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बुधवार, 5 अक्तूबर 2011

Irritable bowel syndrome


Irritable bowel syndrome is a non inflammatory condition of unknown etiology. It is now believed that it is a functional disease related with hyper or hypo movement of intestine which results in diarrhea or constipation. Some believe that this disease is an outcome of communication error between brain and intestine.
            Main clinical features are mucous mixed stools, abdominal pain, abdominal bloating, symptoms aggravated by taking wheat and products, dairy products, leafy vegetables, pulses and spicy food items, no symptom after getting in to sleep or never awakened by IBS symptoms, and also fibromyalgia, depression are common co morbidity.
            There are many differential diagnosis for IBS, important are Ulcerative colitis, Crohn’s disease, other Inflammatory bowel disease, giardiasis, amoebiasis, celiac sprue, colon malignancies, chronic mesenteric ischemia etc are some of main DD’s.
            There are mainly four sub varieties of IBS- they are 1) IBS-D, with diarrhea,    2) IBS-C, with constipation, 3) IBS-M, mixed, 4) IBS-A alternating diarrhea and constipation.
            Another condition which is called as post infectious IBS, where there will be micro inflammation in large and small intestines,an atypical variety of IBS, usually with severe symptoms which usually initiated after gastroenteritis.In our place we come across with such many cases and many IBS condition becomes worst after they suffer from gastroenteritis.
            Being a chronic relapsing condition most of the patient suffer from severe form of depression many times with suicidal tendencies.

Treatment adopted in Ukkinadkas Ayurveda:

The success rate widely varies from patient to patient. Most of the patient being a chronic condition we get after 10-15 years after the onset of symptoms.
-         first part of the treatment is DIET.
We advise to avoid wheat, milk products, most of the vegetables and pulses, spicy food, fried food etc.
We allow only taking rice, some specific vegetables like peel of pomegranate, ash guard, bottle guard, tender leaves of cashew nut plant, kakamachi leaves, dhathaki kusuma bheda leaves(in our place called as enjiru in Tulu), and other food which the patient is confident of harmless as per his experience. This strict diet is for 45 days, and then onwards he can take wide range of food.

-         Kwatha prepared out of Kutaja, Chithramula, Pata, Amalaki, Punarnava, Shunti, etc along with Ananda Bhairavi, Agnitundi or Lahsunadi vati etc
-         We have not tried with any Panchakarma till now because most of the patient refused to undergo Panchakarma treatment and many were poor patients.

We have treated many cases of IBS with above line of treatment, many patients get result to some extent and then once again relapses, in some patients we get no result, but in few patients we get very good result. Most of the patients who come to us are chronic, after few years most of IBS patients become depressed and while on treatment they become more depressed with varied symptoms and becomes difficult to make them to stay on treatment.
I have one special case, a female of 30 years of age now 43, took treatment for 3 years and got relieved of all the symptoms. After some time she took medicine for some other illness and that doctor gave her Chyavana prasha leha, immediately after starting the Leha symptoms reccured and once again she came to my clinic, I gave her the same medicine and got relived of the symptom and this time she continued the same for 5 years. Afterwards till now for any kind of illness she comes to us for treatment due to the fear of relapse. She is the only one IBS case who is under my treatment from day one of my practice. My father was practicing the strict diet method in all Grahanis and many other GIT diseases wherever AMA was there. Even today I follow the same diet plan for IBS patients with satisfactory result. Now a day it becomes very difficult to make the patient to stay on that diet for 45 days. Many patients arise the question of nutritional deficiency and afraid to follow the strict diet. But as per our experience afterwards absorption will be better and condition improves a lot.
But with all these we are not satisfied with the result because most of the patients they fail to continue the treatment. Many times we don’t get satisfactory result etc etc.
Jayagovinda Ukkinadka
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