Wednesday, May 18, 2016

Shitpitta (urticaria or hives) and its #Ayurvedic management

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:
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Next topic for discussion:  Shitpitta (urticaria or hives) and its Ayurvedic management
Vd. Piyush Prajapati: Shitpitta is Pitta and Kapha dosha involvement…..In shitpitta,practically Dravatva Gun of pitta increases so kapha mixed with pitta developed shitpitta..

Dr. Bhaskar B Nymathi: Sheeta-pitta chikitsa usage of "Haridra khanda" &
Amra gandhi haridra phanta (Curcuma amada) is beneficial.

Vd. Gurumahantesh: I am using haridra khanda with mahatiktaka ghruta.
And sariva kalpa

Vd. Piyush Prajapati: Laghu sutshekhar itself nice.. ..Sunthi and gairik..
Plain gairik is also nice.

Dr Premsukh: Aamali (Tamarind) 2gm, shitpit bhanjan ras 500mg, gandhak rasayan 2 tab and Haridar khanda

Dr. J. T. Contractor: Put a piece of zinger in water (matka) round the season, black pepper & zinger is an ideal combination to make decoction in treating shitpitta-kafa

Vd. Tapan: Swarjika

Dr Jayesh Patel: 1)Guduchi churn + shitpitbhanjan ras   2)Haridrakhand avleh
3) Khadirashtak kwath     4) lodhra churn for bath

 Vd Tushar Trivedi MD: Dipana pachana should be prescribed first with sunthi, musta and nagkeshar…….Nagkeshar itself pachana dravya as well as pitta shamaka………In chronic cases vamana and virechana is useful as per condition.

Dr. Bhadresh Naik: Elevan marich everyday on morning empty stomach for eleven days……..Repet every month up to six months……….Anubhut prayog

Shri Minoo parabia: Apply fresh juice of Piper betel leaves to get immediate relief. ….About three gram powder of pepper and 5g ghee to be licked with warm water. …..Sanshamani vati is an effective immunomodulator to curb such allergic manifestation.

Vd. sandeep Ahirkar: When coming in contact with cold air, a person’s Kapha or Vata may be affected easily. This in combination with Pitta Dosha spreads to the blood or Raktadhaatu and goes deep in to the blood. This is the main reason for the SthanSanshrya (relocation) on the skin and causes Shitpitta, as Urticaria to occur……. the body’s heated toxins are cleansed and pacified by the herbs. Applying several herbs on the skin helps in reducing the itchy patches on the skin.  it is essential that Panchakarma and other massage therapies are followed for noticeable effects. Few of the massages include ones like Virechen,vaman , or svedana Abhyanga have been found effective for the condition of Urticaria.
…….. Shitpita is also one udark (manifestation )of chronic amlapitaa by which ushnatwa and sartwa of pita increase which leads to shitpita when in contact with Vata here shita guna wrudhi expected

Dr. J. T. Contractor: Due to shitpitta not only nose but ears also face the problem

Dr. Rachana Mumbai: Shitpitta is an allergic condition,  As per ayurved it can undertaken as rakta dushti, due to pitta & vayu. It has differential diagnosis on basis of doshas ……But generally we manage with vata pitta shaman aushadhi and also improve rakta dushti by rakta shodhak dravyas. …….Sarivadyasava …….If there is no aamavastha than we can give shatavari ghrt Samsamni vatti, gandhak rasayan, mahamanjisthadi kadha. Many more rakta shodhak along with vata pitta shamak……Haridra khanada, histatin of kerala ayurved can be used as anti allergic and rakta shodhak both in shitpitta

Anand Javeri: What does rakta shodhak mean?

Dr. Rachana Mumbai: Rakta shodhak medicines are those which remove the impurities from blood like maha manjisthadi kadha

Dr. Anup Torane: Chapakadi agad aslo useful in shitpitta.rachana mam 👌🏻👌🏻 i m doing same treatment like u! saras(imis pharma) is also good remedies for shitpitt

Vd. Hardik bhatt, Idar: Raktmokshan is also gives good results for shitpitt ...

Germany Helga Fuchs: Virechana,

Dr. Rachana Mumbai: Sadhyo vaman can give good result
And yes virechan also can give results depending on which dosh is more

Germany Helga Fuchs: No sour or spicy food. No diary products.  Regular sleep, no night work, no extrem situation, soft walks but regular.

Dr. Bhadresh Naik: Excessive proteins diet is one of cause, Virudh ahar, Avoiding allergic factor, Psychotic factors may effects

Dr. Bhavesh Modh:
Charak including SHITPIT & UDARD  in 20 Diseases of KAFAJ Sutrasthan ch.20.
* Shitpit - VAT PRADHAN  generally occur in PRAVRUT (monsoon ) due to  food allergic reaction
*Udard - KAFA PRADHAN generally occur in Shishir  (winter ) due to environmental allergic reaction.
* UTKOTH - recurrent urticaria described by VAGHBHATT.
Recurring urticaria after active emergency treatment 12 to 24 hrs time period . generally seen  in nonveg food allergic reaction &  intestinal  worm infestation.

Urticaria - emergency management in modern medicine with anti histamine drug  (Avil, Betnesol, Adrenaline. )
Headache & dry mouth adverse effects it's.
In traditional emergency management of urticaria use Ash = રાખ / વાની.

Dr. Sheetal Sumra: First of all sheetapitta has no specific or satisfactory treatment in modern medicines.  It can be treated or  effectively managed through Ayurveda……In this all three doshas are involved…..And ras and rakta dhatu is also involved……..First of all we can can ras and rakta dhatu pachak yog………Virechan can be given..

Vd. Pankaj Chhayani: If there is h/o amlapitta then use avipatikkara…….If there is past h/o fever then   punaravartaka jvar chikitsa(Kirattiktadi kwath) should be done…………In some conditions , udarda prashamana dashemani is also used...

