Uttarbasti …..a special #ayurveda treatment

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:

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Next topic for discussion: Uttarbasti …..a special #ayurveda treatment

Dr Sandeep kakuste Nandurbar: 24 yr female pt h/o ectopic pregnancy last yr, operated rt tube removed, now hsg done but Lt tubal block Plz advice treatment

Vd. Binal Jagani: In tubal blockage arka patra sweda very beneficial

Dr. Sushant Patil: Kumari siddha tel uttar basti also beneficial. Shankha bhasma internally too

Vd. Avni Kaneria: Vrunadi kwath is also useful....

Dr Sandeep kakuste Nandurbar: @Dr sushant patil sir shankh bhasma how it works on tubal blockage and how many times kumar siddh tail basti

 Dr. Sushant Patil: Uttar basti of Kumari Siddha tail

 Many Vaidya also use Kshar taila basti too but I hadn't seen or used it.

I treated  patients . 3 basti settings 3 times with interval of 5 days in each 3 settings.

Dr Sandeep kakuste Nandurbar: Plz share Dr s ur valuable opinion

 Dr. Sushant Patil: But about Shankh I can not say what is the path of action. You may consider it As a Aapta Vachana as I also used it

Dr. Abha. l. Ravi: Uttara vasthi with shadpala ghritha is also good

Vd. Tanuja Gokhale: The anatomy is mentioned as Tryavarta Yoni ie it has 3 avarta or layers similar to Shankha. Besides, shankha bhasma is deepan pachan anuloman, vibandhhar n a kshar so may act to clear blockages is the thought behind using it.

 Dr. Arvind Shahane: Vadhya Ramdas ahvad sir uses kshar oil utter basti n gets very good results in tubal blockage

Vd. Tanuja Gokhale: SO, many vaidyas use Kshar tail in Maharashtra to clear tubal block.

 Dr. Sushant Patil:

 Dr. Sushant Patil: What's ur experience or thinking about case like this

 Dr. Shruthi Arun: Best thing to go with vamana first, That too repeated shodhana will help in this case, Then suggest some medhya drugs- like Brahmi to regulate HPO axis, Then lashunaadi vati to increase rasa dhatu, Then some rasayanas

 Dr. Shruthi Arun: Uttarabasti with kshara taila will give very good results - done on alternate days from 10th , 12th n 14th day of LMP ,

 Dr. Dayanand Bothre: Mam for how many cycle??

Dr. Shruthi Arun: For 3 cycles

 Dr. Dayanand Bothre: After 3 cycle if block remain then should we repeat?? Or if repeat then for how many times we can give kshar basti?

 Dr. Shruthi Arun: Usually it won't remain,

If at all it remains you can repeat on alternate cycles for next 3 cycles

Dr. Shruthi Arun: Once you can even go with mustaadi yapana basti in b/w ,

 Dr. Mrugeshkumar Patel: Any complications see in uttara basti?

 Dr. Dayanand Bothre: After kshar basti is patients compliant about burning or any irritation

 Dr. Shruthi Arun: Till now in my practice I haven't seen any complications

We need to do under aseptic measures

Nope, There might be slightly dragging pain in pelvic region which is very mild

 Dr. Mrugeshkumar Patel: What type of precautions is required during uttarbasti

 Dr. Shruthi Arun: 1. Aseptic measures  2. Check BP before and after procedure  3. Before going  for procedure USG / HSG should be done to rule out abnormalities like unicornate uterus / septate uterus , 4. P/v done to know the position of uterus

Dr. Mrugeshkumar Patel: When complications occurred What type of treatment required?

Dr. Dayanand Bothre: Mam I also heard that falghrut basti is followed by kshar basti. So could you please evaluate what is the logic behind this?

Dr. Shruthi Arun: Phala gritha will give nourishment to uterus,

Kshara taila will have lekhana/ scraping properties which will scrap debris and make tubes patent

Vd. Ajayraj V. Bal: What should be the  matra of kshartail   used in uttarbasti in tubal blockage?

Dr. Sharmila Kulkarni: As far my experience goes.Uttar basti with Kshatriya or Sanchar tail. is the line of treatment. No complication,unless bit is done with all aseptic precaution.

Dr. Suyog Kulkarni: Do you mean Kshar taila and Sahachar taila ,dr. Sharmila ?

 Precautions, Pt may feel a little pain or discomfort initially

 Dr. Sharmila Kulkarni: You can give Dashmool ghana vati 2 TDs to expect anti inflammatory action. Ask pt to reduce wt

 Dr. Sharmila Kulkarni: This can be supplemented with Phalakalyanak ghruta

Doctor, where is the block? If at fimbrial end easy to treat

Any history of Tuberculosis?

 Dr. Bhadresh Naik: Tb of fallopian tubes Of course debut is good. Results are encouraging but my personal opinion about tb is different. Along with anti tb drugs ayurvedic  treatment is suggests.Because  advance tb having lots of complications

Vd. Dhruti Nirav Bhatt: Uttarbasti has very good result but precaution is very important .one patient with infertility gave uttarbasti and Anaphylatic shock ,pain

 Vd. Piyush Prajapati: What to do when anaphylatic shock occurs??

Dr. Mrugeshkumar Patel: Perforation,coma what to do?

 Dr. Tukaram Shinde: Vaat dosha related to

Dr. Suvarna V. Khairnar: In uttarbasti according to you what should be done to avoid anaphylactic shock and any other complications purvakarma?

