E-ISSN:2456-3110

Case Report

Vataja Grahani

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 1 JANUARY
Publisherwww.maharshicharaka.in

An Ayurvedic approach of Vataja Grahani vis-à-vis Irritable Bowel Syndrome - A Case Study

Shashikala V1*, Beena MD2
DOI:10.21760/jaims.10.1.39

1* Shashikala V, Post Graduate Scholar, Department of PG Studies in Kayachikitsa, JSS Ayurveda Medical College, Mysuru, Karnataka, India.

2 Beena MD, Professor, Department of PG Studies in Kayachikitsa, JSS Ayurveda Medical College, Mysuru, Karnataka, India.

Grahani is considered as Agni Adhishtana, which help in the process of metabolism and digestion of food. The ancient text of Ayurveda described that ingestion, digestion, absorption and assimilation of Aahara is regulated by Grahani. Any disturbances in the status of Agni leads to Mandagni which further leads to improper digestion of ingested food leading to Grahani Roga which nowadays affects large population globally, especially in developing countries due to improper food habits along with stressful lifestyle. In Modern parlance, it can be correlated to IBS. Irritable bowel syndrome (IBS) is characterized by recurrent abdominal discomfort in association with alternate episodes of diarrhoea and constipation. Physiological, luminal, behavioural and psychosocial factors are responsible for IBS. They are caused by two entirely different mechanisms such as Bowels habits disturbed by diarrhoea or constipation occurring alone or alternating. A case of 57 years old female diagnosed with Vataja Grahani Roga after detailed history taking, thorough clinical examinations and was diagnosed with IBS using Rome IV criteria and Mannings Criteria to assess the severity of the disease. Patient was then treated with Ayurveda Panchakarma therapies such as Kashayaseka, Sarvanga Abhyanga, Takra Basti and Shamanaushadhis. Assessment was done using IBS Symptoms Severity Scoring Scale. After completion of Ayurveda treatments, there was a marked improvement in the condition of the patient in terms of symptoms and IBS Severity scoring scale was reduced to score 9 from 34 within a span of 11 days. Hence this case is an evidence to demonstrate the effectiveness of Ayurveda treatment in case of Grahani Roga.

Keywords: Grahani, Irritable bowel syndrome (IBS), Sarvanga Abhyanga, Takra Basti, Shamanaushadhis

Corresponding Author How to Cite this Article To Browse
Shashikala V, Post Graduate Scholar, Department of PG Studies in Kayachikitsa, JSS Ayurveda Medical College, Mysuru, Karnataka, India.
Email: 		Shashikala V, Beena MD, An Ayurvedic approach of Vataja Grahani vis-à-vis Irritable Bowel Syndrome - A Case Study. J Ayu Int Med Sci. 2025;10(1):253-263.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-12-10 2024-12-21 2025-01-02 2025-01-13 2025-01-27
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© 2025by Shashikala V, Beena MDand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Shashikala V. et al. Ayurvedic approach of Vataja Grahani

Introduction

Ayurveda has its unique concept of Trayopastambha[1] which are Ahara, Nidra and Brahmacharya which is an aid for the balance of Tridoshas. According to Ayurveda, the growth, nourishment, procreation, and dissolution of living beings are all the result of food consumed.[2] Ayurveda emphasises the importance of Aahara by a reference which says that all the things that help to lead a quality life such as strength, intellect, complexion, cheerfulness, good voice, happiness, contentment, intellect etc are dependent on Ahara.[3] Acharya Kashyapa even considered Aahara as Mahabhaishajya which promotes health in both diseased and normal people.[4] If the Aahara is not taken properly in terms of quantity or quality, it will eventually lead to the manifestation of various diseases. Grahani is the structural seat of Agni which retains the food until it is fully digested and then passes it into the Pakvashaya.[5] Due to the vitiation of Pachaka pitta, Samana Vata and Kledaka Kapha, in which there will be impairment of status of Agni, which eventually vitiates the structure Grahani and further called as Grahani Roga.[6]

