiological factors its taste gets transferred from pungent to sour. This pitta which has developed an abnormal taste i.e. sour taste is called as ‘amla pitta’ i.e. sour pitta.
Read – Fruitful Ayurvedic Remedies For Gastritis

Etiological factors, Pathogenesis of amlapitta

Backdrop for pitta aggravation – Monsoon season is the season for accumulation of pitta and in the following season i.e in Autumn season pitta gets aggravated. If pitta is not taken care of in the monsoon season, it gains abnormal increase and tends to produce diseases in the autumn season. The nature will anyhow have its influence on pitta naturally. Along with this if the person consumes etiological factors which tend to increase pitta, inclusive of foods and lifestyle practices, pitta aggravation will take place in severe form.
Read – 19 Ayurveda Health Tips For Rainy Season

Etiology of amlapitta –

• Viruddha pana anna – foods and drinks of mutually opposite / antagonistic nature (qualities)
• Dushta pana anna – contaminated foods and drinks
• Amla pana anna – sour foods and drinks
• Vidahi pana anna – foods and drinks which are corrosive in nature
• Pitta prakopi pana anna – foods and drinks which tend to increase pitta to abnormal proportions
  Read – Lifestyle, Food And Factors That Cause Pitta Dosha Increase

Pathogenesis of amlapitta

Accumulation of pitta in monsoon season – The pitta gets accumulated due to the effect of monsoon / rainy season and other etiological factors of its own (causative factors which tend to increase pitta).

Aggravation of pitta in the autumn season – This pitta which has already accumulated will further get aggravated in the autumn season.

Pitta developing vidagdhata / sourness – This aggravated pitta gets vidagdha i.e. attains more sourness in persons who are influenced by the above mentioned etiological factors and cause a disease called as amlapitta.
Read – Pitta Increase Symptoms – Pitta Vriddhi Lakshana

Signs and Symptoms of Amlapitta

The signs and symptoms of amlapitta may be categorized and classified under 3 groups for better understanding of the disease –

1. Samanya Lakshanas – common symptoms of amlapitta
2. Bhedanusara Lakshanas – symptoms according to the types of amlapitta
3. Doshanubandhanusara Lakshanas – symptoms according to association of doshas in amlapitta

1. Common (general) symptoms of amlapitta

• Avipaka – indigestion
• Klama – exhaustion without exercise or physical workouts
• Utklesha – excessive salivation / nausea
• Tikta udgara – bitter belching
• Amla udgara – sour belching
• Gaurava – heaviness of the body
• Hrt daha – burning sensation in the chest
• Kanta daha – burning sensation in the throat
• Aruchi – tastelessness
  Read – How To Balance Pitta Dosha? Line Of Treatment

2. Symptoms according to the types of amlapitta

Depending on the direction / pathway in which the symptoms of the disease are manifested, amlapitta is classified into two types, i.e.

• Adhoga Amlapitta – amlapitta in which the symptoms are manifested in the downward direction
• Urdhwaga Amlapitta – amlapitta in which the symptoms are manifested in the upward direction

a. Symptoms of Adhoga Amlapitta

• Trt – thirst
• Daha – burning sensation
• Murcha – fainting
• Bhrama – giddiness
• Moha – confusion
• Vividha prakara – associated with different colors like yellow, green, black and red and also different kinds of foul smell

Amlapitta associated with above mentioned symptoms sometimes moves and manifests in the downward direction and is called as adhoga amlapitta. It manifests with the below mentioned symptoms –

• Hrllasa – nausea
• Kotha – urticaria
• Anala sada – weakness of digestive fire
• Harsha – goosebumps
• Sweda – excessive sweating
• Anga pitatva – yellowish discoloration of body parts

b. Symptoms of Urdhwaga Amlapitta

When amlapitta is associated with kapha manifests in the upward direction and the vomitus is –

• Harit pitaka nila krshnam araktam raktabham – green, yellow, blue, black and light or dark red in color
• Ativa cha amlam – excessively sour
• Mamsodakabham – appears like the meat wash
• Ati pichchilam – excessively sticky
• Accha shleshmanugatam – mixed with clear mucus
• Vividham rasena – has salty, pungent or bitter taste
• Bhukte vidagdhe tu athava api abhukte karoti tikta amla vamim kadachit – bitter or sour vomiting occurs when the food gets improperly digested or even when the patient doesn’t take food
• Udgaram evam vidhameva – the person gets belching of the same tastes
• Kantha hrt kukshi daham – burning sensation in the throat, chest and belly
• Shiraso rujam – headache
• Kara charana daham aushnyam – burning sensation and increased heat in the hands and feet
• Mahatim aruchim – severe anorexia
• Jwaram cha kaphapittam – fever of kapha-pitta origin
• Kandu mandala pidaka shata nichita gatra roga chayam – itching and manifestation of rounded elevated skin eruptions and hundreds of boils spread over through the body and causes disease symptoms like indigestion, nausea etc (explained already)
  Read – Vomiting: Causes, Complications, Pathophysiology, Treatment

