Inflammatory Bowel Disease
Inflammatory Bowel Disease is psychosomatic and has a high risk due to a fast lifestyle and increased stress full life. In the past few decades, the prevalence of IBD has reached an alarming proportion among Indians. Inflammatory Bowel Disease comprises a group of o+ commoners in psychosomatic disorders that share the phenotype of abdominal pain, diarrhea, vomiting, rectal bleeding, and severe internal cramps/muscle spasm. The metabolic deregulation associated with Inflammatory Bowel Disease causes a secondary path of physiologic changes in the digestive system.
Ayurveda considers health and disease both as the products of food, lifestyle & Mansika bhava. Positive thinking and Mansika health prevent diseases. It is in tune with this concept that Ayurveda involved intensive Mansika health/Achar Rasayana, Dhi, smriti, etc. Such codes of life and health conduct relate to the personal, social as well as spiritual dimensions of an individual. It is amazing that thousand years ago, Ayurveda conceived the significance of the error of lifestyle in causations of all kinds of disease, both physical and mental now which is considered the principal cause of many illnesses prevalent today. Ayurveda provides a better solution in the form of proper dietary management, lifestyle advice like Ahara- vihara, yoga, Basti- panchakarma, and medication for better management of IBD
The psychosomatic term is known as the relation between psycho (mind) and soma (body). So Psychosomatic disorders are manifestations of physical imbalance in which emotional components have a strong influence. It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary nervous system and the glands of internal secretion which resulting Skin eruption, heart disorder, metabolic disorder, and digestive disorders like IBD, PEPTIC ULCER, etc. IBD or Inflammatory Bowel Disease is characterized by ulceration in the bowel. Clinically manifest as blood and mucous in stool. Ulcerative colitis with Crohn’s disease comes under this heading. Hence Amoebic dysentery, Intestinal TB, and Enteric fever with intestinal manifestation can also include in this. IBD affects 11% of the population globally. Autoimmune factors, Psychosomatic, and Dietary factors are mainly responsible causative factors for IBD.
In Ayurveda Acharya has mentioned that Sharira doshas and Manasika doshas (psychosomatic) both are affecting Agni. Agni is important for Samyaka Ahara Pachana Kriya. They mentioned various types of Agni in which Mandagni is responsible for Atisara, Grahani, Fever, etc. Acharya Sushruta mentioned Grahani rog and Atisara in Shusruta Samhita Uttar tantra. IBD is treated in Ayurveda as Grahani rog and Raktaj and Shokaj Atisara after assessing the dosha predominance based on signs and symptoms by the Devprasrya and Yuktivipasrya Chikitsa for correcting the doshas involved in it.
Classification of IBD:
The two most common diseases are described under IBD
(2) Crohn‟s disease
Diagnosis of IBD:
The investigation is colonoscopy/ sigmoidoscopy/ barium enema
Symptoms of IBD
Abdominal pain · Diarrhoea · Rectal bleeding · Severe cramps/ muscle spasm · Tenesmus
Complication of IBD
|Toxic megacolon||Carcinoma of the colon|
|massive hemorrhage||Recurrent perianal abscess|
Management of IBD
The drawback of modern therapy for IBD –
- Steroids can harm CNS. They can produce diseases like cardiovascular disease, infertility, renal disease, and liver disease.
- A long intake of antibiotics harms the digestive system and produces side effects.
- Blood transfusion- Transferred infection, hemolytic reaction, etc.
IBD in Ayurveda
In Ayurveda, an exact correlation cannot be found of IBD, but according to signs & symptoms and pathology of the disease, it can be compared with Sangrahani (mild to moderate) and Raktatisar (severe stage) according to severity. Raktatisar is mentioned in Sushruta Samhita Atisarpratisedha‟ Adhyaya and its symptom like diarrhea with hemorrhage from the rectum, jwar, udarshool, Trishna, Daha, Vrana can be compared with rectal pain, inflammation, rectal ulceration, and bleeding per rectum of IBD. The description of Sangrahani is given by acharya Madhav in the textbook „Madhav Nidana‟. Symptom of Sangrahani is very much similar to those of the Mild to moderate stage of IBD as Antrakunjan relates with Tenesmus, Daurbalya to weakness and sadnam reflects the debility condition of the patient due to Aam bahu paichilyam stool along with mucous.
The main causative factor of these diseases is Aam dosha and Vata-Pitta doshas. Mithya Ahara- vihara i.e; Samashana, Adhyashana, Vishamashana and not following the proper dietary rules (Astahar Vidhi viseshaytan) and vihara i.e.; Faulty food habits (Ahara Vidhi) associated with disturbed and stress full mind is responsible for mand Agni (Decreased quality and quantity of digestive enzymes), which is the main causative factor for producing aam dosha and in vitiation of Vata-pitta doshas.
