“Clinical Evaluation of Shamana Chikitsa in Pittashmari w.s.r. to Cholelithiasis: A Case Study”

About Author

Correspondence Address

D.M.M.AYURVED COLLEGE,ARNI ROAD, SHIVAJINAGAR, YAVATMAL.
Contact No. : 9834670385, Email : nandsaste2000@gmail.com

Date of Acceptance : 28 Jun 2026

Date of Publication : 30 Jun 2026

Article ID : SD-IJAY_186

How to cite this article : http://doi.org/10.55552/SDNJAY.2026.4213

Abstract

Background: Cholelithiasis is a common hepatobiliary disorder characterized by the formation of gallstones and is a frequent cause of abdominal pain and dyspeptic symptoms. In Ayurveda, it can be correlated with Pittashmari based on its clinical features and pathogenesis. Ayurvedic management aims to restore the balance of Doshas, improve Agni, and facilitate the resolution of pathological processes responsible for stone formation.

Aim: To evaluate the clinical outcome of Ayurvedic management in a case of Pittashmari w.s.r. cholelithiasis. Materials and Methods: A 35-year-old male patient presented with intermittent right hypochondriac pain, nausea, occasional vomiting, indigestion, loss of appetite, and burning sensation after intake of oily and spicy food. Ultrasonography revealed mobile gallbladder calculi measuring 3.7 mm and 3.3 mm without evidence of cholecystitis. The patient was managed with Aarogyavardhini Vati, Punarnava Mandura, Sutshekhar Rasa, Punarnavasava, a combination of Punarnava Guggulu, Kutaki Churna, Punarnava Churna, Hajral Yahud Bhasma, and Sukhvirechan Churna. Clinical symptoms and ultrasonographic findings were assessed before and after treatment.Results: The patient showed marked improvement in abdominal pain, nausea, indigestion, burning sensation, and appetite. Follow-up ultrasonography demonstrated complete resolution of the previously detected gallbladder calculi with no significant diagnostic abnormality. Conclusion: The present case indicates that Ayurvedic management may provide significant symptomatic relief and may facilitate the resolution of small gallbladder calculi in uncomplicated cases. Further well-designed clinical studies with larger sample sizes are required to validate these findings.

Introduction

According to Ayurveda, not every disease can be assigned a specific name; however, effective management is possible through an assessment of its Nidana Panchaka.

विकारनामाकुशलो न जिह्रीयात् कदाचन ।

न हि सर्वविकाराणां नामतोऽस्ति ध्रुवा स्थितिः || च. सु. 18/44 [1]

Cholelithiasis is not directly described in the Ayurvedic classics; however, based on its etiopathogenesis, clinical manifestations, and anatomical location, it can be correlated with Pittashmari or Pittashaya Ashmari. According to Ayurveda, vitiation of Pitta and Kapha Dosha, along with Agnimandya, leads to the formation of Ashmari-like structures. The pathological process involves the accumulation, condensation, and solidification of morbid materials, ultimately resulting in stone formation. Symptoms such as Udarashoola, Aruchi, Agnimandya, Chardi, and Ajirna described in Ayurveda closely resemble the clinical features of cholelithiasis.[2]

Ayurveda advocates a holistic treatment approach aimed at correcting Dosha imbalance, enhancing Agni, eliminating accumulated pathological substances, and restoring normal physiological functioning. Several Ayurvedic formulations possessing Ashmaribhedana (lithotriptic), Deepana, Pachana, Pittashamaka, and Shothahara properties have been reported to be beneficial in the management of Pittashmari. Clinical observations and case reports have demonstrated encouraging outcomes in terms of symptomatic relief and reduction in gallstone size through Ayurvedic interventions. [3,4]

Gallstones are a common medical problem in the general population, often leading to

Surgical intervention. It is more often seen in Women than men, with the ratio of 4:1.

It is said that gallstones are more common in Fat, Fertile, forty, and females, i.e., four F’s.[5]

Cholelithiasis is a common biliary tract disorder characterized by the formation of gallstones within the gallbladder. Gallstones are broadly classified into cholesterol stones and pigment stones. While many gallstones remain asymptomatic, symptoms develop when stones cause inflammation or obstruct the cystic duct or common bile duct. The characteristic presentation is biliary colic, a severe and persistent pain in the right upper quadrant or epigastric region, often radiating to the back or right scapula and frequently associated with nausea and vomiting. Symptoms commonly occur after meals, particularly fatty foods, due to gallbladder contraction and transient biliary obstruction. Management depends on the severity of symptoms and associated complications. Asymptomatic patients are generally managed conservatively, whereas symptomatic cholelithiasis is commonly treated with laparoscopic cholecystectomy, which remains the gold standard treatment. However, surgical intervention may not be suitable for all patients, highlighting the need for safe and effective conservative treatment approaches. [6]

AIM – To evaluate the efficacy of ayurvedic management of Pittashamri (cholelithiasis).

Discussion

Conclusion

The present case study demonstrates that an Ayurvedic treatment protocol focused on Agni correction, Pitta-Kapha pacification, Shothahara action, and Ashmaribhedana principles was associated with significant clinical improvement in a patient with cholelithiasis correlated with Pittashmari. The patient experienced substantial relief from abdominal pain, nausea, indigestion, and burning sensation, while follow-up ultrasonography revealed complete resolution of previously documented small gallbladder calculi. The combined actions of Deepana, Pachana, hepatoprotective, cholagogue, and lithotriptic formulations may have contributed to improved biliary physiology and gradual elimination of calculi. Although this is a single-case observation and cannot establish definitive efficacy, it highlights the potential role of Ayurvedic management as a conservative therapeutic approach in selected patients with uncomplicated cholelithiasis. Further well-designed randomized controlled trials with larger sample sizes and long-term follow-up are needed to scientifically validate these findings.

References