WhatsApp Discussion Series 38: Gluten-enteropathy v/s Grahani by Dr. Ashwini Kumar Sood, Dr. D. C. Katoch, Dr. Mayur Surana, Vd. Bhooshan Bhakkad, Dr. Pawan Madan, Dr. Subhash Sharma, Dr. Anupama Patra, Dr. Pankaj Chhayani, Dr. Ravishankar Khatri, Dr. Radheshyam Soni, Dr. Shivali Arora and others.

[5/17, 7:03 AM] Ashwini Kumar Sood Dr:

A 7yrs old male boy has a complaint of passing mucoid stools after major meals . 6 weaks of treatment with chitrakadi , baeladi churanam , pranda parpati didn't show any significant improvement and was found to be gluten positive. Please advise treatment for this pt.

[5/17, 8:44 AM] Ravishankar Khatri Dr: 

Go for tissue transglutaminase (tTG) test to rule out celiac disase

[5/17, 8:46 AM] Ravishankar Khatri Dr: 

Keep the pt on Mdhuyasti churna 100mg/kg and kutaz parpati

[5/17, 8:53 AM] Trivendra Sharma Jpr: 

Saunf ark dena hai 4 -4-4-4 chammach khane k pahale barabar pani milak . 

Dadimashtak churna dena hai 1/2 - 1/2 chammach khane k baad . 

Lavan Aur kshar k yog nahin dene hai ,  ense fayeda nahin hoga .

[5/17, 8:44 AM] Ravishankar Khatri Dr: 

Go for tissue transglutaminase (tTG) test to rule out celiac disase.

[5/17, 8:46 AM] Ravishankar Khatri Dr:

 Keep the pt on Mdhuyasti churna 100mg/kg and kutaz parpati

[5/17, 8:53 AM] Trivendra Sharma Jpr: 

Saunf ark dena hai 4 -4-4-4 chammach khane k pahale barabar pani milak . 

Dadimashtak churna dena hai 1/2 - 1/2 chammach khane k baad . 

Lavan Aur kshar k yog nahin dene hai ,  ense fayeda nahin hoga .

[5/17, 9:02 AM] rakesh nagar dr. jpr: 

Start gluten free diet..

Tablet Entrid 1-1-1

Tablet Kutaj parpati vati 1-1-1,

With buttermilk.

Shubhra bhasma 125mg,

Godanti 250mg,

Tankan 125mg,

Guduchi satva 250mg,

Panchkol 250 mg,

Dadimastak 1gm.

With Syp Septilene 2Tsf three times.

[5/17, 10:56 AM] Bhushan bhakad Vd. Nasik: 

Yes , lavan yog nhi..

Sanjivani vati can be added.. 

Pishtanna(पिष्टान्न) band.. advice laghu supachya bhojan, 

Ardhodak or padavshist jal as per dosh. Kshudha se adha hi khana Lena hai..

[5/17, 11:13 AM] ‪+91 70156 59098‬: 

Stop gluten diet n start balcharbhadra churna +

Syp Amydiofort (Aimil)

[5/17, 1:38 PM] Dr. Dharmendra Sharma Indore: 

1. Ras pipari 125 mg+ 

kutaj parpati 125 mg+

 jahar Mohra khatai pishti 125 mg+ mustak cap 1..... 

With bilagyl (sandu) thrice a day..                          

 2. Syp. Autozyme 2 tsf twice a day. 

Avoid gluten-free diet..

[5/17, 1:45 PM]Dr. Dharmendra Sharma Indore:    

Stop junk food & fast food...

following grains and other starch-containing foods are naturally gluten-free:

Rice.                 Cassava.                 Corn (maize).           Soy.                      Potato.              Tapioca.              Beans.             Sorghum

[5/17, 2:24 PM] Dr Surendra A Soni: 

Gluten free is the only solution forever...??

[5/17, 2:25 PM] Jagdish Nama Dr:

 Bibhitak churn-2gm

Balsudha-250mg

For 15 days two time in a day

 No more medicine apply in this case

Diet as advise

 According to growth

And age

Automaticaly solved the problm in many cases

[5/17, 2:31 PM] Vd Ranga Prasad Ji Chennai: 

Shunthi churnam with  takra

+ Bhaskara lavanam.

[5/17, 2:43 PM] Ashwini Kumar Sood Dr: 

A term non celiac gluten sensitively is also recognised which means not all pts with gluten sensitivity are suffering from celiac disease. Celiac disease is difficult to treat autoimmune disorder with extra intestinal features. In general practice no. of pts with non celiac gluten sensitive pts are more.  So interest in the treatment is naturally more as it's symptoms are similar to SANGRAHNI  so called IBS but pts do not respond to this conventional treatment of SANGRAHNI . So you are requested to inform a rx of non celiac gluten sesitivety and if possible what to administer that pt  he can have wheat etc in later life after treatment.

 That for showing concern in my above query.

THANKS

[5/17, 3:00 PM] Vd Ranga Prasad Ji Chennai:

 Agni need to be addressed and corrected. 

Only hence *Shunthi churna with takra* was suggested.

[5/17, 3:04 PM] Dharmendra Sharma Kb: Correct..

[5/17, 5:31 PM] Parul Ben Joshi: 

Child is too young diet restrictions

Heated water

Cleanliness measures like washing hands before food / drinks, legs on returning home

Dadima Dana/Tvcha/Dried powder+Phudina+Ajwayan

Takra prayog if possible: it's summer anukul kal.

[5/17, 6:26 PM] Dr. Sagar Bhide BVV:

 Sir

aapne batae iss symptoms aur anupshaya ke mutabik mera ye manna he ki 

Is ko agni thik karne k liye sunthi (summer hone ki vajah se) de sakte he aur kutaj parpati dena chahie.

[5/17, 6:27 PM] Dr. Sagar Bhide BVV: 

Actively sirf mung aur chaval pe rakhna chahie

 Mebarid syp S G Phytopharma ki aati he

 1tsp tds

Aur mene personally esa patient nahi face kiya he 

To ye sirf mera anuman he

Off course gluten free diet should be given

Jyada mahiti ki apexa sah 😊 !

[5/17, 6:32 PM] Bhushan bhakad Vd. Nasik:

 I think no.. ayurved view se laghu ahar diya to Apne aap sab ho jayega.. 

