Understanding the GIT disorders in Ayurveda on the

basis of ICD Submitted By:

DR. PRIYANKA BURAGOHAIN1st year P.G. Scholar.

DR. NIBEDITA SARMAH2nd year P.G. Scholar.

Guided By:

DR. ANUP BAISHYAAssociate Professor

P.G. Department of Roga Nidan Govt. Ayurvedic College & Hospital

Jalukbari, Guwahati-14

Gastrointestinal tract which starts from mouth and ends in the anus have played important role for the homeostasis of the different systems. As the digested food is the key factor for nourishment of the body; hypo functioning of it may lead to different diseases involved in different systems.

In Ayurveda Annavaha and Purishavaha srota combinely can be considered as a whole as gastrointestinal tract.

Introduction :

Annavaha and Purishavaha srotagata vyadhi can also be classified to make it easier for the diagnosis and treatment of the diseases.

International Classification of Diseases is the basis to classify diseases. It is the diagnostic classification standard for reporting diseases and health conditions.

Introduction contd...

To classify the diseases of GIT as per Ayurveda for the easier diagnosis and treatment of Gastrointestinal tract disorders in Ayurveda .

Aims and objectives:

Mukha (oral cavity) kledak kapha kledana

Amashaya (stomach) salivery digestion   Grahani pachak pitta

pachan Pittadhara kala gastrointestinal digestion

Unduka separation,absorption Pakwashaya samana vayu sara

kitta vibhajana

sara

soshana Guda Apana Vayu

Gudavalli excretion mala

bisharjana Gudostha

DIGESTION PROCESS :

Physiology of digestive system

Ahara diet

Mukha oral

cavity

Amashaya

stomach

Grahani small

intestineUnduka caecum

Pakwashaya colon & rectum

Bodhak kapha

Kledak kapha

Pachak pitta +Samana vayu

Samanavayu

Samana vayu +Apana vayu

sara

kitta

Rasavaha srotas

Purishvaha srotasMutravaha srotas

Vyadhi according to involvement of organs:

Amashaya

Ajeerna Agnimanda Shula Amaja shula Parinam shula Annadrava shula Amla pitta Krimi Udara Chardi Arsa

Vishuchika Alasaka Vilambika Anaha Adhman Atopa Rakta pitta Atisara Pravahika Krimi

Vyadhi acc to involvement of organs contd...

Pakwashaya

Grahani

Atisara Pravahika Krimi

Grahani Parinam shula

Vyadhi acc to involvement of organs contd...

Yakrit Udara/kostha

Yakrit dhalyudara Kamala Rakta pitta

Gulma Udar roga Arsha Kamala

Pliha

Plihodara Rakta pitta

Antra

Chidrodara Baddhagudadara

Vyadhi according to Agni Mandagni Visamagni Atisara Chardi Pravahika Agnimandya Ajeerna Vishuchika Grahani Arsa Udavarta Shula Atisara Grahani Udara roga Trishna Arochak Pandu Kamala Raktapitta

Agnimandya Ajeerna Alasaka Vilambika Gulma

Atyagni Amla pitta

Tikshnagni

Vyadhi according to involvement of Ama Amaja Niramaja Alasaka Vishuchika Vilambhika Amajeerna Agnimandya Amaja sula Amaja atisara Agantuja chardi(amaja) Prabahika Anaha Udara roga Amaja trishna Grahani Pandu Kamala Arsha Krimi roga Gulma Anaha Adhmana

Amla pitta udavarta

Vyadhi on the basis of chronocity: Asukari Chirakari Amlapitta Raktapitta Gulma Atisara Krima Ajeerna Arochaka Chardi Visuchika Alasaka Anaha Adhman Atopa Sula Trishna Agni mandya

Amlapitta Raktapitta Gulma Atisara Krimi Grahani Udar roga Pandu Kamala Pravahika Arsa Vilambhika