Dr. Bhadresh Naik:

Dr. Sheetal Sumra: Dr Pankaj and what if patient is diabetic

Vd. Pankaj Chhayani: Haridra ,tikta dravyas are useful in DM

Dr. Sheetal Sumra: Shatavari + yashtimadhu +guduchi satav can be given

Dr. Bhadresh Naik: I disagreed with Rakta dusti Only, V and k is abnormal,
Virudh ahar, Many patient use to vomiting early morning , Is one of the causes
Even after ayogya vamankarma get rid of sitpita

Dr. Sheetal Sumra: Avipittakar churna, Prawal panchamrut,

Vd. sandeep Ahirkar: In urticaria we have to think of over used of anti histamines,
Due to every time suppression its, Not in urticaria but in all kushta related vyadhis, N steroid over use also ....then we have to think like visha

Dr. Bhadresh Naik: Sarsav oil. Massage, Kala mari (black pepper) 11 pieces to be taken for11 days early morning empty stomach, Allergan granules, Sitpit, banjanras, Panchsakar churna, Avoid causative factor, Avoid wind, Cold atmosphere

Vd. sandeep Ahirkar: Sirji in morning vomiting case it's utklesha of pita. . Chronic amlpitaa………Here it's not ayoga of vamavikara………..

Dr. Bhadresh Naik: Improperly vomiting…………Even look at side effects of vaman…. Pitant vomiting is criteria for proper vaman

Vd. sandeep Ahirkar: If in ayoga of vamana whatever Snehapan we are giving to patients then dosha utklesha will happen that utkleshit dosha not getting out then it would be ayoga of vaman……….Here it's difference in chardi nidaan and vamana procedure
Dr. Bhadresh Naik:

Justification for my post………Madhanidan clearly mention
Sitpit, Koth, Utkoth…Is difficult to understand

Vd. Piyush Prajapati: I suggest only Warm Cow milk and Plain rice in Shitpitta….. I don't know reference exactly,but there is reference somewhere…..After shodhana like Vaman and virechan,if patient don't follow proper Sansarjan Kram then also Urticaria happens . In this way,panch tikta ghruta gugulu is my first choice of medicine

Dr. Bhadresh Naik: Vd prerakbhai……Please inform about vaman induse sitpit
Line of treatment

Dr. Bhavesh Modh: nd Treatment Options
Urticarial rashes are commonly known as hives. They are most commonly caused due to an allergic reaction. In Ayurveda, a condition called Sheetapitta is explained, which bears similar symptoms of Urticaria. There is no specific and satisfactory treatment in contemporary science for the condition of urticaria. But, it can be effectively managed through Ayurveda system of medicine.

Even though it is not a life threatening problem, it seriously affects the quality of life. Though not all, few of the individuals suffer from hives for months or years together and the incidences of relapse is also frequently found. Repeated intake of anti histamines or cortico-steroids reduces the immunity of the body and thus Ayurveda has a definitive edge in providing a comprehensive solution to this health problem.

Sheetapitta is a condition caused due to vitiation of all the three doshas with predominant involvement of Vata.
Dhatu (body tissues involved) – Rasa (serum) and Rakta (blood).

Sheetapitta comprises of two words- sheeta and pitta.
Sheeta means cold and pitta refers to warmth. So, it is a condition caused due to the dominance of ‘cold’ (existing in vata and kapha dosha) over pitta dosha.

Causative factors:
Excess intake of salty (lavana) and pungent (katu) foodConsumption of large amount of sour gruels (arnala & shukta)Excess intake of mustard (sarshapa sevana)Exposure to cold wind (sheeta maruta samsparsha)Contact of cold substances (sheeta paneeya samsparsha)Day sleep (Diwaswapna)Improper emesis (asamyak vamana)Altered features in winter and rainy season (shishira-varsha ritu viparyaya)Insect bite (keeta damsha)Krimi samsarga (contact of poisonous insects or bugs) etc

Pathophysiology (Origin of the disease):
Due to the above said factors, importantly, exposures to cold breeze, vata and kapha doshas are aggravated and in turn they are mixed up with pitta dosha. Further, they spread all over the body and lodge in the external surface of the body (beneath the skin) and produce reddish rashes with intense itching and pricking sensation. Thus, the condition sheetapitta, resembling with the features of Urticarial rashes is manifested.

Prodromal symptoms:
🔹Thirst (pipasa)
🔹Tastelessness (aruchi)
🔹nausea (hrillasa)
Debility/fatigue (dehasada)
🔹Heaviness of the body/lethargy (anga gaurava)
🔹Rakta lochanata (reddish discoloration of the eyes)

Clinical features:
🔹The skin marks resembling the bite of nettle sting (varatidamshtra vatashotha)
🔹Itching (kandu)
Pricking sensation (toda)
🔹Nausea and vomiting (chardi, hrillasa)
🔹Fever (jwara)
🔹Burning sensation (vidaha)

Line of treatment:
🔹body purificatory therapy (samshodhana)
🔹Oral medications (shamanoushada)
🔹Avoidance of causative factors (nidana parivarjana)

Oil massage:
Application of mustard oil all over the body.
🔹Yavakshara and saindhava lavana mixed mustard oil
🔹applicationMedicated oil prepared by the drugs of Eladi gana

External application of medicated paste:
🔹paste of Doorva (Cynodon dactylon) and Haridra (Curcuma longa)
🔹Fine paste of saindhava (rock salt), kushta (Saussaria lappa) and ghee

According to the dosha dominance,
🔹Vamana (emesis),
🔹virechana (purgation) or 🔹rakta mokshana (blood letting) are carried with suitable medicaments.