 Grahani can be cured, specially in children its sukh sadhya..

Krumi should be think apon as a d.d.

 I think potato can't be given if one thinks ayurved point of view, cause its guru.. 

Vidvan Jan Prakash daliye

[5/17, 6:37 PM] pawan madan Dr: 

Good evening all. Nice discussions. Thank u dr Katoch ji And surendra ji.

 we really need to think about cases like gluten sensitivity. Practically in most of the cases the Nidaan is one or the other type of Grahni but eventually there are no signs or symptoms of agnidushti. Thats why the chikitsaa sutra of grahni like agni deepan doesnt work. Even the principle of graahi and stambhan according to the stage of the patient dont work. I request the ayurvedic Gurujan here to kindly guide us - how to make a chikitsaa sutra for such cases ?

 aur agar gluten free diet hi dena hai fir to kisi khaas treatment ki jarurat hi nahi rahati.

[5/17, 6:41 PM] Arvind Aggarwal Dr. Physiology: Right !

[5/17, 6:43 PM] Jagdish Nama Dr: ✅

[5/17, 6:47 PM] Ashwini Kumar Sood Dr: 

True if gluten free diet is only option then why give KUTAJ like bitter medicines to the child. The pts are allergic to GLUTEN , to combat gluten what we have to offer as anti allergic.

[5/17, 6:48 PM] pawan madan Dr: 

yes true....okk....we can do gluten free diet for few weeks ....but not for whole of the life as far as treatment is concerned.

[5/17, 6:48 PM] pawan madan Dr: 

Gluten sensitivity (also gluten intolerance) is a spectrum of disorders including celiac disease in which gluten has an adverse effect on the body. Symptoms include bloating, abdominal discomfort or pain, diarrhea, constipation, muscular disturbances, headaches, migraines, severe acne, fatigue, and bone or joint pain.

[1][2] Wheat allergy and gluten sensitivity are not the same conditions.

However, self-reported Non-Celiac Gluten Sensitivity (NCGS) may not be a discrete entity or part of this spectrum disorder bringing its role in functional bowel disorders like irritable bowel syndrome into question.

[3]Gluten, named from the Latin gluten meaning glue,

[4] is a substance that gives elasticity to dough helping it to rise and to keep its shape. It is found in many staple foods in the Western diet. It occurs in wheat and other grains, including barley and rye, and in foods or drinks derived from them, but not in corn, rice, or oats. Gluten is a protein composite consisting of a gliadin fraction (alcohol soluble) and a glutenin fraction (only soluble in dilute acids or alkali).  

                                                                      .....copy pasted

[5/17, 7:28 PM] D C Katoch sir: 

So many prescriptions with multiple formulations not consistent with each other have been suggested by the experts- perhaps without recognizing the underlying pathological process as well as the age of the patient.    The case seems to be of 'Asatmyaj Grahani Dushti' resulted from ingestion of so called gluten i.e. a sort of Garvish. I feel the case can be effectively managed with bhrist jeerak churna, takra, dadim ras and diet of peya/ vilepi /yavagoo for 3-5 weeks providing physiological rest to digestive tract  (particularly Grahani part) to restore its normal functions.

[5/17, 7:29 PM] Sandip Verma Dr: 🙏🙏

[5/17, 7:47 PM] Pankaj Chhayani dr ndyad:

 👌 👌 Shunthi Ghrita is also good. Takra should be सधस्क एवम् अविदाहि .

I have found very good result of Pippali , even in autoimmune conditions too.

[5/17, 8:11 PM] priya-ranjan tiwari Dr.: 

grahani chikitsa me kaha gaya hai ki 1 aam pakva pareekcha.2 yadi rukcha padarthon ke sewan se grahni dosh utpann hai to aushadh sidha ghrita tatha sneha ke ati dewan se grahni dosh utpann hai to rukcha yatha aasav arisst etc.

[5/17, 8:11 PM] Anupma Patra AIMS AYU: 

U r right sir. As per my understanding there is no such diseases as per ayurveda where the most pathya diet like yava,wheat should be restricted life long. This may be as per modern science because they have only limited medications. If we try to findout the original diagnosis of it and follow accordingly then definitely a permanent solution without any permanent diet restriction may be achieved.

I think it may be kaphaj atisaar also or just a mother induced problem. Usually due to lack of proper knowledge, Indian mothers force their children to take diet without their willing ness which results into such problem. 

So proper counselling about diet habits is essential.

I ve seen very good response of simple jaiphal or even mustak with honey or bal chaturbhadrika  with proper diet counseling in such cases. Sorry I never thought about the existence of gluten intolerance in Ayurvedic perspective.

🙏🙏🙏

[5/17, 8:26 PM] pawan madan Dr:

Dhanyvaad. 

Aapne jo bataaya wo sab agni pradeep and agni corrective measures but sir I really want to emphasize here that giving many sch chikitsa we dont get desired results.

Have used  many regimens but in vain...

Thats why I requested to discuss samprapti.

Your suggestion of garavisha is very appealibg and practical but then *how to make the body so capble to fight with such garavisha or dooshivish factors* ...this remains a big question.

Please guide us or give some clues so that we can further search for its management.

[5/17, 8:30 PM] Prof. R. K. Chulet Sir Nia: 

One more option 

Use -पलाशादि पानीयम् 

यवागू तैश्च साधयेत् ---ग्रहणी चि.

औषधान्नविहाराणाम् --उपयोग: सुखावह :

यही पर्याप्त है , सुविधा जनक भी !

[5/17, 8:33 PM] D. C. Katoch sir:

 Please refer to the medicinal properties of the items I mentioned in the post to understand how these could benefit the patient gluten intolerance.

[5/17, 8:35 PM] pawan madan Dr: 

Okk....will revert after refering.

[5/17, 8:35 PM] Ashwini Kumar Sood Dr: 

इस रोग की चिकित्सा असात्मज गृहणी दुष्टि को लेकर करना उचित प्रतीत होता है !

[5/17, 8:36 PM] Katoch sir: 

Ayurvedic principles are simple and mathematical but not understood clearly by many.

