Grahani (Irritable bowel syndrome)

Grahani (duodenum, first part of intestine) which is the site of Agni (digestive enzymes), is called so, because of its power to restrain the downward movement of food. It is located above the umbilical region and is supported and nourished by the support of Agni. Normally it restrains the downward movement of undigested food and after the digestion it releases the food through its lumen. In the abnormal condition when it gets vitiated because of weakness of agni, it releases the food in undigested form only.
Grahani

Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in abdomen and changes in bowel movements, which may be diarrhoea, constipation or both. With IBS, they have these symptoms without any visible signs of damage or disease in digestive tract.

IBS comes in multiple forms. These include IBS –C, IBS – D and IBS-M/ IBS-A. Sometimes IBS may develop as a result of an intestinal infection or diverticulitis too.

It is important to pay close attention to your symptoms so your doctor can provide with a more accurate diagnosis. Knowing the type of IBS and can they lead to better treatment measures.

1) IBS – C
IBS with constipation or IBS- C is one of the more common types. This form of IBS abnormal bowel movement days consist of stools that are at least 25 % hard and lumpy, but also less than 25 % loose in consistency.

With this type of IBS experience fewer bowel movements overall may some times strain to go when do have them. IBS – C can also cause abdominal pain that accompanies gas and bloating.

2) IBS – D
IBS – D also known as IBS with Diarrhea. With IBS – D more than a quarter of stools on your abnormal bowel movement days are loose, while less than a quarter are hard and lumpy.

IBS-D also feels abdominal pain along with more frequent urges to go and excessive gas is also common.

3) IBS – M/ IBS – A
IBS with mixed bowel habits or IBS – M. IBS – M is also sometimes called IBS with alternating constipation and diarrhea (IBS – A). If having this form of IBS stools on abnormal bowel movement days will be both hard and watery. Both must occur at least 25 % of the time each.

4) Post infectious IBS
Post infectious IBS refers to symptoms that occur after had a GI infection. After infection may still have chronic inflammation along with issues with gut flora and intestinal permeability. Diarrhea is the most prominent sign of PI – IBS. Vomiting may also occur. Its estimated that anywhere from 5 to 32 % of people who have these types of bacterial infections will develop IBS. Around half of people may eventually recover, but it can take many years to treat the underlying inflammation that’s causing the IBS symptoms.

4) Post – diverticulitis IBS
In diverticulitis cases having the risk of developing IBS. The condition itself causes nausea, abdominal pain, fever and along with constipation. Post diverticulitis IBS is just one possible complication following diverticulitis. While similar in symptoms to PI – IBS, this type of IBS occurs after diverticulitis has been treated.

According to Ayurveda 5 types are there:

• Vataja Grahani – Caused by the aggravation of vata dosha.
• Pittaja Grahani – Caused by the aggravation of pitta dosha.
• Kaphaja Grahani – Caused by the aggravation of Kapha dosha.
• Sannipatika Grahani – Aggravation of all the 3 doshas.
• Ama Grahani – Caused by the ama.

1. Vataja Grahani

• Kanta Asya Shosha – dryness of mouth and throat.
• Kshut, Trushna – excessive hunger & thirst.
• Timira – appearance of darkness in eyes.
• Karnayo Swana – abnormal sound in the ears,tinnitus.
• Parshwa ruk – frequent pain in the sides of cardiac region, neck, chest, pelvic region and thighs.
• Visuchika – severe diarrhoea.

Vataja grahani patient passes stools with difficulty. Stool is frequently and gets afflicted with cough and dyspnoea.

2. Pittaja Grahanai
The aggravated pitta suppresses and extinguishes agni as hot water causes extinction of physical fire, the patient voids loose stool containing undigested material which is bluish yellow or yellow in colour. The person suffers from eructation foul smell and sour taste.

• Hrut kanta daha – burning sensation in the cardiac region and throat.
• Aruchi – Anorexia.
• Trushna – excess thirst.

3. Kaphaja Grahani
By the intake of food in excess quantity and by sleeping immediately after food, in such circumstances food does not get easly digested and suffer from:

Eructation with foul smell and sweet taste, low libido.
This condition stool which is split into pieces, mixed with mucous and phlegm and heavy. Even if not emaciated the patient feels weak and indolent.

4. Sannipatika Grahani
The sannipatika grahani is to be determined on the basis of simultaneous anifestation of all signs and symptoms pertaining to the 3 doshas.

5. Ama Grahani
When dosha located in grahani is affected by food which is not fully digested then the signs of ama (product of improper digestion and metabolism) are manifested:

1) Vataja Grahani
Intake of Katu (Pungent), Tikta (Bitter), Kashaya (Astringent), Rookshana Sheetala Bhojana (Dry and cold foods), Pramitashana (Intake of less of food, fasting, Atyadhva (Supptession of natural urges), Ati maithuna (Excessive sexual intercourse).