In Shabdakalpadruma, The root word of "Grahani" is derived from "Grah Dhatu," which means to catch, hold, or obtain (Shabda Kalpadrum). The specialised portion of the Mahasrotas is called Grahani (Gastrointestinal system). Jatharagni's seat is the organ Grahani, which holds onto the food until it is completely digested before passing it into Pakwashaya (intestine). Agni when lacks functionality, leads to Grahani Roga as a result of faulty food digestion and metabolism influenced by Mandagni. Because of its direct connection to bad eating habits and a stressful lifestyle in the modern era, Grahani is a disease with significant clinical relevance.[7]

Grahani Roga is one of the Mahagadas according to Ayurveda. There are three ways to interpret the word "Grahani," i.e., Grahani Roga, Grahani Dosha, and Grahani Avayava. The term "Grahani Dosha" refers to any deviation from the state of Samagni, Mandagni, Teekshnagni, and Vishamagni. Classical Ayurvedic texts describe the illness condition known as Grahani (Malabsorption sickness). Following the physiological digestion, absorption, and assimilation of any food into Saara and Kitta by Jatharagni Vyapara (tissue interaction),

Rasa must then circulate normally throughout Shareera and Kittavisarjana (waste removal) must be carried out regularly for Jeeva Poshana or maintaining homeostasis through adequate nutrition. Agni Dosha, which is located within Grahani, is regarded as Grahani Dosha. Grahani Dosha and Grahani Roga respectively, might be thought of as functional disintegration caused by Agni dysfunction and organic disintegration caused by improper dynamics of the interior mucosa.[8] In contemporary science, Grahani can be correlated to Irritable Bowel Syndrome (IBS).

Irritable Bowel Syndrome (IBS) is a functional disorder that is common in almost all parts of the world. The prevalence of IBS all over the world is estimated to be 11.2% whereas in India, it is estimated to be between 4.2% to 7.7%.[9] The aetiology of IBS is broad and not clearly understood. However, as below in the pathophysiology section, motility, visceral sensation, brain-gut interaction, and psychosocial distress can all play a role in the development of IBS The pathophysiology of IBS is broad and includes abnormalities involving motility, visceral sensation, brain-gut interaction, and psychosocial distress. One of these can usually be demonstrated in the majority of IBS patients; however, not all symptoms can be attributed to them. Recent studies have also shown altered gut immune activation and intestinal and colonic microbiome are associated with IBS. Environmental contributors to IBS include early life stressors, food intolerance, antibiotics, and enteric infections. Patients often complain that IBS symptoms are related to food intake. However, a true food allergen has a limited contribution to IBS. The symptoms commonly encountered include abdominal pain or discomfort, bloating, diarrhoea, constipation etc. IBS is a symptom-based disorder, and thus treatment goals are aimed at resolving symptoms such as pain, bloating, cramping, and diarrhoea or constipation. For constipation, fibre supplements and laxatives can be helpful whereas, in those with diarrhoea, medications such as loperamide or probiotics can be helpful. Moreover, increased physical activity can increase colonic transit time and improve symptoms. Patients also often associate food intake with IBS symptoms. Foods such as wheat products, onions, fruits, vegetables, sorbitol, and some dairy can include short-chain, poorly absorbed, highly fermentable carbohydrates, which are known as FODMAPs.


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FODMAPs have been associated with increased gastrointestinal symptoms in IBS patients.[10] In this case, the symptomatology of IBS mimics the symptoms explained in Grahani Roga Adhyaya (Charaka Samhita) with respect to Vataja Grahani. The treatment explained in Ayurvedic classics for Grahani Roga effectively manages the symptoms mentioned above. A successfully treated case of Vataja Grahani will be discussed here in this article.