[5/17, 8:59 PM] Namrata Sharma  Dr: 

gluten sensitivity को रक्त धातु का शुद्धि करने वाली औषधियों जो कि विरेचक न हों जैसे कि केवल मंजिष्ठा या अन्य कोई औषधि देने के बारे में आप सब क्या सोचते हैं???

मुझे अनुभव नहीं है आप सबकी राय जानना चाहती हूँ।

Gluten insensitivity एक प्रकार की अल्प विषाक्तता जैसे लक्षण पैदा करती है जैसा कि ऊपर किसी के विचार हैं दूषी विष के संदर्भ के।

[5/17, 9:03 PM] Radheshyam Soni  dr: 

यदि इस प्रकार की ग्रहणी को दूषिविष जन्य माना जाए तो क्या फिर श्रेष्ठ विषघ्न के रूप में कोई स्वर्ण योग यथा स्वर्णपर्पटी का उपयोग समीचीन नहीं होगा !

[5/17, 9:16 PM] Dr Surendra A Soni: 

Great interpretation Katoch Sir. Summarised the whole management for gluten pathogenesis.

Gluten that is protein mainly found in Godhooma (गेंहूँ) should be considered as a sort of Garavisha....? Can we say that it is acting as a Garavisha due to impaired function of Agni..?

 As I have no experience in treating such cases so can't suggest/say anything. 

Gluten may be taken as *Guru gun based substance* that is not being digested by Agni. It may also be understood as per kaphaja atisar. Almost all experts responded accordingly, I think. Please correct if I am incorrect.

🙏🙏

[5/17, 9:29 PM] Dr. Pankaj B. khedkar: 

Please note-

Gluten sensitivity is an autoimmune like condition which is moreover self limiting.

Seen some cases but it may not be sufficient data to share.

But, instead; 

Sharing an article on Gluten-

Published in American Journal of Cardiology 

Available on NIH website too.

Proceedings (Baylor University. Medical Center)

Baylor Health Care System

Gluten sensitivity: new epidemic or new myth?

David T. Nash, MD and Amy R. Slutzky, PhD, MSLIS

Additional article information

Abstract

Fueled in part by recent bestselling books that warn of the evils of gluten in our diets, a significant proportion of our population is now either avoiding foods that contain gluten or eliminating gluten entirely from their diets, and these numbers continue to grow. The gluten-free trend—and the accompanying multibillion-dollar industry it has created—stems from the spreading belief that eating foods containing wheat or other gluten-laden grains may not only result in weight gain and obesity, but can also lead to a laundry list of ailments ranging from depression and anxiety to arthritis and autism. One popular book contends that current recommendations for a high-grain/low-fat diet underlie much of today's chronic health problems and that a low-carbohydrate, high-fat/cholesterol diet is ideal. Every major change in our diet carries with it the possibility of unforeseen risks. Concern about the impact of such popularized dietary recommendations on overall well-being—and on cardiovascular health in particular—warrants discussion in the medical community.

Fueled in part by recent bestselling books—and the television talk shows and celebrity endorsements that accompany them—that warn of the evils of gluten in our diets, a significant proportion of our population is rapidly changing its eating habits. Approximately 30% of all Americans are now either avoiding foods that contain gluten or eliminating gluten entirely from their diets, and these numbers continue to grow (1). The gluten-free trend—and the accompanying multibillion-dollar industry it has created—stems from the spreading belief that eating foods containing wheat or other gluten-laden grains may not only result in weight gain and obesity, but can also lead to a laundry list of ailments ranging from depression and anxiety to arthritis and autism.

In the book Grain Brain, for example, the author, David Perlmutter, lists dozens of diseases and symptoms that he believes are all related to gluten sensitivity and thus may be prevented or cured by a gluten-free diet. His list includes 38 different diseases or symptoms, including autism, infertility, and schizophrenia (p. 67) (2). He asserts that a low-carbohydrate, high-fat/cholesterol diet is ideal not just for those afflicted with celiac disease, but for most of the rest of us, as well. According to the book, “the alleged correlation between higher cholesterol and higher cardiac risk is an absolute fallacy” (p. 72), and the author entreats the reader to “start swapping out your daily bread with butter and eggs” (p. 12). Further, he charges that our nation's glorification of a high-grain/low-fat diet underlies today's epidemics of obesity, memory loss, and other common chronic illnesses, all of which is supported by uninformed physicians and a rapacious drug industry. It all makes for eye-catching reading and causational rhetoric.

A response is required.

The declaration that a single, simple “cure” can successfully treat numerous diverse diseases and symptoms is reminiscent of the oratory of the “snake oil” merchants of generations ago. These doctor-showmen plied their craft centuries ago in the sparsely populated areas of the American frontier and were known for their elixirs or “miracle cures” (which often included alcoholic admixtures of various nostrums). Of course, this was long before the development of placebo-controlled, randomized clinical trials, which have become the mainstay of proof of efficacy and safety in our modern era of health care.

According to Grain Brain, much chronic disease originates in the widespread ingestion of carbohydrates, and these foodstuff, rather than cholesterol or saturated fats, are the premier contributor to an unhealthy individual. Numerous recent studies, however, have provided high-level evidence to the contrary. A recent systematic review found several prospective cohort studies that demonstrated a relationship between consumption of saturated and trans fats and cognitive decline (3). A prospective study of a large heterogeneous population reported that a high-fat diet increases risk of specific breast cancer subtypes (4). A meta-analysis of 16 prospective cohort studies found that “higher consumption of fruit and vegetables [all containing carbohydrates] is associated with a lower risk of mortality from all causes, particularly from cardiovascular mortality” (5). Likewise, a multisite randomized controlled trial found that a low-fat, plant-based nutrition program reduced cardiovascular risk factors (6). Evidence-based findings such as these have led international panels to issue guidelines that recommend minimizing intake of saturated fats and trans fats and including whole grains as a primary staple of the diet (7).

Flaws in the arguments presented in the book have not entirely escaped the notice of health care professionals. Some have spoken up, calling the book “comfortably simplistic” (8), one of “brawn, not brain” (9). Others have charged the author with ignoring “the bulk of science,” exaggerating the truth, and making false assumptions (10), and have noted that the book makes claims that are contrary to “what some pretty reliable sources have to say,” referring to recommendations from the World Health Organization and Consumer Reports (11). Yet, the book remains a New York Times bestseller after 43 weeks, and sales of gluten-free products are projected to grow at an annual rate of 10.2% over each of the next 5 years (12).

