Grahani ( Sprue / Malabsorption )

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.