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IBS/Irritable Bowel Syndrome (Grahani in Ayurveda)

Updated: Apr 11

Grahani is an Ayurveda term related to the anatomical seat (small intestine or duodenum) of Agni (digestive fire), which helps in the ingestion, digestion, absorption and assimilation of food.


Weak Digestive fire and deranged Vata Dosha are the root cause for IBS/Grahani


Understanding Grahani


Normally Grahani restrains the downward movement of the undigested food into small intestines when digestion is complete, the food passes onto the next stage of digestion through Lumen.

  • If the person is not able to digest the food easily, then it implies that his/her digestion is weak or you can say the fire element “Agni” is weak and results in the release of the undigested food.

  • This downward movement of the digested & undigested food is called “Grahani”, and the dosha responsible is Vata.

  • This weak and improper digestion can lead to the accumulation of toxins (ama) and all the major symptoms of IBS can be the result of these toxins.




Factors responsible for IBS

  1. Physiological

  2. Luminal

  3. Behavioral

  4. Psychosocial


Agni mandhya ( low digestive fire ) and Manas (Mind) are involved in this disease. Treatment without considering the psychological part of the patient does not help


Young women are affected 2–3 times more often than men. Coexisting conditions, such as non-ulcer dyspepsia, chronic fatigue syndrome, dysmenorrhoea and fibromyalgia, are common.





Grahanai/ IBS classification based on Doshas


1. Constipation predominant Grahani/IBS (Vataja)


Passage of stools is difficult, sometimes voids stools frequently. Stools are hard, thin and produce gurgling sounds. Foul taste in mouth, craving for all tastes,flatulence.


2. Diarrhea predominant Grahani/IBS (Pittaja)


Stools are loose with undigested food and foul smelling.Burning sensation in the throat and increased thirst are some of the symptoms.


3. Dysentery predominant Grahani/IBS (Kaphaja)


Stools come out in small pieces, heavy and along with Phlegm. Weakness and slothfulness.


4. When a person encounters a combination of all the above symptoms (Sannipatika)


Symptoms of all the three Doshas are usually present.





Modern View

According to the updated ROME III criteria

IBS is a clinical diagnosis and presents as one of the three predominant subtypes



  1. IBS with constipation (IBS-C)

  2. IBS with diarrhea (IBS-D)

  3. Mixed IBS (IBS-M)




NIDANA

(Etiological factors)


  • Improper functioning of digestive fire

  • Diseased condition which weakened Agni

  • Frequent fasting

  • Having food while having indigestion

  • Overeating

  • Incompatible diet intake

  • Following irregular pattern of eating

  • Food that is heavy, dry and rough in nature

  • Debilitation due to diseases

  • Holding natural urges like : Urine, stools, etc.

  • Stress, anxiety and grief

  • Undisciplined lifestyle and bad food habits

  • Unhygienic environmental condition

  • Nutritional insufficiency : e.g. Niacin, B-12 or Folic acid

  • Avoidance of concept of Desha and kala during consumption of foodstuffs

  • Excessive use of antibiotics

  • The abuse of laxatives is a common cause, which is often overlooked

  • Disease of the pancreas may cause large, frequent, fatty stools


Early symptoms


  • Excessive Thirst

  • Burning sensation

  • Cough

  • Tinnitus

  • Gurgling sounds in the abdomen

  • Laziness

  • Reduced of strength

  • Delayed digestion

  • Feeling of heaviness in the body



Symptoms of fully manifested IBS



  • Diarrhea characteristically occurs in the morning, and almost never at night.

  • Urge to defecate after meals.

  • Pain in the lower abdomen, pain often occurs in attacks usually relieved by defecation and sometimes provoked by food.

  • Bowel habit is variable.

  • Almost all patients notice ribbons like stools with or without mucus.

  • Sensation of incomplete emptying of the rectum.

  • Abdominal distension, excessive flatus, dyspepsia, heartburn, increased urine frequency.


Line of treatment in IBS


Ayurvedic treatment is conducted according to your body constitution (Know your body-Type). It is necessary to consult an experienced ayurvedic physician who can diagnose your mind/body type and customize a program for your particular health needs.


The first step in Ayurvedic Treatment of IBS is the treatment and reduction of Ama/Toxins. This way the body is detoxified and doshas are brought into balance.