Case Report

A 57 years old female visited to Kayachikitsa OPD of JSS Ayurveda Hospital, with the complaints of altered bowel habits (8-10 episodes of watery, loose stools associated with foul smell everyday with occasional evacuation of hard stools every 3 or 5 days once) associated with severe lower abdominal pain, persistent bloating of abdomen, occasional nausea following food intake which aggravates on taking spicy, non-vegetarian food, beverages, on taking stress and relieves on taking oral medications for the same, and also weight loss of about 5-8kgs within a span of 2 months. For which she had approached C.S.I.

Holdsworth Memorial Hospital where relevant blood investigations was done and was tested as HbsAg positive and advised for UGI scopy & colonoscopy & histopathological studies and was diagnosed as Chronic diarrhoea with Dimorphic Anemia. For which conservative line of management was given along with 2 unit PRBC infusion was done and patient found temporary symptomatic relief. Patient was on continuous conservative management for the same on and off when symptoms occur till 2 years ago. As she experienced sudden mental trauma i.e., due to the death of her husband) 1 year ago, condition of the patient aggravated and had persistent altered bowel habits (around 8-10 episodes of loose stools/ day) associated with gradual weight loss of about 15kgs within span of 2 years, later 6 months back, she visited Apollo hospital and was advised with Colonoscopy which showed Normal study and advised to oral medications. Also, complaints of blackish skin rashes over inner thighs, upper abdomen including both flanks associated with severe itching, burning sensation since 2 years, for which she had visited nearly allopathic hospital and took oral medications and local applicants for 15 days, condition used to aggravate on having sweets, curd intake and relieved on taking medications.

For all these above mentioned complaints, patient had approached our hospital for further management of the same.

History of past illness

  • Childhood illness: Nil
  • Adult illness:

Medical

1. Chronic Diarrhea x 5 years along with Dimorphic Anaemia
2. HbsAg positive status 5years ago, current report shows negative result
3. N/K/C/O DMT2, HTN, Thyroid dysfunction, cardio-pulmonary ailments.

Surgical - Nil

Psychiatric - Depression and anxiety episodes since the death of her husband

1. Allopathic Medicine

Medical - Was on Irregular medications since 5years

1. L-Doper 1-0-1 A/F
2. Amitriptyline 10mg 0-0-1 x 5days
3. Meva-C 1-0-1 X 3 days
4. Rifaximin 400mg 1-0-1 x 5days
5. Creon 10,000U 1-1-1 X 5Days

Surgery - Nil

2. Ayurveda Medicine

Medical - Nil

Surgical - Nil

3. Others - Nil

Family history

All family members are said to be healthy

Personal history

Ahara

Diet type - Mixed, stopped non vegetarian food intake since 5 years

  • Breakfast @ 11:00 A.M - Upma, Dosa, Idli, Rice Bath, Kichadi
  • Lunch @ 2 or 3 P.M- Ragiball, Rice, Sambar, Vegetable Palya
  • Snacks- Coffee and Biscuit.

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  • Dinner 9 P.M - Chapathi, Sambar, Vegetable Palya, 1 glass of milk Untimely food intake.

Vihara - Sedentary

Vyasana - Tea on empty stomach once a day around 200ml since many years, stopped since 15 days.

Agni-Vishama - Altered since 5 years

Reduced appetite since 2 years Nidra - Disturbed since 2 years

Mootra - 5-6 times/day, once or twice/night, No pain / burning / excessive / incontinence / suppression during micturition.

Mala - altered (8-10 episodes of loose stools and evacuation of hard stools every 3 or 5 days once) since 5 years - no painful/ burning/ blood/ mucus/ suppression during defecation.

