In 'Panchakarma' or 'retreat therapies', many steps are taken, each tailored to patient with the right dose and proportion of the ingredients and activities, and each treatment in sync with others in the sequence. A Vaidya uses his/her knowledge, training, experience and intuition to plan a schedule that helps your body cleanse, repair and rejuvenate as fast and efficient as possible so that you can heal faster, easier and more completely.
PANCHAKARMA SEQUENCE
Preparatory relaxation therapies Stress is the beginning and toxicity is the next step in almost all diseases. Ayurveda recommends appropriate relaxation, cleanse and repair in a disease. We use literally tens of thousands of herbs in hundreds of time-tested recipes and fine-tuned treatment techniques to achieve renewal of your body and mind. Relaxation therapies start with horizontal position, herbal oils, hot baths and deep strokes.
Abhyanga, Sekam, Pichu, Varti
Mardana and marma points
Anulomana and strokes
Pre-Panchakarma therapies This is to dissolve and dislodge the toxins effectively from the cells and thus giving the cells the best environment to heal, faster and better.
Snehana - internal and external - includes a large range of techniques such as such as abhyanga, seka, pichu, vasti and avagaha using recipes such as medicated ghees, oils, and fats.
Svedana - internal and external - includes a large range of techniques such as drava, ruksha, sankara, prastara, nadi, parisheka, avagahana, jentaka, ashmaghna, karshu, kuti, bhu, kumbhika, kupa, and holaka using heated water and oils.
Panchakarma/Panchashodhana therapies This is to remove toxins from the cells safely. Not all therapies are required in any given disease. These treatments are used based on the biochemical nature and anatomical location of the toxins and disease.
Nasya
Raktamoksha
Vamana
Virechana
Vasti - Snehavasti and Kashayavasti
Post-panchakarma therapies This is to stabilise the digestion and metabolism to address the world.
Peyadikrama
Rasayana therapies This is to empower the body and mind.
Reconditioning and renewal therapies
A few interesting facts Panchakarma and Panchashodhana are theoretically similar and different. No one requires all these karmas, at least during one stay. Nasya and Vasti are done in a course of 3-28 daily treatment sessions. Vamana, Virechana and Raktamoksha are done once during the stay.
A SMALL LIST OF AYURVEDA THERAPIES
Each of these therapies are personalised using the preparation method, timing, duration, technique applied and ingredients used. In short, each therapy can be done in innumerable ways.
Abhyanga - Abhyanga is known as Ayurvedic massage. Technically massage is mardana. Abhyanga is only application of oil on the body. The massage style varies according to the therapist but it generally involves long strokes on the long bones and circular strokes around the joints. It can be firm or gentle according to the patient’s needs. A warm herb- infused oil suitable to the patient’s problem or constitution is applied or in some cases a herbal powder is employed (churna-abhyanga.)
Avagaham - Immersion of the body or limbs in an individualised herbal fluid or oil to strengthen the area, reduce inflammation and accelerate healing.
Bahyavasti - Pooling herbal fluids over an area of the body. This ensures the area absorbs the maximum amount of the therapeutic herbs. Kativasti (back), greevavasti (neck), urovasti (chest) are some specific styles of Bahya-vasti.
Brihmana - A series of therapies to rebuild and replenish the mind and body.
Dehadhara - In Deha-dhara (also known as pizhichil) a warm herbal oil or milk is poured over the body. This is one the most rejuvenating and soothing therapies to empower the nervous, muscular and skeletal systems. Chronic fatigue syndrome, poor circulation and chronic muscle tension is treated successfully with deha-dhara.
Dhumam - Herbal fumes to remove toxins and purify areas such as the ear canal, sinus and skin.
Gandharva-veda - Gandharva-veda This is Ayurvedic music therapy. It uses musical melodies (ragas) or mantras to create a harmonious vibration in the mind and body.
Gandusham - Herbal oil gargling to restore the health of teeth and gums.