Sharirik Manashik

1. Grahani 1. Ajeerna

2. Udara roga 2. Arochak

3. Pandu 3. Chardi

4. Kamala 4. Sula

5. Amlapitta 5. Atisara

6. Arsa 6. Gulma

7. Vishuchika 7. Raktapitta

8. Krimi 8. Trishna

9. Gulma

Vyadhi according to involvement of sharira and mana

According to symptoms:Digestive/ secretory disorder Distension of abdomen Agnimandya Amajeerna Vidagdhajeerna Vistabdhajeerna Amlapitta Vishuchika Alasaka Vilambika Anaha

Alasaka Anaha Atopa Udar roga Baddhagudodara Udakodara Apanavata

vegadharana udavarta

Atisara- vriddhoati baddhah saratyesha Pravahika- pravahamanasya muhurmalaktam Grahanidosa Grahani roga-atisristam vivandham va dravam Sangrahani- pakhana masaha sadhwat va nityam Ghatiyantra grahani- malajjala ghati dhwanih Adhoga Amlapitta- adho va vividha prakaram Vishuchika Purishaja krimi

Acc. To symptoms contd...

Diarrhoeal diseases

Acc. To symptoms contd...

Constipating disease Disease with abdominal pain/ colics

Vivandha Anaha Adhman Pratyaadhman Udavarta

Sula Parinam sula Annadrava sula Amlapitta Atopa Krimi

Acc. to symptoms contd...

Diseases with swellings and lumps: Diseases with krimi

Udar roga Gulma roga

Chardi Atisara Sula Pandu

Acc. to symptoms contd...

Diseases with vomiting Hepatobiliary diseases Kaphaja agnimandya Urdhwaga vishuchika Annadrava sula Kaphaja amlapitta Kaphaja krimi Grhani Ajeerna

Pandu Kamala Halimak Panaki Kumbha kamala Sakhashrita kamala Kosthasrita kamala yakritdalyudara

First creation in 1948 by WHO as ICD- 6 WHO Nomenclature Regulations adopted it

in 1967 ICD-10 was endorsed in May 1990 by the

fourty third world health assembly. It is used by more than 100 countries. At present ICD – 9 and ICD-10 are being in

use. ICD – 11 will be released by 2017

INTERNATIONAL CLASSIFICATION OF DISEASES

(ICD) :

ICD coding is the backbone of Medical coding. Necessary for transforming descriptions of

diagnosis & procedures into universal acceptable medical code numbers.

It is the diagnostic classification standard for all clinical & research purposes.

All diseases, disorders, injuries and other related health conditions are listed in a comprehensive, hierarchical fashion.

ICD contd...

Used for easy storage, retrieval & analysis of health information for evidence based decision making.

Sharing and comparing health information between hospitals, regions, settings & countries.

Monitoring of the incidence & prevalence of diseases.

Keeping track of safety & quality guidelines. Observing reimbursements & resource allocation

trends. Counting of mortality and morbidity rates etc.

ICD contd...

Diseases of the digestive system :

ICD 9 Codes 520-579 ICD 10 Codes K00-K95

Diseases of oesophagus, stomach, and duodenum : ICD 9 (530-537), ICD 10 (K20- K31)

Appendicitis: ICD 9 (540-543), ICD 10 (K35-K38) Hernia of abdominal Cavity : ICD 9 (550-553) Non infective enteritis and colitis: ICD 9 (555-558), ICD 10 (K50- K52) Other diseases of intestines and peritoneum: ICD 9 (560-569), ICD 10 (K55-

K63) Peritonitis: ICD 10 (K65- K67) Diseases of Liver : ICD 10 (K70-K77) Diseases of Gall Bladder, Biliary tract and Pancreas: ICD 10 (K80-K87) Other diseases of Digestive System: ICD 9 (570-579), ICD 10 (K90-K93)