Vayu ( Flatus) - Normal/ with sound/ bad smell/ suppression

Obstetric history

  • G3P3L3A0D0
  • FTND - 3 issues, LSCS- Nil
  • 1st - Male child - 36 years
  • 2nd - Male child - 34 years
  • 3rd - Male child - 32 years
  • B/L Permanent sterilization - 32 years ago
  • No pregnancy induced complications

Menstrual History

  • Age of Menarche - 14 years
  • Regularity - regular since menarche till menopause
  • No of days - 3-4 days/ 28-30 days
  • Blood flow - Moderate bleeding
  • Discomfort - Abdominal cramps, Pain in calf muscles, Lower back pain
  • Menopause - at the years of 55
  • History of other gynecological complaints - Nil

General Examination

  • Nadi - Vata-Pitta
  • P - 120/80mmhg
  • PR - 78bpm, regular

  • SPO2 - 98% @ RA
  • Temperature - Afebrile
  • Height - 149 cms
  • Weight - 44kg
  • BMI - 19.8 kg/m2 (normal)
  • Built - Normal
  • Nourishment - Poor

Ashta Sthana Pareeksha

  • Nadi - Vata- pitta
  • Mala - altered (8-10 episodes of loose stools and evacuation of hard stools every 3 or 5 days once) since 5 years
  • Mutra - 5-6 times/day, once or twice / night
  • Jihwa - Lipta
  • Shabda - Vikruta (Bowel sounds heard extensively, tinnitus present occasionally)
  • Sparsha - Anushna-Sheeta
  • Drik - Vikruta - not able to see distant objects since 3 years
  • Akriti - Madhyama

Systemic Examination

1. CNS - Conscious, Oriented, No FND
2. CVS - S1,S2 heard, no murmurs
3.RS - B/L NVBS heard, no added sounds
4. Musculoskeletal system:
Gait - normal
ROM of all the joints possible without pain
5. Gastrointestinal tract examination

On Inspection:

Shape of the abdomen - scaphoid
Skin over the abdomen - no discoloration
Symmetry - normal
Umbilicus - inverted
No dilated veins, visible mass, visible peristalsis, scars, sinuses

On Auscultation: Bowel sounds heard, no bruits

On Percussion: Tympanic, but dull in Right Hypochodriac region, No shifting dullness, no fluid thrill

On Palpation:

1. Superficial palpation:


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Warmth - normal temperature
Tenderness - Absent
No Abdominal Guarding/ Rigidity

2. Deep palpation:
No tenderness in all 9 quadrants
No organomegaly, No Abdominal rigidity/guarding

Mental Status Examination

  • General appearance and behaviour - Normal
  • Speech - Normal
  • Mood - Sad
  • Thoughts - Anxious, overthinking. No delusions
  • Perceptions - Normal. No hallucinations
  • Insight - Present
  • Judgement - Intact
  • Cognition - Normal

Dashavidha Pareeksha

1. Prakruthi - Shareerika - Vata-Pitta, Manasika - Rajas
2. Vikruthi - Dosha - Tridosha
A. Dhatu - Rasa
B. Mala - Pureesha
3. Sara - Avara
4. Samhanana - Avara
5. Pramana - Supramanitha
6. Satmya - Madhyama
7.Satva - Avara
8. Aahara Shakthi-
A. Abhyavarana Shakthi - Avara
B. Jarana Shakthi - Avara
9. Vyayama Shakthi - Madhyama
10. Vaya - Madhyama

Previous Investigations

1. Histopathology - Large Report - dated on 9/3/2019

Impression:

  • Sections from the duodenum show partial villous atrophy glands appear normal . Many chronic inflammatory cells seen. No granulomas/ parasites seen.
  • Sections show bits of normal gastric mucosa

2. USG Abdomen Scan - dated on 5/3/2023

Impression:

  • Few subcentemetric mesenteric lymph nodes in RIF region
  • Otherwise essentially normal study

