Abstract
Ulcerative colitis is a chronic inflammatory bowel disease that affects the whole intestine resulting in Irritable Bowel Disease (IBD). This can occur at any age, with peak occurrences occurring between the ages of 15-20 years and 55-65 years. There are no known primary causes of ulcerative colitis, however, there are several potential variables connected to heredity and stress. The most common symptoms of Ulcerative colitis include diarrhoea, rectal bleeding, tenesmus, mucous passage, and crampy stomach discomfort.
The primary cause of this disease is Agni (digestive strength) disruptions, i.e., Mandagni, which leads to Ama formation, the major cause of the autoimmune condition in Ayurveda. Although both Sanshaman and Sanshodhan therapies are utilized to treat this condition, Sansodhan therapy is the mainstay of treatment.
Case description
A 36-year-old male patient who visited the OPD in 2021, complained that since 2016, he started showing symptoms of increased frequency of bowel habits 10-15 times per day. He then gradually started developing a burning sensation in the abdomen associated with pain. The stool was initially watery, non-mucoid and non-offensive. Along with this he also suffered abdominal pain with nausea. The pain was crampy in nature which was localized to the umbilical and suprapubic region.
Physical examination
Clinical Examinations revealed:
- Abdomen pain
- Loss of weight
- Loose stools with signs and symptoms of an ulcer.
- Irregular defecation with mucous. Soft Consistency.
- Irregular urination
Gastrointestinal tract examination revealed slight discomfort in the periumbilical area on systemic assessment. There was no mention of an abdominal mass. The patient was recommended to undergo certain necessary investigations such as a complete blood count, ESR, liver function test, biochemistry examination, stool examination for occult blood, and histology. A sigmoidoscopy was also recommended.
Diagnosis
The patient was diagnosed with Ulcerative colitis post the investigation.
Treatment plan
According to the course of the disease and the involvement of Dosha, the patient was treated with the following Ayurvedic management.
- Kutajaghana vati
- Rasa parpati
- Kamadudha rasa
- Bol Badha Rasa
- Prawal pishti
- Chitrakadi vati
- Bilwadi churna
Other medicinal interventions were symptomatic according to the present complaint of the patient.
Observation
The improvement in the patient was assessed based on relief in signs and symptoms of disease before and after treatment. Clinical examination was also performed and reduction in the lesion was also measured as improvement criteria. Post the treatment following improvements were observed:
- Effective defecation time reduced from 20 times to 10 times per day.
- Mucus was seen less in stools within 15 days
- Physical examination revealed that he was neither icterus, anemic, nor cyanosed. The hydration was enough. His heart rate was 78 beats per minute, his blood pressure was 110/80 mmHg, and he had a normal body temperature. Mucous membranes and nails were both normal. The sleeping schedule improved, and his appetite had been adjusted to normal.
In the first 15 days, the patient’s condition improved gradually. He maintained the therapy and conducted clinical assessments on a regular basis after every 15 days. He improved even further after the treatment of 3 months and now is free of all the symptoms he earlier had developed.
Discussion
Ulcerative colitis is an idiopathic chronic inflammatory condition of the mucosa of the colon that generally lasts for years and follows a relapsing and remitting pattern. It is part of the IBD spectrum, which also includes Ulcerative colitis and Crohn’s disease.
In Ayurveda Ghrahani is synonyms to ulcerative colitis. Ayurveda describes various treatment modalities for the management of ulcerative colitis such as proper nutritional supply, herbal therapy Picha Basti, etc. It is well managed with Ayurvedic multidrug therapy and dosha shamak regimen. Ayurvedic drugs act as a stambhak, vranropan (wound healing) and pachan (digestive) effect as per the pharmacological aspect of Ayurvedic medicine.
Bilwadi Churna contains cannabinoids as well as Bilwa, Mochrasa, Dhataki, Dhanyak, and Shunthi, which primarily mediate inhibitory pathways in the gastrointestinal tract through the lowering of vagal cholinergic tone and offers potential therapeutic targets for the treatment of ulcerative colitis.
Conclusion
In Ayurveda, there is no direct association between ulcerative colitis and Grahini Dusti. However, we can regard this clinical entity as Grahini Dusti based on the signs and symptoms and pathology of the disease. The clinical characteristics of Grahini Dusti includes partly pakva and apakvamala (formed and unformed faeces), as well as trishna (morbid thirst), arocaka (anorexia), vairsya (distaste in mouth), preshake (excessive salivation), vomiting, fever, and ama odour (undigested food).
Bilwadi churna is dominated by Kashaya and Tikta Rasa, Laghu and Ruksha Guna, Ushna Veerya, Katu Vipaka and Deepan, Paachan, and Graahi. In Agrya Dravya, Acharya Charak stated that Bilva is Sangraahik, Deepaniya, and Vata-Kapha Prashaamak. While Acharya Charak mentioned Kutaja as the best (Agraya Dravya) in Sangraahik and Upshoshan Dravya.
Ayurvedic therapy of ulcerative colitis and other chronic inflammatory bowel illnesses is successful in lowering disease symptoms and relapses, as well as minimising the need for conventional standard medications. Furthermore, the medication is safe, affordable, simple to administer, and well tolerated by the patient.
Case Study by Dr. Raj Tayal
Published by Hempstreet
