DESCRIPTION

• The liver is the largest gland that detoxifies metabolites, synthesized protein, and produces biochemical required for digestion and growth.
• Location of the liver – it is present in the right upper quadrant of the abdomen, below the diaphragm. 
• It regulates glycogen storage, red blood cell decomposition, and hormone production. 
• The liver produces bile, an alkaline fluid containing cholesterol and bile acids, which helps to break down the fat.  
• The gallbladder is a small pouch that presents under the liver, it stores bile that produced by the liver which moves towards the small intestine and the complete digestion process.
• The liver’s highly specialized tissue, consisting of mostly 70 – 80% of hepatocytes (the chief functional cells of the liver) plays a vital role in metabolism, detoxification, and protein synthesis. 
• It activates innate immunity.

CAUSES OF LIVER DISEASES

• Many diseases and conditions can affect the liver such as;
• Drugs like acetaminophen, and acetaminophen combination medications like Vicodin,
• Cirrhosis, 
• Alcohol abuse, 
• Hepatitis A, B, C, D, and E, 
• Infectious mononucleosis (Epstein Barr virus), 
• Nonalcoholic fatty liver disease (NASH), 
• Iron overload (hemochromatosis).

FUNCTIONS

• DETOXIFICATION 

• Drugs/alcohol 
• Fatty acids 
• Steroids hormones
• Ammonia – urea 
• Environmental toxins/allergens 

• METABOLISM

• Conversion of T4 into T3 
• Detoxification of fats 

• IMMUNE SYSTEMS

• Contains viruses and pathogens 

• Maintenance of the hepatic and portal vein immune system 

• PRODUCTION OF CHOLESTEROL 

• The precursor to sex hormones, vitamin D

• PROTEIN SYNTHESIS

• Blood clotting (prothrombin)
• Cholesterol transport (lipoproteins)
• Immune function (globulins)
• Oncotic pressure (albumin)
• Copper bioavailability (ceruloplasama)

• STORAGE OF MICRONUTRIENTS 

• Minerals – copper, zinc, magnesium, iron.
• Vitamins – vitamin A, D, E, K, B12

• BLOOD SUGAR BALANCE 

• Storage of glycogen

• PRODUCTION OF BILE 

• Needed for digestion
• GI anti-microbial

DISEASE ASSOCIATED WITH LIVER

Infections 

Sometimes, an infection inflames your liver. Viral hepatitis is the most common causes including:

• Hepatitis A – Highly contagious liver infection caused by hepatitis A. Most people get it by eating or drinking something that is contaminated by fecal matter. You might not have any symptoms. It usually disappears within 6 months without any long-term harm to the body.
• Hepatitis B – it is a serious liver infection caused by the hepatitis B virus. It is easily preventable by vaccine. People get it through unprotected sex or taking drugs with shared needles. It lasts for 6 months or more than 6 months, it causes liver cancer or other diseases.
• Hepatitis C – it is caused by the hepatitis C virus, this virus can cause both acute and chronic hepatitis. Hepatitis C can cause liver cancer. The hepatitis C virus is a blood-borne virus the most common mode of infection is exposure to small quantities of blood, through injection drug use, unsafe injection practices, transfusion of unscreened blood and blood products, and sexual practice that lead to exposure of blood.

Immune System Problems

The immune system fights with various bacteria and viruses. But sometimes it might go wrong and attack one or more parts of the body, such as the liver.

• Autoimmune hepatitis – this condition inflames your liver and leads to other disorders and even liver failure. Mainly occur in girls and women than boys or men.
• Primary biliary cholangitis – this condition attacks tiny tubes in the liver called bile ducts. They carry bile juice, a chemical that helps to digest food. When the ducts are injured, the bile backs up inside the liver and scars it. 
• Primary sclerosing cholangitis – in this condition scars occur in bile ducts, and it can eventually block the duct. The bile builds up inside the liver, and that makes it harder for your liver to work. It may cause liver cancer, and a person needs a liver transplant in this condition. 