Greevavasti - This entails pooling oil over the neck for conditions such as prolapsed disc, degenerative spinal conditions, chronic neck pain, compressed discs and spondylosis.
Januvasti - When therapeutic oils are pooled over the knee it is known as janu-vasti. This strengthens the knee joint by improving the circulation, joint lubrication strength and stability. It is often employed in arthritis and knee injuries.
Kayakalpa - A complete program of rejuvenative therapies and observances undergone over weeks or months.
Karnapuranam - A therapy for ear problems, vertigo or tinnitus whereby warm herbal oil is poured into the ear canal.
Kashayadhara - Herbal decoctions are poured continuously over the body. Kashaya dhara treats conditions such as rheumatoid arthritis, osteoarthritis, varicose veins, blocked circulation, dull skin, pain, psoriasis and eczema.
Kativasti - Warm oil is pooled over the sacrum or lower back to rejuvenate joints, tendons and muscles. Extremely useful in sacro-iliac problems, disc prolapses, lumbar spondylosis, osteoporosis, sciatica, periformis syndrome and chronic backache.
Kavalagraham - Keeping the mouth full with a herbal liquid to heal or tones the tonsils, sinuses, teeth, gums, vocal cords, pharynx and larynx.
Ksheeradhumam - Steam fomentation with medicated cow’s milk. This treatment is good for facial paralysis, Bell’s palsy, speech disorders and other neurological disorders of the face.
Langhanam - A series of lightening therapies to reduce excess weight and waste.
Lepanam - Herbal pastes are used to purify and replenish the skin. Lepanam is also used for lymphatic congestion, bruises, fractures, rashes and poison.
Mardana - The traditional term for Ayurvedic massage
Marma-chikitsa - Marma-chikitsa Ayurvedic acupressure to reduce pain and promote healing energy.
Nasya - Nasya involves medication up the nasal passages. It is applied in conditions related to the eyes, nose, throat, brain, vocal cords and tonsils.
Navara-kizhi - Also known as shashtika- pinda-swedam. A bolus of herbal or plain rice is dipped in warm herbalised milk or decoction and massaged over the body. This treatment is used to regenerate wasted tissues such as muscles, tendons and ligaments, stabilise joints and cartilage. It is also assists recovery from strokes and paralysis.
Netra-dhara - For deep eye rejuvenation and purification herbal fluids are allowed to flow continuously over the eyes. Useful for all vision and eye problems.
Netra-tarpanam - Warm herbal gee is pooled over the eyes to renew the vision, optic nerves and retina. Retinal detachment, short sightedness, glaucoma and neurological weaknesses of the eyes are treated with Netra- tarpanam. This is also known as Akshi- tarpanam.
Paada-aghata - An Ayurvedic massage whereby the therapist massages the client with their feet, keeping their balance by holding on to an overhanging rope.
Pancha-karma - Five Ayurvedic therapies that are designed to cleanse every organ and tissue of our body. Panchakarma may include vomiting, laxatives, nasal medication, enema and blood letting.
Paschaat-karma - Post panchakarma therapies designed to ease the body back to a normal diet and routine.
Patra-pinda-swedanam - A herbal bolus is massaged over the body. This is often used to relieve back pain, lymphatic congestion, spondylosis, sciatica or arthritis.
Pichu - A warm oil pad is applied to the body, keeping it constantly warm by dipping in hot oil. This therapy is used successfully on prolapsed discs, damaged joints, chronically tense tendons and muscles, memory loss and insomnia. Based on the location it may be known as shiropichu (head), prishtapichu (back), sandhipichu (joints) or greevapichu (neck).
Purva-karma - Pre-panchakarma therapies to optimize one’s ability to assimilate the effect of deep cleansing and rejuvenation. This may include abhyanga, snehapana, swedana and other therapies.
Puta-paakam - Puta-paakam employs herbal juices to purify and tone the eyes. This is used in conjunction with Netra-tarpanam. Dry eye syndrome and cataracts are some of the conditions where these therapies are utilised.
