A Beginner’s Guide to GERD Treatment in Ayurveda

Gastroesophageal reflux disease (GERD) is a condition in which there is reflux of gastric contents into the esophagus. Heartburn and regurgitation are the major symptoms of gastroesophageal reflux disease that are provoked by bending, straining, or lying down. The other features are waterbrash (salivation of the mouth), dysphagia, atypical chest pain that can mimic angina, repeated chest infections, chronic cough, hoarseness, etc. This condition is correlated with the clinical conditions of Ayurveda namely Amlapitta, Ajeerna, Parinamashoola, and Annadravashoola. These conditions are related to Annavaha Srotas.  

GERD in Ayurveda

In Ayurveda, GERD is correlated with Amlapitta, Ajeerna, Parinamashoola, and Annadravashoola. All these conditions are of Annavaha srotas and Agnimandya (impaired digestion) is the main and common cause of all the conditions mentioned above.

Amlapitta is a condition in which the Amla (sour) and Drava guna (liquid) qualities of Pitta dosha are increased. The etiological factors viz, Viruddha ahara (incompatible food), excess intake of Amla (sour), Katu (pungent), Lavana (salt) food items, Dushita Ahara (contaminated or stale food), Vidahi Ahara (food that causes burning sensation and these can be spicy, deep fried, junk foods, street foods, foods that are cooked with artificial coloring agents), Diwaswapna (daytime sleep), sleeping or lying down immediately after the intake of the food, Avyayama (less or no physical exercise), Ratrijagarana (keeping awake till late night) Chinta (worry), Shoka (grief), Bhaya (fear), Krodha (anger), etc. vitiate Pitta dosha, Vata dosha, Kapha dosha.

Pitta dosha is predominantly affected both quantitatively and qualitatively. Pitta dosha attains Amlata Bhava and the food that is in the Amashaya (stomach) turns Vidagdha (fermentation) and there is aggravation of pitta dosha. Along with this, Vata dosha and Kapha dosha are also affected. Thus, there is Mandagni (reduced digestion capacity).

The clinical signs and symptoms of Amlapitta are Avipaka (indigestion), Klama (fatigue), Utklesha (watering or salivation in the mouth/water brash), Tikta-Amla Udgara (bitter-sour belchings), Hrit daha (burning sensation in the chest), Kantha daha (burning sensation in the throat), Aruchi (loss of taste).

Based on the dosha, the types explained in the texts of Ayurveda are, Vataja Amlapitta, Pittaja Amlapitta, and Kaphaja Amlapitta. In some other contexts, the types are Vatadhikya Amlapitta, Kaphadhikya Amlapitta, and Vata-Kaphadhikya Amlapitta.

Some accept the involvement of three doshaVata, Pitta, and Kapha while others have mentioned the involvement of Vata and Kapha dosha respectively. Based on the movement of vitiated Pitta dosha, there are two types of Amlapitta, Urdhwaga Amlapitta, and Adhoga Amlapitta. Urdhwaga Amlapitta is the type in which there is upward movement of vitiated Pitta dosha. Adhoga Amlapitta is the downward movement of vitiated Pitta dosha.

Ajeerna is the condition in which there is indigestion and is related to Annavaha srotas. The causes of Ajeerna are Atimatra bhojana (overeating), Atyambu pana (drinking excess water or fluids on an empty stomach or when there is hunger), Kaphakara Ahara (the food that aggravates Kapha dosha), Vishamashana (untimely food intake), Atiruksha bhojana (intake of food that is excess dry), Atiguru Ahara sevana (intake of food that is excess unctuous, deep fried or oily food), Atilanghana (excess fasting or eating less quantity of food), Diwaswapna (daytime sleep), Ratrijagarana (staying awake at late night), Swapnaviparyaya (improper sleep untimely sleep and wake up), disregard of Rutucharya (seasonal regimen), Dinacharya (daily regimen), Vegadharana (suppression of natural urges), Sneha Basti and Virechana Vyapad (complications of medicated oil enema and purgation therapies).

Due to the above etiology, there is Agnimandya (reduced appetite) and vitiation of Vata dosha, Pitta dosha, and Kapha dosha. Also, there is the improper formation of Ahara Rasa since there is no proper digestion. Based on this pathogenesis, the types of Ajeerna mentioned are, Vishtabdhajeerna due to the vitiation of Vata dosha, Vidagdhajeerna due to the vitiation of Pitta dosha, Amajeerna due to the vitiation of Kapha dosha, Rasasheshajeerna is due to the improperly formed Ahara Rasa and the indigestion that is relieved or the digestion that occurs the next day but does not cause any discomfort is called Dinapaki Ajeerna. The food attains Amlata Bhava (sour quality).

Parinamashoola is the pain that occurs during the digestion of the food. The dosha that are vitiated are the Vata dosha which obstructs the Pitta and the Kapha dosha. Thus, the pain occurs during the digestion of the food. There are seven types of Parinamashoola, Vataja, Pittaja, Kaphaja, Vata-Pittaja, Pitta-Kaphaja, Vata-Kaphaja, and Sannipataja Parinamashoola.

Annadravashoola is the condition in which the pain occurs before, during, and after the digestion of the food. The pain is persistent irrespective of whether the person is hungry, on an empty stomach, or had the food.

GERD Treatment in Ayurveda

As there is Agnimandya (impaired digestion) and formation of Ama, in all the conditions viz, Amlapitta, Ajeerna, Parinamashoola, and Annadravashoola, Deepana (appetizers) and Pachana (digestives)are to be done to stimulate the power of Agni and digest the undigested food material.

Vamana (emesis therapy), Virechana (purgation therapy), Anuvasana Basti (medicated oil/ghee enema therapy), and Asthapana Basti (medicated decoction enema) are the treatments of Panchakarma or purificatory procedures to treat vitiated Kapha dosha, Pitta dosha, and Vata dosha respectively.

The medicines either in single-drug therapy form or compound formulations that possess Tikta Rasa (bitter taste), Kashaya Rasa (astringent taste), Madhura Rasa (sweet taste), etc. to mitigate the Pitta dosha in Amlapitta.

The medicines used in Ajeerna, are to be chosen based on the dosha that is predominant to cause the condition.

In Parinamashoola and Annadravashoola, as Vata dosha obstructs the Pitta and Kapha dosha causing pain abdomen, the drugs that subside aggravated Vata dosha are selected and tackle Pitta and Kapha dosha.

Diet and Lifestyle in GERD

Purana Rakta Shali (old red variety of rice), Yava (barley), Godhuma (wheat), Mudga (green gram), Sharkara (sugar), Madhu (honey), Karavellaka (bitter gourd), Rambhapushpa (flowers of banana plantations), Patola (pointed gourd), Dadima (pomegranate), Vriddha Kushmanda (old ash gourd)are the food items to be taken in GERD.

Timely food intake, regular sleep, and wake cycle, regular physical exercise, brisk walking, eating food with a focused mind, yoga asana, pranayama, meditation, etc. are the lifestyle modifications.


Gastroesophageal reflux disease is a reflux condition in which gastric secretions are regurgitated in the esophagus. Amlapitta, Ajeerna, Parinamashoola, and Annadravashoola are the clinical conditions in Ayurveda that are correlated with GERD of contemporary science. The common underlying cause of all these conditions is Agnimandya and Ama Utpatti. The management of the conditions is aimed at Deepana and Pachana in the initial stages and then depending on the dosha, the Panchakarma treatment is decided.

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