Ayurvedic Management of IBS (Grahani)-1

Irritable Bowel Syndrome (IBS) is also known as Irritable colon. It is a gastrointestinal (GI) motility disorder for which there is no organic or structural cause.

The disease condition is called Grahani, which indicates the pathological state of function and integrity of the intestinal tract (mostly small intestine), a particular part of the GI system known as grahani in Sanskrit.Grahani is the seat of enzymes (agni). Normally, it holds up the food (until it is digested) and releases it from the side after it is digested. But when it is deranged due to weak digestive enzymes, it releases the ingested material even in undigested conditions.

A disorder characterized by abnormally increased motility of the small and large intestines, producing abdominal pain, constipation, or diarrhea, is also known as irritable colon, spastic colon, or mucous colitis.

Sympoms of IBS (Grahani): Ayurveda characterizes the disease by the passage of stools alternated with constipation or diarrhea and with undigested food particles. This disease is also associated with thirst, distaste, blackouts, pedal edema, pain in the bone, fever, and vomiting. It is a motility disorder involving the entire GI tract, causing recurring upper and lower GI symptoms, including variable degrees of abdominal pain, constipation and diarrhea, and abdominal bloating.

IBS is also associated with non gastrointestinal conditions such as headache, low back pain, arthritis, non cardiac chest pain, difficult urination, and fibromyalgia.

Ayurvedic Types of IBS (Grahani):

Ayurveda indicates that there are four different types of IBS. They are 1] Constipation- predominant IBS (vata grahani), 2] Diarrhea-predominant IBS (pitta grahani), 3]Dysentery-predominant IBS (kapha grahani), and 4]Complex IBS (tridosha grahani). All three dosas are involved (vata,pitta, andkapha). Other literature also escribes two chronic types of IBS: accrual IBS (samgraha grahani) and an incurable type called tympanitis predominant IBS (ghatiyanthra grahani).

Clinical features of IBS (Grahani):
1. Constipation-predominant IBS - This type of IBS presents the clinical features of dryness in skin, mouth, or throat; more constipation or alternating constipation and diarrhea; thirst; bloating; flatulence; and a cold feeling. It is also associated with back or groin pain, weight loss, debility, anal fissures, insomnia, and anxiety.
2. Diarrhea-predominant IBS - This type of IBS clinically shows the presence of heartburn, thirst, feeling hot, irritable or angry, inflammation, sweating and fever, fluid, and foul smelling stools and eructation.
3. Dysentery-predominant IBS - This type of IBS exhibits the presence of nausea, indigestion, and excess sputum in the pharyngeal region, heaviness in the chest and abdomen, bad-smelling eructation, lethargy, sluggish bowels, and mucus in the stools.
4. Complex IBS - This type reveals the combined signs and symptoms of all the above types. 5. Accrual IBS - This type of IBS presents the combined features of all the tridosas and is more chronic. It is specially diagnosed with clinical features of borborygmi, diurnal changes that the bowel movements are increased in the daytime and stop at night. The nature of the stool will be pastier and slimy, have undigested food particles, and be eliminated with pain. The pattern of the bowel movement will be accumulation of stools for some days followed by passage of loose stools for several days.
6. Tympanites-predominant IBS - In this type of IBS, the clinical symptoms are rumbling sounds heard in abdomen and increased bowel movements with lots of undigested food particles.

Prognosis of IBS (Grahani):

- According to Ayurveda, IBS is curable in children, difficult to treat in middle age, and incurable in older patients. The chronic accrual IBS is difficult to cure whereas tympanites-predominant IBS is incurable.

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