Role of Manasika Nidana in Chronic Amlapitta – A Clinical Case Study

Chronic Amlapitta is one of the common Annavaha Srotas disorders, often corresponding to long- standing dyspepsia and acid peptic complaints in contemporary practice. Classical texts emphasize faulty Ahara–Vihara and Agnimandya, but the contributory role of Manasika Nidana such as Chinta (worry), Shoka (grief) and Bhaya (fear) is frequently under-addressed in day-to-day management. This case report presents a 36-yearold male with chronic upper abdominal burning, frequent Tiktaamla Udgara, epigastric discomfort, disturbed sleep and reduced appetite for more than three years, with partial relief on proton-pump inhibitors and antacids. Detailed history revealed persistent occupational stress, suppressed emotions, irregular meals and sleep disturbance as predominant Manasika and Aharaja factors. The patient was diagnosed as Chirakali Urdhwaga Amlapitta with significant Manasika Nidana involvement based on Nidana Panchaka and correlation with dyspepsia. An integrated Ayurvedic approach focusing on Manasika Nidana modification counselling, Satvavajaya Chikitsa, relaxation and sleep hygiene — along with Pitta- Shamana drugs, Deepana- Pachana and lifestyle correction was instituted for eight weeks. Marked reduction was observed in symptom-severity scores of Tikta-amla Udgara, Hrit-Kukshi Daha, Avipaka and associated anxiety, with sustained benefit on follow-up. This case highlights that addressing Manasika Nidana as a key pathogenic factor may enhance clinical outcomes and reduce chronicity in Amlapitta, and underscores the need for larger systematic studies in this domain.