Role of Manas Bhavas in Grahani Roga (Irritable Bowel Syndrome)

Neha Sajwan; Rajesh Kumar Sharma; Dinesh Chandra Sharma

Role of Manas Bhavas in Grahani Roga (Irritable Bowel Syndrome)

Sajwan N.^1*, Kumar Sharma R.², Chandra Sharma D.³

DOI:

^1* Neha Sajwan, Post graduate Scholar, P.G. Department of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

² Rajesh Kumar Sharma, Professor and HOD, P.G. Department of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

³ Dinesh Chandra Sharma, Associate Professor, P.G. Department of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

Grahani Roga is the prime disease of gastro-intestinal tract and seen often in day-today practice. In our classics Grahani is described as an Agni Adhishthana. Any disturbance in the status of Agni leads to Grahani Roga. The rapid increase in the prevalence of Grahani is a matter of great concern now days. It is a result of sedentary life style, bad dietary habits, stress and also due to the altered environmental conditions. Ayurveda described the individuality of Mana and Shareera and their inseparable and interdependent relation in the body. Grahani Roga is a predominant Pitta-Vata Dosha and the Manasika Bhavas can be easily be disturbed by Vata and Pitta Dosha. IBS can be considered as Agnimandyajanya Vikara. The functional dependency between normal Vata Dosha and Agni is altered in IBS. The role of Dhatus and concerned Srotas i.e., Purishavaha Srotas is also considerable. Purishavaha Srotas does majority of function with the help of Apana Vayu. So, the Dusti lies at Apana Vayu & Samana Vayu level. The Mansik Bhavas which hamper Agni and Rasavahasrotas, are the main causative factor of IBS.

Keywords: Agni, Rasavaha Srotas, Grahani Roga, Irritable bowel syndrome, Manas Bhava

Corresponding Author	How to Cite this Article	To Browse
Neha Sajwan, Post graduate Scholar, P.G. Department of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India. Email:	Neha Sajwan, Rajesh Kumar Sharma, Dinesh Chandra Sharma, Role of Manas Bhavas in Grahani Roga (Irritable Bowel Syndrome). J Ayu Int Med Sci. 2022;7(8):25-29. Available From https://www.jaims.in/jaims/article/view/2024

Introduction

Ayurveda is a branch of medicine that primarily focuses on two areas of disease analysis, understanding, and treatment: Manasika and Shaaririka.^[1]Whatever the Vedas' origins, they hold a special place in human history since they shed light on Indian medical science and practises. The essential ideas of Ayurveda, which holds that the Shareera is closely linked with Manas and Atma and whose explanations are dispersed throughout the full body of Vedic science, are actually derived from the Vedas. Vedas contain a wealth of information about illnesses, treatments, and descriptions of various bodily parts and organs; hence it is widely believed that Vedas are where Indian medicine got its start.

Vikarapara (intelligent) or Vicharapara approaches are both possible (emotional). Before is preferable than after. The Manasika Bhavas may also use one of these two ways. Approach will be spiritual if it is educated. It will be tangible if it is emotional. None of the Manasika Bhavas may be harmful if used properly. Even Srimadbhagwadgeeta provides a straightforward example of the Mano Vikaras' workings.^[2]

An organ called the Grahani, which is placed between the Amashaya and Pakvashaya and is the primary location of the digestive glands that produce the digestive juices, is where food is properly digested. It is also in charge of retaining food for a long enough period of time to allow for adequate digestion and nutrient absorption from the food that has been digested. Grahani Dosha is the name for Grahani's dysfunction. The development of Ama, which is the root of numerous other diseases, may be caused by this condition.^[3]

According to Acharya Vagbhata, the hypo functioning of "Agni" is the cause of all physiological diseases, especially disorders of the digestive tract.^[4] When Agni, or mandagni, is impaired, Grahani Roga results. Because it is one of Ashta Maha Gada, Grahani Roga has significance. Grahani Roga has strong Psyho-somatic base. And Manasik Bhavas such as Krodha, Shoka, Bhaya, Kama etc. results in Agnidushti causing Grahanidosha.^[5]

In our rapidly evolving technological era, alterations in lifestyle, eating habits, stress, tension, and the repression of cravings due to a busy schedule,

among other factors, contribute to the emergence of a number of disorders. People initially ignore their difficulties and wait until their daily routine is disrupted before seeking a solution. One such intestinal functional illness is Grahani Roga (IBS). With its symptoms of chronic stomach pain and severe bowel dysfunction, IBS is thought to impact up to 15% of the world's population.^[6]

All that is required is that cases be handled in accordance with the fundamental Ayurvedic principles for understanding the condition. According to Ayurveda, IBS is a condition caused by a disturbance of Vata in Pakvashaya, particularly of Apana Vayu, which manifests as abdominal pain and irregular bowel movements. The disturbance of Agni is the main cause of almost all disorders. Dosha Prakopa is reached via Mandagni. The Agni is impacted differently by the emotions such as Krodha, Bhaya, and Shoka, among others. Indigestion is caused by Mana or Agni Dusti, while Vata Prakopa is brought on by Shoka, Bhaya, etc.