Every major change in our diet carries with it the possibility of unforeseen risks. Many readers—the general public, as well as medical professionals—accept what they read at first glance. Myths have been part of our medical lore for millennia (13). Those jumping on the gluten-free/high-fat bandwagon may be disappointed when their symptoms are not mitigated; more critically, they may be at increased risk for other, more dangerous ailments. At the very least, concern about the impact of encouraging a high-cholesterol, high-saturated-fat diet warrants discussion in the medical community. In short, it is time to review some of the most egregious misinformation being spread and separate some of the wheat from the chaff.

Acknowledgments

The authors wish to acknowledge the invaluable efforts of Jim Capodagli, MLS, and Rachel Mondo.

Article information

Proc (Bayl Univ Med Cent). 2014 Oct; 27(4): 377–378.

PMCID: PMC4255872

David T. Nash, MD and Amy R. Slutzky, PhD, MSLIScorresponding author

From State University of New York Upstate Medical University, Syracuse, New York.

corresponding authorCorresponding author.

Corresponding author: Amy R. Slutzky, PhD, MSLIS, Health Sciences Library, SUNY Upstate Medical University, 766 Irving Avenue, Syracuse, NY 13210 (e-mail: ude.etatspu@aykztuls).

[5/17, 9:35 PM] Arvind Aggarwal Dr. Physiology: 

Godhuma ko pathya bataya gya h fir bhi agar iske sevan se agar kisi bhi prakar ki vyadhi ho rhi h to jaruri to nahi ki gadbad sharir me hi ho... Gadbad godhuma ke production, collection, storage, consumption etc me bhi to ho sakti h 

[5/17, 9:49 PM] pawan madan Dr: 

Gluten senitivity ncludes many many systemic symptoms.

[5/17, 9:51 PM] pawan madan Dr: 

Kahte hain ke vaman virechana se sharer ka shodhan ho jaataa hai.

Kyaa is sanshodhan.se garvisha ko sharir se baahar nikaalaq ja saktaa hai ??

[5/17, 9:51 PM] Dr. Pankaj B. khedkar : 

Yes. All symptoms fall under the immune disorders.

[5/17, 10:12 PM] Prof. Daya Shankarji Mishra: 

आप सीलियक डिजीज को पैत्तिक ग्रहणी मान कर चिकित्सा करें, मै दो रोगी देखे हैं और सफलता भी मिली है. !

[5/17, 10:24 PM] Anupma Patra AIMS AYU: 

कहीं जौ, गेहूं आदि के बहु वर्च या सर गुण जैसे स्वाभाविक कर्म को मॉडर्न वाले ग्लूटिन इनटॉलेरेंस तो नहीं सोच रहे हैं ????

[5/17, 10:26 PM] Dr. Pankaj B. khedkar: 

Let us know your experiences time to time.

Like to understand.

[5/17, 10:42 PM] Arvind Aggarwal Dr. Physiology: 

May be the vaikrita godhuma is having excess SARA guna (w.s.r. to GI).

[5/17, 10:43 PM] Arvind Aggarwal Dr. Physiology:  

informative article Dr Pankaj Sir !👌👍

[5/17, 10:44 PM] Pankaj Chhayani dr nadaad: 

Should be checked if there is intolerance of only Navina Dhanya or both(Navina and Purana),as both are different.

[5/17, 10:46 PM] Anupma Patra AIMS AYU:

 Ye bhi ho sakta hai normal gehun ke normal sara gun ho aur paittik prakriti ke aadmi jyada iske sevan se aur bhi motion jyada ho rahi ho??

Isiliye humaare diet ko prakriti ke hisaab se nirdharan karne ko kaha gaya hai.🙏🙏

[5/17, 10:48 PM] Arvind Aggarwal Dr. Physiology: 

But GI is not so common as Paittik Prakriti.

[5/17, 10:48 PM] Anupma Patra AIMS AYU: 

Saath mein masale daar khana tatha garam godugdha sevan ka habbit ho.

[5/17, 10:49 PM] Arvind Aggarwal Dr. Physiology: 

But madam ye factors population me bahut common hai aur aise sabhi logo ko GI/GS nhi h.

[5/17, 10:50 PM] J K Pandey Dr. Lukhnau: 

Sir if gluten is garvish,then it should affect all..bt it affects few.? If agnimandya is reason then why all other  type of food except wheat r well digested and tolerated...due to mand agni a permanent feature of ajeerna must be there,.bt generally only products containg gluten cause diarrhea etc,,so agni doesnt seem to be only factor,,

if we assume gluten as guru gun pradhan,,then all guru padarth pishtann,.ghrit,dadhi..madhur ras padarth should behave same ?

[5/17, 10:51 PM] Arvind Aggarwal Dr. Physiology: 

It means body of some peoples is not accepting the gluten !

[5/17, 10:52 PM] Anupma Patra AIMS AYU:

 Sir mere samajh se humein phirse is prakriti ke najar se dekhna padega. Ho sakta hai hum us soch se history nahin liye hein ?

[5/17, 10:53 PM] Arvind Aggarwal Dr. Physiology: 

In the cases of GS, Vikriti sharira me mani jaye ya aahar me ?

[5/17, 11:00 PM] pawan madan Dr: 

There are few things which may act as garvish  at one time  but normal otherwise.

[5/17, 11:02 PM] Anupma Patra AIMS AYU: 

As per my opinion, Vikriti na sharir mein hai na ahaar mein yaha prakriti hi hai jisko hum vikriti samajh rahe hein. Is case mein raat ko hi wheat ya barley item prefer kiya jaaye tatha mung daal, masura daal aadi grahi aahaar ko samavesh karke patient ke problem ko solve kiya ja sakta hai.🙏🙏

[5/17, 11:02 PM] pawan madan Dr:

 All valid points..

...if agimaandya is there ..it ahould not be only for wheat

...guru gua point...✅

[5/17, 11:03 PM] J K Pandey Dr. Lukhnau: 🙏

[5/17, 11:03 PM] pawan madan Dr: 

Sara guna here doesn't always mean that it will increase peristalsis always.