Rakta-moksha - Rakta-moksha means blood-letting. It helps to heal diseases caused by toxins trapped in the blood. Special leeches or instruments are used to extract blood. Chronic migraine, ulcers, varicose veins and eczema are some conditions where rakta- moksha may be applied.
Rasayanam - A series of tailored therapies to rejuvenate the mind and body. Rasayanam invariably involves a strict diet, rest, meditation and herbs.
Rukshanam - Reducing and drying therapies to remove excess cholesterol, unwanted fat and fluid from the body.
Samsarjana-kriya - Select dietary or herbal preparations are given to rekindle the digestion and metabolism. This optimises assimilation of nutrients.
Shamanam - A group of therapies that prevent from accumulating in the body as wellYogaTherapyInstitute.com.au
Shirobhyanga - Soothing Ayurvedic massage of the head, neck & shoulders using warm herbal oils. Indicated in insomnia, eyestrain, headache, premature greying & hair loss.
Shirodhara - Approximately two litres of warm, herbalised oil is poured onto the forehead in a soothing rhythm from temple to temple for 40-50 minutes.
Shirovasti - A tall, open-topped cap is sealed around the head and filled with therapeutic herbal oil. The cap remains in place for up to an hour. Common conditions for shiro- vasti are anxiety, facial paralysis, insomnia, psychological conditions, psoriasis and stress.
Snaanam - Snaanam Bathing in different therapeutic substances which may include Ksheera-snanam (milk), taila-snaanam (oil), lavana-snanam (salt).
Snehanam - These nourishing therapies involve the use of oil or ghee externally and internally to restore essential fats and moisture to the body. It also lubricates the body to promote purification.
Snehapaanam - Drinking herbal ghee in order to lubricate the channels and dilute deep- seated cellular toxins. This prepares the body for deep detoxification.
Soundarya-charya - Ayurvedic beauty therapy utilizes innumerable methods to enhance one’s innate beauty. It includes treatments for smooth radiant skin, lustrous hair and a toned physique. Therapies may involve facials, hair treatments, steam, exfoliation, masks, wraps and massage.
Svedana - Is sweating therapies to optimize circulation, assimilation and elimination through the channels. Various forms of heat may be such as a steam chamber, sauna, warm blanket or warm bolus.
Talam - Application of herbal paste over a small area such as a bruise, torn tendon or joint subluxation is known as Talam. For insomnia and bad dreams it is used on the crown.
Udvartana - Ayurvedic massage with herbal or legume powder. It is used for weight loss and tones the skin, cleanses the lymphatics, reduces cellulite and stimulates the metabolism.
Uzhichil - Another term for Ayurvedic massage.
Vajeekaranam - Rejuvenating therapies to improve the quality and quantity of one’s sexual fluids in order to optimise fertility. The ultimate goal of this therapy is ultimate sexual satisfaction and to produce healthy progeny. Vajeekaranam also prevents genetic and congenital disorders.
Vamanam - Vamanam is a vomiting therapy to remove kapha predominant toxins that usually give rise to disorders related to mucus, congestion, heaviness, swelling and obesity. Conditions which can improve with vamanam include asthma, respiratory allergies, hay fever, psoriasis and eczema.
Varti - Herbs are soaked in a cotton tube and inserted into tubular structures of the body such as the nose, vagina, tubular ulcers or fistulas. This is used to treat infections, lubricate the channel and accelerate healing.
Vasti - Vasti is a decoction or oil enema that cleanses and rejuvenates the whole body. It is generally inserted in the anus but also the vagina in rare cases. Vasti is a broad-spectrum remedy particularly prescribed for vata disorders.
Veshtanam - Wraps with warm herbal pastes that reduce swelling, cellulite and lymphatic congestion.
Virechanam - Virechanam is a strong laxative (purgation) process. It removes excess pitta which can cause acidity, rashes, burning, bleeding, diarrhoea, irritability and agitation. Virechanam treats disorders of the liver, spleen, gall bladder, stomach, small intestine and skin when applicable.