ICD 9 ICD 10 Disease Ayurvedic interpretation

531 K25 Gastric ulcer Annadrava sula

532 K26 Duodenal ulcer Parinam sula

533 K27 Peptic ulcer(unspec) Parinam sula

534 K28 Gastrojejeunal ulcer Parinam sula

535 K29 Gastritis and duodenitis

Amlapitta

536.3 Gastroparesis Vilamvika

536.8 K30 Dyspepsia Atopa

Comparision of ICD 9 with GIT disorders in Ayurveda

540 K35 Acute appendicitis Unduka puccha sotha

541 K37 Appendicitis unqualified Unduka puccha sotha/ chidrodara

542 K36 Other Appendicitis Unduka puccha sotha/ chidrodara

543 K38 Other diseases of Appendix Unduka puccha sotha/ chidrodara

550-553 Hernia of Abdominal cavity Vriddhi roga/ gulma

555 K50 Regional enteritis Grahani556 Idiopathic proctocolitis Guda paka556.9 K51 Ulcerative colitis, unspecified Sokaja/raktaja

atisara557 K55 Vascular insufficiency of

intestineDhamani pratisaya of annavaha and purishavaha srota

558 K52 Other noninfectious gastroenteritis and colitis

Visuchika

560 K56 Intestinal obstruction without hernia

Badhagudodara

562 K57 Diverticula of intestine Badhagudodara

564.0 K59.0 Constipation unspecified Mala badhata

564.1 K58 IBS Pakwasayagata vata/ grahani

564.6 K59.4 Anal spasm Guda sankoch

565 K60 Anal fissure and fistula Parikartika and bhagandara

566 K61 Abscess of anal and rectal region

Guda pidaka

567 K65 Peritonitis Chidrodara

569.3 K62.5 Bleeding rectal Adhoga raktapitta

K63.1 Perforation of intestine Chidrodara

571 Chronic liver disease and cirrhosis

Kumbha kamala

571.0 K76 Fatty liver, alcoholic Kapanubandha yakritaja vikara

571.2 K70 Cirrhosis, liver, alcoholic Madatyay janya yakrit vikara

571.4 K73 Hepatitis,chronic, unspecified Kamala 571.5 K74 Cirrhosis, NOS Kumbha kamala572 K75.0 Liver abscess and sequelae of

CLDYakrit vidradhi

572.2 K72 Coma, hepatic Yakrit janya murcha573.3 K71 Hepatitis, toxic Virrudha aharaja

yakrit vikara

574 K80 cholelithisis Pitta Asmari575.0 K81 Cholecystitis, Acute Pittaja Gulma575.9 K83 Gallbladder disease, unspec gulma

576.3

K83.2 Perforation of bile duct chidrodara

576.5 K83.4 Spasm of sphincter of oddi Vataja sula

577.0 K85 Pancreatitis , Acute Pittaja sula

577.1 K86.1 Pancreatitis, Chronic Kapha Pitta sula

577.2 K86.3 Pancreatic Cyst, pseudocyst Gulma

578 K92.2 Gastrointestinal haemorrhage Raktapitta

578.0 K92.0 Haematemesis Raktapitta

578.1 K92.1 Blood in stool, melena Amashayagata vrana / adhoga Raktapitta

579 K90 Intestinal malabsorption Grahani

579.1 K90.1 Tropical Sprue Sangraha Grahani

¦ÉäkÉÉ Ê½ý ¦Éät¨ÉxªÉlÉÉʦÉxÉÊkÉ, +xªÉlÉÉ {ÉÖ®ºiÉÉÊ‘zÉÆ ¦Éänü|ÉEÞúiªÉxiÉ®ähÉ Ê¦ÉxnxÉ ¦ÉänüºÉÆJªÉÉʴɶÉä¹É¨ÉÉ{ÉÉnªÉiªÉxÉäEúvÉÉ, xÉ SÉ {ÉÚ´ÉÈ ¦ÉänÉOɨÉÖ{ɽýÎxiÉ * Ch. Vi. 6/ 4An individual has the liberty to classify things as he likes. If something is already classified into some groups in a particular manner, he may reclassify it on the basis of different criteria which may result in changes in the number of groups in different ways. This does not invalidate the number of groups according to some other mode of classification.

Conclusion:

ICD coding is the backbone of medical coding. Therefore if we are able to code the gastrointestinal tract diseases in Ayurveda i.e Annavaha and purishavaha srotagata Vyadhis too with relation to ICD it will be easier for us to diagnose, record, and report them. It will help in the diagnostic classification standard for all clinical & research purposes.

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