Recurrent Anaphylaxis Episode: Ayurvedic Understanding and Treatment

Dr JV Hebbar BAMS, MD (Ayu), PGDPSM
Anaphylaxis is a serious allergy mimicking reaction of the body to an external stimulus. It can be life threatening. Ayurveda helps to analyze and treat this unique phenomenon.

Introduction

Anaphylaxis is an hypersensitive reaction of the body towards an insect bite, nuts, certain types of foods and medicines. Allergic skin patches (hives), severe itching all over the body, paleness of skin etc. are its main symptoms. It is an emergency condition requiring intense treatment.
Read – First Thing To Do In Allergy Attack- How I stopped My Daughter’s Cough

Causes

Nuts, peanuts, brinjal, fish, certain types of mushrooms, milk,
Medicines such as penicillin, non steroidal anti inflammatory drugs, aspirin,
Bee sting, latex of plants etc.
In some cases, the exact cause that triggers an anaphylactic reaction is hard to find.
Read – Bindi Allergy: Causes, Remedies, Ayurvedic Treatment

Symptoms

Skin exhibits symptoms such as itching, flushing, allergic hives, swelling and redness
Stomach and intestine related symptoms such as gastritis, vomiting sensation, vomiting, diarrhea, colic pain of abdomen
Respiratory symptoms such as nasal dripping, difficulty in breathing, tightness of chest, wheezing, congestion
Cardiovascular symptoms such as dizziness, lightheadedness, fast heart rate (tachycardia), and low blood pressure (source)

Ayurvedic analysis

Same set of causative factors may show anaphylactic reaction in some people whereas they show no symptoms at all in other people.
As per Ayurveda anaphylactic reaction can be commonly seen in
Vata body type persons – People with Vata prakriti often have weak immunity, low ojas due to under-nourished tissues of the body (Dhatu)
Pitta body type persons – People with Pitta Prakriti, are highly sensitive people and their body and mind reacts aggressively to sensitive foods or matters. Read more about Prakriti features as per Master Charaka
The above two categories of people naturally have a tendency for anaphylactic reaction, even if they follow a healthy diet and lifestyle.

The risk of anaphylaxis is more in people –
who have the issues of weak immunity, history of respiratory and skin allergies
Who do not follow healthy daily regimen seasonal regimen
Who are not disciplined with their diet and often indulge in wrong food combinations etc.

Ayurvedic Pathology

Ayurvedic pathology of an anaphylactic reaction can be explained in two stages.
Stage one – Slow toxin buildup:
In people who are prone to anaphylaxis, over a long period of time, Slow Dosha and Ama build up in the patient’s body. This increased Doshas that are circulating all over the body may or may not produce any symptoms.

Stage two – Sudden aggravation:
The increased Doshas get into an aggravated stage, when they are exposed to allergens, wrong foods such as nuts or due to any known or unknown external stimulus. This aggravated Doshas suddenly get lodged in the skin, respiratory system, cardio-vascular system or the digestive system to cause the respective symptoms. This happens in a short period of a few seconds to minutes. This can be considered as an external toxin afflicting hypersensitive reaction. This part of the pathology can be considered as Visha or Dushi Visha (poisoning) 
Read about – Dushi visha here

Samprapti – Flowchart of pathology of anaphylaxis as per Ayurveda:
Wrong food and diet -> Dosha aggravation + weak digestions strength = Ama + Doshas in the digestive tract -> over a period of time, it enters into different srotas (channels) -> joints, skin, respiratory channels etc. + There is sudden exposure to allergen -> Sudden increase of all three Doshas -> anaphylactic reaction.  

Sheetapitta, Udarda, Kotha

Master Madhavakara, in the textbook Madhava Nidana explains about Sheetapitta, which resembles Anaphylaxis. Some masters consider Sheetapitta as allergic dermatitis.
वरटीदष्टसंस्थानः शोथः सञ्जायते बहिः |
सकण्डूस्तोदबहुलश्छर्दिज्वरविदाहवान् ||३||
उदर्दमिति तं विद्याच्छीतपित्तमथापरे |
वाताधिकं शीतपित्तमुदर्दस्तु कफाधिकः ||४||
सोत्सङ्गैश्च सरागैश्च कण्डूमद्भिश्च मण्डलैः |
शैशिरः कफजो व्याधिरुदर्द इति कीर्तितः ||५||