3. Symptoms according to association of doshas in amlapitta

By looking at the symptoms produced by associated vata and kapha, amlapitta shall be considered to be of three types –

• Vatadhika – caused due to increase in vata
• Kaphadhika – caused due to increase in kapha
• Vata-kaphadhika – caused due to increase of both vata and kapha

a. Symptoms of Vatadhika amlapitta

• Kampa – tremors
• Pralapa – delirium
• Murcha – fainting
• Chimichimi – tingling sensation in body parts
• Gatravasada – looseness in body parts
• Shula – pain
• Tamaso darshanam – feeling of darkness in front of the eyes
• Vibhrama – giddiness
• Vimoha – confusion
• Harsha – goosebumps
  Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

b. Symptoms of Kaphadhika amlapitta

• Kapha nishtivana – expectoration of mucus
• Gaurava – heaviness of the body
• Jadata – stiffness
• Aruchi – tastelessness
• Shita – coldness
• Sada – looseness of body parts / slowness
• Vami / chardi – vomiting
• Lepa – coating
• Dahana bala sada – deterioration of digestive fire / power
• Kandu – itching
• Nidra – excessive sleeping
• Tikta amla katuka udgara – belching which tastes bitter, sour and pungent
• Hrt kukshi kantha daha – burning sensation in the chest region, belly and throat
• Bhrama – giddiness
• Murcha – loss of consciousness
• Alasyam – laziness
• Shiroruja – headache
• Praseka – excessive salivation
• Mukha madhurya – sweetness in the mouth

c. Symptoms of Vata-Kaphadhika amlapitta

In this condition the symptoms of vata predominance and kapha predominance are present in mixed proportions.
Read – Lifestyle, Food And Factors That Cause Increase Of Kapha Dosha

Sanskrit Verses

Prognosis of amlapitta

The newly manifested (acute) form of amlapitta is curable with best efforts at treatment.

When the disease becomes chronic it becomes manageable but cannot be cured totally. Sometimes the chronic conditions become incurable.

Treatment Principles of Amlapitta

Vamana – therapeutic emesis and Virechana – therapeutic purgation form the key treatments to combat amlapitta in an effective way.

Emesis is preferred in the amlapitta having upward course and purgation is the treatment of choice in amlapitta having downward course. The intention is to eliminate the disease causing dosha(s) in the direction of their manifestation.

Treatment of Amlapitta

Patoladi Kwatha for emesis – Emesis shall be given first while treating amlapitta. It should be administered with the decoction of the below mentioned herbs –

• Patola – Trichosanthes dioica
• Neem
• Vasa – Adhatoda vasica
• Madana – Randia dumetorum
• Honey
• Rock salt

Trivrt Yoga for purgation – Purgation should be given with the below mentioned formulation –

• Trivrt churna – Operculina turpethum (powder)
• Honey
• Amla fruit juice

Anuvasana Vasti – unctuous enemas with medicated oil / ghee should be administered after proper cleansing has been achieved by the administration of emesis and purgation.

Asthapana Vasti – decoction enemas should be administered in chronic amlapitta after having analyzed the predominance of doshas and status of digestive fire.

Bheshaja Ahara Kalpana – after cleansing the patient by administration of emesis and purgation proper medicinal administration and dietetic regimen should be planned and implemented.

In what conditions of Amlapitta shall emesis and purgation be given?

• The urdhwaga amlapitta i.e. amlapitta having upward course / manifesting upwards should be treated by administering emesis.
• The adhoga amlapitta i.e. amlapitta having downward course / manifesting downwards should be treated by administering purgation.

This rule is to push and flush off the doshas causing amlapitta in their own direction of manifestation.

Useful formulations and dietetic inclusions

Yava Godhuma Vikrti – Soups and other edibles prepared with barley and wheat which is not added or processed with strong spices like pepper etc should be served.

Laja Sattu – Alternatively flour of parched / puffed grains should be administered mixed with sugar and honey in accordance to predominant doshas.