Single herbs recommended in Urticarial rashes:
🔹Guduchi – Tinospora cordifolia (Willd.) Miers.
🔹Nimba – Azadirachta indica A. Juss.
🔹Haridra – Curcuma longa Linn.
🔹Ajamoda – Trachyspermum roxburghianum (DC.) Sprague.
🔹Yashtimadhu –  Glycyrrhiza glabra Linn.
🔹Durva – Cynodon dactylon (Linn.) Pers.
🔹Gambhari – Gmelina arborea Roxb.
🔹Agnimantha – Clerodendrum phlomidisLinn. F.
🔹Amalaki – Emblica officinalis Gaertn.
🔹Parnayavani – Coleus amboinius Lour.

🔹Amritadi kashaya
🔹Amrita rajanyadi kashaya
🔹Triphala churna
🔹Haridra khanda
🔹Ardraka khanda
🔹Brihat haridra khanda
🔹Talakeshwara rasa
🔹Poornabhra rasa
🔹Manikya rasa
🔹Rajamriganka rasa
🔹Vatavidhwamsa rasa
🔹Sarvatobhadra rasa
🔹Sootashekhara rasa
🔹Laghu sootashekhara vati

👌Wholesome diet and habits for Urticarial rashes (Sheetapitta)
🔹older rice (Purana shali)
🔹Green gram (mudga)
🔹Horse gram (kulattha)
🔹Bittergourd (Karavellaka)
🔹Pomegranate (dadima)
🔹Gooseberry (amalaki)
🔹Warm water (ushnajala) etc

👉Unwholesome diet and habits for Urticarial rashes (Sheetapitta)
🔹Milk and milk products (ksira vikara)
🔹Fish (matsya)Sugar and its derivative (ikshuvikara)
🔹Alcohol (madya)
🔹Suppression of vomiting (Vamana rodha)
🔹Cold water (sheeta jala)
🔹Exposure to breeze (sheetala vayusevana) etc

& last ...
Sheetapitta (urticarial rashes) is the most common allergic skin manifestation. It is a condition which makes the individual to frustrate about the disease as well as the medicine. Most of the time we achieve mere symptomatic relief and the underlying pathology is not treated properly. Often the condition may lead to sleep disturbance, altered emotion and social isolation even. So, it is wise to approach  physician and take the treatment at the earliest.

Home remedies for Urticaria :
🔹Salt : About 12 grams of salt should be dissolved in water and taken by patient. The throat should be tickled to induce vomiting. This will help in curing eruption.
🔹Rose water and vinegar : When there is a severe itching on the eruption, abut 35 ml rose water mix with 25 ml of vinegar and applied locally to the affected area. This will give immediate relief.
🔹Mint : 7 gm of mint and 25 gm of sugar should be boiled together in about 175 ml of water and drunk. This will relieve the itching.
🔹Turmeric : Patient should take 2 tsp of turmeric powder mixed with a cup of water daily.
🔹Rauwolfia : 1 gm of powdered root can be taken with a cup of water daily.3 gm of root powder of Arni should be taken with 12 gm of pure ghee twice daily.For local application, prepare a paste from turmeric, seeds of chakramarda and sesame, kooth and massage over the affected portions. Once or twice a day.
🔹Application of calamine lotion is workable up to certain extend in Urticaria.🔹Take a tub, filled 1/2 with luke warm water and add 1/2 cup of cornstarch with 1/2 cup of backing soda. A person suffering from urticaria will have to soak the body in to this at least once a day.
🔹Use the pulp of Aloe or a cream containing Aloe on the affected area.One can have nattle tea. Add honey or lemon for flavor.
🔹Nattle are considered having property to heal urticaria.

Vd. Jignesh Thakkar: First pitta gets aggravated by Katy,alma,lavan, vidahi annapaana (today most people use this type of junk food)…….Then the pitta becomes sita(cold) in skin due to cold weather of air conditioned rooms (sit marut sansparshat as said in books)……Now if you want to destroy the samprapti just reverse the process………..As samprapti is USNA ahar SHITA vihar ……..Apply SITA ahar USHNA vihar as treatment………….This is the rule a follow in treatment of urticaria without failure…… Pitta sodhan by nitya mrudu virechan ………Pitt samak diet …………Pitta samak ausadh………Ushna vihar( ushna jala snan,normal room temperature)……..I'm case of emergency apply sodabicarb with water on lesion.
It will subside it.
Dr. Anup Torane:

Dr. Prerak Shah: @ Dr. Bhadreshbhai: I have seen several cases of Shitpitta (Urticaria as modern diagnosis).....never felt need of Vamana...I simply go with virechan....abhyantar snehapan with jirakadhya ghee or aragwadh ghee....virechan yog consist of either kutaki or trivrutta with aragwadh.....some more herbs may plus or minus...but these are major....local applicaiton of sodabicarb (sodium bicarbonate) with water or juice of crushed spinach + balck long term relief. I do not use much internal medicines.....Me and my patients are happy with this.

Dr. Bhadresh Naik: Sir I am talking about………Vaman vyapad causes of sitpit or not

Vd. Pankaj Chhayani: Tulsi swarsa, mustard oil(mahamarichyadi) is given for local application

Dr. Prerak Shah: asamyak Vaman can cause sfot, koth, kandu, etc...atiyog of vaman can cause dah according to books......but I believe that with any kind of improper vaman can cause many kind of reactions on skin...
[7:10 PM, 5/16/2016] Vd. Pankaj Chhayani: 👍
[7:14 PM, 5/16/2016] Dr. Bhadresh Naik: Very true
Vd. Sandeep Ahirkar:

If we stop chardi (vomiting) then it WL be cause of more skin diseases

Dr. Bhavesh Modh: In practice 90% patients of urticaria come with  H/o eaten  allergic food before 12 to 24 hrs & no vomiting present. ….It's time to vipaka means Anna Ras goes to Rassamvahantantr through intestinal route (skin made by Ras dhatu so mostly skin disease due to Ras dushti )……..Virechan is best & nearest way of  throw out (Allergic ) Dushy & it's stop recurrent urticaria = Uthkoth.

