Ayurveda perspective: the Underlying triggers of Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS), also known as spastic colon, is a gastrointestinal disorder that affects the lower part of the gastrointestinal (GI) tract. It affects the function of the small intestine and large intestine (colon).

Some of the IBS symptoms include bloating and gas, cramps, diarrhea, constipation, abdominal pain, and changes in stool (feces) color.

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Why Ayurveda helps treat Irritable Bowel Syndrome (IBS)

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How Ayurveda works for Irritable Bowel Syndrome (IBS)

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Ayurveda for Irritable Bowel Syndrome (IBS): Treatment Protocol

Ayurvedic treatment for irritable bowel syndrome is specifically tailored to each individual’s case and looks at the dominant dosha in their constitution.

However, Ayurvedic treatment for irritable bowel syndrome (IBS) generally involves the following aspects.

A- Purvakarma treatments:

Purvakarma is Sanskrit for “foremost action.” It comprises herbal and oil treatments that loosen the accumulated toxins in the colon. Ayurvedic medicine believes these toxins trigger irritable bowel syndrome (IBS).

Accordingly, purvakarma practices direct the toxins to specific waste elimination centers in the body. They help prepare people for Panchakarma (detoxification therapies).

Purvakarma consists of three treatments:

1- Pachana (digestion therapy): a practice where herbal treatments are administered to the patient. These herbal formulations help the body digest and eliminate toxins that accumulate in the gut and cause irritable bowel syndrome (IBS).

2- Snehana (oleation therapy): a practice where oils, ghee (purified butter), or oils mixed with herbs are consumed internally or applied externally to loosen toxins in the gut that trigger IBS. It also helps lead the toxins to elimination centers in the body, where they can later be expelled via panchakarma therapies.

3- Swedana (sudation therapy): a practice that involves a thermal treatment to help release toxins that accumulate in the blood and muscles through the skin. Swedana helps relieve pain and inflammation in the digestive tract.

It typically occurs after oleation therapy as the oils help the body absorb the steam. It can target the whole body (bashpa swedana) or a specific part of the body (nadi swedana).

During swedana, the patient sits in a wooden box or room filled with herbal steam to eliminate the toxins in his or her body by sweating. Ayurvedic practitioners recommend having a warm shower after swedana therapy.

B- Panchakarma treatments:

Panchakarma, which is Sanskrit for “five treatments,” is a five-step detox program in Ayurveda. These treatments help detoxify the body and restore balance to the vata, pitta, and kapha doshas.

The five treatments are:

1. Vamana (medicated emesis)

2. Virechana (medicated purgation)

3.Vasti (medicated enema)

4. Nasya (nasal medication)

5. Raktamokshan (bloodletting)

An Ayurvedic practitioner would manage irritable bowel syndrome (IBS) using the following Panchakarma treatments:

1- Virechana (medicated purgation): a practice where patients are given herbal treatments to induce diarrhea. It helps clear out toxins in the gut and restore balance to the pitta dosha. Virechana helps IBS patients who are often constipated.

2- Vasti/Basti (medicated enema): vasti is a practice where patients are given oils or liquids that help cleanse their colon. Basti is a practice where patients are given oils infused with herbs to eliminate toxins in their gut Vasti and basti are primarily used to ease irritation in the colon and rejuvenate it.

C- Rasayana (Rejuvenation treatments):

In Ayurveda, rasayana, which is Sanskrit for “path of essence,” consists of practices that help rejuvenate and nourish the mind and body.

Rasayana practices include consuming herbal treatments or decoctions and maintaining a healthy and balanced diet. They also incorporate exercise, yoga, and a regular self-care routine (dinacharya) to maintain balance in all aspects of life.

The rasayana practices that help treat irritable bowel syndrome (IBS) are explained in more detail below:

1- Dietary Modifications:

The Ayurvedic diet aims to balance all three life energies or doshas in the mind and body. Patients should maintain a diet that restores balance to the pitta dosha (energy of digestion and metabolism) to treat and prevent irritable bowel syndrome (IBS).

An Ayurvedic diet also prescribes eating specific foods as part of Purvakarma (preparatory treatments) before Panchakarma (detoxification therapies) to help loosen the accumulated toxins in the digestive tract that trigger IBS.

Patients should maintain the Ayurvedic diet even after they complete Purvakarma and Panchakarma therapies.

2- Herbal Treatments:

Ayurveda prescribes herbs or herbal treatments to treat irritable bowel syndrome. The treatments are specifically tailored to the person’s symptoms. Practitioners prescribe different herbs depending on the person’s symptoms.

Some of these herbs include:

- Brahmi (Bacopa monnieri): an herb that reduces the body’s cortisol levels and calms the body, which reduces gastrointestinal pain. Brahmi also helps the body better react to stress which might trigger IBS.

- Shatavari (Asparagus racemosus): an herb that helps balance the vata and pitta doshas. It has oily qualities, so it is beneficial for IBS, where constipation is the dominant symptom.

- Triphala: an herbal treatment consisting of three different herbs, amalaki, bibhitaki, and haritaki. These herbs help cleanse the gut and normalize bowel movements. Triphala is most beneficial in IBS, where diarrhea is the dominant symptom.

