"Pancreatitis and Ayurveda: Hope Must Be Matched by Evidence"

Remembering the research legacy of Padma Shri Vaidya Balendu Prakash

By Vaidya Dr Ashok Rathod, M.D. (Ayurveda)

"When Diseases of the Pancreas Entered Public Life"

Publicly known patients demonstrate that pancreatic disease does not follow a single pattern. DJ Avicii and actor Matthew Perry experienced acute pancreatitis in the setting of heavy alcohol exposure. Musician Travis Barker developed severe pancreatitis following a complication during an endoscopic procedure. George Clooney was hospitalised after extreme weight reduction for a film role, although the precise cause of his pancreatitis was never publicly established.

Pancreatitis can reduce a person’s life to a cycle of pain, hospital admission, restricted food and anxiety about the next attack. Some patients become so afraid of eating that every meal feels like a medical risk. Others lose weight, strength and the confidence to travel, work or participate in family life.

This disease demands more than temporary pain relief. It requires accurate diagnosis, nutritional protection, identification of the cause and a long-term plan to prevent further pancreatic damage.

The recent passing of Padma Shri Vaidya Balendu Prakash on 7 August 2026 has brought renewed attention to his extensive work on pancreatic disorders. He was among the Ayurvedic physicians who believed that traditional clinical knowledge should be documented, measured and placed before the scientific community for examination.

Awarded the Padma Shri in 1999, he also served as honorary physician to former President K. R. Narayanan. His medical work included Rasa Shastra, cancer, migraine, allergic disorders and, most prominently, recurrent and chronic pancreatitis. His contribution has been documented in this memorial published by Down To Earth.

His observations offer patients reason for hope. They also raise important scientific questions that should be examined without either blind acceptance or automatic rejection.

When Pancreatitis Creates Fear of Food

A patient featured in a recent discussion on pancreatitis described suffering 11 attacks. A severe episode required approximately three and a half months of hospitalization, during which his weight reportedly fell from 86 kg to 50 kg.

The numbers reveal only part of the suffering. Repeated attacks can make patients associate food with pain. They may stop eating fats, proteins, dairy products and eventually even adequate quantities of simple food. This can lead to calorie deficiency, muscle loss, weakness and worsening nutritional status.

Fear-driven starvation is not treatment. At the same time, telling every patient to resume normal or fatty food without clinical assessment is equally unsafe.

The correct diet depends on whether the person has acute, recurrent or chronic pancreatitis; whether pancreatic exocrine function is impaired; and whether diabetes, high triglycerides, gallstones, malabsorption or significant weight loss are present.

Understanding the Different Forms of Pancreatitis

The pancreas produces digestive enzymes as well as hormones such as insulin. Inflammation can therefore affect digestion, nutrition and blood-sugar regulation.

Acute pancreatitis

Acute pancreatitis develops suddenly. A mild attack may settle within several days with appropriate treatment, but severe inflammation can cause fluid collections, necrosis, infection, shock or organ failure.

Recurrent acute pancreatitis

When acute attacks occur repeatedly, the condition is described as recurrent acute pancreatitis. Repeated attacks require careful investigation. Treating each episode without searching for the underlying cause leaves the patient exposed to further damage.

Chronic pancreatitis

Chronic pancreatitis produces persistent structural changes such as fibrosis, calcification and pancreatic duct abnormalities. The damage is generally irreversible and may gradually impair both the digestive and hormonal functions of the pancreas.

Patients can develop:

• Persistent or recurrent upper abdominal pain

• Pain radiating towards the back

• Nausea and vomiting

• Loss of appetite

• Poor digestion

• Greasy or foul-smelling stools

• Unexplained weight loss

• Deficiency of fat-soluble vitamins

• Exocrine pancreatic insufficiency

• Pancreatogenic or Type 3c diabetes

Necrotizing pancreatitis

In necrotizing pancreatitis, part of the pancreatic or surrounding tissue loses its blood supply and dies. Infection of this necrotic tissue can become life-threatening and may require intensive care, antibiotics, drainage or removal of damaged tissue.

Severe or worsening abdominal pain accompanied by persistent vomiting, fever, breathlessness, rapid heartbeat, faintness or jaundice requires urgent medical attention. The National Institute of Diabetes and Digestive and Kidney Diseases warns that severe pancreatitis and its complications can be fatal if left untreated.

Pancreatitis Is Not Always Caused by Alcohol

Patients are frequently asked about alcohol as soon as pancreatitis is diagnosed. Alcohol is an established cause, but it is not the only one.

Possible causes and risk factors include:

• Gallstones and biliary sludge

• Alcohol consumption

• Very high triglyceride levels

• High blood calcium

• Certain medicines

• Abdominal trauma

• Pancreatic or biliary duct obstruction

• Autoimmune pancreatitis

• Genetic variants

• Smoking

• Anatomical abnormalities

• Previous pancreatic injury

• Idiopathic pancreatitis, in which the cause remains unidentified

Stress, irregular meals and insufficient sleep may worsen pain perception, metabolic health and recovery. They should not, however, be labelled as the sole cause before gallstones, metabolic abnormalities, medicines, autoimmune disease, hereditary factors and structural obstruction have been properly investigated.

Diagnosis also cannot rest on symptoms or a mildly elevated lipase value alone. Medical history, clinical examination, pancreatic enzymes and appropriate imaging must be interpreted together.