Cancer and Tumors

• Liver cancer affects women more than men and it called hepatocellular carcinoma. It is more likely to occur if people have hepatitis or drink too much alcohol.
• Bile duct cancer the tubes that run from your liver to your small intestine to carry bile, a fluid that helps you digest food. This kind of cancer mainly affects people over age 50, this type of cancer is uncommon.
• Liver cell adenoma is a tumor that not cancer. It’s uncommon, but women who take birth control pills for a long time are more prone to develop it. There is a small chance the tumor could eventually turn into cancer.

Conditions You Inherit

• Inherited liver disorders 
• Hemochromatosis – in this condition body store too much of the iron from food. The extra iron store in the liver, heart, or other organs. It may lead to life-threatening diseases such as liver diseases, heart disease, or diabetes.
• Hyperoxaluria – in this condition urine has too much of a chemical called oxalate liver makes too little much oxalate due to a genetic mutation. This can cause kidney stones and kidney failure. 
• Wilson’s disease – in this condition copper build-up in the liver and other organs. Its early symptoms show between the ages of 6 and 35, most often in teen’s age. It not only affects the liver, but it can cause nerve and psychiatric problems.
• Alpha-1 antitrypsin deficiency – this chemical helps the lungs to resist infections. This protein made by the liver. Improper liver function can cause the chemical to build up and cause liver disease.

Other Causes of Liver Disease

Alcohol abuse can lead to cirrhosis. So can nonalcoholic fatty liver disease and long-term cases of hepatitis B and C.

• Drug overdoses – Taking too much acetaminophen or other medications can harm the liver. Make sure you follow the dosing instructions on the label.
• Nonalcoholic fatty liver disease (NAFLD) – this condition occurs if too much fat has built up inside the liver. The extra fat can inflame your liver. One type of NAFLD is nonalcoholic steatohepatitis (NASH). It means inflammation and cell damage in the liver.

Paralysis is a loss of strength in and control over a group of muscles in a specific part of the body or loss of muscle function .It can affect any part of your body resulting from diseases of the cerebral vasculature and cerebral contents. 

In  Ayurveda, Paralysis is correlated Pakshaghata which means “paralysis of half side of the body” where “Paksha” denotes either half side of the body, and disability of body parts and difficulty in movement is known as“Aghata ”.

Types of Paralysis

1.  Facial Paralysis– loss of strength and movement of facial muscles.
2.  Monoplaegia– loss of strength of one limb.
3.  Hemiplegia– involving one side of the body.
4.  Paraplegia– Paralysis of both legs.
5.  Quadriplegia– Paralysis of all four limbs.

Causes

• Cerebro-vascular accidents (Stroke)
• Cerebral hemorrhage
• Subarachnoid hemorrhage
• Cerebral thrombosis
• Internal carotid artery thrombosis or stenosis
• Cerebral embolism
• Venous sinus thrombosis
• Hypertensive encephalopathy
• Cerebral tumors
• Acute encephalitis
• Brain or spinal cord nerve’s impairment
• Multiple sclerosis
• Brain infections and environmental toxins 
• Peripheral neuropathy infectious or autoimmune disorders like HIV, spondylitis, Lyme disease, and   Guillain-Barre syndrome
• Nervous system disorders like Bell’s palsy and cerebral palsy
• Direct trauma to a nerve due to toxin, poison, and radiation

Risk factors

1. Age
2. Sex
3. Smoking, Alcohol abuse
4. Obesity
5. Hyperlipidemia
6. Hypertension
7. Diabetes mellitus

Clinical features

• Changes to the kidneys and gastrointestinal system
• Abnormality in muscles, joints, and bones
• Changes to circulation and respiration
• Spasticity of the limbs
• Clasp-knife type spasticity
• Muscle spasms
• Pressure sores
• Edema
• Blood clots in the lower limbs
• Skin injury
• Mobility of the hands along with finger are more affected than those of the upper arm
• Bacterial infection
• Disruption of the normal functioning of the tissues, glands, and organs
• Constipation
• Loss of control of urination
• Abnormal sweating
• Tongue is projected towards the paralyzed side (in case of facial palsy)
• Unilateral loss of voluntary functions in the affected arm, leg, and the lower portion of the face
• Abnormal breathing or heart rate
• Balance problems
• Difficulty in speaking or swallowing
• Vision difficulty

