Acute Intermittent Porphyria (AIP) is a medical condition
which forms part of a rare group of hereditary conditions known as Porphyrias,
which involve defects in heme metabolism, resulting in excessive secretion of
porphyrins. This causes intermittent
episodes of acute abdominal pain, neuropathies, and constipation. Heme is the iron part of hemoglobin in blood.
Other porphyrias include skin and central nervous system involvement. Diagnosis
is confirmed by elevated levels of urine porphobilinogen, and conservative
treatment is with intravenous glucose infusion, which inhibits heme synthesis
and helps reduce abdominal pain. Patients having attacks of severe pain and
those with neurological involvement usually require treatment with Hematin.
All individuals having this genetic defect have increased
levels of porphyrins secretion, but all do not experience symptoms. It is
stipulated that systemic inflammation brings about a reduction in kidney
function as well as neurological damage, which in turn causes peripheral and
autonomic neuropathies and psychiatric symptoms. AIP usually occurs in the age
from 18 to 40, with women being more affected than men. Attacks of abdominal
pain usually last from 3 to 7 days. Precipitating factors include unknown causes,
fasting, alcohol, prolonged exposure to sun, stress, heavy exercises, and drugs
like Phenobarbital, estrogens, and sulphonamides.
Individuals having AIP who have recurring attacks, severe
incapacitating neuropathies, and those having severe neuropsychiatric
manifestations are suitable candidates for Ayurvedic herbal treatment.
Ayurvedic treatment not only provides good symptomatic relief, it also
significantly reduces inflammation, which is the hallmark of severe symptoms
and recurrence. Involvement of the skin and central nervous system has to be
treated separately.
With the commencement of Ayurvedic treatment, most
patients get relief from severe pain within 1 to 5 days. Further treatment is
aimed at preventing a recurrence, and ensuring a good bowel movement. Patients
need to be treated regularly for about 3 to 5 months in order to get lasting
relief and freedom from recurrence of the symptoms. Treatment is then tapered
off and stopped completely. For day to day medical issues, short courses of
simple Ayurvedic medicines are given to treat symptoms. Ayurvedic medicines are
tolerated quite well and have not been known to aggravate or precipitate AIP;
however, patients should avoid self-medication, and take treatment from a
qualified Ayurvedic practitioner. It is equally important to avoid all known precipitating
factors.
Patients having skin involvement usually present with
severe itching; this can be controlled very well with Ayurvedic herbs within a
few weeks. Patients having neuropsychiatric symptoms or motor neuropathy need specialized
treatment for longer periods – nearly 6 to 9 months. Along with oral
medication, Ayurvedic Panchkarma procedures like full body massage, fomentations,
medicated enemas and Shiro-bastis may be required. A few patients with severe
involvement of the nervous system may even require medications for up to 2
years for a full remission of symptoms.
Ayurvedic herbal medicines can thus be judiciously utilized
in the successful management and treatment of AIP as well as all porphyrias.
