CREST syndrome is characterized by calcinosis, Raynaud phenomenon, oesophagal dysmotility, sclerodactyly, telangiectasia. It is also known as limited cutaneous form of systemic sclerosis.
- SIGNS AND SYMPTOMS OF CREST SYNDROME
- CAUSES OF CREST SYNDROME
- PATHOPHYSIOLOGY OF CREST SYNDROME
- DIAGNOSIS OF CREST SYNDROME
- TREATMENTS FOR CREST SYNDROME
- PROGNOSIS OF CREST SYNDROME
- COMPLICATIONS OF CREST SYNDROME
- CREST SYNDROME AND AYURVEDA
- NIDANA- AYURVEDIC CAUSES OF CREST SYNDROME
- PURVAROOPAM- AYURVEDIC PREMONITORY SYMPTOMS OF CREST SYNDROME
- SAMPRAPTI – AYURVEDIC PATHOGENESIS OF CREST SYNDROME
- LAKSHANA- AYURVEDIC SIGNS AND SYMPTOMS OF CREST SYNDROME
- AYURVEDIC PROGNOSIS OF CREST SYNDROME
- CHIKITSA- AYURVEDIC TREATMENT FOR CREST SYNDROME
- AYURVEDIC LOCAL TREATMENT FOR CREST SYNDROME
- AYURVEDIC SAMANA TREATMENT FOR CREST SYNDROME
- AYURVEDIC SHODHANA TREATMENT FOR CREST SYNDROME
- COMMONLY USED AYURVEDIC MEDICINES FOR CREST SYNDROME
- HOME REMEDIES FOR CREST SYNDROME
- DIET AND BEHAVIOUR FOR CREST SYNDROME
- YOGA FOR CREST SYNDROME
SIGNS AND SYMPTOMS OF CREST SYNDROME
Calcinosis:
- Thickening of skin with calcific nodules
Raynaud’s phenomenon:
- Cold sensitivity
- Pallor
- Cold fingers
- Reduced sensation of touch
- Numbness
- Throbbing pain in fingers or toes
Oesophageal dysmotility:
- Dysphagia
- Acid reflux
Sclerodactyly:
- Thickening and tightening of the skin of fingers and hand
Telangiectasias:
- Dilated capillaries on the skin of the face, hand and mucous membrane
CAUSES OF CREST SYNDROME
- The exact cause is not known
- Autoimmune disease
- Genetic factors
PATHOPHYSIOLOGY OF CREST SYNDROME
The pathophysiological mechanisms are not fully elucidated but seem to involve a multifactorial aetiology. The subcutaneous deposits of calcium occur in calcinosis. The arteries that supply the fingers and toes become narrow and limit blood supply when exposed to cold or stress. Over time, these small arteries become thickened slightly, further limiting blood flow and symptoms of Raynaud’s phenomenon manifested. The smooth muscles in the oesophagus replaced with fibrotic scar tissue lead to oesophageal dysmotility. Dermal fibrosis occurs in sclerodactyly. In telangiectasia, dilation of arteries in the skin occurs.
DIAGNOSIS OF CREST SYNDROME
- Proper history taking by the physician
- Physical examination
- Laboratory tests to find out underlying pathology
TREATMENTS OF CREST SYNDROME
- Treatments are given based on the underlying pathology
- Calcium channel blockers
- Surgical interventions
- Physiotherapy
PROGNOSIS OF CREST SYNDROME
- Symptoms are manageable with appropriate therapy
COMPLICATIONS OF CREST SYNDROME
- CREST syndrome associated with pulmonary hypertension leads to heart and respiratory failure.
CREST SYNDROME AND AYURVEDA
- In Ayurveda CREST syndrome is associated with an imbalance in vata
- It can correlate with ‘uttana vataraktha’
NIDANA- AYURVEDIC CAUSES OF CREST SYNDROME
It is ‘janmakrita’ (genetic). Risk factors are;
- Excess consumption of ununctuous, dry and cold food
- Excessive physical exertion
- Suppression of natural urges
- Depletion of body tissue
PURVAROOPAM- AYURVEDIC PREMONITORY SYMPTOMS OF CREST SYNDROME
- Twak roga – skin diseases
SAMPRAPTI – AYURVEDIC PATHOGENESIS OF CREST SYNDROME
- Vata, pitta and kapha dosha move through all channels of circulation. Due to the subtle nature of vata it impels the remaining two doshas.
- The aggravated vata having provoked these two doshas, exacerbated and fills up the empty channels and moved greatly inside them or by getting enveloped by the other doshas.
- The aggravated vata resides in the skin and blood vessels.
LAKSHANA – AYURVEDIC SIGNS AND SYMPTOMS OF CREST SYNDROME
- Twak sankocham – stretching of skin
- Hasta, anguli, sandhi sankocham
- Twak parushatha
- Ushna kamitwam – liking a warm environment
- Sheeta asahishnutha – cold intolerance
- Twak vaivarnya – discolouration of the skin
AYURVEDIC PROGNOSIS OF CREST SYNDROME
- Symptoms are manageable with proper Ayurvedic management
CHIKITSA- AYURVEDIC TREATMENT FOR CREST SYNDROME
AYURVEDIC SAMANA TREATMENT FOR CREST SYNDROME
- Manjishtadi kashayam
- Maharasnadi kashayam
- Gandhaka rasayanam
- Kaishore guggulu
- Mahatikthaka ghritam
- Manibhadra gulam
AYURVEDIC SODHANA TREATMENT FOR CREST SYNDROME
- Vasthi – medicated enema
- Abhyangam – oil massage on the body
- Svedana
- Lepana
- Upanaha
COMMONLY USED AYURVEDIC MEDICINES TREATMENT FOR CREST SYNDROME
Ayurvedic medicines for internal administration for CREST SYNDROME
- Manjishtadi kashayam
- Maharasnadi kashayam
- Gandhaka rasayanam
- Kaishore guggulu
- Mahatikthaka ghritam
- Manibhadra gulam
HOME REMEDIES FOR CREST SYNDROME
- Intake of warm water
- Intake of water boiled with ‘kokilaksha’ (a herbal medicine)
DIET AND BEHAVIOUR FOR CREST SYNDROME
- Avoid food items that produce dosha imbalance like cold and dry food, hard to digest. Because dosha imbalance aggravates the symptoms.
- Consume easily digestible food items
- Oil massage on body advised. Which alleviates vata dosha
- Practice regular mild exercise
- Avoid exposure to the cold environment
YOGA FOR CREST SYNDROME
- Nadi Shuddi Pranayam – calms the mind and gets relief from the feeling of cold
The patient needs to be seated in a meditative posture with the head and spine erect, and the body relaxed. The patient has to close one nostril (e.g. left nostril if using the right hand and vice versa) with the thumb and exhale completely through the other nostril. Again, he will have to breathe in deeply through the other nostril while the opposite nostril is still closed with the thumb.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Dr. Rajesh Nair,
Expert,
Ayurveda Medicine, India
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