Dr. Bhadresh Naik: Excessive repited……..Used of protein diet leads to sitpit

Dr. Bhavesh Modh: & urticaria by insects bite( Honeybee) pt's  come with  vomiting ………….I think  this vomiting is naturally shodhan by Human body.
I seen many pt's of High grade Fever with urticaria they have no H/o insectbite/environmental or food allergy. & after natural vomiting they relief from H.Fever& Urticaria  with out any kind of active medication.

Vd. Dhruti Nirav Bhatt: Apply  Mahamarichyadi oil,Sarshap oil (Musterd oil) on effected part  its helpful in itching, swarjikakshar mix with water and apply .
Haridrakhand, Kaishor guggulu, Virechan , Pathyapathya must, Ajwain with gud

Vd. Pankaj Chhayani: Rubbing Brick powder is also beneficial in condition of Kapha

Dr. Bhaskar B Nymathi: I think Gairika better than brick powder.

Vd. Pankaj Chhayani: Gairika is good in paitika condition

Dr. Shriniwas Gujjarwar: Yes  Gairika with ghee or butter for local application for shitpitta also

Vd. Kinshuk Hirpara: I have treated a patient with higher level of pitta with kamdudha rasa with mari - black piper twice a day. With yastimadhu. Diet- no high protein foods and no milk with fruits. No fruit milkshakes. Also I suggested lemon water with salt and black pepper after every meal. Also 1 mild virechana - erand bhrasta Haritaki. Daily for 1 month

Vd. Kinshuk Hirpara: Local application - sarsav oil while excess Itching

Dr. Bhavesh Modh: ?? Ash/Gairik& soda bi carb role in shitpit like Calamine lot.(external use )

Dr. Prerak Shah: Yes. It works very fast. Subsides within 10 min.

Dr. Bhavesh Modh: Traditionally use  * Ash in shitpit  (environmental & food allergy ) * गैरीक in unknown insect bite * soda bi carb with water  in Bumblebee 's (ભમરો )bite

Dr. J. T. Contractor: Urticaria an allergy exhibits on skin, alum salt water bath sply in summer is preventive cause, food in summer gets its composition altered while bacterial action takes place in humid weather, sweating accelerates process, dermal surface looses its immunity in infrared rays of sun in summer,
One must avoid potential antibiotics, pain killers or paracetamol content drugs, drink more water without fear of perspiration as to flush toxins out, avoid bitter things like neem juice or decoction which up loads liver & kidney resulting deposition of toxin instead. Virudh ahaar seems the root cause of the ailment

Dr. Bhavesh Modh: A skin rash triggered by a reaction to food, medicine or other irritants………Urticaria  is   very common………More than 10 million cases per year (India)…..Can't be cured, but treatment may help in Morden medicine…….Usually self-diagnosable………Lab tests or imaging rarely required……….Short-term: resolves within days to weeks……. In urticaria, Vatprdhan take :  2gm AJWAIN + गुडPitpradhan take :  2gm Haladi + गुड (jaggary), Kaphapradhan : 10 ml Adarak juice + गुड (jagarry)

Dr. Bhaskar B Nymathi: Usually शीतपित्त अाहारजन्यज seen as in food like
🔹Cashew fruit
🔹चणक(Bengal gram dal)
🔹भल्लातक fruit etc
 Sometimes simple and less quantity of like above food also lead to Urticaria.
As औषधजन्यज seen more in modern pharmacolgy compare to ayurveda.
In ayurveda औषध अति-मिथ्या-अयोग lead to शीतपित्त.
As विहारजन्य seen commonly like sudden continious exposure to oppsite climate
🔹Avoid दोष-देश-कालादि विरुद्ध आहार & विहार.

Shri Minoo parabia: This reminds me of an anecdote personally encountered by me. One of my relations had recurring chronic allergy. He decided to consult Dr. Udvadia of Breachcandy Mumbai. Most venerated and senior physician.
Patient put his sensitivity report in Doctors hand. Dr. Udvadia looked at the papers and mumbled, absurd, absolutely useless.
I happened to be present then and there.
"How will you live without all these mentioned in the list"? Dr. Asked.
Just in connection allergy and allergens.
Ayurveda has strived to boost immunity and not the short term symptomatic treatment.

Dr. Bhavesh Modh:  Types of   urticaria by Morden medicine view
Allergic Urticaria
Histamine and other proinflammatory substances are released from mast cells in the skin and tissues in response to the binding of allergen-bound IgE antibodies to high-affinity cell surface receptors. Basophils and other inflammatory cells are also seen to release histamine and other mediators, and are thought to play an important role, especially in chronic urticarial diseases.

Autoimmune urticaria
Over half of all cases of chronic idiopathicurticaria are the result of an autoimmune trigger. Roughly 50% of patients with chronic urticaria spontaneously develop autoantibodies directed at the receptor FcεRIlocated on skin mast cells. Chronic stimulation of this receptor leads to chronic hives. Patients often have other autoimmune conditions, such as autoimmune thyroiditis,celiac disease, type 1 diabetes, rheumatoid arthritis, Sjögren's syndrome or systemic lupus erythematosus.

Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear three to five days after the cold has started, and may even appear a few days after the cold has resolved.

Nonallergic urticaria
Mechanisms other than allergen-antibody interactions are known to cause histamine release from mast cells. Many drugs, for example morphine, can induce direct histamine release not involving anyimmunoglobulin molecule. Also, a diverse group of signaling substances, calledneuropeptides, have been found to be involved in emotionally induced urticaria. Dominantly inherited cutaneous and neurocutaneous porphyrias (porphyria cutanea tarda, hereditary coproporphyria,variegate porphyria and erythropoietic protoporphyria) have been associated withsolar urticaria. The occurrence of drug-induced solar urticaria may be associated with porphyrias. This may be caused by IgG binding, not IgE.