The Kerala retreat therapies
These are oil and other tactile therapies, which are either rejuvenative or pre-panchakarma therapies practiced in Kerala.
Oil Application ~ Abhyanga: Full body and head massage with herbal oils freshly prepared on the premises. As with most treatments, this is carried out by several trained masseuses or masseurs on a specially carved wooden table. This is called a Droni and is made from a medicinal wood such as teak, sandalwood, Jack tree, Himalayan cedar or neem. Benefits: Most relaxing and rejuvenative. Used in disorders of Vata, such as rheumatism, arthritis, muscle, bone and neurological disorders.
Herbal stream ~ Dhara: Milk, buttermilk, medicated oil, ghee or herbal decoctions are poured on the head or body in a specific rhythmic way from a wide-mouthed earthen vessel with a cord hanging from the centre. The patient lies on the Droni, a clean cloth is then tied around their head to prevent oil from pouring into their eye. The treatment lasts for 60 to 90 minutes. When it is done on the body, it will be accompanied by massage also. Benefits: Dhara alleviates fatigue, improves mental capacities and restores systemic imbalances. It is especially useful in insomnia, chronic fatigue, chronic headaches, ear and nose diseases, neurological diseases, spondylitis, paraplegia and psychiatric disorders.
Oil steam ~ Pizhichil: At least four attendants are required in this treatment. The patient lies on the Droni and the attendants then dip cotton strips of cloth into warm medicated oil and apply the oil by squeezing it from the cloth onto the body. The patient is then massaged all over and then bathed in a special herbal infusion and pulse flours. The treatment generally lasts for about 40 to 90 minutes. Benefits: Specific musculo-skeletal disorders, rheumatoid arthritis, osteoarthritis, lumbago, sciatica, hemiplegia, neuropathry, chronic fatigue, skin disorders and mental disturbances.
Rice pudding massage ~ Navara kizhi: This treatment causes the whole body to sweat by the gentle application of warm medicinal rice and herbs. Medicated oil is massaged over the head and body of the patient. The patient then lies on the Droni and cotton bundles of special navara rice are massaged over the body. Massage is continued for up to one and a half hours. The excess rice is then cleaned from the body, then oil massage and warm bath is taken. Benefits: Musculo-skeletal disorders, rheumatism, paralysis and sciatica.
Cranial oil pooling ~ Sirovasti: This treatment requires the patient to get fitted with an open topped “dunce cap”. It is fitted around the head with special dough and cloth. The patient generally sits upright as the warm medicated oil is poured into the cap, effectively covering the crown of the head. The treatment continues for 45 to 90 minutes. While the oil is taken out and reheated oil will be filled in the hat at regular intervals, without disturbing the system. The body will be massaged with medicated oil before and after treatment. At the end the oil on the head is then wiped with dry towels and the patient’s body is bathed in warm water. Benefits: Ear, nose and throat disorders, chronic headaches, facial paralysis, spondylitis, insomnia, psychiatric and nervous disorders.
Conditions we regularly treat
ANO RECTAL DISEASES
Haemorrhoids: Hemorrhoids develop when the blood vessels in the lower rectum and anus swell, often due to increased pressure from straining during bowel movements, chronic constipation, or prolonged sitting. Over time, the veins become engorged and form protrusions, which can cause discomfort, pain, and bleeding. Inflammation and thrombosis may occur, leading to more severe symptoms. The underlying cause is often a combination of increased abdominal pressure and weakened venous walls, which can be influenced by factors like diet, lifestyle, and genetic predisposition.
Anal Fissure: An anal fissure is a small tear in the lining of the anus, typically caused by passing hard or large stools, which stretches the anal canal beyond its capacity. This tear exposes the underlying muscle, leading to pain and bleeding during bowel movements. The resulting spasm of the anal sphincter muscle further reduces blood flow to the area, delaying healing. Chronic fissures may develop from persistent trauma or underlying conditions like inflammatory bowel disease. The cycle of injury, pain, and muscle spasm perpetuates the condition.