Due to Kapha aggravation, there will be Kandu – itching
Due to Vata aggravation, there will be Toda – pain
Due to Pitta aggravation, there will be Jwara – fever, Chardi – vomiting, Vidaha – burning sensation
If Vata is excessively aggravated, it is called Sheetapitta and if Kapha is excessively aggravated, it is called Udarda. It is more commonly seen during winter.
In Udarda, there can be circular patches with redness, swelling and itching
Read – Urticarial Rashes: Ayurvedic Understanding, Treatment, Medicines, Remedies

Kotha –
असम्यग्वमनोदीर्णपित्तश्लेष्मान्ननिग्रहैः |
मण्डलानि सकण्डूनि रागवन्ति बहूनि च |
उत्कोठः सानुबन्धश्च कोठ इत्यभिधीयते ||६||
Kotha is a condition caused by Kapha and Pitta aggravation with circular allergic skin patches with redness and itching.
Read – Udarda Prashamana Gana – Anti Allergic Herb Group Of Charaka

Ayurvedic Treatment Plan

During an anaphylactic reaction, it is best to refer the client to a higher center
But during other times, based on the history of such anaphylactic reactions, the below line of treatment can help build a strong immunity and may help the person to reduce the frequency and intensity of future anaphylactic reactions.

Deepana,  Pachana treatment–
Helps in improving digestion strength and digesting out the remnant ama in the system (an amalgam of undigested foods and weak digestive juices)
Snehana, Swedana – As preparation for Panchakarma – Oleation and sweating treatments help to dilute and mobilize the aggravated Doshas.
Panchakarma therapy based on Dosha –
Vamana – Emetic therapy for Kapha Dosha,
Virechana – Purgation therapy for Pitta Dosha,
Basti – Enema therapy for Vata Dosha
Nasya (nasal drops) – when more of respiratory anaphylactic symptoms are observed
and Raktamokshana (blood letting therapy) when cardiovascular symptoms are commonly observed 

Daily healthy regimen
Waking up early in the morning, Nasya, oil pulling, herbal smoking, oil massage, exercise, powder massage etc. minor therapies on a daily basis help to nip Dosha aggravation in its bud. They help Doshas go up to toxic levels.  
Read – How to Live Healthy Everyday With Ayurveda

Ayurvedic medicines

Depends on the system affected. 
Detoxifying medicines such as 
Vilwadi Gulika, 
Vidangadi lauha 
Kaivisa Parihari Pills
Bhallataka rasayana are commonly used

If the patient often gets respiratory symptoms, then
Chyawanprash
Talisadi Churna,
Sitopaladi Churna
Shwasa Kuthar Ras
Shwasa Kasa Chintamani Rasa
Pushkara Mulasava
Agastya Rasayana

For skin related symptoms:
Haridra Khanda 
Khadirarishta 
Madhusnuhi Rasayana 
Gandhaka Rasayana 
Pippali Rasayana 
Arogyavardhini Ras

For digestive symptoms:
Madiphala Rasayana
Avipattkiara Churna
Triphala Churna
Sutashekhar Ras
Laghu Sutashekhar ras
Putikaranjasava
Kalyanaka Kashayam
Dantyarishtam

For cardiovascular symptoms:
Prabhakar Vati
Arjunarishta
Dashamoola Rasayana
Dashamoolarishtam

Ayurvedic Herbs

Tulsi, Madhusnuhi, Kutki, 
Neem,
Patola – Pointed gourd 
Curry leaves
Chavya – Piper retrofractum
Kataka – Clearing Nut – Strychnos potatorum
Shirisha 
Vidanga – Embelia ribes 
Turmeric, Tree turmeric, 
Jatamansi, 
Tagara 
Arka 
Devadaru 
Licorice,
Apamarga 
Agastya – Sesbania grandiflora
Swarna Bhasma 
Rajata Bhasma 
Swarna Makshika – Iron pyrite 
Punarnava
Tamra Bhasma – Copper Calx

Foods

Making a list of allergy causing food ingredients and avoiding them helps immensely.
Include more of cinnamon, turmeric, cardamom, cumin, coriander, turmeric in diet
Tulsi tea is useful
CCF tea made of cumin, coriander and fennel is good to have.

Research

Anaphylaxis pathophysiology – A review article has described immunopathogenesis and pathophysiology of anaphylaxis. This study has also reviewed possible host factors which may influence the occurrence or severity of anaphylaxis.