3. Colonoscopy Report - dated on 13/06/23

Impression: Normal Study

4. Vit B12 - on 1/3/2019 - 110pg/ml

5. AFP - on 14/06/23 - 2.19ng/ml

Table 1: Srotas Pareeksha

SNSrotasLakshanas
1.Pranavaha Srotas-
2.Annavaha SrotasAnannabhilasha, Arochaka, Avipaka, Chardi
3.Udakavaha SrotasJihwa-Oshta-Talu-Kanta Shosha, Atipravruddha Pipasa
4.Rasavaha SrotasAshraddha, Aruchi, Asyavairasya, Hrillasa, Agninasha, Glani, Trishna, Hritpeeda, Shosha, Rukshata
5.Raktavaha StrotasDadru, Twak Rukshata, Vaivarnya, Dourbalya, Kandu, Agnimandhya, Aruchi
6.Mamsavaha Srotas-
7.Medovaha SrotasGala-Talu Shosha
8.Asthivaha SrotasVivarnatha, Asthibheda
9.Majjavaha Srotas-
10.Sukravaha Srotas-
11.Pureeshavaha SrotasSashabda-Sashoola- Atidrava- Atibahu
12.Mutravaha Srotas-
13.Swedavaha Srotas-

Vikruthi Pareeksha

Nidana - Untimely intake of food, Spicy food intake, non-vegetarian foods, Intake of tea on empty stomach, stress.

Poorvaroopa - Reduced appetite, Improper digestion, Anorexia

Roopa -

  • Bala Kshaya (generalized weakness)
  • Chira Anna Paka (delayed digestion)
  • Vidaha (burning sensation in chest region on and off)
  • Adhmana (Bloating of abdomen)
  • Visuchika (vomiting & diarrhoea occasionally simultaneously)
  • Kanta-Aasya-Shosha (dryness of throat and mouth)

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  • Muhur-Baddham, Muhur Dravam - 8-10 episodes of loose stools and occasional evacuation of hard stools every 3 or 5 day once

Upashaya - on taking Oral medications

Anupashaya - taking spicy, non-vegetarian food, beverages, stress, untimely intake of food

Samprapti

Nidana Sevana (Untimely intake of food, Spicy food intake, non-vegetarian foods, Intake of tea on empty stomach, stress)
↓
Agnimandhya
↓
Vidagdhata of Anna Rasa
↓
Vidagdha Anna Rasa enters into circulation
↓
Annavaha, Purishavaha, Rasavaha Sroto Dushti
↓
Pratyatma Lakshana of Vataja Grahani - Punaha Punaha Varchah Srujana, Drava, Sushka, Tanu & Shabdha, Phena Mala Pravrutti, Kantaasyashosha, Trushna, Visuchika, Parikartika, Dourbalya, Avipaka, Asyavairasya, Adhmana, Karshyata, Manosada
↓
Vataja Grahani Roga

Samprapthi Ghatakas

  • Dosha - Vata (Samana, Apana, Vyana), Pitta (Pachaka), Kapha (Kledaka)
  • Dushya - Ahara Rasa, Rasa Dhatu, Rakta Dhatu.
  • Upadhatu - Twacha
  • Agni - Jataragnimandhya,
  • Ama - Jataragnijanya
  • Srotas - Annavaha, Purishavaha, Rasavaha, Raktavaha, Mamsavaha
  • Srotodushti Prakara - Sanga, Atipravrutti, Vimarga gamana
  • Udbhava Sthana - Amashaya
  • Sanchara Sthana - Pakshashaya
  • Vyaktha Sthana - Guda
  • Adhisthana - Grahani
  • Rogamarga - Abhyantara, Bahya
  • Vyadhi Swabhava - Chirakari

Diagnostic Criteria

  • The case was diagnosed as Vataja Grahani based on the presence of symptoms explained in our classics.[11]
  • The case was diagnosed as Irritable Bowel Syndrome using Rome IV Criteria[12] as well as Manning’s criteria[13] and both Grahani as well as IBS had some sort of similarities in the symptomatology manifested.

