Journal of Ayurveda and Integrated Medical Sciences

Constipation is generally described as having fewer than three bowel movements a week. Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. The main features of Constipation are infrequent or hard stool, abdominal pain, bloating, and feeling of unsatisfactory bowel evacuation.^[1] Chronic constipation can be correlated with Pureesha Avrita Vata^[2] which is defined as the absolute constipation along with Parikartika (Fissure in Ano), Shroni Vankshana Prstha Ruk (pain in hips, groin and back) and uncomfortable sensation in chest region etc. The common approach groups constipation into primary and secondary causes. Primary causes are intrinsic problems of colonic or anorectal function, whereas secondary causes are related to organic disease, systemic disease or medications.^[3] Contemporary laxatives, which are generally used in Constipation, become habitual after some duration and only symptomatic relief. Moreover, these medicines never alter pathogenesis of disease. So, it is a need of hour to search effective, safe & alternative formulations in Ayurveda, which can completely break the pathogenesis of Pureesha Avrita Vata.

As per Ayurveda, Vata Dosha and Pureesha Mala are the main factor involved in this condition. Therefore, the prime treatment principle recommended by Ancient Acharyas is Snigdha Udavartahar Kriya.

To evaluate role of Chinchalavan Taila Matra Basti, Indukanta Ghrita orally with Snigdha Virechana in the management of Pureesha Avrita Vata on constipation assessment scale.

A 68-year-old male with complaint of severe constipation, abdominal pain, abdominal distension, less frequent bowel movements, rectal fullness or pressure, rectal pain with bowel movement, smaller stool size and inability to pass stool, pain in hips, groin and back, uncomfortable sensation in chest region and H/O of fissure per rectal visited in I.P.D. of department of Kayachikitisa,

The changes observed in the signs and symptoms were assessed by adopting suitable scoring method and the objective signs by using appropriate clinical tools. Assessment was done before treatment on zero day and on 16^th day and 30^th day after completion of treatment.

Compared to your usual pattern you have had, No Problem – 0 score, Some Problem – 1 score or Severe Problem – 2 score.

Table 4: Constipation assessment scale taken in the case of Pureesha Avrita Vata.

Constipation is a heterogeneous, polysymptomatic, multifactorial disease. Acute or transient constipation can be due to changes in diet, travel or stress, and secondary constipation can result from drug treatment, neurological or metabolic conditions.^[9] As per Ayurveda, Vata Dosha and Pureesha Mala are the main factor involved in this condition. Therefore, the prime treatment principle recommended by Ancient Acharyas is Snigdha Udavartahar Kriya.^[10] According to Acharya Charaka, Matra Basti is always applicable to those emaciated due to overwork, physical exercise, weight lifting, journey on vehicles, indulgence in women, in debilitated person and in those afflicted with Vata disorders. Matra Basti promotes strength, without calling for any strict regimen of diet, and also causes easy elimination of Mala and Mutra. It performs the function of Brimhana and cures Vatavyadhi.^[11] Our Acharyas have considered the rectum (Guda) as the root of the body (Mula of Sharira). According to Acharya Charaka: ‘As a tree irrigated in its root attains blue branches with beautiful tender leaves, flowers and fruits in time, and attains a big stature, so too the man with unctuous enema given through the rectum.^[12] On the action of Basti, Vagabhata^[13] says the Virya of Basti is conveyed to Apana and then to Samana Vata, which may regulate the function of Agni. It then goes to Udana, Vyana, and Prana, thus providing its efficacy all over the body. At the same time Basti by pacifying Vata, restores the disturbed Kapha and Pitta at their original seats and thus helps in breaking the pathogenesis. Matra Basti with Chincha Lavana Taila effectively corrects the pathology of Constipation without causing any undue or adverse effect.^[14] Sarvanga Abhyanga (massage) with Til Taila and Sarvanga Svedana are used to improve gastro-intestinal motility.^[15]

Indukanta Ghrita is also effective in various symptoms of Parinama Shula (duodenal ulcer), i.e., pain abdomen, nausea, vomiting, burning sensation in the abdomen, acid eructation, flatulence, indigestion, constipation, and tenderness in the epigastrium^[16] as well as is indicated for strengthening digestive fire (Agni), opening the channels (Srotas).^[17] Thus, overall Tikta Rasa predominant in Indukanta Ghrita clears excessive gastric secretions, absorbs such excess quantities, keeps away the microbes, and helps in maintaining