Introduction
Irritable bowel syndrome (IBS) has an estimated worldwide prevalence of around 5%. It is characterized by recurrent abdominal pain in association with abnormal defecation in the absence of a structural abnormality of the gut. IBS accounts for frequent absenteeism from work and impaired quality of life. The cause of IBS is incompletely understood but biopsychosocial factors are thought to play an important role, along with luminal factors, such as diet and the gut microbiota.[1]
The key symptoms of IBS include recurrent abdominal pain and altered bowel habit. Abdominal pain is usually colicky or cramping in nature, felt in the lower abdomen and related to defecation.[2]
Grahani is considered one of the Mahagadas in Ayurveda.[3] Grahani is closely associated with digestive dysfunction, and in today’s context, the prevalence of this condition has significantly increased due to poor dietary habits, irregular lifestyles, stress, and environmental factors.[4]
The proper functioning of the Grahani, a crucial part of the digestive system, relies on the strength of Agni. When Agni becomes weakened due to various pathological or environmental factors, it disrupts the normal digestive processes, leading to the impairment of Grahani.
This dysfunction results in the release of undigested food particles into the gastrointestinal tract, which further stimulates the formation of Ama. The accumulation of Ama is a key factor in the onset of Grahani, which manifests as digestive discomfort, irregular bowel movements, and other gastrointestinal disturbances. This cascade of imbalances creates a vicious cycle that exacerbates the symptoms and leads to the chronic nature of Grahani.[5]
Grahani manifests through a range of symptoms, such as Muhurbaddha Muhurdrava Mala (alternating episodes of diarrhea and constipation), Udarashoola (abdominal pain), Trushna (excessive thirst), Arochaka (loss of taste), Asyavairasya (inability to perceive flavors), Praseka (excessive salivation), Shoon Padakara , Asthiparva Ruk (joint and bone pain), Chardan (vomiting), Jwara (fever), and Louhagandhi Amlaudgara (iron-like, pungent burps).[6] These diverse symptoms, when present together, significantly affect a patient’s overall well-being.
Although existing medical guidelines offer treatments for IBS, the wide spectrum and complexity of symptoms often lead to partial relief. While common symptoms such as diarrhea, constipation, and abdominal discomfort may improve, other critical symptoms like fatigue, which impact a patient's quality of life, are frequently left unresolved. The impairment of the gut-brain axis in IBS is well-documented, but its therapeutic potential has not yet been fully explored or validated in mainstream treatments.[7,8]
The present case series aims to offer a holistic approach to IBS management by utilizing Gastrointestinal therapy such as Basti (medicated enema) & mind-body interventions like Shirodhara (therapeutic Decoction pouring on forehead), complemented by Ayurvedic counseling & clear communication regarding patient's condition. By integrating these therapies, we seek to address both physical & emotional aspects of IBS, providing a comprehensive solution that may lead to long-lasting relief & enhanced well-being for patients.
Materials and Methods
A case series of 10 patient presenting with the chief complaints of abdominal pain, alternating episodes of constipation and diarrhea, mucus-laden stools, abdominal heaviness, and fatigue diagnosed with IBS a based on ROME IV criteria underwent a personalized Ayurvedic treatment regimen including Panchakarma therapies (Piccha Basti and Shirodhara). Along with Oral medications primarily having digestive and carminative properties to restore Agni and regulate bowel movements. Lifestyle and dietary modifications were also recommended to support digestive health and maintain doshas balance.
Inclusion and Exclusion Criteria
Inclusion Criteria
1. Diagnosis of IBS:
- Confirmed using Rome IV criteria:
- Recurrent abdominal pain (at least 1 day/week in the last 3 months) associated with two or more of the following:
- Related to defecation.
- Change in stool frequency.
- Change in stool form (appearance).
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