Management approaches

1. Prevention

1. Add black gram, horse gram, onion, garlic, ginger, radish, ash gourd, green gram in regular diet.
2. Use fruits like pomegranate, mango, grape, etc.
3. Consume low fat and high fiber diet and take Rasayana drugs
4. Control diabetes mellitus, heart diseases, and hypertension.
5. Take necessary treatment of hypertension (if any)
6. Control cholesterol level and weight
7. Practice regular exercises
8. Regulated consumption of processed food, packed food, refined sugars,  astringent or salty, oily  food and incompatible diet, Bengal gram, peas, and barley 
9. Avoid Excess physical exercises, extreme starvation, suppressing natural urges like thirst, hunger, and urination.
10. Avoid alcohol consumption, smoking
11. Avoid discontinuation of any daily medication without medical advice

2. Medical management

Line of treatment (Charaka Chikitsa sthana-28/100)

Nidana parivarjana (avoid causative factors) 

Handling of treatable risk factors (diseases) like high blood pressure,  encephalitis (Acute inflammation of brain), cardiovascular diseases and avoid trauma.

Samshodhana chikitsa 

Snehana (Oleation)

• Prabhanjana vimardana taila
• Kshirabala taila
• Mahamsha taila
• Bala taila
• Sahacharadi taila
• Dhanvantara taila 
• Karpasasthyadi taila

Svedana (Medicated fomentation)

• Shashtika shali pinda sveda (with shali rice, Bala Mula, Ashvagandha Mula,etc. and milk) and Patra Potli pind sweda for 14 days
• Sarvanga sveda(steaming with decoction) for  14 days.

Virechana (Purgation)  

Decoction of the mentioned herbs is helpful 

(a) Draksha (Vitis vinifera) – 10 gm,

                   or

(b)Aragvadha Phala Majja(Cassia fistula Fruit pulp) – 10gm 

                   or                        

(c) Haritaki (Decoction or powder form) – 10 gm 

                   or              

(d) Katuki  – 5 gm along with Eranda  tail – 10ml or 

only Eranda tail (Riccinus Communis oil)  -20 ml with half glass of warm milk at night 

Vasti (medicated enema) 

Matra Basti with Narayana taila 50 ml daily for 14 days 

• Kashaya vasti for 15 days with Eranda Mula kvatha – 480 ml, Taila – 240 ml, Honey-240ml, Kalka – 30 gm, Saindhava lavana – 15 gm                                              
• Kshira vasti – 400 – 500 ml for 14 days.

Nasya 

Nasya with Shadbindu taila or Anu taila  4-4  drops in both nostrils for 14 days 

Shirovasti 

Medicated oils  like  Ksheera Bala taila or Chandana Balaadi taila or maashadi  taila  can be used to perform Shirovasti regularly for 50 minutes for 14 days 

Shirodhara

Medicated oils such as Narayana taila / Ksheera Bala taila / Chandana Bala lakshadi taila / decoctions etc. can be used to perform Shirodhara daily 40 minutes for 15 days 

Churna Pinda Sweda 

In the disorders of soft tissues like muscles, ligaments ,tendons etc. churna pinda sweda is very beneficial.  Fine  or coarse powder of ayurvedic herbs is known as churna. Pinda means a bolus and Sweda means fomentation. Sudation given by using a potli which is prepared from cotton cloth by the combination of various herbal powders is called Churna pinda sweda. 

3. Yogic practices 

The following yogic practices are very useful in Hemiplegia; but, these should be practiced only under the guidance of a qualified Yoga teacher.

1. Practice of Pranayama (Nadi shodhana, Bhramari,udgeet, and meditation along with the practice of Yama and Niyama.  
2. Deep relaxation technique such as yoga Nidra
3. Asanas to be corrected for postural imbalances

Ulcerative colitis (UC) is a fiery illness influencing the huge inside (colon and rectum). In UC, the irritation is bound to the inward covering of the intestinal divider (mucosa).