- Hingvastak: an herbal preparation that is made up of long pepper, ginger, black pepper, rock salt, black cumin seeds, white cumin seeds, asafoetida, and ghee. It helps increase the number of digestive enzymes in the stomach to stimulate agni. It also clears out toxins in the gut.

- Haldi (Turmeric): an herb that contains the anti-inflammatory chemical curcumin. It helps reduce excess kapha dosha and stimulates agni (digestive fire).

- Dhanyak (Coriander): a cooling herb that improves digestion and balances the pitta dosha. It also stimulates agni (digestive fire).

- Saunf (Fennel): an herb that relieves IBS symptoms like gas, bloating, and constipation. It also soothes the intestines and reduces stomach cramps.

- Pippali (Long pepper): an herb that relieves IBS symptoms because it boosts digestion and restores balance to the pitta dosha. It also clears excess kapha dosha in the body.

- Ela (Cardamom): an herb that improves digestion because it stimulates agni and relieves IBS symptoms like bloating and abdominal spasms.

3- Dinacharya (Routine):

Dinacharya or establishing a routine is one aspect of Rasayana that helps treat irritable bowel syndrome.

It includes:

1- Adjusting dietary habits: Patients should eat foods at regular times. They should also eat healthy foods that help restore balance to the imbalanced vata, pitta, and kapha doshas and ease bowel movements.

2- Regulating sleeping habits: Patients need to adjust their sleeping habits and begin sleeping at regular times every night. Sleeping well improves IBS symptoms.

3- Exercising regularly: Patients should engage in physical activity every day to stabilize the vata, pitta, and kapha doshas to prevent irritable bowel syndrome (IBS). Regular exercise reduces inflammation in the gut. It also reduces stress, which improves IBS symptoms.

4- Practicing yoga: Patients should practice at least 10 minutes of yoga every day to strengthen the abdominal muscles and ease bowel movements. Yoga also releases stress, one factor that worsens irritable bowel syndrome (IBS) symptoms.

5- Practicing breathing techniques: Patients should practice breathing techniques or pranayama every day. Pranayama cools the body, relaxes the intestines, and soothes the mind. Breathing techniques reduce stress levels, which alleviates IBS symptoms.

Ayurvedic Medicine for Irritable Bowel Syndrome (IBS): recommendations

- Eat meals regularly: Eat smaller, more frequent meals throughout the day at regular times to help stimulate the pitta dosha and improve digestion.

- Exercise regularly: Engage in physical activity for 30 minutes every day to restore balance to all the doshas. Exercise helps reduce the severity of IBS symptoms.

- Sleep well: Maintain a regular sleep schedule and get at least 7 hours of sleep to keep all the doshas balanced. Having a good night’s sleep eases IBS symptoms for the next day.

- Practice yoga: Patients should practice at least 10 minutes of yoga, including pranayama (breathing techniques), every day to release stress, one factor that worsens irritable bowel syndrome (IBS) symptoms.

Practice activities that increase mindfulness: Practice meditation for at least 20 minutes every day. Meditation helps relieve stress, one factor that worsens IBS symptoms.

- Try fasting: Fasting helps the body eliminate toxins in the body, especially those that are in the colon or the gut. After fasting, eat kitchari (rice and mung beans) to promote digestion. Avoid excessive fasting, as that might trigger IBS.

- Walk after meals: Take a walk 15-20 minutes after a meal to stimulate digestion.

- Drink lukewarm water after meals: Drink lukewarm water after meals to stimulate digestion.

Foods to eat:

According to Ayurveda, people with IBS should eat fresh fruits and vegetables that contain a lot of fiber. The foods should be easy to digest to prevent the formation of toxins in the gut.

These foods include:

• Fruits: bananas, blueberries, grapes, citrus fruits such as oranges, lemons, limes, kiwis, pomegranates, and strawberries

• Vegetables: eggplants, green beans, celery, carrots, spinach, sweet potatoes, yam, zucchinis, pumpkins, and squash

• Dairy products: buttermilk, cow ghee

• Legumes: Mung beans

• Grains: rice, oats, and sorghum

• Honey

• Spices: coriander, cumin, mint, turmeric, ginger, black pepper, and long pepper

Herbs to use:

According to Ayurveda, people with IBS should consume herbs/herbal preparations that reduce stress, improve digestion, and regulate bowel movements to relieve irritable bowel syndrome (IBS) symptoms.

The following herbs help treat or manage irritable bowel syndrome (IBS):

- Brahmi (Bacopa monnieri): an herb that reduces the body’s cortisol levels and calms the body, which reduces gastrointestinal pain. Brahmi also helps the body better react to stress, one trigger of IBS.

- Shatavari (Asparagus racemosus): an herb that helps balance the vata and pitta doshas. It has oily qualities, so it is beneficial for IBS, where constipation is the dominant symptom.

- Triphala: an herbal treatment consisting of three different herbs, amalaki, bibhitaki, and haritaki. These herbs help cleanse the gut and normalize bowel movements. Triphala is most beneficial in IBS, where diarrhea is the dominant symptom.

