Ayurveda Aetiology, Pathogenesis & Holistic Management of Inflammatory Bowel Disease
Head of Kayachikitsa (Ayurved medicine), Gujarat Ayurved University, India
Submission: August 09, 2018; Published: September 17, 2018
*Corresponding author: Nishant Shukla, Professor & Head of Kayachikitsa (Ayurved medicine), Shri V. M. Mehta Ayurveda College, Anandpar Rajkot, Ex. Head of Kayachikitsa Gulabkunverba Ayurved Mahavidyalaya, Anil 3 Patel Colony, Jamnagar, India, Tel: +91-9426984260;
How to cite this article: Nishant Shukla. Ayurveda Aetiology, Pathogenesis & Holistic Management of Inflammatory Bowel Disease. Adv Res Gastroentero
Hepatol. 2018; 10(4): 555793. DOI:10.19080/ARGH.2018.10.555793.
Keywords: Inflammation; Colon; Large intestine; Abdominal pain; Diarrhoeal disease
Diarrhoeal disease with inflammation of colon or large intestine present with abdominal pain discomfort, passing of liquid stools with mucus, blood or bleeding were observed in ulcerative colitis, Crohn’s disease, etc. pathogenesis of large intestine was grouped as Inflammatory bowel disease. The disease was believed to be occurring due to indulgence of unwholesome food and routines. Mythological texts narrate that the diarrhoeal disease first occurred after demolition of Daksha Yagyna due to indulgence of beef, alcoholic beverages, other unwholesome food, routines and Shiva Kopa (stress induced). The disease has been narrated in ancient scientific texts i.e. Vedas. Ancient ayurvedic texts Charaka Samhita (1500 BC) and Acharya Sushruta (1200 BC) narrated the disease in Chikitsa Sthana (sections dealing with medical management of diseases) and Uttar Tantra (section dealing with management of disease with other then surgical management) respectively .
Both the Ayurveda texts narrates that Agni (digestion, metabolism & assimilation function) gets hampered first due to indulgence of etiological factors, infections, etc. As a general rule of Ayurveda pathogenesis Astang Sangraha (6th century AD) narrates that all the diseases occur due to improper functions of Agni especially the disorders of abdomen & specifically ascites. The disease in early twentieth century believed to be psychosomatic that later on classified as immune mediated inflammatory condition; the study of psychosomatic relationship in various disease has been studied all across the globe and as per present understanding immune system has great deal of relation with psyche of a person that may precipitate or propagate morbid condition of varying morbidity from simple inflammation to grave disease like cancer, diabetes, ulcerative colitis, etc. .Incidence of the disease was as old as human civilization; ancient indian mythological texts narrates that the disease was first seen after demolition of Daksha Yagya due to stress and indulgence of beef and other food irregularities along with Jwara (pyrexia disease). Disease has been described in Vedas; ancient Ayurveda texts Charaka Samhita (1500 BC) and Sushruta Samhita (1200BC) has narrated the all diarrhoeal disease in details i.e. aetiology, pathogenesis, pathological changes, therapeutic management including purification process.
Diarrheal disease, like other abdominal disease occurs due to derangement of Agni (altered digestion, metabolism, assimilation); Agni regulates all the biotransformation within the body, strength, host defence mechanism, longevity, complexion, nourishment, etc. Agni is the concept narrated in ancient ayurvedic classics that may be correlated with enzymes & hormones. Other body humour vitiated in the disease was Vata; Vata regulates all types of transformation & movements within the body. Fluids from different parts of the body get into the colon that leads to inflammation of colon that leads to passing of watery stools – increased frequency of stool. Dietetic indiscretion & contaminated food & beverages, Krimi (helminth’s & pathogen), unwholesome food & beverages and mental stress cause vitiation of Vata, Agni, Pitta, and other body fluids.
The indulgence of these factors produces vitiation of Agni – gastric digestion; Agni governs all digestive functions; indigestion of food results in inflammation in colon, vitiation of Agni & indulgence of aetiological factors produces vitiation of Vayu; the vitiated Vayu draws body fluids (from all parts of the body) to colon. Body fluids collection in colon results in typical symptom of diarrhoeal disease i.e. increased frequency of stool and passing of liquid stools. Bhayatisara and Shokatisara were the two diarrhoeal diseases that occur due to psychological
stress. In early twentieth century the disease was considered as
psychosomatic disease, but now a day these diseases have been
reclassified as inflammatory bowel disease. Acharya Sushruta
narrated that psychological stress & dietetic indiscretion leads
to changes in Agni & host defence mechanism – the leads to
inflammation in part of colon – these inflammation leads to
ulceration in part of colon and lastly presents with passage of
increased frequency of stool with blood, pus or both or passage
of only blood along with another constitutional symptom.
Standardised protocol of treatment narrated in ancient
ayurvedic classics were controlling primary symptoms &
signs of disease second objectives were improve digestion &
metabolism, complete remission & resolution of disease by
reverting pathogenesis. Ancient Ayurveda texts narrated that
disease ought to be treated as per the condition of disease i.e.
Sama & Nirama. In the first stage of disease also known as Sama
Avastha medicaments that improve digestion were to be used
and stopping diarrhoea at once. Once the function of Agni gets
regularised and Vata gets normalised the drugs having antidiarrhoeal
properties like Kutaj (H. antidysentrica) etc. may be
used. In severe cases Basti rectal administration of decoction
made of Mocha Rasa.
Herbal formulation commonly used by for treating the
medical condition was a combination of Shatavari (A. racemose)
1 gms, Yastimadhu (G. glabra) 1 gms, Dhatriloha (ayurvedic
formulation – used for clinical practice since 13th century AD)
250mg, Kutaj (H. antidysenterica) 1 gms, Vrudha Gangadhara
Churna (ayurvedic formulation – used for clinical practice
for more than 5 centuries) 1 gms, and Panchamruta Parpati
(ayurvedic formulation – used for clinical practice for more
than 5 centuries) 125 mg three times a day with honey along
with Shankhavati 1 tablet after meals. Patient were advised
reduce irritant food with restriction of aerated beverages, sour
materials, bakery items, packaged foods, pre – cooked foods,
etc. patient were advised to use ginger juice twice a day before
meals. Patients having complaints of severe bleeding (Hb <9 gm/
dl or profuse bleeding) were given ayurvedic homeostatic were
given. Patients were advised to follow diet easily digestible diet
for regular bowel movements.
As per the clinical data of 30 patient managed by the author
of inflammatory bowel disease marked improvement was
observed in patient treated with these medicines. Patient that
were managed by steroids or sazo were advised to gradually
taper the dosage with these Ayurveda management; no altered
responses were observed after restricting or discontinuing sazo.
Bleeding, frequency of stools, pus, abdominal pain & abdominal
discomfort were relieved in all patients. Other constitutional
symptoms like abdominal pain, discomfort, malaise was relieved
completely. Over and above the cardinal signs & symptoms of
the disease digestion, metabolism, sleep & awakening schedules,
and wellbeing of the patient was improved. Patient were advised
to follow the seasonal routine related to food and use seasonal
fruits & vegetable and modest reduction in quantity of food. No
relapse has been observed within a year after treatment.