Dietary histamine poisoning
This is termed scombroid food poisoning. Ingestion of free histamine released by bacterial decay in fish flesh may result in a rapid-onset, allergic-type symptom complex which includes urticaria. However, the urticaria produced by scombroid is reported not to include wheals.

Stress and chronic idiopathic urticaria
Chronic idiopathic urticaria has been anecdotally linked to stress since the 1940s.
A large body of evidence demonstrates an association between this condition and both poor emotional well-being and reduced health-related quality of life. A link between stress and this condition has also been shown. A recent study has demonstrated an association between stressful life events (e.g. bereavement, divorce, etc.) and chronic idiopathic urticaria and also an association between post-traumatic stress and chronic idiopathic urticaria.

Dr. Bhadresh Naik: Uti, Hematologic disorder, Uremia, Drug reaction, Obstructive jaundice, Viral disorder, Dengue, Leptospirosis, HIV, Measles, Are dd

Dr. Bhavesh Modh: Angioedema is the name given to deeper swelling affecting the skin over the arms, legs, torso or face. It may also affect the tongue, mouth, throat and sometimes the upper airway. These swellings commonly last for more than 24hrs, and usually there is no itching. It is not possible to identify an underlying cause for angioedema in the vast majority of cases. Some drugs (including some used to treat high blood pressure) can cause angioedema, and there is also a rare inherited form which does not respond to antihistamines.

Urticaria and angioedema often occur at different times or together in the same person. They occur in about 15 per cent of the population at some time or other in their lives, women being affected more commonly than men. Urticaria occurs alone in about 40 per cent of cases, angioedema in about 10 per cent and they co-exist in the same individual (not necessarily at the same time) in about 50 per cent of cases.

Dr. Samir Suneri: Seetpita can be correlate with urticaria .in morden view its a kind of allergy . Inorder of severity
Seetpita  <Udarda  <kotha
Dosha :pitta ,kapha, vata
Dusya: skin and raktadi
Vyadi swabhav :acute
This disease is due to sudden changes in climate and as wel as mandagni like
1st pt is going from child conditions ofAC to garden
2nd ledy is  busy in making food suddenly she moved for bath etc
3rd some time its due to krimi
4th due to synthetic clothes
 kostha sudhi by virechan than kustha chikitsha
Mahatikta  girta paan than raktamokshan
Some drugs we r using
1 Seetpita bhanjan ras
2 slesma pitantak ras
3rd haridra khand churna
4th adarak khanda etc
------------------------------------------end of comments from active group ------------------

Dr. Suyog Kulkarni: As we all know , visciated Vata is responsible for sheetapitta.
I have quite encouraging experience with Lavan Bhaskar orally with dry fomantation on the eruptions.

Dr. Binni Shah: Gud (jagarry) + ajmo (ajwain or celery seeds) is also very effective

Dr. Ashish Dholakia: Urticaria in kids.. 3 years old.. What should b the treatment

Vd. Vishal Rajparia: Haridrakhand having good results in acute conditions

Dr Feroz Khan: Honey with water cab.n works better.

Vd. Neeraj Pooner: Arogyavardhini vati , Sutshekhat ras, Kamdhudha ras , Are some of ras aushad for TT of urticaria

Dr. Rahul: Mahamanjisthadi kwath , Gomutra haritki , Arogyavardhini
The above combination Works well in most cases

Dr. Jinal Thakkar: In Sheetapitta vaat prakop occurs due to what hetu….I have seen cases where some food triggers sheetapitta……….Like outside food……..Or stale food

Vd. Bhavdeep Ganatra: I advice 50% boiled water with sunthi + dhana (1 spoon each) : all day only this water to drink when feel thirsty. Reduction of food intake by 25%. ……It gives quick relief in intensity of disease

Vd. Krutika Suhas Chaudhary: Shitpitta is the result of compressed amlapitta….Patients who frequent take antacids and supress acidity...will suffer by shitapitta..wherr our vitiated pitta goes in shakha.....Raktaprasadak...pittashamak..vatanuloman aushadha should be given
……We can give temporary …..relief feom vyadhi pratyanik..but long term pittavirechak should be continued....Also nidanparivarjan is important...

Dr. Archana Panchal: Gud , Haldar , ajmo combination benefited.

Vd. Fulva Kubawat: Same combination jaggery, turmeric and ajwain works very well... Other than haridrakhand , avipattikar had worked for my patients

Vd. Sushmaben hirpara: In kids , shitpitta  may occur due to worms..
S. O. S.  Treatment for any urticaria  -- 2 pinch soda bi carb ( used for cooking,  not ENO ) + 2 pinch sakar powder + 1 pinch mari - black pepper powder  + 1/4 spoon of cow's ghee. Give this mixture thrice a day. Seen miraculous results of this combination.

Dr. Chirag Dobariya: Mustard oil and salt massage then take sun rays fomentation Daily give very good relief in Shitpitta. Unplanned virechan give good results.                         Indravaruni root powder take in night for virechan and also Triphala-Garmalo useful.

Vd. Krutika Suhas Chaudhary: Dr.dilip gadgil sir.advise panchamrut lepa on dis....

Baps Dr. Ghanshyambhai: Can any one explain how these combinations works on disease. Pharmacological review.