Yavadi Kwatha – Decoction prepared with de-husked barley, Vrsha – Adhatoda vasica and amla added with Cinnamon, patra – Cinnamomum tamala, cardamom and honey should be administered. This effectively cures vomiting caused by amlapitta.

Yavadi Kwatha 2 – Decoction prepared with barley, Krishna – Piper longum and Patola – Trichosanthes dioica should be given in amlapitta caused by kapha-pitta predominance.

Sringavera-Patola Kwatha – Decoction of ginger and leaves of pointed gourd should be given.

Patoladi Kwatha – Decoction of Patola Patra – leaves of Trichosanthes dioica, ginger and coriander is beneficial.

Patoladi Kwatha 2 – Decoction of Patola – Trichosanthes dioica, coriander, ginger and Musta – Cyperus rotundus is beneficial.

Guduchyadi Kwatha – Decoction of Guduchi – Tinospora cordifolia, Khadira – bark of Acacia catechu, Licorice and Devadaru – Cedrus deodara should be served mixed with honey.

Guduchyadi Kalka – Paste of Guduchi – Tinospora cordifolia, leaves of neem and Patola patra – leaves of Trichosanthes dioica should be given mixed in honey to drink.

Chinnodbhavadi Kwatha – Decoction of the below mentioned herbs taken in equal quantities should be given mixed with honey –

• Guduchi – Tinospora cordifolia
• Leaves of neem
• Patola patra – leaves of Trichosanthes dioica
• Triphala – Terminalia chebula, Terminalia bellirica and Emblica officinalis

Simhasyadi Kashayam – Decoction of Simhasya / Vasa – Adhatoda vasica, Guduchi – Tinospora cordifolia and Brhati – Solanum indicum should be given mixed with honey.

Phalatrikadi Kwatha – Decoction of Triphala (Terminalia chebula, Terminalia bellirica and Emblica officinalis), Patola Patra – leaves of Trichosanthes dioica and Katuki – Picrorhiza kurroa should be served mixed with sugar, powder of licorice and honey is useful.

Dashanga Kwatha / Vasadi Kwatha – Decoction prepared with the below mentioned herbs should be given mixed with honey –

• Vasa – Adhatoda vasica
• Guduchi
• Parpata – Fumaria parviflora
• Neema
• Markava – Eclipta alba
• Haritaki – Terminalia chebula
• Bibhitaki – Terminalia bellirica
• Amalaki – Emblica officinalis
• Kulaka – variety / synonym of pointed gourd (bitter variety)

Pathyadi Churna – Powder of Haritaki – Terminalia chebula and Bhringaraja – Eclipta alba should be given mixed with jaggery.

Drakshadi Churna – Powder of raisins and Haritaki – Terminalia chebula should be given mixed with old jaggery.

Katuki Churna – powder of Picrorhiza kurroa should be given with sugar powder is beneficial in pitta predominant amlapitta.

Pippali Churna – Powder of Piper longum mixed with honey is good for amlapitta.

Patoladi Churna – Powder of Patola – Trichosanthes dioica and Shunti – Zingiber officinale is beneficial in pitta predominant amlapitta.

Panchanimbadi Sattu – Powder of below mentioned should be given mixed with honey –

• Nimba Panchanga i.e. five parts of neem (leaves, flowers, fruits, bark and roots) – 1 part
• Vruddhadaruka Churna – powder of Argyreia speciosa – 2 parts
• Shaktu / sattu – flour of Chickpea / Bengal gram

Triphala Kalka – Paste of Triphala (Terminalia chebula, Terminalia bellirica and Emblica officinalis) kept overnight in an iron vessel should be given mixed with honey and sugar.

Shivapala Pindi / Pathadi Leha –

Confection prepared with the below mentioned ingredients is useful in treating amlapitta –

• Patha – Cissampelos pariera
• Patola Patra – leaves of Tricosanthes dioica / pointed gourd
• Indrayava – seeds of Holarrhena antidysenterica
• Coriander seeds
• Amalaki – Emblica officinalis
• Cinnamon
• Tejapatra – Cinnamomum tamala
• Nagakeshara – Mesua ferrea
• Kana – Piper longum
• Honey
• Abhaya – Terminalia chebula
• Sugar
• Ghee

Gudadi Modaka – balls made up of jaggery, Pippali churna – powder of Piper longum and Haritaki churna – powder of Terminalia chebula shall be given.

