Grahani ( Sprue / Malabsorption )
Grahani is described as an Agni Adhishthana by most of the acharyas. Mandagni is a root cause of Ama Dosha and it is the crucial factor for manifestation of most of the diseases. Among them, Grahani is the prime disease of gastro-intestinal tract and seen often in day-to-day practice.
Causes
1 Very dry food
2 Heavy meals
3 Half cooked food
4 Cold food and cold drinks.
5 Excessive drinking of water
6 Fasting
7 Suppression of natural urges.
8 Excess oily food
9 Excess intake of Burger . Pizza
10 Excess sweet.
11 Incomplete diet
12 improper sleeping schedule
13 Worry . Anxiety . Fear / Phobia . Anger etc.
Symptoms
1 indigestion
2 Heaviness in Abdomen
3 Flatulence
4 Vomiting
5 Weakness
6 Difficulty in digestion
7 Chest burn
8 Diarrhoea
9 Disorders due to malnutrition anemia .edema.
Clinical features
1 Sudden passing of stool . Mixed with ama and food.
2 Something passing of stool when food is not digested ( undigested ) during digestion or after digestion.
3 There may be no elimination of stool at all.
4 Something passing of soils stool or something passing of loose ( liquid stool )
5 Elimination of stool occurs only after its accumulation in large intestine . This is present in chronic stage .
Vataja Grahani
1 Sashabda
2 Divaprakopa
3 Adhaman.
4 Antrakujanam.
5 Manasa sadanam .
* These features are similar to ( IBS )
Irritable Bowel Syndrome
This is condition in which the person get defecation with abdominal gripping immediately after meals.
Causes
1 Stree
2 Exaggerated gastrocolic reflex.
Symptoms
1 Defecation after meals
2 Abdominal spasms
3 Mucus in stool
4 Stress
These symptoms if found for more than 3 months then it is diagnosed as IBS.
Pittaja Grahani
Loose stools having yellow , green , red colour , indigestion , bad odor Bleaching , sour belching , hrit - kantha daha . Aruchi .Trishna.
Kaphaja Grahani
Digestion with great difficulty , Hrillas , chardi , aruchi , asyopadeha , shareera madhurya , kasa , Stheevana , peenasa .
Sama and Nirama lakhshna of purisha in Grahani dosha
Sama Lakhshna
1 Durgandhit ( foul - smelling stool )
2 Picchilata ( Sticky stool )
3 Sinks in water
Nirama lakhshna
1 Opposite of above qualities.
2 laghu
3 Floats in water .
Investigation
1 Liver function test
2 Malabsorption test
Principal of Treatment
( A) Vataja Grahani
Shodhana Chikitsa
1 Ghirthapana - after proper amapachana . Deepaniya Ghirtha should be given.
2 Niruha Basti - When agnideepti occurs and if there is retention of purisha . Mitra and apna vayu.
In this condition Frist 2- 3 Anuvasana basti and than niruha basti should be given after Abhyanga and Svedana.
3 Virechana - eranda Taila
When the pacification of vayu occurs and when the dosha are loosened.
4 Anuvasana basti - After Virechana . When kostha become shuddha and rukha . Associated with baddhamala , Anuvasana should be given.
5 light diet
6 Deepaniya with Snigdha . Lavana and Amla dravya .
( B ) Pittaja Grahani
1 Vamana - Virechana - The pitta which is situated in its own site utklishta stage . Causes agnimandya should be expelled by vamana and Virechana.
Ahara
Avidahi , Laghu , Tikta , Madhurya , Sarpi , Deepana , Grahi .
(C ) Kaphaja Grahani
1 Vamana - Agnideepana with katu . Amala . Lavana . Kshara. Tikta Dravya.
2 In Kapha Stheevana Ruksha - tiktayukta Deepana should be given.
( D ) Tridosha Grahani
1 Panchakarma
2 Then Ghirtha , Kshara , Asava , Prayoga for agnivardhana.
Recommended Classical Formulation
1 Agnikumar rasa 125 - 250 mg TID with warm water after meals.
2 Grahani Kapata Rasa 125 - 250 mg BD with warm water after meals.
3 Rasa Parpati 125 mg TID with warm water before meals.
4 Brihat jatiphaladi 250 mg BD before meals with warm water
5 Kalyanaka guda 1 tsf BD before meals with water.
6Lavangadi Churna 1 tsf TID with Takra BD
7 Dashamula Guda 1 tsf BD with warm water after meals.
8 Panchamrita Parpati 125 - 250 mg TID with warm water after meals.
Diet and lifestyle
Pathya ( indications )
1 Annavarga - sashti shali , jirna shali , Mansoor , Tuvari , Mudga yusha , Lajamanda , Vilepi etc
2 Pomegranate , Orange
3 Cow milk , Curd , Takra , Ghirtha.
Apthya ( Contraindications )
1 Heavy . too hot . too cool . dry . incomplete foods .
2 Worry , Anger , Sadness.