Vd. Rahul Marwah: Sheetpitta samprapti is mostly vimargami pitta suddenly getting coagulated due to sheet guna of vata or kapha……….Therefore the later stages of sheetpitta is udarda and koth as per the association of these doshas

Dr. Arvind Shahane: When Pt suffering from recurrent urticaria please try with yashad bhasma padmakashth churna orally …..N yavkshar or tutth bhasm for local application ………U will get dramatic result

Vd. Rahul Marwah: For the first time in life I saw dramatic results of Basti in udarda advised by Vd. Dilip Gadgil sir... After that u understood the samprapti of kotha and udarda due to it

Dr. Arvind Shahane: Which basti sir

Vd. Rahul Marwah: Yog Basti kram……….Anuvasan of sahacharadi tail……..Niruh was of Bala, rasna and some more indegrients which I can't recollect right now

Vd. Suhas Chaudhari: Arogyavardhini+nimb churn…….Vyan kale... superb results

Vd. zalak dhruv: Urticeria must be treatment according pt. Prakruti
But commanly we can give
1) urtiplex Cap.
2) nimb panchang tab.
3) maha manjista kasay
4) suvran sutsekhr
5) kamdudha ras
6) katu ki
7) garmala no gol as virechan
For permenant solution panchkarma must be
Virechan + Yog Basti will be good

Surat Sandip Patel: Just give AV250 mg+SAnsamani 200mg+Kali marich 100mg and sadhaya Vaman with Arak ksheer ...just take 10 drops on Kaccha papad and ask patients to eat Kaccha.within 45 minutes Vaman.patiets cure life time it's my daily practice..vaidya SANDIP "NIRAMAY "

Vd. Fulva Kubawat: Ark khshir on papad right Sir?
Vd. Neeraj Pooner: Wat is AV250??

Dr. Chirag Dobariya: Eat roasted or unroasted ??

Surat Sandip Patel: Arogyavardhini

Vd. Vishal Rajparia: I have rough idea that some insects are also used in treatment of urticaria

Surat Sandip Patel: And any Kaccha papad mins do not fried or roasted

Baps Dr. Ghanshyambhai: Can anyone explains how this amayik prayog works on pathology of urticaria.

Vd. Javed Ghumara: In urticaria two types of variety is pitadhikya condition and other is this both condition find out of nidan is very first step is nidan praivarjan....yogrtankar give specific line of treatment that is shodhan with vaman virechan in both variety...he specify the drug for vaman that is patola and nimb here second step is shodhan...third step is kaphadhikya condition use any katu ras drug like ajmoda and pitadhikya condition use any tikta rasa dravya like guduchi

Vd. Sachin Kadlag: Yes,  true, in  nanatmaja vyadhi charak has mentioned rakta kotha and rakta mandala ( these lakshanas are found in shitapitta as well ) in pitta nanatmaja vyadhi. While udarda is mentioned in kaphaj nanatmaja vyadhi.
In charak , separately shitapitta is no described……….Considering hetu ,we can list few of them as follows.
1. Viruddha aahar
2. Chardi veg vidharan
3. Vaman hinayoga or ayoga
4. Punaraavartak jwara
5. Shita- ushna akrama sevan

Dr. Bela Jantaria: Paripathadi Quath gives good result in urticaria

Baroda Arti parimal: 7black pepper and 13 leaves neem for 21 days - empty stomach………Apply shatdyot ghrit……..Just swallow black pepper with water and you can chew with neem leaves …..It's not harmful

Dr. Mahavir Patil: miri is tikshna ushna i.e. it can increse pitta. so how it works in vimaragag pitta ?

Baps Dr. Ghanshyambhai: Whts the logic of 7 black pepper n 13 neen leaves? Any book reference??

Dr. Hardikchandra Kalal: We can try to understand "Shitpitta " words,its meaning pitta become sit ,which one has naturally ushna properties.
hence ,we should try to shit___pitta convert in its natural property ushna, so we should try to use ushna virya medicine in shitpitta, i think in above  discuss medicine for shitpitta all have mention ushna virya here , ultimately we do shit__pitta convert in ushna__pitta which is normal.

Vd. Sachin Kadlag: Even sarshapa taila externally helps a lot in shitapitta.

Dr. Mahavir Patil: pitta not becomes sheet…….along with pitta there is anubandh of sheetgunatmak kafa and vayu………prakupit vata and kafa , make sansarg with already prakupit pitta ---> vimargag pitta---> mandal utpati on skin
its samprapti of sheetpitta……….sheetpitta and udarda are similar.
in both thr is "dah" of pitta but in sheetpitta due to vatanubandh thr is " tod" (तोद) and in udarda due to more kafanubandh thr is kandu

Dr. Hardikchandra Kalal: Yes,sir with..when anubandhya pitta connect with anubandh kaf and vat..that time pitta is become in summer...atmosphere 's air connect with sun rise and air become hot.

Dr. Mahavir Patil: may be some confusion sir. but i disagree with -- pitta became sheet. anyway…………miri is " vyadhipratyanik for sheetpitta. …due to its ushna laghu guna and ushna vipaka it controlls prakupit vat and kafa and thus breaks the samprapti. so then vimargag pitta gets anulom and it cures the sheetpitta

Dr. Hardikchandra Kalal: *Air is vata, *sun rise as pitta……..When vata can  become  ushna than y pitta not become shitta ???

 Vd. Ketan bhimani: Pittam pangu.,  .. Gun can't change

Dr. Hardikchandra Kalal: when Niram pitta is convert in saam that time...change gun

Vd. Rahul Marwah: Guys don't get confused... The samprapti of sheetpitta is of vimarga gaman. The pitta doesn't change its properties but it actually gets freeze ( just to make u understand) due to vayu or kapha…….Therefore the defreeze it marich or sarshap tail are vyadhi pratyanik dravya

Dr. Hardikchandra Kalal: sry ,my intention is not for create confusion..just i try to understand through  another way with help of real samprapti bcz many of doctors have doubt that disease  is already pitt related n y we use ushna dravyas...there for.. i share my thinking about shitpitts...ll

Vd. Akshata Swami: Disease pitta related but involved with kapha and vata... Tht is sheeta,to normalize brajak pitta which is freezed u must need ushna chikitsa to clear passage of pitta

Vd. Ketan bhimani: U r on right tract dr kalal…….. In ancient time, people were using ash from wood fire (rakhiya- chula ni rakh) as best local application .

