🔺CASE STUDY : NO 45 🔺 PART NO : 1 🔺ARUCHI ( ANOREXIA) 🔺NIDANAM (CAUSATIVE FACTORS) -Adhyashana (eating before digestion of previous food) -Viruddha Ahara (incompatible food) -Guru, Snigdha, Abhishyandi Ahara (heavy, oily, and clogging foods) -Manda Agni (low digestive fire) -Suppression of natural urges (Vega Dharana) -Mental factors: Shoka (grief), Bhaya (fear), Krodha (anger), Chinta (worry) -Overuse or misuse of Snigdha and Guru substances -Kapha-prakopa or Ama formation (Classical Reference: Charaka Samhita Sutra Sthana 25/40-41, Madhava Nidana 48) 🔺PURVAROOPAM (PRODROMAL SYMPTOMS) -Loss of interest in food -Coated tongue -Heaviness in abdomen -Nausea -Feeling of indigestion -Dullness and mental aversion to food Reference: described in Madhava Nidana 48 and Ashtanga Hridaya Sutra Sthana 13 🔺 LAKSHANAM (Clinical Features) -Aruchi is of five types based on Dosha involvement: 📌Vataja Aruchi -Dryness in mouth -Astringent or bitter taste -Belching, bloating -Cracking or stiffness of lips -Dislike toward food 📌Pittaja Aruchi -Sour, bitter, metallic taste -Burning sensation in throat, chest, or stomach -Thirst and irritability -Yellow discoloration of tongue 📌 Kaphaja Aruchi -Heaviness in body -Sweet or slimy taste -Excessive salivation -Coated tongue -Aversion to food due to sluggish digestion 📌 Sama Aruchi (due to Ama) -Foul taste, sticky tongue coating -Feeling of incomplete digestion -Lethargy, foul breath 📌Manasika Aruchi (Psychological) -No physical cause, but mental aversion to food -Depression, grief, fear -Normal tongue and digestion markers (Reference: Madhava Nidana 48, Ashtanga Hridaya Sutra 13) 🔺 GENERAL EXAMINATION 📌 History Taking -Onset & duration: Acute or chronic? -Associated symptoms: Weight loss, nausea, vomiting, bloating, early satiety, fatigue. -Dietary habits: Changes in food preferences, alcohol, or smoking. -Psychological factors: Stress, anxiety, depression. -Medical history: Chronic illnesses (TB, diabetes, cancer, HIV), medications. -Family history: Malignancy, GI disorders, psychiatric illness. 📌 Physical Examination -Vitals: Fever, tachycardia (infections, hyperthyroidism). -BMI / Nutritional status -Signs of anemia: Pallor, koilonychia. -Lymphadenopathy or hepatosplenomegaly -Abdominal exam: Tenderness, organomegaly, masses. -Neurological exam (if CNS causes suspected) 🔺LABORATORY INVESTIGATIONS 📌Basic Blood Tests -CBC (Complete Blood Count) Anemia, infections, chronic illness -ESR / CRP :Inflammatory or infectious conditions -Liver Function Tests (LFTs) Hepatitis, cirrhosis, liver metastases -Renal Function Tests (RFTs) Uremia, renal failure -Thyroid Profile (TSH, T3, T4) Hypo-/hyperthyroidism -Blood glucose:Diabetes mellitus Vitamin B12, Iron, Folate Deficiency-related anorexia 📌GI Evaluation -Stool test: Occult blood, parasites (e.g. Giardia) -Helicobacter pylori test (breath, stool antigen, or serology) -Upper GI endoscopy: For gastritis, ulcers, malignancy -Abdominal ultrasound or CT scan: Tumors, liver disease, organ enlargement 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2