Ayurvedic Management of IBS


  • Agni Deepana : This process involves the regulation of the digestive fire

  • Vata Anulomana: correction and balancing out the Vata dosha

  • Manonukulata : Involves relaxation and treatment of these underlying issues

  • Shodhan : Detoxification or purification

  • Shaman : Treating imbalances and neutralizing any impurities that remain after detoxification

  • Ayurvedic formulations : Rejuvenating and restoring the balance of the body with herbal formulations

  • Nidana Parivarajana : Maintaining a healthy lifestyle with a restricted diet, yoga, and meditation & avoiding the etiological factors.

  • Panchkarma : Ayurvedic detox


Diet modification:


Do’s

Don’ts

Grains : Eat old rice, Jawar

Grains : Wheat, Maize, Barley

Vegetables: Gourd, Coriander leaves

Legumes: Pigeon pea, Pea, Cow pea, Spiked dolichos, Soya bean

Lentils: Green gram

Lentils : Black gram,Kidney bean

Spices : Black pepper, Dried ginger

Seeds: Saga

Fruits : Wood apple, Pomegranate, Nutmeg

Vegetables: Potato, Sweet potato, Navalkol, Onion

Dairy : Skimmed milk, Buttermilk

Nuts: Coconut, Groundnut

Sipping Hot water throughout the day.

Spices : Chili

Take probiotic foods like curd,buttermilk, etc. Buttermilk and Sour gruel should be taken as a post-meal drink

Oily food

Identify and remove food intolerances.

Non- Vegetarian : Chicken, red meat, crabs, prawns, fish

Eat according to the individual’s Prakriti/Body Type.

Leafy vegetables: sorrel, drum stick

Fruits: Mango, Pineapple, Apple, Watermelon,Papaya, Fig, Jackfruit,

Dairy : Excess milk



Ayurvedic tips that can help you in IBS


  • Taking more soluble fibers can help prevent diarrhea. This is readily available in sources such as beans, oatmeal, and some fruits such as Apples, Strawberries and Grapes.

  • Drink enough water, as less water intake can obstruct the smooth movement of digested food in the GI/ Intestinal tract.

  • Avoid taking water while you eat. Taking water 1 hour before and after your meals will help considerably.

  • Eat aged rice, jowar, and skimmed milk.


For IBS-C (Constipation dominant)

  1. Herbal laxatives:containing anthraquinones, such as senna, cascara, rhubarb and frangula may stimulate bowel movements.

  2. Triphala:A natural detoxifier, it helps reduce constipation, abdominal pain and bloating.


For IBS-D ( Diarrhea dominant)

  1. Bilwa tea

  2. Pomegranate peel tea

This helps in reducing inflammation. These teas may reduce symptoms of diarrhea also.



Behavior modification

Daily regimen modification

Important Yoga poses

Avoid stress, fear and grief which may affect Agni

Undisciplined lifestyle needs to be avoided

Dhanurasana (Bow pose)

Remain positive and enthusiastic to maintain normal metabolic functioning.

Follow a daily regimen with fixed timing of each and every activity including a fixed daily routine of exercise, breakfast, meal and sleep.

Pavana-muktasana (Wind-relieving pose)

Over thinking should be avoided since during thinking process blood circulation remain associated with brain mainly instead of intestines

Regular exercise to strengthen my body & Agni

Marjariasana (Cat pose)

Be happy and associated with mental empowerment activities

Meditation to calm down stress

Adho-Mukha svanasana (Downward-Facing Dog Pose)

Suppression of urges(urination/passing of bowels) before bed should be avoided

Yoga and Pranayama also offer beneficial effects to increase stress resistance.

Ardha-matsyendra-asana (Sitting Half-Spinal twist)

Sound sleep plays a very important role in your digestion and overall health

​Ayurveda has mentioned some defined regimen such as; Ritucharya (link) and Dinacharya to get beneficial results of daily regimen.

Bhujangasana (Cobra pose


This article is intended for education and awareness. Ayurvedic treatment and advice is always personalized.

Ayurveda treatments for irritable bowel syndrome give good results. The treatment must consider various aspects like Ama, Agni and psychiatric problems along with pathya.

Do consult our expert Vaidya before starting your treatment of IBS.


 




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