When commonly symptoms of Pittaj atisaar are seen in a patient and even then he/she continues to consume pitta increases foods on regular basis. Then pitta is highly aggravated in the body it vitiates blood also and symptoms of Raktaj atisaara(Ulcerative colitis) start appearing.

Pathogenesis of Ulcerative Colitis

The excessive utilization of Paittika ahara (Pitta-exasperating food varieties) by Pitta Prakriti people and extreme utilization of Pitta–irritating regimens like wandering in sun, outrage are principle causative elements of the sickness. 

It expands Pitta in body to limitless degree which thusly vitiates both rakta dhatu and mamsa dhatu. Vata dosha (unevenness brought about by dread, tension, dry, old food, bundled food ) in the lower colon is additionally irritated and in the beginning phases impedes the Pitta and Kapha channels bringing about additional aggravation and, mucous aggregation.

In Raktaj atisaar, stool is watery and mixed with blood and there is excessive loss of water & electrolytes. Frequency of loose motions is more. Origin of disease is from large intestine (Pakvashya) and proctitis (inflammation of rectum-Guda dah and Gudapaak) is main symptom. There is a no relationship of stools with meals.

Causes of Ulcerative Colitis

• As talked about above, wrong eating routine (diet wealthy in greasy, sleek, sharp and hot food varieties) 
• Helpless sustenance 
• Weakened absorption 
• Poison amassing (Aama in body), 
• Immune system causes 
• Food sensitivities 
• Hereditary components 
• Infection in colon or rectum because of quality of microbes, infection or parasite. 
• Imbalance of the sensory system for example stress, tension, dreads. 
• Alcohol and smoking are a typical reason 
• Low insusceptibility.

Common Symptoms of Ulcerative Colitis

• Mild abdominal pain
• Mucous in the stools 
• Unexplained weakness 
• Dullness of composition 
• Exhaustion of sensory system 
• Loss of weight 
• Sharp rectal torment, (which might be of brief term and infrequent) 
• Sensation of completion in the lower mid-region.

Other symptoms of UC include:  

• Anemia due to blood loss
• Fatigue
• Fever,  Nausea,  Weight loss
• Loss of appetite
• Abdominal sounds
• Mouth ulcers
• Loss of body fluids and nutrients
• Skin lesions
• Growth failure in children

Management of Ulcerative Colitis

Suggested diet (Pathya): 

• Curd, Old basmati rice grain, moong dal, coriander, 
• Cumin, fennel (saunf), carrots, bubbled potatoes, 
• Bottle gourd, edge gourd, round gourd, 
• Green lentils, water chestnut (Singhara), pomegranate, 
• Banana, papaya, apple, chikoo, almonds (drenched and stripped), 
• Dried raisin, coconut chutney, dark grams are suggested. 

Avoid Food varieties (Apathya): 

• All extras food varieties, zesty food varieties, 
• Pungent and acidic food varieties, white sugar, pasta, vinegar, mustard, pungent and acidic food varieties. 
• Capsicum, Sarson ka saag, methi, raddish, cashew Nuts, pecans, groundnuts, sesame seeds (white until), jiggery, green chillies, ketchup, pickles, mustard oil and sesame oil. 
• Additionally stay away from crude servings of mixed greens, okra, arbi, cauliflower, grapes, mango, guava, 
• liquor, tea, espresso, milkshake, Soft beverages, cold beverage

Irritable Bowl Syndrome (IBS) is a typical condition that influences the stomach related problem. 

It causes side effects like stomach cramps, bulging, the runs and blockage. These will in general travel every which way over the long run, and can keep going for quite a long time, weeks or months all at once.

In ayurveda, Irritable Bowl Syndrome is called as ‘Grahani roga’.

The disease caused by Pitta produces decolouration of the excrement because of Ranjaka Pitta disturbance so the defecation are of somewhat blue or yellow tone, the personal stench of the individual is rank, exacerbation of Pachaka pitta causes hyperacidity bringing about heart consume and sharp burping, additionally influencing the nature of stool with the goal that it is fluid in consistency. Anorexia and loss of thirst are likewise present in pitta type grahani.