 Vd. Dhruti Nirav Bhatt: Vat shaman medicines give before treatment don't give empty stomach and Yastimadhu ghanvati Laghuvasant Malibu tab gives good result

Vd. Dhruti Nirav Bhatt: Laghuvasant malini tab . U can give lemon water with suger or glucosewater

 Vd. Piyush Prajapati: Proper counselling is must..Dr must b jolly with patient. Complications must b told to patient at some level. Patient must b observed by a lady beside her,holding hand of patient. Eyes of patient must b covered by good cloth. She must b relaxed before uttarvasti by Abhyanga and swedan of lower part of abdomen.Dr should gain confidence about himself in mind of patient so later,patient is ready for anything. She must b cared before and later . Later,she must b relaxed by keeping her legs straight and overlapped. Her pulse and BP is noted before  procedure and after procedure..Her pulse is checked. 

Keep Sitopladi churn and honey mixture ready.. when u feel that pulse is less or hypotension,then start to use Sitopladi with.honey..

Patient must not get up till 10 minutes after completion of procedure

Vd. Piyush Prajapati: When u r pushing oil by syringe,u must remember that patient must not feel it.. so keep pushing oil by speed of 1 ml per minute so patient  can't feel oil Vasti.

 Dr. Mrugeshkumar Patel: What to do when anaphylatic shock occurs??

Perforation,coma what to do?

 Dr. Shriniwas Gujjarwar: In this stage. We have to manage acording to modern line of treatment of anaphylactic shock (O2, iv line, life saving drugs etc.) . Otherwise patient may go in further serous condition and death also.

 Dr. Mrugeshkumar Patel: Any other treatment is required?

Dr. Suvarna V. Khairnar: Is Yogbasti karma compulsory done before uttarbasti

 Vd. Piyush Prajapati: Put her head down than leg. Leg must b up than head.

Never try to make patient drink water in this type of shock. I write again,keep Sitopladi churn and honey mixture ready. When shock occurs,just keep this in her mouth by your hand.

 Dr. Shriniwas Gujjarwar: In case of anaphylactic shock occurs. .

 Dr. Bhadresh Naik: What's causing factors. Is it vasovagal shock

 Dr. Abha. l. Ravi: Niroohath utharam va deeyathe ithi .if we are doing uttara vasthi after nirooha we can expect more result and less complications. Vatha will be under control

Dr. Bhadresh Naik: We must inform about proceed.  Ensure her. See the satva of patients

 Vd. Piyush Prajapati: No.. vasovegal shock occurs when patient see something bloody . Lower abdomen part of female is too much sensitive and full of nerves internally. So when someone try to make medicine enter the uterus,some pressure is created. if u pushing medicine suddenly or fast,pain will started.. in a such completion,patient becomes drowsy and then there is a shock.

 Dr. Suvarna V. Khairnar: One of my friend who is practising Ayurveda told me that inj. Atropine should be given before uttarbasti to avoid anaphylactic shock . Is it necessary always?

 Vd. Piyush Prajapati: Never.. I never gives..

 Dr. Shriniwas Gujjarwar: It is better

Vd. Piyush Prajapati: Sometimes,first hard coitus also make such type of Complications.. if u have heard in news.

Dr. Gaurav Makan: Atropine will increase the pulse rate of the patient causing tachycardia

Dr. Gaurav Makan: Must check the pulse before injecting.

 Dr. Shriniwas Gujjarwar: For uttarbasti-

1) Oil should be steriled, autoclaved. 2) All equipments autoclaved 3) use sterile instruments, gloves etc.4) aseptic precaution is must.5) should be done in Steriled and fumigated O.T. or labour room. Not in opd or any room.6) keep ready all emergency life saving drugs and oxygen .7) after all patients life is important not procedure.8) written consent is to be taken prior to the procedure. 9) expertise is also important for doing any procedure. (At least should learn under expert for some days or months for perfection and to avoid complications.

Dr. Madhuri Patil Chaudhari: uttarbasti nice discussion. Too deep inutero may make uterus React  hypertonic condition.   Hypersensitive females may experience shock due to Fear. Psychological preparation is pre-requisite as Purvakarma also proper snehan swedan , virechan too. for +ve results.

 if adverse reaction to uttarbasti, shock, check vital sigs,Breathing esp.inj. Avil if BP too low iv.or else glucose water. Keep MD Gynec' s ref. number on hand b4 proceeding( to stay out of medicolegal cases in case of emergency.

 Vd. Dhruti Nirav Bhatt: Sometimes patient may be sensitive or due to spasmodic pain can be

Dr. Shriniwas Gujjarwar: This is not similar to basti or nasya. .Here you have to take very much precautions to prevent the infection in the uterus /Bladder and also with kshar may get irritation and cause ulcer too.

I have experience of shock during uttarbasti in male for stricture of Urethra.  For the same patient for first 4 sittings nothing happened but 5th time patient went in anaphylactic shock. Started sudden dyspnoea,  cyanosis,  tachycardia then bradycardia,  hypotension etc.... I managed immediately with life saving drugs and oxygen and he is survived.  He is a jailor of Goa Jail.

 Dr. Madhuri Patil Chaudhari: uttarbasti is too invasive procedure , full of risks, first try pichu dharan with khsar tel or bastidravya,if pichu dharan is well tolerated then only proceed for uttarbasti.

Dr Sandeep kakuste Nandurbar: But mam pichudharan of khsar tel help tubal blockage

Dr. Shriniwas Gujjarwar: No use. Kshar Pichu will give irritation to vaginal wall.

Vd. Dhruti Nirav Bhatt: Sir I agree with you because its a very risky process .

 Dr. Madhuri Patil Chaudhari: thats why i typed 'if tolerated', if not Contraindicated for uttarbasti..

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Compilation courtesy: Vd. Kinshuk Hirpara & Vd. Dhruti Kagrana