Management of Stomatitis (Mukhpaka)

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Next topic of discussion:

Management of Stomatitis (Mukhpaka)

 

+91 XXXXX 671 201:

Guluchyadi Kashayam with Avipatti Churna, Stoma tab, Yashtimadhu Churna with honey give good results.

 

Dr. Tarun Vaidya:

Management:

Tab. Samsamni

Tab. Arogyavardhini

Tab. Yashtimadhu

Tab. Shatavari
(All tablets three times daily for 7 days)

Local application:

Cow ghee or any pure ghee is best.

Aahar & Vihar:

Increase water intake

Milk

Soft food

Avoid hard food (papad, puri, bajra rotlo)

Avoid spicy food

 

+91 XXXXX 91290:

Repeated the same tablet protocol and asked:
Anything for local application??

 

Dr. Dinesh Pandya:

What if Mukhpaka does not respond to standard treatments?

Wants to understand etiology and Ayurvedic samprapti in treatment failure.

Asked: “Any new samprapti?”

“What is lacking in discussion?”

Suggested considering Vishada (stress/depression) when ulcers do not respond.

 

+91 XXXXX 70737:

Recurrent stomatitis may be due to Vitamin B complex deficiency.

Correcting nutrition can be highly beneficial.

Diet correction and nutritional assessment are important.

 

Ayu Stu. K:

Stomatitis involves Pitta & Rakta dhatu with weak Jatharagni.

Avoid:

Spicy food

Ushna and Amla rasa foods

Line of treatment:

Pittashamak herbs: Manjistha, Sariva

Shodhana / Vrana Ropana

Kavala & Gandusha

Tankana Bhasma gargle

Kadira churna with ghee (local application)

 

Dr. Hasan:
Common causes:

Constipation

Pan masala / gutkha

Spicy food

Vitamin deficiency

Nidan Parivarjanam is first-line treatment

If constipation:

Swadisht Virechan Churna / Panchsakar Churna

If Vata predominant: Erand Bhrasht Haritaki

Local application:

Powder of badam + ghee + honey

If nutritional deficiency:

Improve Agni & digestion

Avipattikar Churna

Laghu Sutshekhar Rasa (4–5 days) → then Shatavari Ghrita

 

Dr. Jenil Nayak:

Supported and appreciated the above protocol.

 

Vd. Dhruti Kagrana:

Common triggers:

Heat-producing food

Gastritis / hyperacidity

Constipation

Stress & sleep disturbance

Long-term medications / antibiotics

Vitamin B12 or iron deficiency

Local Treatment:

Yashtimadhu + honey application

Gargling with raw milk

Khadi sakhar + ghee application

Dietary Advice

Avoid:

Spicy, fried, fermented food

Excess tea/coffee

Very hot food

Pickles & junk food

Recommend:

Ghee, milk, coconut water

Soft cooling foods

Moong dal, rice, vegetables

Adequate hydration

Lifestyle Advice:

Proper sleep

Stress management

Regular bowel movement

Avoid tobacco & alcohol

Case Study:
Female, 32 yrs, recurrent ulcers every 15–20 days for 2 years with acidity & constipation.

Treatment:
Avipattikar + Kamdudha + Yashtimadhu + milk gargle

Result:
Pain reduced in 3 days; ulcers healed in 5–6 days.
Recurrence stopped after digestive correction over 6 weeks.

 

+91 XXXXX 19188:

Khadiradi Vati effective in stomatitis.

Applying Trikatu churna on ulcer and spitting saliva gives good results.

Saindhavadi tail Matra Basti is effective.

 

Vd. Dhruti Kagrana:

Asked: Any logic to use Saindhavadi in ulcer?

 

+91 XXXXX 19188:

Saindhavadi helps relieve constipation, as most stomatitis patients have gut issues.

 

 

AYULINK CME SUMMARY

Management of Stomatitis (Mukhpaka)

🔎 Clinical Understanding

Stomatitis (Mukhpaka) is commonly associated with Pitta–Rakta dushti, impaired Jatharagni, and involvement of gastrointestinal and lifestyle factors. Recurrence is often linked with digestive disturbance, nutritional deficiency, and stress.

⚠️ Common Etiological Factors (Nidana)

• Excess spicy, fried, fermented, and heat-producing foods
• Hyperacidity / gastritis
• Constipation & gut dysfunction
• Vitamin B12 / iron deficiency
• Pan masala, gutkha, tobacco
• Long-term medications / antibiotics
• Stress, sleep disturbance
• Weak digestion (Mandagni)

🔬 Pathogenic Considerations

• Pitta & Rakta aggravation
• Agnimandya and Ama formation
• Kapha & gut involvement in recurrent cases
• Vishada (stress factor) in non-responsive cases
• Nutritional deficiencies contributing to recurrence

🌿 Treatment Principles

✔ Nidana Parivarjanam (remove causative factors)
✔ Agni deepana & digestive correction
✔ Pittashamana & Raktaprasadana
✔ Mridu virechana where indicated
✔ Vrana ropana & local soothing therapy
✔ Address stress & nutrition

💊 Commonly Suggested Internal Medicines

• Avipattikar Churna
• Kamdudha Rasa
• Arogyavardhini Vati
• Samsamni Vati
• Yashtimadhu preparations
• Shatavari / Shatavari Ghrita
• Laghu Sutshekhar Rasa
• Erand Bhrasht Haritaki (Vata-predominant constipation)
• Panchsakar / Swadisht Virechan Churna
• Manjistha & Sariva (Pitta-Rakta pacifying)

🪥 Local Applications & Procedures

• Yashtimadhu + honey application
• Khadi sakhar + ghee
• Pure ghee application
• Kadira churna + ghee
• Tankana bhasma gargle
• Raw milk gargling
• Badam paste + ghee + honey
• Khadiradi Vati sucking
• Kavala & Gandusha therapies

 

🥗 Diet & Lifestyle Guidelines

Avoid

• Spicy, fried, fermented foods
• Very hot food & beverages
• Pickles, junk food
• Excess tea/coffee
• Tobacco & gutkha

Recommended

• Soft, cooling foods
• Ghee, milk, coconut water
• Moong dal, rice, vegetables
• Adequate hydration

Lifestyle

• Maintain proper sleep
• Manage stress
• Ensure regular bowel movement

🧠 Special Clinical Insights

✔ Correct digestion to prevent recurrence
✔ Consider Vitamin B deficiency in recurrent cases
✔ Stress-related ulcers require mental health support
✔ Gut correction often improves resistant cases

📌 Clinical Outcome Insight

Digestive correction with Pitta-pacifying treatment and local soothing therapy can relieve pain within days and prevent recurrence when gut health is restored.