Anal Fistula: An anal fistula is an abnormal tunnel-like connection between the inner anal canal and the skin around the anus. It often arises from an untreated anal abscess, where an infected gland inside the anus forms a collection of pus. If the abscess does not heal properly, it can create a pathway through the tissue, resulting in a fistula. This condition can cause recurrent infections, pain, and discharge. The underlying pathology involves chronic infection and inflammation, often requiring surgical intervention to fully resolve.
Faecal Incontinence: Faecal incontinence occurs when the muscles and nerves that control bowel movements weaken or become damaged, leading to an inability to control the release of stool. This can result from childbirth, aging, surgery, or neurological conditions that impair the function of the anal sphincters and pelvic floor muscles. The loss of control may be partial or complete, causing embarrassment and affecting quality of life. The condition is often linked to both structural damage and neurological dysfunction, which disrupts normal bowel regulation.
Pruritus Ani: Pruritus ani, or itching around the anus, is often caused by irritation from moisture, friction, or chemical irritants such as soaps or food irritants. This itching can lead to scratching, which further irritates the skin and perpetuates the cycle. Conditions like haemorrhoids, infections, or dermatitis can also contribute to the problem. In many cases, the exact cause remains unclear, but it is often linked to skin sensitivity and hygiene habits that disrupt the normal protective barrier of the skin.
Proctalgia Fugax: Proctalgia fugax is a sudden, severe pain in the rectum, lasting from seconds to minutes, and is often described as a spasm or cramp. The exact cause is unknown, but it is thought to be related to muscle spasms in the anal sphincter or pelvic floor. The condition is benign and self-limiting, but the intense pain can be distressing. Triggers may include stress, constipation, or pelvic muscle dysfunction, although the pain often occurs without any identifiable cause.
Rectoanal Abscess: A rectoanal abscess is an infection in the anal glands that leads to the accumulation of pus in the tissues around the anus and rectum. It is often caused by blockage of the anal glands, which allows bacteria to multiply and form an abscess. The condition presents with pain, swelling, and fever, and if left untreated, it can lead to the formation of an anal fistula. The underlying pathology involves infection, inflammation, and the body's response to the trapped pus.
Excessive Perineal Descent: Excessive perineal descent occurs when the pelvic floor muscles weaken, causing the perineum (the area between the anus and genitals) to drop below its normal position. This can lead to discomfort, a feeling of heaviness, and difficulty with bowel movements. The condition is often associated with chronic straining, childbirth, or age-related weakening of the pelvic floor. The descent can disrupt normal bowel function and contribute to conditions like faecal incontinence or rectal prolapse.
Diverticulosis: Diverticulosis is the formation of small, bulging pouches (diverticula) in the lining of the colon, typically as a result of increased pressure within the colon. This condition is often associated with a low-fibre diet, which leads to hard stools and straining during bowel movements. The diverticula themselves are usually harmless, but they can become inflamed or infected, leading to complications. The underlying pathology involves weakening of the colonic wall and increased intracolonic pressure.
Diverticulitis: Diverticulitis occurs when one or more diverticula in the colon become inflamed or infected, often due to trapped fecal matter. This leads to localized pain, fever, and changes in bowel habits. The inflammation can cause complications such as abscess formation, perforation, or bleeding. The condition is a progression of diverticulosis and is typically triggered by a combination of factors including diet, colonic pressure, and bacterial infection.
Colitis: Colitis refers to inflammation of the colon, which can be caused by infections, autoimmune disorders, or reduced blood flow. The inflammation leads to symptoms such as diarrhoea, abdominal pain, and bleeding. In conditions like ulcerative colitis, the immune system mistakenly attacks the lining of the colon, causing chronic inflammation. The pathogenesis involves a complex interplay of genetic, environmental, and immune factors that disrupt the normal function of the colon, leading to inflammation and tissue damage.