Vd. Akshata Swami: As dr. Kalal ji said gud example of atmosphere air.... Here is ans. In question itself... In atmosphere air going to get sheeta when it become extremely sheeta it covers reduces heat of even sun too but not sun itself become sheeta.. As like happens in sheetpitt.when atmosphere is balanced then v can experience both sheetata and ushnata. Like normal function of vata pitta n kapha in body, sama dosh, desha deha... Relationship

Dr. Hardikchandra Kalal:why we give ushna virya dravya in shitpitta ???

Vd. Ketan bhimani: For samprapti vighatan

Dr. Hardikchandra Kalal: Yes sir....with this ushna dravyas...which process will be done ??

Vd. Ketan bhimani: Swedan, Best therapy as I experienced

Dr. Hardikchandra Kalal: sved is Shitaghnam.....ll here , svedan is remove  shitata of which dosh??

 Vd. Ketan bhimani: Obviously pitta

Dr. Hardikchandra Kalal: Hence, why we can not say pitta become  shit in shitpitta ???Actually ,in our field no one has freedom for new thoughts...😷

Vd. Ketan bhimani: Pitta + shit = urticaria, ………….Yojakstu shreshthah
Don't wait for ref or aapt jan………..You have best quality of speech n write, ..... Say loudly ….
--------------------------------- end of comments from Group 1 --------------------------------
Dr.Yogesh Gorakhnath Patil: Haridra khand,  haritaki + sariva+ Dhanyak + Jeerak

Dr. Jyoti Ashok: Sheetapitta is amashaya samudbhava vamana is indicated. Depending on the conditions, khadirarishta,haridra khanda,sariva kalpa,tiktaka grita,triphala,avipattikara, etc.(not all together)

Falgunbhai Patel : In shitpitt if  pittadhiky use kamdudha Ras/sudhdh gairik, sut sekhar, sudarshan+swarjika kshar,   in kaph adhiky use marich / trikatu ,  vata adhiky kaishor guglu .... haridrakhand in all types………..Local application Mahamarichyadi oil for  vat kaph pradhan, swarjika kshar with water in Pitt pradhan

LVG Shriram Gandhi: People use to give kokam sharbat as a home remedy.

Dr. Sachin A. M.: शीतमारूतसंस्पर्शात्प्रदुष्टौ कफमारुतौ।
पित्तेन सह संभूय बहिरन्तर्विसर्पतः।।      मा.नि. 50/1
By contact with very cold breeze, kapha and vata gets increased, associated with pitta, nd starts moving internally and externally..... This is called sheetapitta initially .... Also termed as udarda and kota after its complications.....

Dr. Lalit Kansal: Sarshp oil for external application

Dr. Neha P. Bhatt: vaman and raktamokshan for shodhan………….mahatiktak ghrita,haridra khand,panchtiktak churna,urtiplex capsule n urtiplex lotion are giving good results with pathypalan

Dr. Ravi Dewan: Blood letting is very effective, especially if it is pitta-rakta origin. Avoid in vaatik type. Tab. Iobin takes good care of associated itching.

Canada Vd Priti Patel: Patient must not have constipation. 
- Allergen grannuels front nagarjuna (main contain Haridra khanda)
- Khadirarist/ maha Manjistadi kadha/ chandanasav according dosha
- Sit pitta bhanya Ras.

Vd. Kinjal Patel: But as patient stop.medicine  its may be recurrent……Majority patients have complain ..they intake sour taste food than happen that

Dr. Renu Agarwal: Marich (black pepper) and cow ghee internally

Australia Vd. Neerja Ahuja: Neem n yashtimadhu n amalaki are all useful herbs for urticaria

Vd. Vishal Patel: If pittadhikya than can do virechan and if kafadhikya than can do vaman.....ushna with katu tikta rasatmak drvya can be used in kafadik shitpitta.

Australia Vd. Neerja Ahuja: Diet include bitter gourd n avoid sugar n alcohol…..Rasa n rakta dhatu are involved

Vd. Rajal shukla: Haridrakhand, Sanshamani vati 1-1-1 , Ral malam application on redness , If inching is prominent. .Itchsam tsblet (Kandughna Mahakashay Bhavana: Kandughna Mahakashay without sarshap)
------------------------------------- end of comments from Group 2 ----------------------------

Dr. Sreedevi N V: Shitapitta kotha n utkotha mentioned in madhava nidana……...Medicines include amrtarajanyadi ks (BR sitapitta chikitsa)also haridra khanda in the same adhikara .other medicines include guluchyadi ks, panchatiktakam ks, nimbadi ks, nimbamrtasava, patolasava, avipattikara churna .ghrtas are guduchyadi,patoladi ,tiktakam and panchatiktakam ghrtas. Pravala bhasma,sidhamakaradhwaja rasa and arogyavardhini rasa also effective.

Dr. Jyoti Yagnik: Give laxative during treatment . Shatavari ; yastimadhu ; kamdudha ; rasayan churna ; kshirpak ; trifala- bedtime ; samsamnivati ; manjisthadi ; Avoid fried ; heavy ; chilly diet, Acidic diet also, Goxuradi & chandraprabha also useful, If needed, Xirpak - Shatavari+milk +water made kshirpak….So kusthahara,visarpahara,pittahara,mutrala chikitsa ..can we say so?

Dr. Sreedevi N V: Also raktasudhikara chikitsa? Kapha and vata are the dosas involved in sitapitta.purva rupas include rakta lochanata, pipasa, aruchi, hrllasa, dehasada, angagourava

Dr. Supratim Bir: Pitta kapha naasak karma particularly gives good results. I tried Castor oil with milk n it was good. **Along with protocols mentioned in reference to virechan.

Dr. Sreedevi N V: If able to differentiate shitapitta,kotha n udarda it will be good..any pictures available to differentiate all these?