Pathology of Grahani

Grahani or IBS is set off by stomach diseases, eating undesirable food or potentially persistent pressure. 

Because of one of the causative elements, samana vata is influenced and frustrates the strength of processing and ingestion in the small digestive tract. 

The small digestive system neglects to play out its typical capacity of anna grahana (accepting food from the stomach.) 

Pachana (assimilation) and vivechana (partition of nutritive food and byproduct) is munchana (food item is pushed to the internal organ). Hence, grahani creates.

Causes of Grahani

• Excessive fasting
• Eating before the previous food is digested
• Overeating
• Eating improper foods, unwholesome food, too heavy, cold
• Eating foods that are too dry and processed
• Eating foods that are too old
• Suppression of natural urges
• Improper virechana (purgation)
• Improper oleation therapy
• Improper sleep, awake at night and asleep during day
• Anger
• Fear
• Suffering due to chronic illness, leading to lowered digestion strength
• Moving or traveling
• Seasonal changes

Signs & Symptoms of Grahani dosha

Vataja Grahani – stomach torment, expanded recurrence of stool, modified solid discharge, enlargement of the midsection, flatus, migraine, weakness, chest torment. 

Pittaja Grahani – consuming of the chest, burping, migraine. 

Kaphaja Grahani – mucousystool, impression of inadequate departure of the entrail, sickness, retching, flatus, substantialness of midsection. 

Sannipataja Grahani – each of the three dosas are included giving blended highlights of all the dosas, including absence of fixation and extreme weakness. This stage is additionally called sangrahani. 

With sangrahani, murmuring in the mid-region, exhaustion, inside with flatus or bodily fluid, consistent inclination to pass stools, discontinuous scenes and expanded recurrence of solid discharges in the daytime are normal.

Complicatons

• Untreated IBS may prompt inconveniences, for example, 
• Skin sickness 
• Sickliness (low iron levels) 
• Oedema (liquid maintenance) 
• Anorectal infection (like hemorrhoids, gap or fistula in rear-end) 
• Stomach torment 
• Stomach tumor

Management of IBS

Ayurveda trusts it is ideal to treat the main driver as opposed to the manifestations of sickness. A full ayurvedic detox (panchakarma) is essential for freeing poisons from the body and restoring colon wellbeing. Panchakarma treatment for IBS underlines cured douche (vasti), which is a colon purging treatment. Ayurvedic douches give home grown purging and sustenance straightforwardly into the digestive system and colon, without going through the stomach and upper gastro-intestinal plot. With a helpful ayurvedic purification, a purifying and mending message is sent straightforwardly to the colon. 

Panchakarma for IBS will likewise include: 

• Abhyanga (ayurvedic helpful back rub) 
• Shirodhara (warm oil treatment on temple) 
• Chakra basti (warm oil treatment around the maritime and related marma focuses)

Ayurvedic herbs suggested for IBS

Pomegranate 

Kutaja-Holarrhena antidysenterica 

Bilva-Aegle marmelos 

Musta-Cyperus rotundus 

Dhataki-Woodfordia fruticosa 

Patha-Cissampelos pareira 

Lodhra-Symplocos racemosa 

Pushkaramoola-Inula racemosa 

Chavya-Piper chaba 

Daruharidra-Berberis aristata 

Shalmali-Shalmalia malabarica

Diet for IBS Patient

Do’es

• Cook hand crafted dinners utilizing new fixings when you can 
• Keep a journal of what you eat and any side effects you get – attempt to stay away from Things that trigger your IBS 
• Attempt to discover approaches to unwind 
• Get a lot of activity 
• Attempt probiotics for a month to check whether they help 

Don’ts

• Try not to defer or skip suppers 
• Try not to eat excessively fast 
• Try not to eat bunches of greasy, zesty or prepared food sources  
• Try not to eat multiple parts of new organic product daily (a bit is 80g) 
• Try not to drink multiple cups of tea or espresso daily 
• Try not to drink bunches of liquor or bubbly beverages