AUTOIMMUNE CONDITIONS
Addison's Disease: Addison's disease occurs when the adrenal glands fail to produce sufficient levels of cortisol and, in some cases, aldosterone. This is usually due to autoimmune destruction of the adrenal cortex, where the body’s immune system mistakenly attacks its own adrenal tissue. The resulting hormone deficiency affects many bodily functions, leading to symptoms like fatigue, weight loss, low blood pressure, and electrolyte imbalances. The pathogenesis involves chronic inflammation and gradual loss of adrenal function, often triggered by a combination of genetic predisposition and environmental factors.
Celiac Disease (Gluten-Sensitive Enteropathy): Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. In genetically predisposed individuals, gluten causes an abnormal immune response that damages the lining of the small intestine, leading to malabsorption of nutrients. The inflammation and villous atrophy (flattening of the villi) result in gastrointestinal symptoms like diarrhoea, bloating, and weight loss, as well as systemic effects such as anaemia and osteoporosis. The pathogenesis involves a combination of genetic susceptibility, environmental exposure to gluten, and immune-mediated tissue damage.
Dermatomyositis: Dermatomyositis is an inflammatory disease marked by muscle weakness and a distinctive skin rash. It occurs when the immune system mistakenly targets muscle tissue and blood vessels, leading to inflammation and muscle fibre damage. The exact cause is unclear, but it is thought to involve a combination of genetic predisposition and environmental triggers, such as infections or UV exposure. The resulting inflammation leads to muscle weakness, primarily in the shoulders and hips, along with characteristic skin changes. The chronic immune response causes progressive muscle degeneration and fibrosis.
Graves' Disease: Graves' disease is an autoimmune disorder where the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones, leading to hyperthyroidism. These antibodies, known as thyroid-stimulating immunoglobulins (TSIs), mimic the action of thyroid-stimulating hormone (TSH) and cause the thyroid to enlarge (goitre) and become overactive. The condition results in symptoms like weight loss, rapid heartbeat, anxiety, and eye problems. The underlying pathogenesis involves a combination of genetic predisposition and environmental triggers that lead to the dysregulation of the immune system.
Hashimoto's Thyroiditis: Hashimoto's thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, leading to chronic inflammation and gradual loss of thyroid function. Over time, this results in hypothyroidism, where the gland cannot produce enough thyroid hormones to meet the body's needs. The condition often presents with symptoms like fatigue, weight gain, cold intolerance, and depression. The pathogenesis involves a complex interplay of genetic, environmental, and immunological factors that lead to the progressive destruction of thyroid tissue.
Multiple Sclerosis: Multiple sclerosis (MS) is a chronic autoimmune disease in which the immune system attacks the protective myelin sheath surrounding nerve fibres in the central nervous system. This leads to inflammation, demyelination, and eventual damage to the nerves themselves, disrupting the flow of electrical signals between the brain and the rest of the body. The resulting neurological symptoms can vary widely but often include fatigue, weakness, vision problems, and difficulty with coordination and balance. The pathogenesis is thought to involve a combination of genetic susceptibility and environmental factors.
Myasthenia Gravis: Myasthenia gravis is an autoimmune disorder that disrupts communication between nerves and muscles, leading to muscle weakness and fatigue. The immune system produces antibodies that block or destroy acetylcholine receptors at the neuromuscular junction, preventing proper muscle contraction. The condition typically affects voluntary muscles, especially those controlling eye movement, facial expression, and swallowing. The pathogenesis involves a combination of genetic predisposition and an abnormal immune response, often triggered by factors such as infections or thymus gland abnormalities.
Pernicious Anemia: Pernicious anaemia is an autoimmune condition where the immune system attacks the stomach's parietal cells or intrinsic factor, both of which are necessary for the absorption of vitamin B12. This leads to a deficiency in vitamin B12, which is crucial for the production of healthy red blood cells and proper neurological function. The resulting anaemia causes symptoms like fatigue, weakness, and neurological disturbances. The pathogenesis involves chronic inflammation and atrophy of the stomach lining, leading to impaired B12 absorption and subsequent haematological and neurological effects.