Table 2: Rome IV Criteria[12]

Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteriaCriteria satisfied by the patient
1.  Related to defecationYes
2.  Associated with a change in the frequency of stoolYes
3.  Associated with a change in the form (appearance) of stoolYes

Table 3: Manning’s Criteria[13]

Manning CriteriaCriteria satisfied by the patient
Looser Stools at pain onsetYes
More frequent stools at pain onsetYes
Pain relief with defecationYes
Visible abdominal distensionYes
Mucus per rectumYes
Feeling of incomplete evacuationYes

Table 4: Treatment Plan

SNName of the procedureTreatment medicineNo. of days given
1.Sarvanga Kashaya SekaPanchavala Kwatha + Yashtimadhu Churna + Triphala Churna + Neem leaves with Bruhat Marichadi Taila and Yashtimadhu TailaFor 5 days
From (1-9-2023 to 5-9-2023)
2.Sarvanga Abhyanga followed by Nadi SwedaYashtimadhu TailaFor 2 days
From (6-9-2023 to 7-9-2023)
3.Takra BastiFor 8 days
From (4-9-2023 to 11-9-2023)

Ingredients of Takra Basti

Anuvasana Basti

  • Dadimadi Ghrita (100ml)

Niruha Basti

  • Takra - 300ml
  • Yashtimadhu Churna - 5g at 12:30pm before lunch
  • Shatavari Churna - 5g

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  • Dadimadi Ghrita (100ml)
  • Honey - 30ml
4/9/235/9/236/9/237/9/238/9/239/9/2310/9/2311/9/23
ANANANAA

Table 5: Oral Medication

SNMedicineDose with AnupanaTime
1.Syrup Mannol10ml -10ml-10mlAfter food
2.Kutajaghanavati(2-2-2) with warm milkAfter food
3.Punarnava Mandura(1-1-1) with TakraAfter food
4.Kutajarishta(15ml-15ml-15ml) with 30ml warm waterAfter food
5.Dadimashtaka Churna(5g) with 1 glass of Takra (5g-0-0)After food
6.Limiron granules¼ tsp with milk at 8pmAfter food

Table 6: Advice on discharge

SNMedicineDose with AnupanaTime
1.Syrup Mannol10ml -10ml-10mlAfter food
2.Kutajaghanavati(2-2-2) with warm milkAfter food
3.Punarnava Mandura(1-1-1) with TakraAfter food
4.Kutajarishta(15ml-15ml-15ml) with 30ml warm waterAfter food
5.Dadimashtaka Churna(5g) with 1 glass of Takra (5g-0-0)After food
6.Limiron granules¼ Tsp with milk at 8pmAfter food

Observations and Results

Table 7: Parameters before and after treatment.

Symptoms (Parameters)Before TreatmentAfter treatment
After 11days
Frequently passing Liquid Stool (Muhurdrava Mala Pravruthi)8 - 10 times/day1-2 times/ day
Repeated passing of Stool (Muhur Muhur Mala Pravruthi)8 - 10 times/day1-2 times/ day
Consistency (Guruta)WaterySemisolid
Mucous in stool (Amayukta Mala)PresentAbsent
Abdominal Discomfort (Udara Shoola)ModerateAbsent
Sense of incomplete evacuation (Feeling of Mala Badhata)PresentAbsent
Mental statusLow moods and overthinking presentMood have improved and overthinking have reduced upto 50%
Weight44kg46kg

Table 8: Irritable Bowel Syndrome (IBS) Severity Score[14]

SNQuestionnaire with scoringBefore TreatmentAfter treatment
1.

How severe has you has your abdominal (tummy) pain been over the last ten days?