Vd. Khyati Jariwala: pitt kaphaj……..And udard koth r mainly kaphaj
Treatment of shittpitt includes haridra khand,Pitt n kapha shamak aushadhi like galo haridra neem abhrak etc....also aam paachak can help.
Marichyadi tailam topically…………N nidan parivarjanam...

Dr. Supratim Bir: Sitapitta is acute where udarda n kotha are usually chronic  condition comparatively

Dr. Mrugeshkumar Patel: Rice mag ghee rakh lagadvi marichayadi tail lagadvu  haritaki in the morning with water banana & virechana are helpful manjisthadi kwatha haridrakhand arogyavardhani gandhak rasayana are very useful....

Dr. Sreedevi N V: Why the name sheetapitta given? Sheeta denotes kapha only? Or involvement of vata too??

Dr. Dayanand Bothre: Shitpit is due to vaat nd Pitta, It's intensity more in night which is vaat kal than day time, Udard is due to kaf nd Pitt

Dr. Nitish Dubey: What about sarivadyasav, mahamanjisthadristha??
Holland Devina Praktijk: With urticaria you mean only small spots? I have a picture of patient with an extreme swelling of upperlip of mouth. Might be Angio Oedemia, but gives the same doshas according to my observations: kapha/pitta disordered mainly (pulse)

Dr. Dilip Pithiya: Shitpitta is Due to Vat & Pitta Dosh.
Haridrakhand is very useful medicine for Shitpita.
Acc. to Chakrapani. Ajmoda + Gud(jeggary) is useful.

Vd. Khyati Jariwala: Yup...Ajmodadi in urticaria gives miracle result

Dr. Yogin Patel: Kamadudha ras-rogathikar-shitapitt

Dr. Hiral Sengal: kamdudha Ras..

USA Sivakami Kapoor: Manjistadi kashayam works very good

Dr. Dharna Tiku: Ghritham+ khand+ few black peppers mixed together and consumed twice daily, is supposed to be effective for sheeta pitta.
Haridrakhandam is no doubt helpful in shamana and banana for Shodhana is good……..Indukant kashayam can be used to maintain the Bala……..Vamana: not banana in the text above.

Vd. Sandeep J. Prasad: 1spoon haridra mixed in 1 cup of water put for a night . The filtered water should be consumed empty stomach .it works good…..I received a patient few days back with complain of itching whole body with rashes only after 2am in night and subside after morning………..We prescribed him harida khand kamdudha gandhak rasayan mnjithadi kashay ………… Improved 30% in 1 mnth but not 100% resolved………..

Dr. Supratim Bir: In short the treatment principle - 1) Ama pachan (to manage vata by clearing srota). 2) Tikta rasa pradhan drugs (to mitigate pitta n kapha). 3) Lastly kandughna chikitsa to support.

Dr. Manju Mishra: Sheetpitta  is  vaat pradhan  ,  udarda  is  kapha ,,n koth  is  pitta  pradhan  ....OK?  if  koth  than  utkoth….Haridrakhanda   ,, kaamdudha ras…..Vaman virechan , abhayang n  shinchan , After than  kushta  like  treatment  n  dadru  tt

USA Sivakami Kapoor: Castor oil + milk at night virechana helps

--------------------------- end of comments from Group 3 --------------------------------------
Compilation : Dr. Prerak Shah

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  2. Roopesh:
    " Unless i have already missed it somewhere, and if no objection, perhaps it may be useful to discuss/outline/clarify samprapti or Ayur pathogenesis of urticaria (or any disorders) for our mixed audience, (along with any acceptable, well established modern correlations/explanation where applicable) ~ net effect being to help identify processes involved at each stage, & reinforce, or better guide understanding, and of course in refining targeted individual treatments effectively in specific cases as the well esteemed professionals have nicely been doing here so far. "

  3. We can use nasya in shitapitta treatment?

  4. This comment has been removed by the author.

  5. Let's begin live chat

  6. Avoid viruddha ahara example fruits with milk, food allergies are the main reason

  7. Avoid viruddha ahara example fruits with milk, food allergies are the main reason

  8. I found good results of Vacha in shittpita

  9. For shittpitta if we take as a allergy:-
    Histamine occurs in food as a result of microbial enzymes converting the amino acid histidine (present in all proteins) to histamine. All foods subjected to microbial fermentation in the manufacturing process contain histamine. Included in this category are cheeses, fermented soy products, other fermented foods (e.g. sauerkraut), alcoholic beverages, and vinegars.

  10. Hi, I would suggest to go for sat ang dhara for good result.

  11. Rubbing of kansya dhatu all over body is effective in accute stage of shitpatt

  12. I found good results after virechan

  13. Many of our freonds mentioned that shitpitta is due to Vata and kapha imbalance. Some mention abt pitta imbalance. Some says Vata aggravation. So what's to consider?

  14. As it is a kapha pittaja disorder start mahamanjistadhi kashayam and patola mooladhi kashayam.

    Dr.C.Srinivas Rao.

  15. Hello everyone.I am Dr Ravishanker,a son 9yrs, has been suffering from urticaria for the past 2yrs(no welts from Jan -august but the itchy welts resemble mosquito bites and they increase in severity during Oct,nov & Dec).I was told by a dermatologist that it is Chr.idiopathic urticaria.nothing to do with food,weather.i repeat,it occurs only during months of aug-dec. Any solutions dear experts?

  16. Saw a TV program.betel leaf juice +pepper b4food. Bermuda grass juice after food, twice a day. My son has been taking this for the past 1month.there is some effect.any better solutions plz...

  17. Saw a TV program.betel leaf juice +pepper b4food. Bermuda grass juice after food, twice a day. My son has been taking this for the past 1month.there is some effect.any better solutions plz...

  18. In 2014(started first), the intensity was very severe. Swollen face, huge welts hot to touch on the back. In 2015, severity was half of 2014.


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