Along with Apana Vata, additional Doshas such as Prana Vata, Samana Vata, Pachaka Pitta, and Kledaka Kapha are also recognised to play significant roles in the pathophysiology of IBS. Both Ayurveda and contemporary science acknowledge that psychological factors play a crucial part in the treatment and prevention of Grahani Roga (IBS).^[7]

In the manifestation of Grahani Roga, Manasika Bhavas are crucial. Impaired Manasika Bhavas can cause any disease and have long-lasting, adverse repercussions in addition to being confined to Grahani Roga. The clinical characteristics of Irritable Bowel Syndrome (IBS) as described in modern research share the most similarities with the fundamental characteristics of Grahani as described in the old Ayurvedic texts. With its symptoms of chronic stomach pain and severe bowel dysfunction.

Modern aspect of Grahani Roga (IBS)

Other names for IBS include spastic colitic, irritable colon, mucous colitis, and spastic colon. It is an intestinal condition that causes stomach pain, diarrhoea, constipation, bloating, and gas. Individual differences in the severity and duration of symptoms make it difficult to pinpoint the exact aetiology of IBS. According to the definition of irritable bowel syndrome (IBS), it is "a functional bowel illness in which abdominal pain is related to urination or a change in bowel habits

with symptoms of disorganised defecation and distension."

The most prevalent functional gastrointestinal condition, IBS is characterised by irregular bowel movements and abdominal pain without visible anatomical abnormalities.^[8] Numerous extra-intestinal disorders, including fibromyalgia, sexual dysfunctions, urinary complaints, and specific psychiatric disorders are also linked to IBS.

IBS is a disease that manifests mostly as a result of appropriate Agni & Dosa Dusti, according to Ayurveda. In IBS, the normal Vata Dosha and Agni's functional dependence are changed. Dhatus and worried Srotas, or Purishavahasrotas, play a significant part as well. Apana Vayu assists Purishvahasrotas in performing the majority of its functions, so the Dusti is at the level of Apana Vayu and Samana Vayu. The primary cause of IBS is Mansik Bhavas, which hinder Agni and Rasavahasrotas, as well as Ahara Viharas, which result in Vatakopa.

Intestinal sensitivity, motility, secretion, and permeability are all significantly affected by psychological stress, and the underlying process is closely related to mucosal immune activation, changes in the central nervous system, peripheral neurons, and gastrointestinal microbiota.

The gut-brain axis and the microbiota-gut-brain axis are affected by stress-induced changes in neuro-endocrine-immune pathways, which in turn cause symptom flare-ups or exacerbation in IBS. Since IBS is a stress-sensitive disorder, managing stress and the reactions that stress causes should be the main focus of treatment.^[9]

The Rome 3 criteria are used to rate IBS. Recurrent abdominal pain or discomfort lasting at least three days or a month and being linked to two or more of the following are the requirements.^[10]

1. A alteration in defecation.

2. The onset of a change in bowel frequency.

3. The onset of the change in stool composition.

Samprapti of Grahani Roga

According to Ayurveda, Grahani Roga is a condition caused by a derangement of Vata in Pakvashaya, particularly of Apana Vayu, which manifests as symptoms of abdominal pain and irregular bowel

movements. Nearly all diseases are primarily brought on by the dysfunction of Agni.

Dosha Prakopa is caused by Mandagni. the feelings of Shoka, Bhaya, and Krodha, among others. on the Agni their own consequences. Shoka, Bhaya, and Mana's or Agni's Dusti cause dyspepsia etc. cause Vata Prakopa. Along with Apana Vata, additional Doshas such as Prana Vata, Samana Vata, Pachaka Pitta, and Kledaka Kapha are seen to play vital roles in manifestation in the Samprapti of Grahani Roga.

Mansik Bhavas in Grahani Roga

In Ayurveda, diseases are divided in two types i.e., Sharirika (Somatic)) and Manasika (Psychological).^[11] After some time, any Sharirika Roga that a person has may transform into Manasik Roga, and the same Samprapti (pathogenesis) applies to the transformation of Manasik roga into Sharirika Roga. This demonstrates that Ayurveda has made the most of the significance of Manas in the development of diseases.