2) Pittaja Grahani
Intake of Katu (Pungent), Ajirna (Indigestion), Vidahi (Which cause burning sensation), Amla (Sour), Kshara (Alkaline).

3) Kaphaja Grahani
Intake of Guru (Heavy), Snigdha (Excessively unctuous), Sheeta (cold).

If the IBS is not treated properly then it leads to complications such as:

• Age: – IBS can affect people of all ages, but it is more likely for people in their teens through their 40s.
• Family history: – The condition seems to run in families. Some studies have shown that your genes may play a role.
• Emotional trouble: – Some people with IBS seem to have trouble with stress, have a mental disorder or have been through a traumatic event in their lives, such as sexual abuse or domestic violence.
• Regular smoking
• Frequent alcohol

When you consult an Ayurveda physician with symptoms of Irritable bowel syndrome they will examine your case in detail. They will inquire about any risk factors in your life and will take a stock of your life to know if you have been knowingly or unknowingly doing any of the causative factors. They will also examine you for understand more about the IBS is before coming to a decision about the management.

• Complete blood count helps for anaemia, infection or some other bowel disease.
• Colonoscopy or Flexible sigmoidoscopy.
• X –Ray GI series.
• Stool test.

Any treatment for Irritable Bowel Syndrome should aim at preserving the functionality of the duodenum. It involves alleviating aggravated body energies, restoring the function of the digestive system and eliminating accumulated toxins. As stress also a significant cause of the disorder. Important management of Ayurveda is lifestyle guidance and herbs to nourish the mind and nervous system.

Allopathic management of irritable bowel syndrome are:

• Changes to what you eat and other lifestyle changes.
• Medicines – maily for constipation, diorrhea.
• Probiotics.
• Mental health therapies.

In comparison, Ayurvedic approach is holistic, consisting of diet modifications, lifestyle changes, stress management, herbal medication and Ayurvedic therapies, Yoga asanas, pranayama and meditation. All of these together can help the body get back to a state of balance. The approach is effective in a majority of patients.

• Medicines for Ayurveda: Ayurveda has a rich tradition of plant pharmacotherapy with a great variety of plant origin medicines believed to reduce inflammation, remove impurities, and balance the doshas that cause grahani. In Ayurvedic treatment, the selection and dosage of medicines are specific to the patient and will depend on which of the three doshas are out of balance.
•  Ayurveda Therapies: Panchakarma: The traditional treatment system to balance doshas involves five therapies: therapeutic vomiting (Vamana), therapeutic purgation (Viechana), medicated enema (vasthi), nasal administration of medicines(nasya), and blood purification(rakta mokshana). If the patient is strong enough to undergo such treatments, they can undergo the ones that are most suitable for them.

Ayurvedic treatment for Irritable bowel syndrome is much more than panchakarma. It also includes herbal medicines, medicated oil and therapies.
Oil therapies are known to increase the strength of body, digestive power and push accumulated toxins into the large intestine, ready for elimination. Oil therapies like abhyangam oleates the body, whereas others like pizhichil, potalis or kizhis combine both oleation and sudation techniques to improve circulation in the body, reduce inflammation, and improve the day today life of the patient.
In Irritable bowel syndrome especially doing treatments are:

• Kaadi dhara (Poring of medicated fermented liquid all over the body) for improving digestion, circulation and amapachanam.
• Abhyangam oleates the body and improve circulation and digestion.
• Siro Dhara & Pizhichil – Improve mental and physical health and help to give healthy life style.
• Virechanam – purgation therapy is helps to improve digestion and absorption, remove the accumulated morbid metabolic wastes in the body.
• Diet: A light vegetarian diet is recommended, with avoidance of foods known to trigger gastric complaints like potatoes, mushroom, cauliflower, cabbage, radish, leafy vegetables, fast food, half cooked food, vinegar, packed food products, tined and preserved food products, packed carbonated waters, tomato, sour fruits, oily and spicy foods, deep fry foods, yogurt, Refined flower (Maida), Tuvar dal.

Took food for proper time and avoid heavy food in dinner. Don’t skip breakfast.

•  Lifestyle: Do some yoga, pranayama and meditation for reducing stress and to improve digestion and absorption. Daily go for a gentle walk or do simple exercises.

Ayurveda offers a holistic, historically rooted, reportedly safe, alternative treatment for Grahani.

At Saranya, we believe in the old school application of Ayurveda wisdom with a modern approach rooted in evidence based practise. The medicines and therapies are fixed only after individual consultation through listening, understanding the need and analysing the root cause. We incorporate different diagnostic methodologies in identifying the root cause of pain and plan unique customized treatment strategies to eliminate the causes.

We believe in restoring the quality of life by relieving the hardships and pain of those who suffer from Irritable bowel syndrome.