History
81-year-old resident of Mumbai, with the comoebodies of Hypothyroid, essential hypertension, with Pace maker and Angioplasty done ten years ago. Presented with complaints of intermittent episodes’ vertigo, nausea and vomiting, followed by frequent episodes of, slur speech, disorientation, could be due to Hyponitramia. He was well examined and evaluated by Cardiologist, Neurologist and ENT and gastroenterologist, even PET CT scan and Endoscopy was done to identify the cause of Vertigo and vomiting. Unfortunately, nothing was concluding.
Finally, He was diagnosed as vertigo due to vestibulopathy and treated with multiple Medicines, with no satisfactory relief. When I saw him a day ago on home visit, he looked in lots of pain, slightly disoriented with slur speech and loss of balance, falling on back direction, when asked to stand.
Further, he had full bladder as he had not passed urine or little urine since morning and said not passed stool for almost five days. He had lost considerable weight, as per the relatives. His pulse was 76 per minute BP: 130 / 70 mm/Hg and sugars were normal. Creatinine (a month ago was 1.2, on high normal range)
Treatment based on the principles of Ayurveda for Aavrutta Vata
I asked his son to apply warm castor oil on the tummy gently and give him Liquid Duphalac 20 ml after dinner and after two hours of that to give Softovac powder 10 gms with plain water and instructed him to admit if required.
Next day early morning his son called me to inform that, Patient has passed lots of urine so much so that mattresses spoiled. But more interesting thing, he passed stool in midnight, in his son’s words “Dad passed so much stool that whole commode was chocked up and could not flush out with twice pressing the flus, he (son) had to throw another full bucket to clean it. Son further added that, he had to give support to his father to take him to the wash room but afterwards, he could get up and walk easily without any support.
He felt fresh and demanded some hot tea and some things to eat at 3.30 am as he felt hunger. In the morning he got up his own, voided urine had another cup of tea breakfast and put on the TV to watch news. Became fully alert with no loss of balance or giddiness.
Discussion and Conclusion:
No-where in the modern medical literature is mentioning that constipation can cause vertigo or loss of balance neither any mentioning that, reliving constipation will solve these issues.
Based on the philosophy of Ayurveda, Such a severe constipation causes retrograde flow of Vata (an Entity in the body which controls all Neuro muscular and endocrine axis and all kinetics of the body) , it is responsible for defecation, urination, assimilation of food etc. but when its forward movement is obstructed by some object or by other component of Vata, (Total five types of Vata are preeentbin the body) it is called Avrutta Vata (I feel it is Udan Avrutta Apana) and it can cause such kind of symptoms.
The treatment for Avrutta vata is to give virechan (Purgation). But with so many complications and comorbidities and weak health, it was not possible to give Vichada, so I thought of giving modern formulations. Like Duphalac which is a stool softener and followed by a mild purgative with isabgoal and senna. And it seems that this strategy worked for him.
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