  • no pain - 0, 1
  • not very severe - 2,3,4
  • quite severe - 5,6,
  • severe - 7,8
  • very severe - 9,10
52
2.On how many of the last 10 days did you get pain? _____________ number of days with pain50
3.how severe has your abdominal distension (bloating, swollen or tight) been over the last ten days?
  • no distension - 0, 1
  • not very severe - 2,3,4
  • quite severe - 5,6,
  • severe - 7,8
  • very severe - 9,10
52
4.How satisfied have you been with your bowel habit (frequency, ease, etc) over the last ten days?
  • Very Happy - 0, 1,2
  • Quite Happy - 3,4
  • Unhappy - 5,6,7
  • Very Unhappy - 8,9,10
102
5.How much has your IBS been affecting/interfering with your life in general over the last ten days
  • Not at all - 0, 1,2
  • Not much - 3,4
  • Quite a lot - 5,6,7
  • Completely - 8,9,10
93
6.Wherwell et al’s classification of IBS severity using this scale was:
  • in remission - less than 7.5
  • mild -7.5 to 17.5
  • moderate - 17.5 to 30
  • severe - more than 30
Total		349

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Results

After 11 days of therapy with internal medication, she got significant relief in complaints like altered bowel habits, Low mood and there was increase in weight by 2 kg. Clinical assessments were made from the subjective symptoms & irritable bowel syndrome (IBS) Severity Score. Before the treatment score was 34 and after the treatment there was a marked improvement in the symptoms of the patient and the score was 9. Thus, there was a remarkable reduction in the signs and symptoms and quality of life of the patient was improved.

Discussion

Based on the history given, signs & symptoms, clinical examination & diagnostic criteria for assessing the severity, case was diagnosed as Vatajagrahani w.s.r. to IBS & the treatment was planned and was managed using treatment principles of Grahani Roga which includes - Deepana, Ama Pachana, Anuvasana Basti, Virechana, Niruha Basti, Nitya Ghritapana and Shamaushadhi’s.

Role of Takra Basti in Grahani

Takra possesses Deepana, Grahi and Laghu Guna’s, it is highlighted as the best Oushadhi Dravya in the management of Grahani Roga by almost all the classical textbooks of Ayurveda.[15] Takra can be corelated with butter milk, which is rich in potassium, phosphorus, Vitamin B12 and riboflavin. Riboflavin the key ingredient mainly helps in complete digestion of carbohydrates, proteins and fat. Acharya Charaka explains Takra as Basti Dravya under Amlaskanda which is one among Shad Asthapana Skanda.[16,17] Acharya Sushruta has mentioned Takra as Avapa Dravya for Grahi Basti.[18] Basti Chikitsa is one of the Shodhana Chikitsa which is explained in Panchakarma which possess evacuatory, nourishing as well as Deepana qualities.[19] Along with this, Basti Karma is considered to be superior among Panchakarma due to its wide applicability in various conditions in various forms. Hence, Takra Basti which is also classically mentioned in the Chikitsa of Grahani[20] gives very good relief in its symptoms.

Dadimadi Ghrita for Anuvasana Basti

Dadimadi Ghrita contains - Dadima, Dhanyaka, Chitraka, Sringabera,

Pippali Dravyas - which possess Laghu, Ruksha and Teeksha Guna, Katu, Tiktha, Amla and Madhura Rasa. Mandagni is a predominant feature of Grahani Dosha which results in Ama formation and in turn may lead to Shuktapaka. Dadimadi Ghrita has properties like Katu, Madhura, Kashaya Rasa, Katu Vipaka, Laghu, Ruksha and Tikshna Guna which are capable of combating the Ama and prevent the formation of Shuktapaka. By this function the Dadimadi Ghrita helps in bringing down the vitiation of Rasadi Dhatus. It also nourishes the Rasadi Dhatus. These properties of the Ghrita also reduce the colonic motility and there by decreases the Ama Mala Pravrutti. Thus, Dadimadi Ghrita acts on disease Grahani Dosha and helps to overcome disease process and provides beneficial action.[21] Yashtimadhu Churna and Shatavari Churna given in Basti acts as Vatapitta Shamaka and Jatagnivardhakara and Pushtidayaka.[22]

Sarvanga Abhyanga is the application of any Sneha Dravyas all over the body. Abhyanga makes the body Mridu, controls Vata and Kapha, and does Poshana to Dhatus; it also provides good Varna and Bala to the body. Yashti Madhu Taila acts as Varnya and helps to reduce Rakta and Pitta Dushti.[23]