• Sarcoidosis is a condition in which the growth of persistent or inappropriate granulomas or clusters of inflammatory cells.
• Sarcoidosis can occur in any organ, an estimated 90 percent of cases engage the lungs.
•  Recently, there is no cure for sarcoidosis, but some cases resolve without medical intervention.
•  Granulomas can harm organs and may require treatment. This may be the case if they start to involve a significant portion of an organ or persist for prolong period.
•  Sarcoidosis is a chronic inflammatory condition that results in the formation of persistent granulomas of inflammatory cells.
• Granulomas developed as a normal part of the immune response, but they typically break up after foreign objects have been expelled.
• Sarcoidosis involves the development of granulomas that linger when they are no longer essential.

It may be the result of an extreme immune response to an irritant or allergens, such as:

• viruses
• bacteria
• pollution
• dust
• toxins

There is some evidence to suggest certain people may be more genetically inclined to develop the condition.

Organs involved

• A large of sarcoidosis cases involve or begin in the lungs.
• The lymph nodes and glands, especially being around the lungs, are also impacted. However, sarcoidosis can damage any organ in the body.
• Though less common, cases affecting organs, such as the heart, brain, and kidneys, are often far extreme severe. Also, they can be tough to treat and may cause serious health complications.

Risk factors

 Major population depending on individual factors. These include:

• Race or ethnicity: Rates of sarcoidosis among African-Americans are supposed to be 3 to 4 times higher than white people.
• Age: Sarcoidosis most commonly affects those between 20 to 40 years of age.
• Sex: As with most inflammatory conditions, women are supposed at greater risk of developing sarcoidosis, especially over the age of 50.
• Family history: Those who have family members who have had sarcoidosis are at a major risk of developing the disease.

Symptoms

• The symptoms associated with sarcoidosis can vary drastically between individuals depending on the organ involved and the size of granulomas.
•  In acute sarcoidosis, symptoms are present for less than 2 years, and 50 percent of those affected by them will have no symptoms after that.
• In chronic cases, symptoms progress, linger, or recur for weeks or years. The concern with chronic sarcoidosis is the evolution from granulomas to fibrosis in organs, such as in the lungs.

The signs and symptoms of sarcoidosis include:

• Fever
• Exhaustion
• Pain in the joints
• Abnormal sweating
• Wheezing
• Cough
• Weight loss
• Depression
• Cough
• Shortness of breath
• Rashes on lower extremities such as ankles and shins

Lungs

• Chronic dry cough
• Dyspnea
• Wheezing
• Shallow breath – Shortness of breath or trouble in catching the breath
• Unidentifiable chest pain, usually radiating out

Lymphatic system

• Swelling or edema, excess accumulation of fluid
• Pain
• Redness
• Difficulty in swallowing
• Sore throat
• General exhaustion

Heart

• Pain, often radiating out of the chest
• Painting
• Unexplained exertion
• Palpitations with a rapid and fluttering heartbeat
• Irregular heartbeat
• Edema or swelling caused by the accumulation of fluid
• Shortness of breath or difficulty in breath

Eyes

Cases of sarcoidosis that affect the eyes do not usually cause symptoms. This means many go undiagnosed until permanent harm has been done.

• Soreness
• Redness in eyes
• Sensitivity to light
• Blurred or cloudy vision

Nervous System

• Facial paralysis or loss of facial muscle control
• Inflammation in the brain, resulting in seizures and other changes
• Meningitis symptoms, such as headache and stiffness in the neck 
• Damage to small nerves of the brain

Skin

• Erythema Nodosum, which is an elevated red rash on the shins and ankles, usually warm and tender to touch
• Nodules or growths beneath the skin, especially around scar tissue
• Skin discoloration, where some areas become lighter or darker than normal
• Lesions or sores, resulting in permanent skin damage and disfigurement, usually on the cheeks, nose, and ears

Joints, connective tissues, bones, and muscles

• Arthritis
• Loss of muscle control, tone, or power
• Loss of flexibility, comfort, or range of motion
• Generalized joint pain
• Generalized weakness and exertion

Diagnosis

Almost 90 percent of all cases are not enough for doctors to be able to diagnose them. Sometimes they may also be undetectable by radiographic devices.

