Health of an individual is directly related with a person’s Diet, Sleep and other lifestyle factors. The changes in the food habit and stress are main culprits in the causation of a variety of diseases.
According to Ayurvedic pathology , both of these factors have strong impact on the health status. Any causative factor which aﬀect the normal functioning of biological ﬁre- Jatharagni will lead to diseases of gastrointestinal tract. Irritable Bowel Syndrome and other related gastrointestinal disorders are the results of a person’s pradnyaparadha (ignorance about disease causing factors or inability to control consumption of unhealthy food etc.) which directly or indirectly aﬀect the normal functioning of Agni. Irritable bowel Syndrome (IBS) or spastic colon is functional bowel disorder characterized by abdominal pain and changes in bowel habits. It is fairly common in current scenario of stressful life style. Lower abdominal pain, bloating associated with alteration of bowel habits and abdominal discomfort which relieves with defecation are the most frequent symptoms. The abdominal pain type usually presents in a patient as either diarrhea predominant (IBS-D), constipation predominant (IBS-C) or with alternating stool pattern (IBS- A)
What Causes Irritable Bowel Syndrome?
There are no firm causes attributed for causation of irritable bowel syndrome. The available evidence suggests that IBS is primarily a motility disorder of intestines. The walls of the intestines are lined with layers of muscle that contract and relax as they move food from stomach through intestinal tract to the rectum. Normally these muscles contract and relax in a coordinated rhythm. But in irritable bowel syndrome, the contractions may be stronger and last longer than normal. Food is forced through the intestines more quickly, causing gas, bloating and diarrhea. In some cases , however the opposite occurs. Food movement slows down, stools become hard and dry due to excessive reabsorption of fluids. Hence it can be seen that the abnormal motility of the intestine is the deciding factor in the pathogenesis of IBS.
Some researchers believe that IBS is caused by autonomic nervous system changes. Women are twice likely to have IBS than males and researchers believe that hormonal changes may be the reason behind this higher risk. Also there is a debatable amount of association between gynaecological disorders and IBS. Menstruation related disorders frequently worsen IBS symptoms, while pregnancy and menopause can either worsen or improve symptoms.
- Abdominal pain – Pain is felt in left/ right iliac fossa or hypogastrium. The pain may be continuous, colicky, diﬀused or localized. Abdominal pain is generally relieved after defecation and provoked by food intake. Pain is usually associated with constipation.
- Painless intermittent diarrhea – it is characterized by passage of several loose watery stools. When constipated, stools are hard, pellet like accompanied by mucus.
- Bloating of abdomen
- Alternate constipation and diarrhea
- Awareness of intestinal peristalsis, nausea, anorexia and redness
- Tenderness of abdomen
Management strategy of IBS
The treatment principles can be divided into two phases
Diarrhea dominant stage- Atisara avastha
- Agni deepana (Restoration of optimum metabolic function)
- Grahi dravyas (Anti-diarrheal treatment)
- Dhatu balakara (Strengthening of depleted body tissues)
Constipation dominant stage- Vibandha avastha
- Kosthagni deepana (Restoration of optimum metabolic function)
- Sroto shodhana (Cleansing process of body channels)
- Vatanulomana (Restoration of normal Vata Gati)
Churna kalpanas and Paneeya kalpanas are used as drug of choice for deepana and vatanulomana. The target is to improve agni and reduce the eﬀects of mudhavata (deranged vata). In the second phase, agnideepaka ghrita and avalehas are used. Administration of snehana dravyas are not good in diarrhea dominant stage. But when pakwashaya becomes vata dominant due to the chronicity of the disease, taila prayoga is found to be very eﬀective. Administration of sneha can be done by pana, anuvasana, and even abhyanga. It is important to note that the agnideepana once acquired by Snehapana will show prolonged effects. Ghrita based preparaons are ideal in IBS because of their Vatanulomana and Agnideepan property.
Takra (Butter milk) – It can be taken along with deepana drugs in diarrheal conditions
Mamasa rasa (Meat soup) – to bring vata shamana in pakwashaya and strengthen intestines
Pakwashaya snehana is very essential to pacify the pakwashayagata vata and this can be done by snehapana or anuvasana.
Avagaha swedana – to reduce koshta stabdhata
Anuvasana Basti with pippalyadi taila and Asathapana basti with dashamula
Murdha tailas – to achieve manaprasadana and to normalize Aapana-Prana axis
Meditation and Yoga – to relive stress and psycho-social factors
As IBS is having a multifactorial pathogenesis, management of IBS is only possible with a multi-dimensional holistic approach which includes application of Ayurvedic drug treatment with panchakarma, yoga and meditation, healthy lifestyle and healthy food habits.