The Quantity of Food Matters as Much as Its Name

Patients often ask for a fixed list of foods that are “allowed” or “prohibited.” Such lists can be helpful initially, but they rarely account for differences in disease severity, digestive capacity, body weight and pancreatic function.

Charaka states:

मात्राशी स्यात्। आहारमात्रा पुनरग्निबलापेक्षिणी॥

— Charaka Samhita, Sutra Sthana 5/3

Food should be consumed in an appropriate quantity, and that quantity must correspond to the person’s digestive capacity.

This principle is highly relevant to pancreatitis. Even relatively light food may create discomfort when consumed in excessive quantity. Conversely, prolonged intake of inadequate food can worsen nutritional depletion.

Another verse cautions against choosing food through craving or ignorance:

न रागान्नाप्यविज्ञानादाहारानुपयोजयेत्।
परीक्ष्य हितमश्नीयाद्देहो ह्याहारसम्भवः॥

— Charaka Samhita, Sutra Sthana 28/41

Food should be selected after examining whether it is genuinely suitable, because the body is built and sustained by nutrition.

A Pancreatitis Diet Should Not Become a Starvation Diet

Many patients live for months on thin porridge, plain rice or diluted khichdi. Such food may be useful temporarily when tolerance is limited, but it cannot automatically provide adequate protein, energy, minerals and vitamins over the long term.

Complete avoidance of fat can also become counterproductive. The body needs dietary fat for energy and for the absorption of vitamins A, D, E and K. Nevertheless, this does not mean that every pancreatitis patient should begin consuming large quantities of ghee, paneer or other fatty foods.

Tolerance varies. The appropriate amount and source of fat must be decided according to the disease stage, triglyceride levels, nutritional status and presence of pancreatic exocrine insufficiency.

During mild acute pancreatitis, current gastroenterology guidance supports early oral feeding with a low-fat solid diet when tolerated. Patients unable to eat may require enteral feeding. These decisions should be made under hospital supervision. American College of Gastroenterology guidelines

Chronic pancreatitis patients should also be evaluated for exocrine pancreatic insufficiency. When the pancreas cannot release adequate digestive enzymes, patients may require pancreatic enzyme replacement therapy, nutritional supplementation and monitoring for vitamin deficiencies.

No patient should stop prescribed pancreatic enzymes after reading an article, watching a patient interview or learning that enzymes were withdrawn in a particular research protocol.

What Vaidya Balendu Prakash’s Research Reported

Vaidya Balendu Prakash and his colleagues developed a structured, year-long Ayurvedic treatment protocol for recurrent acute and chronic pancreatitis.

The protocol combined:

• A regulated diet

• Structured daily routine

• Physical and mental rest

• Supportive Ayurvedic medicines

• A proprietary processed herbo-mineral formulation known as AMAR

• Regular follow-up

A 2024 retrospective, non-randomized study reviewed 1,750 patients with recurrent acute or chronic pancreatitis treated between 1997 and 2023. Of these, 916 completed one year of treatment.

Among the patients who completed the protocol, the investigators reported:

• A 93% reduction in pancreatitis attacks

• A 97% reduction in emergency hospitalizations

• Extended remission in many patients

• Improvement in quality of life

• No treatment-related toxicity identified by the investigators

The study, “Ayurvedic treatment protocol in the management of pancreatitis: A nonrandomized observational study”, concluded that the results justified further randomized clinical trials.

A separate observational study examined 151 patients with hereditary pancreatitis. Eighty-eight completed the year-long protocol. Among these patients, the researchers reported a 92.8% reduction in attack frequency and a 98.7% reduction in emergency hospitalizations. The study is indexed on PubMed.

These results are substantial enough to warrant independent investigation. They cannot reasonably be dismissed without examination.

Warning: "Herbo-Mineral Medicines Are Not Home Remedies. A pancreatitis patient should never self-medicate."

Symptoms That Require Urgent Hospital Assessment

Seek immediate medical care for:

• Severe or worsening upper abdominal pain

• Pain radiating towards the back

• Persistent vomiting

• Inability to drink or retain fluids

• Fever or chills

• Rapid heartbeat

• Faintness or low blood pressure

• Breathlessness

• Increasing abdominal swelling

• Confusion or unusual drowsiness

• Jaundice

• Reduced urine output

• Sudden deterioration in a known pancreatitis patient

"A suspected acute attack should not be managed at home."

A Legacy That Deserves Proper Scientific Continuation

Vaidya Balendu Prakash gave serious attention to patients living with recurrent and chronic pancreatitis at a time when many had exhausted available options. His work produced a large body of clinical observations and several published studies suggesting meaningful reductions in attacks and hospital admissions.

For patients, success is not represented by a single normal laboratory value. It means fewer attacks, preservation of pancreatic function, improved nutrition, freedom from repeated hospital admission and the ability to resume a productive life.

"Continuing this work through transparent research would be a more valuable tribute."

Medical Disclaimer: This article is intended for education and public awareness. It does not diagnose pancreatitis or prescribe treatment. Acute pancreatitis can be life-threatening. Patients should seek urgent hospital care for severe symptoms and must not discontinue pancreatic enzymes, diabetes medicines or other prescribed treatments without consulting their treating doctors.

About the Author

Vaidya Dr Ashok Rathod, M.D. (Ayurveda) is an Ayurvedic physician with more than 20 years of clinical experience in chronic-disease management, Panchakarma, pulse diagnosis, preventive healthcare and individualized diet and lifestyle guidance.

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