Characteristic of Sangrahani and Raktatisar
Sangrahani: Antrakunjan, Alashya, Daurbalya, Kativedna, Shit(cold)- draw(liquid)-ghan(semisolid)-Snigdha(oily) stool with mild pain.
Raktatisar: Diarrhoea with hemorrhage, jwar, udarshool, Trishna, Daha, and vran(ulcer).
Complication of Sangrhani and Raktatisar –
Soth -Kaas -Chardi -Jwar -Swash – Murch -Trishna-Arochak -Hikka -Pandu -Gudabhransh
Line of treatment
Ayurveda is broadly divided into two parts; Devprashrya(mantra) and Yuktiprashrya (Ahara-Vihara and Aushadha karma).
Nowadays Devprashrya Chikitsa is well known as Spiritual karma (mantra tapa etc) and Yuktiprashrya is Ahara-vihara karma and Samashana and Sodhana(panchakarma) chikitsa, where Spiritual karma act over Mansika doshas by prabhav guna.
· Nidan parivarjan: by following dincharya and Ritucharya.
· Samshan: · Deepan- Pachan aushad-Chitrakadi vati.
· Snehan: changeryadi ghrat, local massage of saindhav with tail
· Sanghrahi: kapithastak churna, Bilvadi churna
· Vasti: Picha vasti
· Yoga: Pranayam, Vajrasan, mayurasan, bandh-karma, Jal kunjan.
|Pathya / what to eat||Apathya / what to avoid|
|Laghu(light), Supachaya (easily digestible) deepan-paachan(digestive)ie; Moong, masoor, moth, arhar indar jau, ghee, nimbu, anaar, makhana, Yoga, and Pranayam||Guru(heavy), Abhisyandi(cause of channel blocker), ushan(hot), tiksn- aahar- vihar i.e; mash(pulse), mash(meat), tail,mirch- masala‟s|
Discussion: Picha Basti is considered best among all of the Basti by Acharyas for the Treatment of Sangrahni, Raktaatisara.
CONTENTS OF PICHA VASTI:
Makshika – 250 ml
Saindhav Lavana – 2 gm
Sneha ( Changreyadi Ghrit + Shatadhauta Ghrit) – 125 ml+125 ml
Kalka ( Mulethi Churna ) – 30 g
Kwath ( Salmali Niryasa and Mustadi Ksheer) – 200 ml
Mode of action of Picha vasti:
- Picha Basti is Pichhila (sticky or lubricant) and Agnideepaka in nature (due to its content).
- In ulcerative colitis, the intestine gets inflamed and sensitized, and when food passes through the intestine and makes contact with the mucosa of the intestine it gets irritated.
- It is said that Basti should be administered to the patient lying on the left lateral side as the Grahani and Guda are situated on the left side of the body, and the valves of the Guda get relaxed, in this position Basti drugs reach up to the Grahani due to Vyavyi and Vikasi Guna of Saindhav lavana.
- It forms a protective film over the intestine, avoids friction over mucosa, inflammation subsides and mucosa becomes normal.
- Agni Deepak property of Picha Basti helps in the ignition of the Agni (Grahani is the main seat of Agni) so that absorption and digestion of Basti over the colon takes place effectively.
- Simultaneously Picha Basti which also has Sangrahi properties reduces the bowel frequency and there will also be no loss of electrolytes and enteropathy protein (prevent hypoalbuminemia state).
- Honey and Saindhav Lavana colloidal solution along with Sneha form an impervious coating over the entire colon. There will be no loss of electrolytes and prevent the direct attack of inflammatory mediators on the mucosa, thereby reducing the inflammatory process and facilitating healing.
In inflammatory bowel disease in which Psychosomatic factors play role in the progression of the disease, Ayurvedic treatment rapidly heals the inflamed ulcer area. Simultaneously have a mind relaxation effect without having an ill effect on health and also prevents remissions.
In the present era‟ Ayurveda is a good treatment modality of IBD as it reduces stress by Devprashrya and Yoga karma Reduces inflammation by Picha-vasti and Agni –Deepak drugs by forming an impervious coating over the entire colon.
So it can be concluded that Ayurveda provides a better solution in the form of proper dietary management, lifestyle advice like –Panchakarma (detoxification and bio purification procedures), meditation, yoga-like- Padmasan, shavasan, etc are better managed in Sangrahani and Raktatisar (IBD).
Dr. Neeraj Sharma
Ph.D. (AYU), M.S(Shalya)
Serving for Health & Education New Delhi & Jodhpur.
Consult for – ANORECTAL DISEASES, BPH, and Renal Stone disease.
Wound and Pain management