Conservative Ayurvedic Treatment in Chronic Calculus Cholecystitis (Pittashmari)

Chronic calculus cholecystitis is commonly treated by cholecystectomy; however, a subset of patients either decline surgery or are medically unfit, underscoring the need for organ-preserving alternatives. Within the Ayurvedic framework, gallstone disease (Pittashmari) is managed by correcting Dosha imbalance, normalizing Agni, and promoting the disintegration and expulsion of calculi. A 58-year-old female presented with 30-day history of recurrent right upper abdominal pain radiating to the back, associated with bloating, flatulence, indigestion, occasional vomiting, reduced appetite and altered bowel habits. Baseline Ultrasonography demonstrated a contracted gallbladder with 6mm wall thickening and a solitary 7mm calculus, consistent with chronic calculus cholecystitis (Pittasmari), along with mild fatty changes in the pancreas. The patient declined cholecystectomy and elected to undergo Ayurvedic management. An Ayurvedic treatment protocol was implemented for 2 months and 23 days. Symptomatic improvement was observed within 15 days of initiating therapy and a reduction of calculus size by 35.70% and normalisation of pancreatic echotexture and duct caliber. The case study suggest that a structured Ayurvedic treatment protocol may achieve meaningful Symptomatic relief and partial radiological improvement in chronic calculus cholecystitis (Pittaasmari), thereby justifying further evaluation in larger controlled studies.