Case Study

Case Study

Case study of Ulcerative colitis
A female patient aged 31 years approached here for ayurvedic treatment .her case history goes like this.
Patient presented with
• 8-10 bowel movements along with blood and mucous
occasionally.
• Severe pain and swelling in ankle joint
• Pain in neck and shoulder
• Slight fever frequently
• Had a sudden weight loss of 25 kg.( a drop from 61 kg to
36 kg).
• Reduced hemoglobin and vitamin D
• Irregular periods

On august 2014
• Bowel movements -7-8/ day
She was diagnosed with h – pylori stomach bug. And was on
• Amoxicillin 500 mg bid.
• Clindamycin 300 mg bid.
• Omeprazole 20 mg big.

September 2014
Frequency of stool became 7-8 / day, and she was on ciprofloxacin 500mg OD for 5 days.

October 2014
• Loose stools 6-7/ day on good days and 10-12/ day on bad
days.
• Stool was associated with blood and mucous.
• Abdominal cramps
• Diagnosed with chron’s by colonoscopy.

November 2014
• Bowel movements 7-10/ day

On 24/11/2014
She had undergone colonoscopy which revealed discontinuous areas of non bleeding ulcerated mucosa with no stigmata of recent bleeding were present in the entire colon.
A diffuse area of mucosa in the terminal ileum was severely friable with contact bleeding.

On 28/11/2014
• Bowel movements same
• Biopsy of terminal ileum shows chronic ileitis.
• Random colon biopsy shows active chronic colitis with focal granulomas, microscopic skin lesions.

December 2014
• Bowel movements 8-10 /day
• Chest x –ray, stool examinations and blood work done to
eliminate other infections.
• x- ray chest shows mild scoliosis in thoracic spine.
• Stool examination was normal
• Blood picture revealed a reduced haemoglobin count along
with reduced Vit.D
• Chron’s was confirmed by this time , prednisone was
started for 5 days which shown no improvement

January 2015
Bowel movements was reduced for 2 months after starting remicade infliximab (an anti tnf drug), later allergic reactions started

March 2015
• Bowel movement frequency increased, and was associated
with
• Blood and mucous
• Abdominal cramps
• Reduced weight
• Weakness

May 2015
• Started humira adalimumab (another anti tnf drug), with
no markable improvements.
• Bowel movement frequency was not improved.

July 2015
• Underwent biopsy and colonoscopy
• Biopsy on 23.07.2015 shown focal active colitis of
ascending colon, descending colon and sigmoid colon.
• Colonoscopy on 23.07.2015 shown chrons entercolitis
compatable with chron’s disease.

August 2015
• Stopped humira due to allergic reactions and she
approached famous Ayurveda treatment center. (Medicines
included –gangadharchoornam, vilwadichurnam,
shankabasmam, kaparadhakabhasma, motipisti,
pravalapanchamritha rasa, kutajaganavati, kutajarishtam
along with 5 anuvasanavasthi and 3 nirushavasthi) no
significant improvement was noted.

September 2015
• Started ayurvedic treatment with a famous doctor
• Started medicines like indhukanthamkashayam,
ashtachoornam, dhasamoolarishtam,
jeerakadyarishtam,mustharishtam, bifilac , granules,
indhukantahmgritham, n. bael, banana powder.

December 2015
• Medicines were stopped and changed according to symptoms
and she started to feels better.
• Frequency came down to 4-5 / day

January 2016
• Started experiencing neck pain, pain and swelling in
ankle joint
• Irregular menstrual cycle from last several months
• Taking medications like indhukanthamkwantham, immurich ,
max cal-c, bilifac, banana powder(ragi vita)

February 2016
• Conditions aggrevated , she had taken ayurvedic
treatment somewhere in kerala , no changes were noted

March 2016
She approached our hospital (Vinayaka Ayurveda hospital Kerala) on march , and got admitted on 5th march 2016
1st day – 05.03.2016
• Weight – 37 kgs
• Frequency of stools- 10
• Weakness ++
• Ankle pain ++
• Rashes over body +

Treatment given
• Abhyangam with mahasneham
• Kaidaryadikashayam 20 ml bid
• Villwadigulika 2 bid
• Dadimashtakachurnam for kashayam + tsf honey 50 ml bid
• Bactifer capsule 1 bid
• Dadimadighritham 1 tsf + kalyanaksharam 1 tsf as frequent
doses
• Guggulupanchapalachurnamfor kashayam +1 tsf honey 50 ml
bid
• Diet – avoided spicy and salty food
• Breakfast upma, items prepared out of laaja (malar),
green gram, pomegranate juice
• Lunch and dinner – rice and freshly prepared buttermilk