Reactive Arthritis: Reactive arthritis is an autoimmune condition that develops in response to an infection elsewhere in the body, typically in the urinary tract, intestines, or genitals. The immune system mistakenly attacks the joints, causing inflammation, pain, and swelling, often in the knees, ankles, or feet. The condition may also affect the eyes, skin, and urinary tract. The pathogenesis involves a cross-reactivity between bacterial antigens and the body’s own tissues, leading to an abnormal immune response in genetically predisposed individuals.
Rheumatoid Arthritis: Rheumatoid arthritis (RA) is a chronic autoimmune disorder where the immune system mistakenly attacks the synovium—the lining of the joints—leading to inflammation, pain, and swelling. Over time, this inflammation can cause joint damage, erosion of bone and cartilage, and loss of joint function. RA typically affects multiple joints symmetrically and can also cause systemic symptoms such as fatigue and organ involvement. The pathogenesis involves a complex interplay of genetic factors, environmental triggers, and immune system dysregulation, leading to chronic inflammation and tissue destruction.
Sjögren's Syndrome: Sjögren's syndrome is an autoimmune disorder where the immune system attacks the body's moisture-producing glands, particularly the salivary and lacrimal glands, leading to dryness of the mouth and eyes. The inflammation can also affect other organs, causing symptoms like joint pain, fatigue, and organ dysfunction. The pathogenesis involves a combination of genetic predisposition, environmental triggers, and immune system abnormalities that lead to chronic inflammation and glandular dysfunction.
Systemic Lupus Erythematosus (SLE): Systemic lupus erythematosus (SLE) is a chronic autoimmune disease where the immune system attacks multiple tissues and organs, including the skin, joints, kidneys, heart, and brain. The disease is characterised by periods of inflammation and tissue damage, with symptoms that can vary widely depending on the organs affected. The pathogenesis involves a complex interplay of genetic, hormonal, and environmental factors that lead to immune system dysregulation and the production of autoantibodies, which target the body’s own tissues.
Ulcerative Colitis: Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon and rectum, leading to inflammation and ulceration of the inner lining. The exact cause is unknown, but it is believed to involve an abnormal immune response to the gut’s normal flora, possibly triggered by genetic and environmental factors. The inflammation causes symptoms like diarrhoea, abdominal pain, and rectal bleeding. The chronic inflammation can lead to complications such as strictures, perforations, and an increased risk of colon cancer.
Crohn's Disease: Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, from the mouth to the anus, but most commonly affects the terminal ileum and colon. The inflammation can penetrate deep into the layers of the bowel wall, leading to symptoms like abdominal pain, diarrhoea, and weight loss. The exact cause is unknown, but the pathogenesis involves a combination of genetic susceptibility, environmental factors, and an abnormal immune response to intestinal bacteria, resulting in chronic inflammation and tissue damage.
BONE HEALTH
Osteopenia: Osteopenia is a condition characterized by lower-than-normal bone density, which is a precursor to osteoporosis. It occurs when bone resorption slightly outpaces bone formation, leading to a reduction in bone mineral density (BMD). Although not as severe as osteoporosis, osteopenia indicates that bones are weaker than they should be, increasing the risk of fractures over time. The condition can be influenced by factors such as age, hormonal changes, nutritional deficiencies, and a sedentary lifestyle. The pathogenesis involves gradual bone thinning due to imbalanced bone remodelling processes.
Osteoporosis: Osteoporosis is a condition where bones become weak and brittle due to a decrease in bone density and mass. It occurs when the rate of bone resorption by osteoclasts exceeds the rate of bone formation by osteoblasts. This imbalance is often influenced by hormonal changes, particularly a drop in oestrogen levels in postmenopausal women, as well as age, genetics, and lifestyle factors like poor diet and lack of exercise. The weakened bones are more susceptible to fractures, particularly in the hips, spine, and wrists. The pathogenesis involves progressive bone loss and structural deterioration.