[5/17, 11:05 PM] Anupma Patra AIMS AYU:

 Sir ye practically bhi dekha jaata hai. Jinko constipation rahta hai. Gehun ki roti khaane se motion thik ho jaati hai.

[5/17, 11:05 PM] Bhushan bhakad Vd. Nasik: 

Though godhum is pathya, ham use pishta kar ke khate hai and today's era due to machinary extra fine aata hota hai jo pachne me guru nd less fibrous hota hai comapred to traditional ghatti pe ghar me jo aata banaya jata tha. 

So prblm godhum me nhi, pishtanna me hai. 

Usi godhum ki thuli pachane me roti se laghu hoti hai.

[5/17, 11:06 PM] pawan madan Dr: 

Fir.....ye pishtaanna hai .....to kewal kuch percent logo me hi kyu ??

[5/17, 11:08 PM] Arvind Aggarwal Dr. Physiology: 

Kya GS wale pts ko sahi quality ki, sahi guno wali gehu se sahi kalpana kar ke sevan kraya jaye to result milega ?

[5/17, 11:08 PM] Radheshyam Soni dr: 

चरक अनुसार नित्य सेवनीय में गोधूम नही है ।

[5/17, 11:09 PM] Bhushan bhakad Vd. Nasik:

 Unka Agni and Grahani achi nhi hai na.. 

Agr gluten is the only problem then every person should suffer.

I think fault person/ patient me hai, ahar me nahi.

[5/17, 11:09 PM] J K Pandey Dr. Lukhnau: 

Can we give whole wheat to eat and then observe if gluten affects?

if cause is gluten it will affect weather as flour or whole wheat grain

so we eat pishtaann of wheat or coarse flour wont change gluten sensitivity.

[5/17, 11:10 PM] Bhushan bhakad Vd. Nasik:

 Nahi hi hai, Aur Hoga bhi nahi.. 

[5/17, 11:11 PM] Mayur Surana Dr. : 

Lot of things needed to be considered...

First and foremost--Nava dhanya abhishyandi, early harvesting-ripening leads to further increase in abhishyand guna...

So wheat esp.should be 1 year old/yukti bharjit...

Also whatever is satmya in 3-4 generations to us is ideal for us...if we are used to wheat then wheat, if bajra then bajra ...

Ideally this staple food of generations mustn't be changed...if at all required to change--not to be changed abruptly but by padanshik krama...

Therefore though godhuma, madhu etc are nityasevaneeya, jati and desh satmya need to be considered...interestingly in nitya sevaneeya vaagbhat includes godhuma but Charak has not included it...

[5/17, 11:12 PM] Bhushan bhakad Vd. Nasik:

 Sorry sir, me gluten, etc chijo ka Jada load nhi leta mere practice me.. ayurved ki sochta hu. 

Mera thesis tha Grahani pe, nd roti Sare patients me band hi karta hu me Grahani wale. , found g8 improvement.

[5/17, 11:13 PM] Mayur Surana Dr.: 

अनुपानं हिमं वारि यवगोधूमयोर्हितम्..

(Ashtanga)

[5/17, 11:14 PM] Bhushan bhakad Vd. Nasik: 

But I think whole wheat also can cause prblm if Agni mandya/ hamperd. cause wheat is guru bruhan...

[5/17, 11:15 PM] Radheshyam Soni dr: 

अतः नित्य सेवनार्थ अन्न का चयन शालि धान्य या यव के रूप में होना चाहिए। गेहूं को पथ्य नही माना गया है चरक संहिता के अनुसार।

इसलिए गेहूं से इस प्रकार की विकृति होना कोई विशेष बात नहीं। उसे पथ्य भोजन के रूप में शालि, ब्रिहि यव, बाजरा आदि अन्य विकल्प उपलब्ध हैं। और 13-14 वर्ष की आयु के बाद रोगी के गेहूं खाने व पचाने योग्य अग्नि उपलब्ध हो जाती है और वो सामान्य जीवन व्यतीत करता है।

ऐसे 1 रोगी को मैंने निकट से देखा है। आज वो बालिका 12 वर्ष की है और उसने गेंहू खाना प्रारम्भ कर दिया है बिना किसी परेशानी के।

[5/17, 11:16 PM] J K Pandey Dr. Lukhnau:

 No sir 

I was talking about other aspect..we r discussing about possible factors of loose stools when few ppl eat wheat made eatables..

and just for naming in modern terms we r discussing gluten

other wise emphasis is on grahni only

bt then why due to wheat only,,

and if banning wheat solves all problems then no need to discuss the topic for discussions,,

here point is can we do some thing to solve the issue without bannng wheat?

[5/17, 11:16 PM] Mayur Surana Dr.: 

Yes Dr Bhushan...hence imp of pt.avastha avastha and our tradition of savatsaroshit / yukti bharjit dhanya to mk it laghu...

[5/17, 11:19 PM] Anupma Patra AIMS AYU:

 Valid point sir. 

ओडिशा आदि ईस्ट बेल्ट में दिन में राइस रात में रोटी या फिर सिर्फ चावल ज्यादा खाया जाता है। पर नार्थ  में गेहूं ज्यादा लिया जाता है। सात्म्य दृष्टी से देखा जाए तो ठीक है जब तक प्रॉब्लम नहीं होता हो। अगर प्रॉब्लम आरही हो तो डाइट पैटर्न को बदला जा सकता है।🙏🙏

[5/17, 11:19 PM] Mayur Surana Dr.: 

Godhuma ajeerna--shuddha Dhattur beej is indicated ....it may be tried...

[5/17, 11:20 PM] Arvind Aggarwal Dr. Physiology: 

Cultural practices me samayanusar roti k aate me badlav hota rehta h.... Gehu, bajra, chana etc. This is also suggestive of nonacceptance of godhuma nitya dirghkaal sevan. 

[5/17, 11:23 PM] pawan madan Dr:

 All thinks.right

Par abhi bhi itni saari discusaion se kuch khas factors nikal.kar nahi aaye.

[5/17, 11:24 PM] Mayur Surana Dr.: 

Pavan sir !

almost 10 new points have come up...how to use dhanya, when to use, jati satmya Desh satmya, antidotes, agni, avastha etc...