Diagnosis is usually made during examinations for other health conditions, for example, chest X-rays for:

• Pneumonia
• Accidental injury
• Lung cancer

If sarcoidosis is suspected, a doctor will initiate by examining the impacted area and reviewing a person’s medical history.

Additional tests used to diagnose sarcoidosis include:

• Computerized tomography scan
• Positron emission tomography scan
• Chest X-ray to assess lymph node involvement
• Lung function tests to assess lung volume
• Examination of the eyes
• Blood tests to assess organ function or alteration, in particular, measuring kidney enzymes and markers
• Biopsies of involved organ tissues

Complications

• Heart Disease
• Blindness
• Difficulty in breathing
• Kidney damage or failure
• Muscle paralysis
• Skin discoloration

Treatment

Chandigarh Ayurved centre provides a special kit for the management of sarcoidosis, which contains Kapha powder sachet, cough go tablet, shwashari Chintamani rasa, Amrit tulsi rasa, trikatu tablet,Kapha balance tablet.

Ear pain generally occurs in children, but it can also occur in adults. Ear pain that starts inside the ear is known as primary or 1degree otalgia, whereas pain that begins outside the ear is known as secondary or 2-degree otalgia.

Generally, ear pain can originate gradually or suddenly. The pain can be sharp, dull, and can be temporary or on and off. Usually, the pain feels in only one ear, but sometimes it can occur in both ears.

Karna Roga, according to Ayurveda can be caused by one of four imbalances:

• Vata: Imbalances of Vata can cause thin discharge from the ear, dry ear wax, sharp pain, abnormal sound in the ear (tinnitus), and deafness.
•  Pitta: Imbalances of pitta leads to inflammation, yellow discharge, redness, tearing, and burning sensation.
•  Kapha: Imbalances of Kapha causes white or slurry discharge, abnormal sound, severe itching, swelling, and mild pain.
•  Sannipatataja: This happens when there is an imbalance of all doshas Vata, pitta, and Kapha; the discharge may be colored depending on the predominant dosha.

Signs and Symptoms of Ear Pain can occur with

• Fever
• Drainage from the ear
• Loss of appetite (in children)
• Excessive crying (in children)
• Hearing loss
• Irritability
• Headache
• Difficulty in chewing
• Jaw pain
• Throbbing pain
• Fussiness

Possible causes of ear pain include

• Allergies
• Blockage in Eustachian tube causing a build-up in pressure and pain
• By scratching the ear with a finger
• Middle ear infections like otitis media ( build-up of fluid in the middle ear)
• Children are more susceptible to the infection because their Eustachian tubes are smaller and straight
• Sinus infectionSore throat
• Tooth infection
• Swimmer’s ear
• Buildup of earwax
• Otitis externa ( infection of the outer ear)
• Ruptured eardrum
• Altitude pressure changes (barotrauma)
• Temporomandibular joint syndrome (TMJ, or problems with the joint that connects your jaw to the side of your head)
• Arthritis of the jaw
• Ear infections usually aren’t the main cause of ear pain in adults. Rather, the pain may stem from a problem such as TMJ.

How Is Ear Pain Diagnosed?

On basis of symptoms and history of the patient, a doctor can diagnose ear pain. By examining your ears, throat, and nose with an otoscope (an instrument) diagnosis can be made. With the help of an otoscope redness and other signs can be evaluated to find the cause of ear pain.

The otoscope can be used to see if the eardrum is moving normally or not. 

Prognosis of Ear Pain

The prognosis of ear pain depends on the cause. For example, ear infections tend to go away on their own within one or two weeks. 

If the eardrum is ruptured or damaged it is also likely to heal on its own within a few months depending on the injury. The prognosis is good except for, long-term hearing loss and problems like vertigo and giddiness can occur. 