The origin and symptoms of many diseases, according to the classics, emphasise the significance of Manasik Bhava or Psychological Factors. Body and mind are interconnected. One can affect the other because one is Adhara and the other is Adheya. Therefore, it is evident that psychological factors support somatic illnesses. Even while each Manasika Bhava (psychological element) plays a unique part in every ailment, according to classical Ayurvedic theory, certain of them have been shown to play a significant impact in Grahani Roga.^[12]

Even healthy food consumed in the right quantity does not get digested by an Agni person, according to Acharya Charaka, if that person is also experiencing Chinta, Krodha, Bhaya, Shoka, and Dukh-Shayya Prajagare.^[13] According to Acharya Susrutha, the disturbed functions of Agni are what cause the Grahani illness to appear. "The food is also not correctly digested if ingested by a person who is emotionally agitated due to jealously, fear, rage, or greed, or who is distressed due to suffering from various diseases, or who has taken food not to his liking," continued Acharya Sushrut.^[14]

Role of Mansik Bhavas in Samprapti of Grahani Roga

In this stage, even a light food cannot be digested due to the vitiation of Dosha and Agni caused by Manas as Nidana (psychological

influences), which also results in Agnimandya (loss of digestive fire) and Avipaka (indigestion). It remains unchanged and creates Shuktatva in Aamashaya (fermented), resulting in the development of Annavisha. Ajirna is produced by this Annavisha (indigestion).^[15] And after Agnidushti happens, Avipaka and Ajirna follow, severely harming the Agni. Agnidushti further upsets the Agni and results in Shuktapakatwa of Ahara. As a result, when Amavisha is formed, it disrupts the Grahani, which then leads to the production of Amadosha and the beginning of a vicious cycle. Only a few etiological elements actually cause Dosha.^[16]

Discussion

The mind is a key factor in all forms of intestinal bowel syndrome. Anxiety and stress heighten awareness of colon spasms in the mind. The immune system, which is impacted by stress, may cause IBS. The visceral reactions to stress include modifications in gastrointestinal (GI) motor function. ENS, ANS, and CNS are in charge of controlling the GIT's neural system. An important component of the gut brain, according to gut brain psychology, is the gut microbiota, which communicates with the brain via the microbiota-gut-brain axis. The pathophysiology of many mental and neurological diseases is influenced by the gut microbiota, which also has an impact on a variety of normal mental processes and mental phenomena.^[17] The Manasik Bhavas affect the Agni in their own unique ways. Indigestion is caused by Dusti of Mana or Agni; while Tridosha is involved, Pitta and Kapha are the dominant Doshas in this condition. Pitta and Kapha are the two predominant Doshas in the Grahani Roga Samprapti, with Vata being the least active.

According to the classics of Ayurveda, psychological variables in Grahani Roga include Chinta, Kama, Krodha, Shoka, and Bhaya. Atichinta causes vitiation of Pitta, Vata, and Rasavahasrotodusti, according to Ayurvedic literature. Many psychosomatic ailments are mostly caused by Chinta (worry) turning into stress. The Harvard Mental Health Letter discusses the connection between mental stress and gastrointestinal discomfort and how stress can both cause and exacerbate gastrointestinal symptoms. There is reciprocity here.

Fear, or Bhaya, promotes anxiety, stress, depression, and hopelessness. The fact that the gut's enteric nervous system and the brain communicate is widely established. Through secretions and motility, this enteric nervous system contributes significantly to the physiology of the gut.

A number of hormonal abnormalities can be blamed for the effects of Kama (greed). These hormones have the direct ability to alter the GI tract's regular function. Sex hormones like testosterone and oestrogen are linked to IBS in addition to gut hormones like gastrin, motilin, cholecystokinin, and secretin.

A mood illness is Shoka (grief). Shah and colleagues (2014) have demonstrated a link between psychological illnesses and irritable bowel syndrome.

Conclusion

The abdomen is the "sounding board of the emotion," reflecting emotional disorders more than any other system. As a result, various symptoms related to digestion, or "functional abnormalities of the gastrointestinal tract," arise from mouth to anus. As a result, it may be said that Grahani Roga is a psychosomatic illness because stress plays a part in its pathogenesis. Because psychology is so important for preserving one's health. An individual's abnormal psychology, such as worry, anger, greed, etc., would have an impact on the physiology of digestion, upsetting homeostasis and interning Grahani. In modern science, patients simply receive symptomatic treatment and assurance. Since the Rogi is treated by Ayurveda as a whole, the mental state of the patient is taken into account before therapy. Therefore, pharmaceutical intervention therapy and counselling are used.

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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-07-30	2022-08-01	2022-08-08	2022-08-15	2022-08-22
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	16%

Review Article

Grahani Roga

Journal of Ayurveda and Integrated Medical Sciences