Introduction : Irritable Bowel Syndrome (IBS) is characterised by recurrent abdominal pain in association with abnormal defecation. There is no structural abnormality seen in the gut.
It is associated with physical and sexual abuse, thus psychological therapies helps in IBS.In Ayurveda we have a similar condition known as ग्रहणी.
One suffers from grahani when grahani (deodenum) is not able to do ग्रहण (hold) of digested food (Anna ras) properly.
Causes :
There are no fixed causes but following factors can contribute to IBS-
- Psychological factors like anxiety, depression etc.
- Luminal factors like altered intestinal microbiota.
- Inappropriate diet
- Abuse of antibiotics
Symptoms :
- Recurrent abdominal discomfort i.e. cramps in lower abdomen which are relieved after passing motions
- Abdominal bloating
- Patient alter between constipation and diarrhoea
- But ग्रहणी shows various symptoms on the basis of प्रकृती of the patient and the साम or निराम stages of the stools.
Investigations :
- Diagnosis is mostly clinical and can be made using Rome criteria.
- A full blood count with or without sigmoidoscopy
- Colonoscopy to rule out colorectal cancer in patients above 40 years of age.
- Other tests can be performed depending on the symptoms of patients.
Principles of treatment :
1) If ग्रहणी is associated with aam dosh then aam pachan and vaman is administered.
2) If ग्रहणी is associated with लीन दोष in stomach (पक्वाशय), then Virechan (विरेचन) is administered with दीपन (digestive fire igniting) drugs.
3)Patients are asked to practise लंघन (fasting) for पचन (digestion) of आम दोष in body.
4) Other treatment varies according to the types of ग्रहणी.
Treatment:
Patients having IBS should do the following treatments:
1) Langhan -fasting (deprivation treatment)
Deepaniya Drugs for the stimulation of the power of digestion like churma yog, lavan, kshar prayog, different types of Takra and Ghrita, etc..
2)Snehan – oleation therapy
Ghritapana -Intake of medicated ghrita is called internal snehapana.
Ghrita such as trayushanadi Ghrita, chitraka Ghrita, dashamoola ghrita etc are used.
3)Sweden– sudation therapy involves inducing sweat in the patient by different methods. Thus snehan and sweden therapies are used to bring the doshas to the koshtha.
4)Shodhan -elimination therapy
Ayurvedic panchakarma therapies such as vaman, virechana, basti, nasya and raktamokshan are called shodhan because these treatments include detoxification of doshas and their elimination out of the body.
Shodhan therapy used in IBS are –
- Virechana – Castor oil or tilvaka Ghrita or draksha- Aragvada Kashaya.
- Pichha Basti – This basti has sangrahi (styptic), ropana (healing), and shonitasthapana (hemostatic) properties to help the Grahani (deodenum).
- Anuvasana basti – Dashamula Ghrita.
5)Shamana – it is a healing treatment.
Even after shodhana, effects of toxins can linger inside the body hence shaman is administered by giving drugs.
Drug of choice is तक्र (Buttermilk)
But why Takra?
Takra increases your digestion power.
According to Ayurveda, takra is Grahi that is why it is used in Grahani Dosh Chikitsa. Takra has Madhur Vipaka which helps in managing Pitta Dosha.
It has an astringent taste, hot potency and is dry in nature so it manages Kapha Dosha and its taste is Madhur and it is dense so helps in diminishing Vata Dosha.
It is Tridosha Shamak and ghrahi, thus a drug of choice in this disease.
As mentioned earlier, psychological factors are involved in IBS so Takradhara is done if there is an association of manasa bhava in the samprapti.
Yoga Therapy
- Bhujangasana (1 min)
- Pawanmuktasan (2 min)
- Halasan (1 min)
- Paschimottanasana (1 min)
- Makarasana (2 min)
- Trikonasana (1 min on each side)
Diet and Lifestyle
Pathya (factors which does not support the causes )
- Soup of masoor dal.
- Butter obtained from goat’s milk.
- Cow’s milk and curd, buttermilk.
- Ghrahi fruits like pomegranate.
- All types of sour liquids.
- Til taila.
- Nidra, vishram,
- activities which make the mind happy.
Apathya (factors which support the causes)
- Too cold, contaminated food or water.
- Viruddha ahara (eat before the previous food is digested)
- Chinta, Shok, Bhay and Krodh (Mental Problems)
- Alcohol and Smoking
- Too many antibiotics or medications.