Osteomalacia: Osteomalacia is the softening of bones due to defective bone mineralization, primarily caused by a deficiency of vitamin D, which is necessary for calcium absorption. This deficiency leads to insufficient calcium and phosphate levels in the bone matrix, resulting in weakened, soft bones that are prone to fractures and deformities. Symptoms include bone pain, muscle weakness, and difficulty walking. The condition is more common in adults, while a similar condition in children is known as rickets. The pathogenesis involves impaired bone mineralization and the subsequent reduction in bone strength.
Avascular Necrosis: Avascular necrosis (AVN), also known as osteonecrosis, occurs when blood supply to a bone is disrupted, leading to the death of bone tissue. Without adequate blood flow, the affected bone tissue collapses, leading to joint pain and, eventually, arthritis. Common causes include trauma, prolonged use of corticosteroids, excessive alcohol consumption, and certain medical conditions like sickle cell disease. The condition most commonly affects the hip joint but can occur in other bones. The pathogenesis involves ischemia (loss of blood flow), leading to bone tissue death and structural collapse.
Fracture Management: Fracture management involves the diagnosis, treatment, and rehabilitation of broken bones to ensure proper healing and restoration of function. The initial response to a fracture includes the formation of a blood clot (haematoma) at the site, followed by the development of a fibrocartilaginous callus. Over time, this is replaced by a bony callus and eventually remodelled into mature bone. The management process may include immobilisation, reduction (aligning the bone), and surgical intervention if necessary. The goal is to promote optimal healing, prevent complications, and restore the bone’s structural integrity.
Calcaneus Spur: A calcaneus spur, commonly known as a heel spur, is a bony outgrowth on the underside of the heel bone (calcaneus). It typically develops due to chronic stress and strain on the foot, often associated with conditions like plantar fasciitis. The spur forms as the body attempts to repair the microtears in the plantar fascia by depositing calcium, leading to a sharp projection of bone. While the spur itself is not always painful, it can contribute to heel pain and discomfort when it irritates surrounding soft tissues. The pathogenesis involves repetitive strain and abnormal bone growth.
BREAST Issues
Breast Pain (Mastodynia): Breast pain, or mastodynia, is a common condition that can be cyclical (related to the menstrual cycle) or non-cyclical. Cyclical breast pain is often linked to hormonal fluctuations, particularly the rise and fall of oestrogen and progesterone during the menstrual cycle, causing the breast tissue to swell and become tender. Non-cyclical breast pain can be due to factors such as trauma, mastitis, cysts, or musculoskeletal issues. The pain may also be linked to benign breast conditions like fibrocystic changes. The pathogenesis involves hormonal sensitivity, tissue inflammation, and physical strain on the breast tissue.
Breast Infection (Mastitis): Mastitis is an infection of the breast tissue, commonly occurring in breastfeeding women when bacteria, often from the skin or baby's mouth, enter the milk ducts through cracked nipples. The infection leads to inflammation, swelling, redness, and pain in the affected area, sometimes accompanied by fever and flu-like symptoms. Stagnant milk flow, due to blocked ducts or incomplete emptying of the breast, can exacerbate the condition by providing an environment for bacterial growth. The pathogenesis involves bacterial invasion, immune response, and subsequent tissue inflammation and abscess formation.
Galactorrhea: Galactorrhea is the abnormal flow of milk from the breast, unrelated to childbirth or nursing. It can be caused by various factors, including hormonal imbalances, particularly elevated prolactin levels, often due to a pituitary gland tumour (prolactinoma). Other causes may include medications (e.g., antipsychotics, antidepressants), thyroid dysfunction, or excessive breast stimulation. The excess prolactin stimulates the mammary glands to produce milk. The condition can occur in both women and men, and the pathogenesis involves the disruption of the hormonal regulatory pathways that control milk production.
CHANGES IN THE BREASTS
Growths or thickening of the breast or armpit
Puckering, dimpling or other changes in the skin of the breast
Newly retracted nipples or bleeding or discharge from the nipple