[5/17, 11:25 PM] Arvind Aggarwal Dr. Physiology:

 Continue the discussion.... Nichod ki aasha to katoch sir and surendra soni sir se hi hai. 😊

[5/17, 11:26 PM] Arvind Aggarwal Dr. Physiology: 

Tadvidya sambhasha gyanvardhananam !

[5/17, 11:26 PM] Anupma Patra AIMS AYU: 

Mein apne paksha mein sthir hun. Gluten intolerance karke kuch nahin hai .ho sakta hai iske piche bhi ek bada scam chal rahi ho.

[5/17, 11:32 PM] Pankaj Chhayani dr ndyad:

 I think according to A.H. it's Nitya Sevaniya, pls check it....

[5/17, 11:36 PM] Mayur Surana Dr.: 

I hv mentioned that...sir...

[5/17, 11:39 PM] shekhar singh MP: 

Percentage of GS is very low. So the possibility of scam is also very low.

[5/17, 11:43 PM] shekhar singh MP:

 एक रोगी बालक को Pediatrician ने एक वर्ष के लिए गेहूं बन्द कराया है। और आश्वस्त किया है कि धीरे धीरे खाने लगेगा।

[5/17, 11:48 PM] Anupma Patra AIMS AYU: 

Yes sir .it may be due to lack of knowledge about the normal quality of  these diet by modern scientist, that have been mentioned in ayurveda.

[5/18, 12:19 AM] D C  Katoch sir: 

How garvish can be guru? Vish is always laghu, teeksna, vyavayi, vikasi etc. But garvish being alpavegi and a sort of asatmya padarth does not cause dravibhoot atisaar but atypical indigestion with retention problem of stools due to garvishaj kshobh in the intestines.

[5/18, 2:01 AM] Vd. Subhash Sharma Ji Delhi: 

*कुछ रोगों मे मेरे अनुभव, आपका सहमत होना आवश्यक नही पर try कर लेना result मिलता है*

*आज से शायद 30 साल पहले एक एसा ही case याद है, सभी pathies की चिकित्सा हो चुकी थी तो शास्त्रानुसार एक बात याद आई कि सभी रोगों का नामाकरण जरूरी नही फिर भी सम्प्राप्ति विघटनानुसार आप निदान कर सकते हैं*

*मेरा diagnosis था जब आगंतुक कारणों से कुपित वात और पित्तदोष अनेक लक्षणों को उत्पन्न करते है और कफ अग्निमान्द्य कर व्याधि क्षमता को कम कर के उदर में जीर्ण और दारूण व्याधि उत्पन्न कर मल को अनेक बार , कदाचित आंव युक्त, अनेक बार, पीड़ा युक्त या रहित और अनेक लक्षणों से पीडित कर लाते है तो उसे आगंतुक संग्रहणी कहते हैं*

*इसके पीछे कारण ? हम लोग ग्रन्थों मे तो कारण ढूंड रहे है हैं पर समय बदल चुका है।लोगों ने जानवर भी घरों में पाल रखें है, कुत्तों को भी gluten allergy होती है , जिस patient की मैं बात कर रहा हूं मैने उस से से यही पूछा था कि तुमने कोई कुत्ता तो नही पाल रखा और उसका जवाब था हां, जो उसका मुंह भी चाटता था और साथ में सोता था lips to lips उसको kiss भी करता था। जैसे ही वो उस जर्मन शेफर्ड को दूसरी जगह छोड़ के आया तो उसकी तकलीफ ठीक होती गई।*

*व्यवहार में कई रोग आपकी खिड़की पर रहने वाले कबूतर भी ला रहे हैं, आपके घर के बाहर से जाने वाला auto rickshaw या car भी ला रहा है,मेर मत इतना ही है कि उन पर भी विचार करना है ये। नही कहना कि चरक में इनका नाम नही लिखा को हम नही मानते*

*psoriasis ! कुछ हमारे विद्वान इसे किटिभ कुष्ठ में भी लेते है, मैं इस रोग की चिकित्सा नही करता क्योंकि मेरी अपनी एक range है जिन रोगों कों मैं ठीक नही कर सकता उनमें फालतू experiments नही करता, मगर suggestions जरूर दे देता हूं कि try कर के देख लो*

* मगर इस पिछले 30 साल में इस रोग के सैंकड़ों रोगियों मे पाया कि ये रोग ज्यादातर उन रोगियों में आता है जो पिछले तीन महीनों    से एक साल तक, एसे पानी में नहाऐ होते हैं जिसमे मछलियां होती हैं*

*जैसे किसी tour पर जा कर sea में या नदी या तालाब में जहां भी मछलियां होती हैं*

*मगर आश्चर्य ये मिला कि ऐसे पानी मे या सल्फर वाले मिनरल युक्त पानी मे जैसे कुल्लू के मणिकर्ण के पानी में जब रोगियों को मैने भेजा कि तीन दिन सुबह शाम लगातार इस पानी में आधा घंटा स्नान करें तो 20 से 30 दिन में patches clear होने लगते हैं और और उसके बाद तीन चार दिन sea water या मछलियों के पानी में ही नहाने के लिये कहा जाता है तो लगभग एक साल ठीक निकल जाता है*

[5/18, 6:23 AM] Katoch sir: 

One thing is sure that initially this problem is Agantuj (exogenous) not Nija (endogenous) and susequently becomes Nija.

[5/18, 6:51 AM] Ashwini Kumar Sood Dr: 👌👌👌

[5/18, 7:39 AM] Katoch sir: 

Yes, many times  Daiv Chikitsa  works well in otherwise intractable disease conditions- अचिन्त्यः हि प्रभावः

[5/18, 8:13 AM] Katoch sir: 

Appreciate your concerns. Scope of the hetu (Gluten in the current reference) to manifest disease depends upon its nature -whether Pradhanik, Viprakrisht, Sannikrisht or Vyabhichari as well as  Dosh-Dushya-Agni avastha ( biological status). Gluten may be present in wheat but it cannot induce disease in every individual, it's causativeness for enteropathy  (grahani dushti) depends on its own status vis a vis internal environment.  Without सेतिकर्त्तव्यता hetu can not produce disease.

[5/18, 8:34 AM] Dr Surendra A Soni: 

Yes Sir !