Use of Amalaki Rasa – The person who regularly consumes juice of Indian gooseberry along with food is said to get rid of amlapitta, emesis, tastelessness, burning sensation, diabetes, and effects of cold, ulcers and all diseases of semen.

Khanda Kushmanda Avaleha

Ingredients

• Kushmanda Swarasa – fresh expressed juice of good quality Benincasa Hispida – 400 tola quantity (4,800 grams approximately)
• Cow milk – same quantity as the above said juice
• Amalaki Churna – powder of Emblica officinalis – 32 tola quantity (384 grams approximately)
• Sugar candy – same quantity as that of Emblica officinalis powder
• Ghee extracted from cow milk – 8 tola quantity (96 grams approximately)

Method of preparation – The above said ingredients should be cooked together until they attain semi-solid / granular form.

Dose – 2-4 tola (24-48 grams every day)

Narikela Khanda

Ingredients

Narikela – pulp of coconut – 1 kudava quantity (192 grams approximately) should be cooked on mild fire in the coconut water. If coconut water is not available, milk of cow shall be used. It should be cooked until the contents are thickened.

To this, the powder of the below mentioned ingredients should be added in 1 tanka quantity (3 grams approximately) and mixed well –

• Coriander
• Pippali – Piper longum
• Musta – Cyperus rotundus
• Twak – Cinnamomum zeylanicum
• Patra – Cinnamomum tamala
• Cardamomum
• Nagakesara – Messua ferrea

Dose – 24-48 grams every day

Brihat Narikela Khanda

Ingredients

• Narikela – finely ground pulp of coconut – 64 tola quantity (768 grams approximately)
• Kushmanda – Benincasa hispida pulp – 128 tola quantity (1536 grams approximately)
• Go Ghrta – ghee extracted from cow’s milk – 16 tola quantity (192 grams approximately)
• Go Dugdha – cow milk – 256 tola quantity (3072 grams approximately)
• Sita – sugar candy – 128 tola quantity (1536 grams approximately)

Coconut pulp and Benincasa hispida are fried in ghee and cooked with milk and sugar on mild fire.

When the contents are properly cooked and prepared it should be made cold. To this, powders of the below mentioned in a quantity of 2 tola – 24 grams approximately should be added and mixed properly –

• Cardamomum
• Coriander
• Amalaki – Emblica officinalis
• Parpata – Fumaria indica
• Musta – Cyperus rotundus
• Sugandhabala – Valeriana wallichii
• Ushira – Vetiveria zizanioides
• Sandalwood
• Raisins
• Sringataka – Trapa bispinosa
• Kasherukam – Scirpus grossus
• Twak – Cinnamomum zeylanicum
• Patra – Cinnamomum tamala
• Camphor

This formulation should be kept in new earthen pot.

Dose – 4 tola – 48 grams or according to one’s digestive capacity.

Other useful Formulations

• Vasa Ghrta
• Tiktaka Ghrta
• Pippali Ghrta
• Patoladi Ghta
• Shunti Ghrta
• Pippali Ghrta
• Drakshadi Ghrta
• Shatavari Ghrta
• Guda Kushmanda
• Khandamalaki
• Abhraka Bhasma
• Loha Bhasma
• Mandura Bhasma
• Shuddha Gandhaka

Medicines for Amlapitta from Sahasra yoga Text book
1. Punarnavasaava
2. Chinchadi Lehyam
3. Dasamoola Hareetaki Lehyam
4. Gaganeshwara Rasa
5. Kuajadyavaleha
6. Lavangadyam Modakam
7. Aragwdhamrutadi Kashayam

Dietetic regimen

Foods prepared with bitter tasting herbs, devoid of strong ingredients i.e. sour, pungent and salty foods and inclusive of barley and wheat should be included in the diet. Laja Sattu – flour of parched grains should be given to drink after mixing with honey and sugar after considering the strength of doshas.

Pathya apathya – Yogaratnakara

Wholesome herbs, diet and habits

Barley, wheat, green gram, old red rice, boiled and cooled water, sugar, honey, fried flour, spiny gourd, bittr gourd, banana flower , brinjal, old pumpkin, pointed gourd, pomegranate, food & drinks that alleviate Kapha & Pitta dosha etc.

Unwholesome herbs, diet and habits

Sppression of urge of vomiting, sesame, black gram, horse gram, dishes prepared out of sesame, sheep milk, fermented gruel, salt, sour & pungent substances, heavy to digest food, curd, alcohol etc.

Click to Consult Dr Raghuram Y.S. MD (Ayu)