Irritable bowel syndrome (IBS) is a chronic disease which affects the Gastrointestinal tract (GIT). It is characterised by a cluster of symptoms like abdominal pain/cramps, bloating, indigestion and altered bowel habits. This article by Dr. Manu will help us understand the different treatments in Ayurveda that will help in curing this disease.
IBS is not a life threatening disease but it often adversely affects the quality of the patients life causing them to avoid social events, travel plans, work schedule etc because of the fear and embarrassment of unexpected IBS symptoms like abdominal cramps and/or diarrhoea. Found to affect one in five people at some point of their life It can affect both men and women, but is likely to affect twice as many women as men.
The symptoms of IBS include:
- Abdominal pain and cramping
- Abdominal bloating and/or heart burn, excessive flatus indigestion
- Immediate urge to pass motion after food
- A feeling of incomplete emptying after bowel movement
- Diarrhoea and/or constipation. Alternating between the two
- Ribbon – like stools or loose stools with or without mucous.
Cause of IBS in Ayurveda
As we all know, IBS is a chronic disease that affects our digestive system. Hence, the influence of the food we eat play a huge role in the development of this disease. Thus, it turns out that the primary cause of IBS is nothing other than our food habits. All other factors like stress and pressure at work play only a secondary role in the development of IBS. In Ayurveda, food is called “Mahabheshajam”, which means “the greatest medicine”. The correct kind of food can prevent almost all chronic diseases, cure most of them, enhance our immunity, help our brain function well, keep us happy, keep us young, repair our DNA, and enrich all the dimensions of our life. But the sad truth is that the incorrect manner of food intake can have a delirious effect on our body.
An ayurveda saying goes like this, “If your diet is right, there is no NEED for medicine. If your diet is not right, there is no USE for medicine.” So the causative factors of IBS according to Ayurveda are connected to unhealthy food habits.
Vishamasanam means eating food that is not conducive to the optimal functioning of the digestive system. It can happen in multiple ways
- Wrong types of food: Unfortunately we don’t eat real food anymore. We eat industrially produced, nutritionally depleted food that contains loads of MSG, artificial sweeteners, additives, pesticides, preservatives, allergens etc. Many of our foods are genetically modified too. We don’t drink normal water any more. Instead, we drink sodas, fruit juices with loads of sugar and that which poses a great challenge to our digestive system and its enzymes. These kind of foods are detrimental to our GIT and can trigger inflammation of the gut, allergic reactions, food sensitivities and cause motility problems to our intestines.
- Wrong combinations of food: Our digestive system is not designed to digest complicated and sophisticated food combinations. Digestive enzymes have well defined actions and limitations and when we disregard these limitations and eat haphazardly, abdominal distress is bound to happen. Ayurveda says that the wrong combination of food can create toxic metabolites which can cause IBS and/or other chronic diseases.
- Eating food at the wrong time: We have a biological clock in our genes. It works according to the natural rhythm of our body which is nearly a 24 hour cycle. This rhythm controls and regulates and decides the best time to eat and digest food, time of sleep and every other physiological activity. Eating at the wrong time will disturb the biological clock within us and this can result in IBS or other chronic diseases.
Adhyasanam means eating anything before the previously eaten food is digested completely. This creates a crisis in the stomach causing abdominal distress and hinders the proper digestion and metabolism of the food consumed.
Anasanam means not eating in a healthy manner when we need to. Missing the right nutrients repeatedly can cause havoc in the immune system, nervous system and endocrine system which controls and regulates our body and especially digestive system leading to IBS and other nutritional disorders.
Atyambupanam means drinking excessive amount of water. It has become a fad to drink a few litres of water or tea etc daily. This has a detrimental effect on gastric functions.
This means infections by either bacteria, virus, or other parasites in the gut can lead to IBS if not managed properly. For e.g., if one gets an infectious diarrhoea and gets treated with antibiotics but does not follow the right diet and regimen, the effects of the infection can remain in the gut and lead to a later attack of IBS.
- Vega dharanam
Vega dharanam means controlling and postponing the natural urges of Bowel movement, or urination or flatus. In this fast paced world people often ignore the above said urges for hours or even days. This can cause severe dysfunction in the motility and normal functioning of the colon in the long-term resulting in IBS.