I ve also put under the question mark in my post that how a ahardravya can be a gara-visha...??

This is a contribution of modern science that they identified the basic pathology (auto-immune) at the cellular level. 

Definitely guru is causative factor. It's also true that it is mainly responsible in almost all condition in grahani. 

Either As per concept of modern auto-immunity or our concept of Agni/aam/aam-visha, we are to treat the patient as per agni-dushti due to guru guna of kapha.

Management suggested by honourable members indicates this.

🙏🙏

[5/18, 8:36 AM] Dr Surendra A Soni: 

सेतिकर्त्तव्यता 👍👍👌👌

This is ultimate. 

👌👌👏👏🙏🙏

Namo namah Katoch Sir !!

[5/18, 8:38 AM] Dr Surendra A Soni: 

Excellent observation Subhash Sir !

When regular management fails we should adopt such way of thinking to find out exact cause.

🙏👌

[5/18, 9:09 AM] Katoch sir: 

Point I made was with reference to Gluten not wheat as a whole. After all chemistry of the plant material depends on many factors. Gluten can be compared to garvish, which may  prove to be vyabhichari if fails to do its कर्त्तव्यता owing to strong internal environment (Dosh-Dushya-Agni Avastha).

[5/18, 10:57 AM] Anupma Patra AIMS AYU:

 🙏🙏🙏

Jab vidwajjan aap danon  ke nirnay ki apeksha kar rahe hein, mein bhi apne dwara uthaaye gaye sandarbh par aap ke mat sunne ke liye apeksha kar rahi hun.

 Jab kuch nirdisht aahaar(yav and gadhum and their derivatives) se mareej ko problem (mal nisaaran roopi)ho rahi hai, aur woh aahaar ayurved dristi se maal nisaarak hai. To is pariprekshi mein hum sidhe ayurved ke is gyaan ko yahaan  kyun nahin prayog kar sakte ?????

Kyun hum garvisha ki aur sochenge, jab ki gar visa ke aur koi lakshan nahin hai ?aur 7 saal ke bacche mein garvisha ke sambhavna kit na hai?

Mein bhi pahle isko vikriti soch rahi thi par jab gluten ki sawaal aayi to sochne mein majbur ho gayi ki gehun ,yav jaise  ahaar se vyadhi utpanna kaise  sambhav ho sakta hai ???

Tab jaake ye nishkarsh pe pahunchi. Jo mujhe ab 100% sahi lag rahi hai.

Isliye kripiya is sandarbh mein apna mat pradaan karne ka kast karein?

🙏🙏🙏

[5/18, 11:11 AM] Anupma Patra AIMS AYU: 

Yes ,as per A.H. it is nitya sevaniya. Where as as per charak samhita it is not counted under nitya sevaniya. Practically we are seeing problems in some cases due to nitya sevan of gadhum. I donot want to tell more about it . 

गुरुनिन्दा रुपी इतना बड़ा पाप मेरे ऊपर लगी है, इसलिए ही में अपने ऊपर से लगे पाप को धोने के लिए ये सन्दर्भ को फिरसे उद्धरण की। विद्वजन इसके ऊपर विचार कर सकते हैं। 😊🙏🙏🙏

[5/18, 11:20 AM] pawan madan Dr: 

Thats true.

*How can then we make our inner status or environemt to such a stage that nothing act as Garvish or if it has happened......how to make it  to reverse normal avastha?*

[5/18, 11:21 AM] pawan madan Dr: 

Usually all these points are needed to be keep in mind in every chikitsaa in one way or the other.

[5/18, 11:25 AM] Pankaj Chhayani dr ndyad: 

गुजरात में रोटी बनाते समय आटे को अच्छी तरह छानके गेहु के उपर का भाग (पोषण वाला)निकालके, अंदर के पिष्ट वाले भाग से रोटी बनाते है, जो बहोत ही चिकना होता है।

[5/18, 12:03 PM] Anupma Patra AIMS AYU:

 अगर फिजिकल एक्सरसाइज़ ठीक ठाक कर रहे हैं तो उतना गुरु को पचाने में प्रॉब्लम नहीं होगी। जहां तक मैंने 3 साल में observe किया है गुजरात के लोग परिश्रमी हैं। अतः वो ऐसे पिस्ट अन्न को पचा लेते हैं। 

प्रमेह रोगी में पिस्ट अन्न नुक्सान कर सकता है।

[5/18, 12:28 PM] Dr Rupinder Kaur: 

Respected vaidyas

I would like to add one more point in discussion that wheat grown these days is not the same as was in previous time. Now seeds are modified and hybrid variety is made available by Punjab Agriculture University to produce more wheat. Farmers choose these seeds on traditional one for more benifit. 

May be a cause for this disease.

[5/18, 1:53 PM] Katoch sir: 

Holistic view should be taken when we discuss any Ayurvedic  issue. We are not living in the era when Samhitas were written and it is also recognised that पाठभेद, अपभ्रंश, आक्शेप are seen in the different versions of same Samhita. Socio-geographic conditions were different when Charak Samhita and Asthang Hridya were documented. Important is to understand overall perspective and arrive at consensus in accordance with the Ayurvedic concepts of the subject matter we discuss rather than to raise doubts, ambiguities and unfounded points on what is written in the sahmitas. Things can be resolved only with consensual approach coming to the same level of understanding.  Thoughts of different experts without deviating from the Ayurvedic concepts /principles are always welcome for fruitful discussions.

[5/18, 1:53 PM] J K Pandey Dr. Lukhnau: 

Bilkul sahi Katoch sir 🙏

[5/18, 1:55 PM] shekhar singh MP: !👍👌💐

[5/18, 2:11 PM] Dr Surendra A Soni:

 👏👏👌👌🙏🙏

नमन ।।

[5/18, 2:12 PM] Prof. Daya Shankarji Mishra Sir:

 हम सभी व्याधियों को आयुर्वेद के परिपेक्ष्य में ही समझ कर चिकित्सा करें  तो अवश्य लाभ होगा !

