Atisaram (Diarrhoea)

Atisara is a condition, wherein loose watery stools are passed many times a day. Atisara is described as Diarrhoea in modern medical science, where three or more loose or watery stools occur a day.The general symptoms associated with diarrhea include abdominal pain especially cramping, bloating, thirst, dehydration, fatigue and weakness etc.
Atisaram

The World Health Organization (WHO) estimates that there are more than 1000 million cases of acute diarrhea annually in developing countries, with 3–4 million deaths, half of these in infants and children.Diarrhea is described as three or more loose or watery stools a day.

In Ayurvedic literature Atisara is classified into six types, are as follow:

Diarrhea is categorized into acute or chronic and infectious or non-infectious based on the duration and type of symptoms.

• Acute diarrhea is defined as an episode lasting less than 2 weeks. An infection most commonly causes acute diarrhea.
• Chronic diarrhea is defined as a duration lasting longer than 4 weeks and tends to be non-infectious. Common causes include malabsorption, inflammatory bowel disease, and medication side effects.

Due to consumption of etiological factors apa dhatu (watery elements) is increased in excess quantity which brings forth diminution of strength of agni, gets mixed with the feces, causes downward movement in annavahasrotas by vata leading to passage of excess watery stool is known as Atisara.

Vataja atisara

• Colic.
• Suppression of urine.
• Rumbling sound in the intestines.
• Looseness (constant movement in the intestines) of the abdominal (Apana) wind.
• A gone feeling in the waist, in the thighs and in the legs.
• Frequent emissions with flatus of a scanty, frothy, dry (Ruksha) brown-coloured (yellowish black) stool.

Pittaja atisara

The stool is fetid, hot, yellow, blue or slightly red-coloured, or resembles the washings of meat, and is emitted with sharp or acute force and is accompanied by thirst.

• Epileptic fits (fainting).
• Burning sensation.
• Perspiration.
• Suppuration and inflammation (Paka) of the affected organs.
• Fever.
• In Raktatisara, which is the forward stage of Pittatisara, patient suffers from Trishna (thirst), Shula (colic pain), Vidaha (burning sensation) and Guda Paka (inflammation of the ano-rectal region).

Kaphaja atisara

• The stool becomes loose and constant, gets mixed with the lump of mucus and looks white.
• The stool comes out without any sound.
• A sense of constant urging is complained of and each motion only creates the apprehension of a fresh one in the mind.
• The patient becomes drowsy or sleepy, and feels a sense of heaviness in the limbs.
• Nausea.
• Disrelish for food.
• Horripilation.
• Lassitude.

Sannipataja atisara

Sokaja atisara

The suppressed tears of a bereaved person of sparing diet, on quenching the digestive fire, reach down into the Koshtha (intestines) and there freely mix with, and vitiate the local blood which becomes dark-red like Kakananti (Gunja). It then passes through the rectum, charged with a peculiar feature imparted to it by the fecal matter in case of its combination with the latter or without any fetid smell, when passing out unmixed.

Aamaja atisara

The undigested food emitted in combination with the undigested fecal matter in various ways, and are attended with pain and characterised by a variety of colour.
Symptoms of diarrhoea

The etiological factors for atisara are as follows:
Dietetic Factors

• Over indulgence in foods which are very heavy(hard to digest), very fatty, very dry, very hot, very watery, very hard, very cold.
• Food which contains incompatibles, taken in large quantities very frequently.
• Food which are not cooked, and taken at unusual times.
• Drinking of polluted water, excess of alcoholic drinks.

Behavioral Factors

• Excess or improper usage of therapies like oleation etc.
• Poisons.
• Changes in accustomed habits and seasonal features.
• Over – indulgence in water sports.
• Suppression of natural urges of the body.
• Infestation by worms (intestinal parasites).

Psychological Factors

• Fear.
• Sorrow.

Some causative factors of diarrhea as per modern science are:

• Parasites and worms can also cause diarrhea.
• Lactose intolerance due to the absence of lactase enzyme which is essential for metabolizing the lactose, the absence of lactase in infants may cause diarrhea.
• Allergy to certain food items.
• Sorrow.

Diarrhea can cause dehydration, which can be life-threatening if untreated. Dehydration is particularly dangerous in children, older adults and those with weakened immune systems.

• Blood test: A complete blood count test, measurement of electrolytes and kidney function tests can help indicate the severity of your diarrhea.
• Stool test: Your doctor might recommend a stool test to see if a bacteria or parasite is causing your diarrhea.

• In the initial state i.e. ama (primary) stage of diarrhea, stopping or binding therapies are never indicated.
• If the diarrhea is associated with griping pain (difficulty in evacuating), then haritaki should be given as a mild laxative.
• Moderately aggravated dosha should be managed by pramathya (a type of decoction of drugs) which stimulates the power of digestion (dipana) and which is carminative (pachana) should be administered.
• Slightly aggravated dosha should be managed by langhana (fasting therapy).
• Laja Manda (scum of parched paddy) is one of the famous and routinely used pathya kalpana in diseases like atisara (diarrhea), chhardi (vomiting), jvara (fever). Laja manda is prepared by adding laja to Water in the ratio of 1:14 and cooked on low flame till Lajas get cooked.

Management of diarrhea as per modern science:

• Antibiotics are used in case of bacterial infection.
• Use of medicine for cramps & vomiting.
• Maintenance of hygienic conditions.
• Intake of water and salts.
• Management of fever if persisted.
• Consumption of light and digestible liquid diet.
• Probiotics containing; lactobacillus or acidophilus may be helpful.