Digestive Disorders in Ayurveda: A Clinical Review of Agnimandya, Amlapitta, Grahani, and Arshas

Digestive Disorders in Ayurveda: A Clinical Review of Agnimandya, Amlapitta, Grahani, and Arshas

Abstract:
Digestive health is a cornerstone of Ayurvedic well-being. Diseases of the gastrointestinal system are primarily governed by Agni (digestive fire), and any disturbance in Agni leads to a wide spectrum of disorders. This article elaborates the Ayurvedic understanding of digestive disorders such as Agnimandya (low digestive fire), Amlapitta (hyperacidity), Grahani (malabsorption syndrome), and Arshas (hemorrhoids), with emphasis on etiology, pathology, clinical signs, chikitsa, medicines, and Panchakarma interventions.

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1. Introduction
Ayurveda considers Agni as the root of health. Proper digestion, absorption, and assimilation depend on the balance of Jatharagni, Bhutagni, and Dhatvagni. Impairment in Agni leads to Ama formation, which is the root cause of many gastrointestinal disorders.

2. Nidana (Etiological Factors)

• Irregular eating habits and incompatible foods

• Overeating, excessive spicy, oily or sour food

• Emotional stress, sedentary life

• Viruddha Ahara (incompatible food combinations)

3. Major Digestive Disorders

• Agnimandya – Indigestion due to diminished digestive fire

• Amlapitta – Acid dyspepsia or hyperacidity

• Grahani – Chronic indigestion or IBS-like conditions

• Arshas – Hemorrhoids

• Atisara – Diarrhea

• Ajirna – Indigestion

4. Samprapti (Pathogenesis)

• Impairment of Jatharagni leads to Ama production

• Ama along with vitiated doshas vitiates the gastrointestinal tract

• In Grahani, the function of the small intestine is hampered

• Arshas arises from chronic constipation and pressure on Apana Vata

5. Rupa (Clinical Features)

• Agnimandya: Bloating, heaviness, loss of appetite

• Amlapitta: Sour belching, burning sensation, nausea

• Grahani: Alternating diarrhea and constipation, fatigue

• Arshas: Bleeding, pain, mass in anal region

6. Prognosis (Sadhya-Asadhyata)

• Functional disorders like Agnimandya, Amlapitta, and Grahani are generally curable

• Arshas can be Sadhya or Yapya depending on severity and duration

7. Chikitsa Sutra (Treatment Principles)

• Deepana-Pachana to rekindle Agni

• Ama Pachana in early stages

• Virechana in Pitta and Rakta involvement

• Basti in chronic Vata-related conditions

• Kshara Karma and Agni Karma for Arshas

8. Ayurvedic Medicines

• Agnimandya: Trikatu Churna, Hingwashtaka Churna, Chitrakadi Vati

• Amlapitta: Kamdudha Rasa, Avipattikar Churna, Sootashekhara Rasa

• Grahani: Kutajarishta, Musta, Nagarmotha, Bilvadi Churna

• Arshas: Arshoghni Vati, Abhayarishta, Kankayana Vati, Triphala Guggulu

9. Panchakarma Therapies

• Vamana: In Kapha-induced Amlapitta or Grahani

• Virechana: For Pitta dominance and liver involvement

• Basti: Niruhabasti in chronic Grahani, Arshas

• Kshara Sutra: For internal hemorrhoids

10. Pathya-Apathya (Diet and Lifestyle)

• Warm, easily digestible foods, avoid junk, fried, spicy meals

• Timely eating habits, avoid overeating

• Buttermilk with trikatu or jeera

• Regular physical activity, yoga: Pavanmuktasana, Vajrasana

11. Conclusion
Ayurveda offers a detailed classification and individualized treatment protocol for digestive disorders. The focus on restoring Agni, eliminating Ama, and rejuvenating the gut makes it highly effective in both acute and chronic conditions.

12. References

1. Charaka Samhita Chikitsa Sthana – Agnimandya, Grahani, Arshas Adhyaya

2. Ashtanga Hridaya Chikitsa – Chapters 8–10

3. Sushruta Samhita – Nidana Sthana on Arshas

4. Bhavaprakasha Nighantu – Chitraka, Haritaki, Kutaja

5. CCRAS Ayurvedic Formulary Vol I & II