[5/18, 2:13 PM] Dr Surendra A Soni: 👌👏🙏

[5/18, 2:18 PM] rakesh nagar dr. jpr: 👏👏🙏🙏

[5/18, 2:23 PM] Dr Surendra A Soni: 

*असात्म्यगुरु*शीतातिरूक्षसन्दुष्टभोजनात् ॥४२॥

विरेकवमनस्नेहविभ्रमाद्व्याधिकर्षणात् ।

देशकालर्तुवैषम्याद्वेगानां च विधारणात् ॥४३॥

Both asatmya and guru are the frontline causes of grahani. Asatmya may be taken as milder form of auto-immunity/allergy in GSE if all are agree. As Dr Rupinder has also pointed out the hybrid concept that must also be taken for consideration.

 honourable  Mishra Sir and Katoch Sir have given very good conclusion.

🙏🙏

[5/18, 2:24 PM] Katoch sir: आधियों को भी।

[5/18, 2:24 PM] Katoch sir: 

बहुत सटीक कहा आपने मिश्रा जी !

[5/18, 2:30 PM] Katoch sir: 

GSE के परिपेक्ष में ग्रहणीदुष्टि समझना उचित होगा न किसी ग्रहणीरोग विशेष ।

[5/18, 2:31 PM] Dr Surendra A Soni: Ji Sir

🙏

[5/18, 4:32 PM] Pradip Soni Dr: 

Celiac में यदि कुधान्य वर्ग के द्रव्यों यथा कोदो आदि का प्रयोग किया जाये तो यह जो ग्राही गुण होने से तथा पित्त रक्त व कफ नाशक होने से सरता को कम करता है !

[5/18, 4:32 PM] Dr Shivali Arora : 

Sorry for the late response... read discussion on Gluten sensitivity... very informative.. I've some points coming to my mind ... will like to discuss,please give your views.... Gluten sensitivity can be due to agnimandya  and asatmaya .. should we take history regarding weaning of the patient, use of formula milk and foods like cerelac, at what age they were introduced... can they affect Agni as it is still in developing phase... Acharya Kashyap has told to introduce fruits at six months and anna at eight months of age....

[5/18, 4:33 PM] Dr Shivali Arora : 

Some mothers are very eager and introduce cerelac even before the recommended age of 6 mths

Other thing is Oksatmaya... although Charaka has not mentioned godhuma as nityasevaniya but it becomes oksatmaya on regular use

[5/18, 4:43 PM] Dr Surendra A Soni: 

Valid point madam ! This must be taken on top priority during history taking.

I hope koumar acharyas Will say something about this issue.

🙏🙏

[5/18, 4:44 PM] Shivali Arora KC: 

Its not about the sara guna only.. gluten sensitive patients get rash on body on taking gluten, red watery eyes, some may develop breathing problems also.

[5/18, 4:48 PM] Dr Surendra A Soni: 

True.... Dr Pradip !

Another important issue...

*Availability of kudhanya...?

*Identification...? Any experience...?

*Uses...? As a diet or medicine...? How long...?

I ve zero knowledge about kudhanya.

[5/18, 6:59 PM] Anupma Patra AIMS AYU:

 🙏🙏Thank u sir for ur nice response. My point was in concern to the said history by Ashwini sir where problem was only passing of mucoid stool after major meal and no improvement was there with normal treatment. As per my understanding in such cases we should give importance to our principle of diet selection as per prakriti. Because of sara guna of gluten containing diet ,may creating problem. So diet pattern may be changed.

My main concern was diet like yav or wheat maynot be harmful  due to presence of gluten as a content. The harmful effect is coming due to improper selection of diet as per prakriti. In our literature , it has been advised to select food  opposite to prakriti  to remain healthy. This is a very good point for further study also regarding gluten.

Sir I am agree with all ur suggestions except limiting ayurveda within  samhita period. As per my opinion though it has been written in past our aaptas  were well-known about the present happening . Because it is a  chaturvidha pramaan siddha fact that ayurved is for every period ,we should also extract the maximum benefit of it through faith.

🙏🙏🙏

[5/18, 7:11 PM] Anupma Patra AIMS AYU: 

Thank u sir.  Yes sir if one take asatmya diet (without in accordance with prakriti) after long period definitely may create problem like grahani or other problem which are observed due to gluten .  We can compare it with milder form of autoimmunity or not is a matter of thinking.

Comparative clinical study needed to draw conclusion about hybrid variety.

🙏🙏🙏

[5/18, 9:20 PM] Katoch sir: 

Dr Anupama, live in present-think in present and act in present. We can take our mind to past but can not do anything to bring the past to the present. Similarly, we can take our eyes to visualise future but present can not go to future unless present thoughts/concepts are realised in the present for future use.

[5/18, 9:54 PM] pawan madan Dr:

 पर मैडम आप तो प्रक्रुति को मानती ही नही है.

[5/18, 11:38 PM] Anupma Patra AIMS AYU:

 Sir I am able to realize and visualize the present clearly in the past writing also. I cannot differentiate any new things in the present except different  way of presentation. Perhaps I am trying to explain something before time, that's why facing problem to convince others.

Sorry sir I couldnot able to change myself.

Hope in future I will be able to convince my understanding to everyone.

🙏🙏🙏😊

[5/18, 11:47 PM] Anupma Patra AIMS AYU:

पवन सर !!

 मेरा मानने या न मानने से कुछ नहीं होता है। में तो शास्त्र में जो कहा गया है उसीको बोलती हूँ। मैंने पहले भी मेंशन की थी पथ्यापथ्य निर्धारण में प्रकृति का रोल है। तथा कुछ स्पेसिफिक ट्रीटमेंट के लिए यथा अग्निकर्म के लिए। ट्रीटमेंट निर्धारण तथा मात्रा निर्धारण में है। जो की चरक में दशविध परीक्षा में स्पस्ट किया गया है।पर   ज्यादातर विद्वानों ने  डिजीज डियग्नोसिस के लिए प्रकृति को मुख्य आधार मानते है ,उसके ऊपर मेरा प्रश्न वाची है? 

🙏🙏🙏

[5/19, 7:23 AM] Katoch sir:

 आपके विचार विशिष्टरूपेण अद्वितीय व मौलिक हैं । धन्य हैं आप आयुर्वेद के प्रति ऐसी अवधारणा के लिए !!

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Above discussion held on 'Kaysampraday" a Famous WhatsApp discussion group  of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.

Email: surendraasoni@gmail.com

Mobile No. +91 9408441150