- Hingvastak: an herbal preparation that is made up of long pepper, ginger, black pepper, rock salt, black cumin seeds, white cumin seeds, asafoetida, and ghee. It helps increase the number of digestive enzymes in the stomach to stimulate agni. It also clears out toxins in the gut.

- Haldi (Turmeric): an herb that contains the anti-inflammatory chemical curcumin. It helps reduce excess kapha dosha and stimulates agni (digestive fire).

- Dhanyak (Coriander): a cooling herb that improves digestion and balances the pitta dosha. It also stimulates agni (digestive fire).

- Saunf (Fennel): an herb that relieves IBS symptoms like gas, bloating, and constipation. It also soothes the intestines and reduces stomach cramps.

- Pippali (Long pepper): an herb that relieves IBS symptoms because it boosts digestion and restores balance to the pitta dosha. It also clears excess kapha dosha in the body.

- Ela (Cardamom): an herb that improves digestion because it stimulates agni and relieves IBS symptoms like bloating and abdominal spasms.

Ayurvedic Medicine for Irritable Bowel Syndrome (IBS): things to avoid

- Don’t skip meals: Skipping meals makes it harder to establish a routine. It also weakens agni and disrupts the balance of the pitta dosha, affecting digestion and triggering IBS symptoms.

- Avoid drinking coffee and tea: these drinks aggravate all three doshas and disrupt their balance. They also contain caffeine, which increases diarrhea and make IBS symptoms worse.

- Avoid or limit alcohol consumption: alcohol consumption disrupts the balance of the pitta dosha. It increases the number of toxins in the gut, which worsens IBS symptoms.

- Avoid soft drinks: these drinks contain a lot of sugar and aggravate the pitta dosha, which can cause toxins to accumulate in the gut, triggering IBS symptoms.

- Stop smoking: smoking aggravates the pitta dosha and triggers the accumulation of toxins in the gut. The tobacco in cigarette smoke also irritates the digestive tract and worsens IBS symptoms.

Foods to avoid:

According to Ayurveda, all foods possess certain gunas (qualities). The gunas in the foods are transferred into energies that influence the balance of the doshas in the body.

People with irritable bowel syndrome (IBS) should avoid foods possess dry gunas (qualities) to manage and treat IBS.

These foods include:

• Vegetables: raw onions, garlic, broccoli, cauliflower, cabbage, and coleslaw.

• Fruits: grapes, plums, apples, watermelons

• Grains: wheat, refined wheat

• Meats: most meats

• Legumes: peas

• Dairy products: cheese, milk, curds, and ice cream

• Sugary foods

• Spicy foods

• Processed foods

•Frozen foods

Ayurveda for Irritable Bowel Syndrome (IBS): precautions

Ayurveda uses natural and herbal remedies to treat diseases. However, if you want to use Ayurvedic medicines, herbs, supplements to treat a particular condition, you should consider the following precautions:

- Consult your Ayurvedic practitioner before taking Ayurvedic products on your own. Let them know if you have diabetes or are taking medication that may affect your treatment plan. They should adjust it to avoid any harmful interactions with the medication you are taking.

- Some Ayurvedic products and practices are banned in the United States. The Food and Drug Administration (FDA) does not approve or review Ayurvedic products. Some herbal compounds or preparations may contain lead, mercury, or arsenic in toxic amounts.

They can cause serious illnesses in children and may be life-threatening for pregnant or lactating women and their babies. Other compounds from untrustworthy manufacturers may contain steroids, which may cause further health issues.

- Some Panchakarma treatments aren’t suitable for all patients who have inflammatory bowel disease. Eligibility for panchakarma is determined by an Ayurvedic practitioner.

People who are classified as having “weak” or lean and thin bodies aren’t eligible for some panchakarma treatments. People who are anemic and pregnant women also aren’t allowed to undergo panchakarma treatments.

WARNING:

- Make sure to disclose to your primary care physician that you are seeing an Ayurvedic practitioner and are taking Ayurvedic formulations. This ensures you stay safe and avoid medication interactions that might cause serious side effects.

- If you are taking medication for diabetes, don’t stop taking them if you begin Ayurvedic treatment unless your doctor approves it.

- Some Ayurvedic practitioners may not be qualified to treat you. Make sure that your Ayurvedic practitioner is well-trained, certified, and has the relevant experience to meet your needs.

- Be careful when buying Ayurvedic herbs or formulas. Don’t buy Ayurvedic products unless they have a GMP (Good Manufacturing Product) stamp on them if you are buying them from India. Be extra careful when purchasing herbs online because online stores may be selling counterfeit products.

Ayurveda for Irritable Bowel Syndrome (IBS): side effects

Since Ayurvedic treatments are derived from natural herbs and plants, most treatments do not cause adverse events. However, if you take some Ayurvedic preparations or herbs, you may experience the following side effects.

- Some Ayurvedic products contain toxic amounts of heavy metals like lead, arsenic, or mercury, and they might cause heavy metal poisoning.

- Some Ayurvedic herbal formulations might cause headaches, nausea, gastrointestinal problems, diarrhea, rashes, or allergic reactions.