2nd day 06.03.2016
• Frequency of stools -10
• Ankle pain++
Treatment given
• Medicines , diet and treatment continued as previous day along with
• Lepanam with grihadhoomadichurnam
• Bandage to the ankle joint with panda thailam
• Fever (100 f) was developed by 8.30 pm , and was managed
by
• Dhasamoolakaduthrayamkashayam 2 tsf +1 vettuamarangulika
2 hourly

3rd day -07.03.2016
• Frequency of stools -11
• Abdominal cramps – reduced
• Ankle pain ++++
• Temperature – 98f
Treatment given
• Continued same medicines , diet and treatments
• Km lepam externally over the angle joint at night

4th day -08.03.2016
• Frequency of stools –09
• Ankle pain +++
• Medicines, treatments and diet was continued

5th day- 09.03.2016
• Frequency of stools –14
• Abdominal cramps – increased
• Ankle pain +++
Treatment given
Continued same medicines, diet and treatments
1. Villwadilehyam 1 tsf bid
2. Rasaghandimezhu 1 bid

6th day -10.03.2016
• Frequency of stools- 12
• Ankle pain ++
• Sleep disturbance ++
Treatments given
• Same medicines, diet and treatments were continued
• Started dhathreethalam due to sleep disturbances

7th day – 11.03.2016
• Frequency of stools- 16
• Ankle pain ++
• Same medicines, diet and treatments were continued
• Started diazyn tablet 1 bid

8th day -12.03.2016
• Frequency of stools -9
• Ankle pain + pedal Oedema – reduced
• Gas troubles ++
• Started njavarakizhi with mamasarasa along with other
medicines and treatments

9th day -13.06.2016
• Frequency of stools-14
• Ankle pain++
• Neck pain +
• Same diet, medicines and treatments along with diazyn 2
tid , and cervical manipulation was done due to neck pain

10th day-14.03.2016
• Frequency of stools-09
• Ankle pain++
• Same treatment, diet and medications continued

11th day -15.03.2016
• Frequency of stools -10
• Same medicines , diet and treatments were continued

12th day -16.03.2016
• Frequency of stools -15
• Neck pain ++
• Same medicines , diet and treatments were continued along
with cervical manipulation

13th day -17.03.2016
• Frequency of stools-13
• Ankle pain ++
• Neck pain++
Advlepanam to neck with jadamayathichurnam. Physiotherapy was done for neck pain. Treatments were continued as previous day .sitz bath with luke warm water was given twice

14th day- 18.03.2016
• Frequency of stools-13
• Same treatment schedule were continued

15th day -19.03.2016
• Frequency of stools- 13
• Fever+(99f)
• No treatment was done due to fever and given
dhasamoolakaduthrayam and vettumaran
• Kaidaryadikashayam was stopped and added kashayam with
mustha, kudajatwak, kutajabeeja, ativisha 50 ml +1 tsf
honey twice daily

16th day -20.03.2016
• Frequency of stools -10
• Same treatment schedule was continued

17th day -21.03.2016
• Frequency of stools -7
• Patient feels better .same treatment schedule was
continued

18th day-22.03.2016
• Frequency of stools-06
• Tiredness reduced same treatment schedule was continued
Given
1. Nagaparapa 100mg 1 bid
2. Shankaparpa 100mg 1 bid
3. Tiripalakarpa 2 bid
4. Velliparpa 100 mg 1 bid
5. Nannarichurnam 10g bid (10 g nannarichurnam was boiled in
1.5 glass water and reduced to 1 glass and added 1
nagaparpa , 1 sankhaparpa , 2 tiripalakarpala , 1
velliparapa and given twice daily)

19th day -23.03.2016
• Frequency of stools-05
• Pain in shoulder +
• Adv local application of ksheerabala 101 drops and
priperita cream. And given nasyam with ksheerabala 101
and same treatment schedule was continued as the previous
day

20th day -24.03.2016
• Frequency of stools-04
• Pain in shoulder was reduced, same treatment schedule was
continued
• Given soup with liver, lungs, heart, spleen and intestine
of goat

21st day -25.03.2016
• Frequency of stools-04
• Same treatment schedule was continued

22nd day-26.03.2016
• Frequency of stools-05
• c/o distension of abdomen . addedulset liquid 2 ml with
hot water sos. And same treatment schedule was continued

23rd day-27.03.2016
• Frequency of stools -03
• Same diet and medicines were continued joint pains were
relived and so lepanam, bandage and physiotherapy was
discontinued

24th day -28.03.2016
• Frequency of stools -2
• Stopped nannarichurnam with nagaparpa, sankhaparpa,
velliparapa and tiripalakarpa . same diet was followed
with same treatment schedule