Ayurvedic Treatment

The ayurvedic management of ear infection comprises finding the vitiated dosha and restoring it to bring balance in the body. Simple aahar, vihar, and aushadh can help manage the disease. The aahar and vihar description for the treatment of ear infection are given below:

Diet Recommendation (AAHAR)

A diet that does not imbalance the Kapha dosha, should be followed, as there is the involvement of Kapha dosha in ear problems. The following dietary guidelines must be followed: –

• Sour foods are restricted as it vitiates the Kapha dosha. These include all sour fruits and curd.
• Fruits like cucumbers, papaya, bananas, watermelons, and oranges must be avoided because these increase the chance of catching a common cold. This can increase the ear problem. All refrigerated and chilled food must be avoided for the same reason.
• Onion, ginger, and garlic should be given to the patient during ear problems.
• Turmeric also helps in treating ear infections and should be used for making meals.
•  Breastfeeding practice for infants
•  Avoid refined and processed food

Lifestyle Changes (VIHAR)

• Keep the ears warm with the help of massage.
• Massage this area while opening and closing the mouth.
• Increase the intake of Vitamin C and zinc. Vitamin C helps in combating infection by boosting immunity. Consumption of Zinc also reduces ear infection
• Avoid smoking as well as exposure to a chain smoker, since smoke can block Eustachian tubes and cause hardening
• Maintain good hygiene, avoid chilled food items. Wash your hands regularly. Avoid touching your eyes and nose unnecessarily.
• We have some beneficial Herbs for the treatment of ear infections and aches include Bael, holy basil, neem, garlic. Medicines made up of these herbs can be used to fight ear infections.
• The Shatkarma procedure, neti, i.e., rinsing of the nasal passages with a mild, saltwater solution, which removes accumulated Kapha and pollutants can also help relieve ear infection.

Karana Purana

Karna Purana word is derived from the Sanskrit word. It is an Ayurvedic procedure of instilling warm oil into the ear canals. It can be performed daily as a ritual, this self-care practice works as restoring medicine to maintain optimal health of the ears and jaw.

Ayurvedic ear cleansing can also be done in a more therapeutic sense to pacify vitiated Vata dosha due to aggravation brought on by cold and windy weather, traveling, overstimulation.

According to Ayurveda, the ears are a natural place in the body where vata resides. It is considered to be rough (harsh), highly mobile, cold, and dry, and these qualities of vata dosha are easily unbalanced through daily modern life. 

The antidote for vitiated vata dosha is Karna Purana, which balances the aggravated Vata Dosha by bringing in opposing warm, moist, and smooth.

In the following diseases, Karna Purana helps:

• Earache
• Blockage due to earwax
• Wax removal
• Hearing loss
• Swimmer’s ear
• Headache
• Migraine (Ardhavbhedhak)
• Pain in the neck
• Ear congestion
• Tinnitus
• Meniere’s disease
• Balances other body disorders
• Jaw pain
• Pain disorders
• Weakness in the acoustic nerve
• Vertigo
• General body ache
• Neurological disorders
• Anxiety

Home Remedies and Alternative and Complementary Therapies

• Many people experience earache and muffling due to sudden changes in air pressure, like when they are traveling in a plane, diving to the bottom of a sea bed, taking an elevator.
• When this happens to someone, try swallowing repeatedly, for example, by chewing gum or sucking on hard candy, this can help clear your ears. This type of ear pain is usually not permanent and doesn’t cause long-lasting problems.
• A cold compress can also help relieve earaches. For this, place a cold pack on the affected side of the ear for about 10 to 20 minutes. Hot packs also help to ease the pain.
• Stress reduction techniques and mouth guards can be helpful in temporomandibular joint disorder.
• Instead of lying flat in the supine position, try resting with your head propped up on a pillow. This can help relieve the pressure in the middle ear.

Prevention of Ear Pain

• There are some techniques you can do to decrease your chance of ear injuries and ear infections as earache is not always preventable.
• Dry your ears thoroughly after bathing, showering, and especially after swimming. Keep all foreign objects away from your ears. You can use custom-fitted swim molds while swimming. You can also wear earplugs and a bathing cap.
• Children should get the pneumococcal vaccine timely since middle ear infections are mainly caused by the bacteria Streptococcus pneumonia