As a cumulative and repetitive result of one or more of the above, a condition called “Ajeernam” may happen in the gut. “Ajeernam” (also called “digestive sludge”) results from incomplete or partial digestion of food in the digestive tract. This “digestive sludge” turns toxic and can cause innumerable diseases. “ Ajeernam” is the cause of many chronic diseases including IBS and can cause a cascade of adverse events in the colon.
- It can damage the lining of the intestines which is only one cell layer thick. The immune system which is present just below this lining gets activated and responds with food sensitivities or allergies (eg, gluten, casein) in the gut.
- The entire nervous system in the intestines gets irritated by the toxic Ajeernam and can force the intestines to go into spasms causing pain and/or diarrhoea and/or constipation.
- Another adverse effect of Ajeernam is that it attracts harmful bacteria into the intestines (which should be sterile) creating a condition called SIBO (Small Intestinal Bacterial Overgrowth). This SIBO can create symptoms like bloating, cramps, diarrhoea, indigestion, nausea etc which are seen in IBS.
Ayurvedic management of IBS
Ayurvedic management of IBS or any other chronic disease is totally different from conventional medicine. Nobody wakes up one fine morning to find he/she has IBS. It is a chronic disease which take a few weeks / months or even years to develop. If there are 100 people with IBS, the causative factors and the course of the disease may not be the same for all of them. Ayurveda emphasises the uniqueness of each individual and uniqueness of the disease-causing factors in each person. So a one-size-fits-all solution will not be feasible for IBS or any other chronic disease. Understanding the underlying causes and the mechanism or the patterns of dysfunction of the disease is crucial in developing a personalised treatment for each individual.
In IBS, treatment is done in multiple phases:
- Nidanaparivarjanam (Removing the causative factors from the diet and lifestyle)
- Pachanam (neutralisation or metabolising the Ajeernam)
- Deepanam (Stabilising and regaining of digestive enzyme-hormone complex functional efficiency)
- Sodhanam (Flushing out the disease causing factors from the colon)
IBS sufferers are advised to avoid eating the following:
- All processed, industrially produced food which contains MSG and other additives, trans fats, artificial sweeteners, preservatives, pesticides allergens
- Gluten, dairy products
- Legumes and beans
- Cruciferous vegetables like cauliflower, cabbage etc
- Chilled foods and drinks, alcohol, coffee, chocolate, raw vegetables, raw green juices and smoothies.
- Excessive drinking of water or tea.
Diet and Lifestyle factors to be adopted when attacked by IBS
- Don’t eat or snack frequently. Leave a gap of minimum 4 hours between meals. Only drink boiled water between meals.
- Avoid late night dinners. Eat dinner 3 hours before going to bed.
- Eat only fresh, well cooked and warm food which is not dry. Raw, cold or dry food can irritate the sensitive colon and aggravate the symptoms. Basmathi rice, Potato, Kichadi, Porridge, steamed vegetables with a little spices, organic lamb meat, gluten free bread, vegetable broth, bone broth are ideal options.
- Chew your food very well. Nearly 20% of digestion happens in the mouth. Proper chewing of food alone will reduce the severity of symptoms of IBS.
- Try to keep the mind stress free. Soft belly breathing and mindfulness meditation will help to manage stress better.
Pachanam is a unique treatment where specific herbal combinations and personalised food regimen are used to neutralise and metabolise the toxic, disease causing “Ajeernam” and its complications like SIBO(Small Intestinal Bacterial Overgrowth), food sensitivities, loss of appetite, nausea etc. Once the Ajeernam gets metabolised, the colon returns to a normal state and the symptoms of IBS subsides naturally.
In IBS, the enzyme-hormone complex will be compromised so they may be functioning sub-optimally. Deepanam is the Ayurvedic methodology to optimise and regain the functional efficiency of the digestive enzyme-hormone system.
Sometimes, the Ajeernam may be stubborn and highly toxic and may not respond to Deepanam or Pachanam. Then the next treatment protocol in Ayurveda is to exercisee the toxic Ajeernam from the colon. There is a unique method of detoxification called Panchakarma through which even the toughest disease-causing factors can be probed, found and flushed out of the body without affecting the normal physiology. This is found to be very effective in treating most of the chronic diseases. In very chronic IBS, Sodhanam can be a very effective tool in reversing the disease. Once Sodhanam is done, the chances of recurrence of the disease are small.
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