25th day-29.03.2016
• Frequency of stools- 2
• Same treatment schedule was continued

26th day – 30.03.2016
• Frequency of stools -2
• Same treatment schedule was continued along with
• Manasamithravatakam 2 hs

27th day -31.03.2016
• Frequency of stools-2
• Weight -39 kgs
Patient got discharge medicines
1. Vilwadigulika 2 bid
2. Dadimashtakachurnam for kashayam 50 ml+ 1 tsf honey bid
3. Cap bactifer 1 bid
4. Dadimadigritham 1 tsf +kalyanaksharam 1 tsf as frequent
doses
5. Guggulupanchapalachurnam for kashayam 50 ml bid +1 tsf
honey
6. Rasaghandhimezhu 1 bid (continuously for 21 days and to
be stopped after that)
7. Kashayam with kudajabeeja +kudajatwak+ mustha +ativisha
+aswagandha +1 tsf honey
8. 10 g nannarichurnam boiled in 1.5 glass water and reduced
to 1 glass and add 1 nagaparpa ,1velliparpa, 2
tiripalakarpa twice daily
9. Siddamakaradwajam 1 bid with betel juice and honey
10. Manasamitravatakam 2 hs
11. Vincal liquid 1 tsf bid
12. Triphalachurnam 1 tsf with half glass hot water at bed
time in case of constipated stools
13. Soup
14. For drinking, water boiled out of jathiphalamajja and
outer cover of pomegranate

May 2016
• Stool frequency: mostly 2/day, sometimes 1/ day
• Consistency: varies between semi solid to solid
• Colour: sometimes dark brown, sometimes light brown
• Weight :41kgs
• BP: 96/60
Medicines continued
1. Guggulupanchapalachurnam
2. Dadimashtakachurnam
3. Dadimadigritham +kalyanakaksharam
4. Vilwadigulika
5. Siddamakaradwajam
6. Tripala (if required )
7. Vincal liquid
8. Tiripalakarpa +nagaparpa +sankhaparpa +velliparpa
+nannarichurnam(re – start after one month)
9. Soup (another 3 preparations)
10. Manasamithravatakam 2 hs
11. Kashayam with kudajabeeja +kutajatwak +ativisha +mustha +
aswagaandha
12. Water made out of outer cover of pomegranate and nutmeg

June 2016
• Stool frequency: 1 or 2 times /day
• Consistency: semi – solid or solid. Gas trouble +
• Weight: 43 kgs
Medicines continued
1. Guggulupanchapala churnam +dadimashtaka churnam +
kudakappalayari+ kudaja twak+ ativisha: kashayam 2 times
in a day
2. Dadimadi gritham +kalyanaka ksharam: 2 times in aday
3. Villwadi gulika : 3 times after food
4. Siddamakaradwajam : 2 times in a day
5. Tiripala karpa + naga parpa + sankha parpa+ velli parpa +
nannari churnam: 1 time in a day
6. Aswagandha churnam : 2 times in day
7. Manasamitravatakam (mmv): 2 tab at night before sleeping
8. Vincal liquid: 2 times with goats milk or warm water
9. Soup : 30 ml 2 times in a day
10. Using boiled water with pomegranate cover or nutmeg
11. Add chapathi in diet

July 2016
• Frequency: 1 / day mostly
• Consistency: normal or semi solid
• Gas and bloating: sometimes
• Problem falling asleep: some times
• Knee pain: mild
• Periods: regular (on times)
• Current weight: close to 45 kgs
Medicines continued
1. Guggulupanchapala churnam + dadimashtaka churnam+
kudakappalayari + kudaja twak + ativisha : kashayam 2
times in a day
2. Dadimadi gritham+ kalyanak ksharam: 2 times in a day
3. Villwadi gulika : 2 times after food
4. Siddamakaradwajam : 2 times in a day with betel juice
5. Tiripala karpa + naga parpa + sanka parpa + velli parpa +
nannari churnam : 1 time in a day
6. Manasamithravatakam (mmv): 2 tab at night before sleeping
7. Vincal liquid : 2 times with warm water

August 2016
• Frequency: 1-2 per day
• Consistency: semi solid / loose
• Gas and bloating: better
• Problem falling asleep: sometimes
• Knee pain: better
• Periods: regular (on times)
• Current weight: 45.5 kgs
Medicines continued:
1. Guggulupanchapalam churnam + dadimashtaka churnam +
kudakappalayari + kudajatwak+ ativisha : kashayam 2 times
in a day
2. Dadimadi gritham + kalyanaka ksharam : 2 times in aday
3. Villwadi gulika : 2 times after food
4. Siddamakaradwajam: once per day with betel juice
5. Vincal liquid: 2 times with warm water