A Trial with An Indigenous Drug for Duodenal Ulcer
Dr. N Rangabashyam M.B.B.S, F.R.C.S.(Edin.) F.A.C.S., F.I.C.S, F.A.C.G
F.I.A.P. Hony. Consultant Surgeon; Surgeon to Gastro-Enterology Dept.
Chief of Proctology Clinic
Dr. K.V Durai Raj, M.B.B.S. Post-graduate student in General Surgery
Government General Hopsital, Madras – 600030
SOOKTYN: An Ayurvedic Drug in the management of Hyperacidity Syndrome
Sooktyn is found to be very effective symptomatically in heartburn,
acid regurgitation, functional dyspepsia and
epigastric discomfort. Sooktyn is helpful in the healing of duodenal ulcer and can be used
pre-operatively to control symptoms.
Duodenal ulcer is a very common condition in South India. Approximately 60% of patients with duodenal ulcer are treated medically where as 40% undergo surgery. Medical treatment consists of bed rest, bland diet, antacids and anticholinergic drugs. Apart from this, various drugs have been tried which would promote healing of the duodenal ulcer by their direct action over the ulcer or indirectly reducing the acidity in the stomach. An indigenous drug Sooktyn is one such. Our experience with this drug on 50 patients with duodenal ulcer is documented here.
MATERIAL & METHOD:
The indigenous drug Sooktyn has been tried in outpatients and inpatients attending the surgical Gastro-enterology Division, Govt. General Hospital, Madras, during the period of one year, from June 1975 to June 1976. The age incidence of these patients ranged from 21 years to 65 years and sex incidence ratio was 40 males to 10 females.
Criteria for inclusion inthis trial
1. Pain characteristic of duodenal ulcer for over 3 years.
2. Nocturnal pain waking up the patients more than twice.
3. Patients with acute exacerbation of duodenal ulcer and dyspepsia.
duodenal ulcers with complication like bleeding
or pyloric obstruction were categorically not included in the trial. Investigations
out in these patients after thorough clinical
(1) Augmented Histamine Test in all cases.
(2) Barium Meal Examination in selected cases.
These investigations showed that:
1. Allthe patients had acid secretion in the hyperacidity range; basal acid level ranging from 4.50 to 5.75; maximal secretion after Histamine Stimulation was 11.45 to 13.50.
2. Ulcer crater and deformed duodenal cap in the Barium Meal Examination.
DRUG & DOSAGE:
Composition of Sooktyn: Each tablet contains:
KapurKachli 80.0 mg
Jatamansi 40.0 mg
Ganthoda 30.0 mg
Khurasaniajmo 30.0 mg
Kel pan raakh 30.0 mg
Vacha 10.0 mg
Dhatura leaves(Detoxicated) 5.0 mg
This tablet was given in doses of 2 tablets, three times daily half an hour after food. Patients were advised to swallow 2 tablets, apart from regular dosage, whenever they got severe pain, this treatment was continued for periods ranging from 3 months to one year.
Patients were followed-up at invervals of 2 weeks. Subjective improvements like the- lol lowing were recorded: (1) Subsidence of epigastric pain and dyspepsia. (2) Disappearance of heart burn and acid regurgitation. (3) Prolonged pain free intervals. (4) Relief from nocturnal pain. (5) Ability to return to routine- work.
Clinical improvements like the following were recorded: (1) Disappearance of tenderness in the epigastrium and rt. hypochon- drium. (2) Improvement in the general condition of the patient. (3) Increase in weight.
Augmented Histamine Test was repeated in all patients, usually three months after administration of Sooktyn. Barium Metal Examination was repeated in cases where it had been taken before starting treatment.
Out of the 50 patients included in this drug trial, six patients were later excluded from the trial after finding stasis in AHT and Barium Meal Examination. Four patients failed to return for follow-up after 3 months.
Of the other 40 Patients, results of the treatment were graded as follows
Very good results
8 cases – 20%
16 cases – 40%
6 cases -15%
GROUP I: (1) Their symptoms disappearing
completely. (2) AHT results showed significant reduction of basal acid
secretion but not the Maximal response which remained however at the
pre-treatment level. (3) Repeat Barium Meal showed disappearance of ulcer
crater in 3 patients in this group. (4) These patients were symptom free after
a 6 months follow-up.
GROUP II:Patients who formed major percentage (40%) in this trial had good subjective improvement but however repeat AHT did not show reduction of acid level and Barium Meal did not show disappearance of ulcer crater. Pain free interval was prolonged in these cases and nocturnal pain disappeared completely.
GROUP III:Symptoms like heart burn, acid regurgitation and dyspepsia disappeared but pain recurred whenever the patients were irregular in their dietary habits.
GROUP IV: These patients did not respond to Sooktyn therapy at all and their symptoms did not subside; repeat AHT did not show reduction in acid level and repeat Barium Meal showed persistence of ulcer crater and deformity.
Sooktyn is an indigenous drug containing a combination of drugs reputed for their usefulness in hyperacidity and peptic ulcer. Reviewof literature reveals that these have their beneficial effects by their individual and combined action on gastric functions by local action and on central regulatory mechanism. Sooktyn did not show any toxicity or side effects.
1. Sooktyn is found to be very effective
symptomatically in heart burn, acid regurgitation, dyspepsia and epigastric
when administered for 4 to 6 weeks.
2. It is helpful in the healing of duodenal ulcer in our short follow-up.
3. But it was not effective in acute exacerbation of duodenal ulcer. In these cases addition of antispasmodics like probanthine and
antrenyl were necessary to control symptoms.
4. This drug is useful in functional dyspepsia.
5. Sooktyn is of no value in cases of duodenal ulcer with complications like bleeding penetration and pyloric obstruction.
6. It can be used pre-operatively to control symptoms.
7. It is palatable, convenient, cheap and has no toxic side effects.
Our grateful thanks are due to Superintendent, Govt. General Hospital, Madras, for permitting us to carry out this trial and to Mr. Thirugriamoorthy, for generous supply of tablets Sooktyn from Alarsin Pharmaceuticals, Bombay