Sarvanga Kashaya Seka was done using (Panchavala Kwatha + Yashtimadhu Churna + Triphala Churna + Neem leaves with Bruhat Marichadi Taila and Yashtimadhu Taila) help to increase local blood circulation. Local deranged Doshas are brought to normalcy. Kashaya Seka might have helped the active principles to enter the Twakgata Dhamanis, which are connected to Romakupa and Swedavaha Srotas there, by absorbing and transferring to the deeper layers with the help of Bhrajaka Pitta.[24]

Syrup Mannol contains Ela, Nagakeshara,Tamala Patra, Vasadi Dravyas which reduces oxidative stress and increases immunity.[25]

Kutaja Arishta contains Kutaja which has Tikta & Kashaya Rasa, Sheeta Veerya, Katu Vipaka and possess Deepana, Stambhana, Pittakapha Shamaka properties. According to Charakacharya, Kutaja is considered as best (Agrya Dravya) for Sangraahi and Upashoshana Karma. Due to above properties Kutaja stimulates Agni, leads to remove Ama (toxin) formation by proper digestion of food and Ama. Due to Tikta & Kashaya Rasa, Ruksha Guna and Sheeta Veerya, it pacify the Kapha & Pitta Dosha.[26,27]


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As the patient was anemic Punarnavamandura was given, which is one of the Herbo mineral preparation which contains Triphala, Trikatu, Chitraka, Vidanga and Pippalimula which has Deepana and Amapachana property which helps in improving the digestive fire, which ultimately helps in absorption of the drug. Haridra, Amalaki, Pippali, Punarnava and Trivrit were mentioned as Panduhara, Amalaki, Danti, Pippali, Punarnava, Kushtha and Daruharidra are documented as drugs which are having immunomodulator and antioxidant properties having the potential of providing beneficial health effects in anaemia. Amalaki is a rich dietary source of Vitamin C, a powerful water-soluble antioxidant, helps in increasing iron absorption from the gut. Mandura Bhasma (incinerated form of iron ‑ Fe2O3), by virtue of Rasa and Guna, pacifies aggravated Pitta and maintains the normalcy thereby improving the digestion and metabolism. The ferric and ferrous fractions of Mandura provide sufficient iron needed for normal erythropoiesis.[28]

Dadimashtaka Churna pacifies Agni, regulates Jataragni. Its Katu and Tikta Rasa pacifies vitiated Kapha while Ushna Veerya pacifies Vata Dosha. Teekshna and Ushna Veerya stimulates Agni. Katu Vipaka and Ushna Veerya of the formulation having Amanashaka and Laghuta property which maintain normal state Of Rasa Dhatu initially and Raktadi Dhatus consequently.[29]

As the Patient was Anaemic and was having general debility, Limiron Granules was given, mainly contain Kukkutanda Twak Bhasma, Vidarikanda, Shatavari and Kharjura having anti-oxidant properties which reduces the oxidative stress and help to improve the process of hemopoiesis and helps to stabilize the membrane of RBCs and hence improving the life span and membrane stability of RBCs. In addition, these drugs help to maintain the growth of RBCs.[30]

Conclusion

Among all the types of Grahani Roga, Vataja Grahani is reasonably similar to the symptoms of Irritable Bowel Symptoms (IBS). In spite of recent advances in the western medicine, the treatment of IBS is mere symptomatic, but the symptomatic management of any disorder is incomplete as it cannot break the chain of pathogenesis.

Hence considering this lacunae, Ayurvedic treatment using Takra Basti, external Panchakarma procedures along with proper Shamanaushadhi’s provided a very satisfactory result in the managing all the presenting complaints in the above discussed Vataja Grahani case. But the effect of the treatment protocol adopted in this case can be ascertained and explored further only if the study is conducted on larger samples.

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