Ayurvedic medicine, treatment and remedies for Diarrhea

Diarrhoea or atisara and is an acute gastrointestinal disorder characterised by frequent watery stools with discomfort in the abdomen and anal region. However, it can also be chronic. It can be caused due to an imbalance in any of the three doshas – vata, kapha, pitta – or all three doshas. Most commonly, diarrhoea is caused due to the presence of ama or microbial infection in the body. Fear or grief can also cause diarrhoea. Excessive eating, unhealthy eating habits, improper digestion, eating incompatible food can also lead to vitiation of the doshas and diarrhoea. Depending on the cause, diarrhoea can be classified into six major types:

• Vata atisara: This type of diarrhoea is caused due to vitiation of vata dosha. IIt is characterised by frothy and watery stools, and pain in the abdomen. The person may also experience weakness and dryness of the mouth.
• Pitta atisara: Pitta dosha is mainly vitiated in this condition. Symptoms of this type of diarrhoea include passage of yellow- or green-coloured stools with burning sensation and pain in the abdomen.
• Kapha atisara: Vitiation of kapha dosha is responsible for this condition. Colicky pain and inflammation are the major symptoms in this case, along with the passage of white slimy stools with mucus.
• Sannipataja: There is an imbalance of all three doshas and mixed symptoms are seen in this condition.
• Shokaja and bhayaja: This type of diarrhoea occurs when you are in grief or afraid of something. These emotional factors cause vitiation of pitta and vata and lead to frequent passage of watery stools.
• Ama atisara: This condition manifests when the undigested food combines with the doshas and vitiates them. The vitiated doshas then travel through the wrong channels and weaken the dhatus. This leads to passage of varied coloured faeces along with abdominal pain.

Apart from these six subtypes, sometimes rakta (blood) may get associated with vata and pitta, and rakta atisara may be experienced.

Acute diarrhoea lasts for less than 3 weeks, while chronic diarrhoea can last for more than 1 month. The treatment aims at the removal of vitiated doshas and infection that is responsible for the disease. In the case of moderate doshas, langhana (fasting) and pachana (digestives) can cure the condition. If langhana and pachana do not work, basti and virechana are advised as panchakarma therapy. Oil enema and picha basti are useful in pitta atisara. Herbal treatment with pippali, bilwa, and ginger is also effective in treating pitta atisara. In the case of ama atisara, it is necessary to remove the ama from the body completely as incomplete removal results in haemorrhoids, fever or other complications. Herbs like haritaki help to remove toxins. In the case of bhayaja and shokaja atisara, along with the Ayurvedic herbs, psychological counselling may help.

Ayurvedic treatment modalities for diarrhoea mainly include nidana parivarjana and shamana chikitsa (pacification treatment) such as langhana, pachana, deepana (hunger increasing), and stambhana (stops diarrhoea). Shodhana (purification) treatment such as virechana and basti are only advised when doshas are in excess or in case of toxin accumulation.

• Nidana parivarjana
  • Nidana parivarjana therapy aims to avoid the causative factors of disease.
  • The causes of atisara such as drinking an excessive amount of water, overeating, not keeping enough gap between meals, drinking bad water, or eating very hot, dry, hard, cold or unaccustomed foods, should be avoided.
  • Avoiding these causes can have dual benefits in treating atisara – it halts the progression of the disease and prevents recurrence.
• Shamana chikitsa
   This treatment aims at pacifying the doshas by the following methods:
  • Langhana: This can be done by complete fasting or eating limited or less quantity of foods, which helps the body to digest ama, thus, removing the root cause of the disease.
  • Pachana and deepana: Digestives and hunger-increasing foods strengthen the digestive fire, thus helping the body get rid of ama faster.
  • Once the ama is digested, stambhana medicines are given to stop diarrhoea.

• Virechana
  • In the treatment of diarrhoea, it is necessary to remove all the ama from the body completely. Medicines and herbs are not recommended in the initial treatment for diarrhoea as incomplete removal of ama can further complicate the disease. Virechana aims to do exactly that, remove the ama completely.
  • For treating diarrhoea, virechana is done using haritaki or pippali.
  • This procedure should be done under the supervision of an Ayurvedic practitioner as excess virechana can result in weakness and even cause electrolyte imbalance.
  • In the treatment of diarrhoea, virechana is followed by light meals to improve digestion.

• Basti
  • Basti is yet another therapy advised under panchakarma for the treatment of diarrhoea.
  • Asthapana basti (decoction-based enema) is given with a decoction of fennel, bilwa, liquorice and tila (sesame oil) oil in cow’s milk. It helps to reduce intestinal motility thus reducing the frequency of stools. It is advised in pitta atisara.

Picha basti is also suggested for pitta atisara and rakta atisara. It contains shalmali (silk cotton tree), lodhra (lodh tree), vatankura (Indian banyan)and yastimadhu (mulethi) mixed with ghee (clarified butter), milk, and honey.

Ayurvedic herbs for diarrhoea

• Haritaki
  • Powdered rind of the haritaki fruit is used in the treatment of diarrhoea and many other digestive system disorders.
  • In case of diarrhoea, it is primarily given to induce purgation so as to remove all the ama that is accumulated in the body.
  • Haritaki is taken as a churna (powder) or decoction.
  • It improves gastric-emptying time and has a protective action on the gastric mucosa.
  • Haritaki is also useful in rakta atisara (diarrhoea with blood) when taken with honey and milk since it stops the haemorrhage of blood vessels.
• Bilwa
  • The pulp of an entire ripe or unripe bilwa fruit and the roots of bilwa plant are used to treat diarrhoea.
  • It is mostly advised in chronic diarrhoea.
  • Bilwa has antibacterial activity; hence, it helps in removal of enterotoxins that produce infectious diarrhoea.
  • It has antiviral and anti-secretory action and also decreases intestinal motility; thus, reducing the frequency of stools.
  • It is used in the form of churna, vati (tablet) or in a semisolid formulation.
• Kutaja
  • Kutaja is one of the most common herbs used for the treatment of diarrhoea. 
  • It is available in several formulations such as arishta, churna and kutaja avaleha (semisolid preparation).
  • It cures abdominal cramping and stools with mucus which are commonly seen in kapha atisara.
  • Kutaja inhibits toxin production by bacteria and offers protection against diarrhoea-causing pathogens.
• Jatiphala
  • Dried seeds of nutmeg are used for the treatment of diarrhoea.
  • Normally this herb is used in the form of a churna, vati or decoction.
  • It is an ingredient in many Ayurvedic formulations for diarrhoea and is effective in reducing gastric motility.
  • Jatiphala also has an anti-secretory effect; thereby, controlling watery stools.

Ayurvedic medicines for diarrhoea

• Dadimashtaka churna
  • It is a polyherbal formulation with dadima as its primary ingredient. Shunthi, maricha, pippali, ela, dalchini (cinnamon), jeeraka (cumin), dhanyaka (coriander), tejpatra (Indian bay leaf), nagakeshar (Indian rose chestnut) and vanslochan (bamboo resin) are the other herbs that comprise this medicine.
  • Dadimashtaka churna improves metabolism and increases appetite.
  • Due to the antimicrobial properties of pippali, maricha and dalchini, this medicine helps in reducing intestinal infections.
  • Twakshiri, tejpatra and ela pacify the vitiated kapha, and this preparation also has the properties to digest ama.
  • Dadimashtaka churna is taken with water or buttermilk.
• Kutajarishta
  • The preparation is an arishta, which has self-generated alcohol.
  • It contains kutaja, draksha (grapes), gambhari (beechwood), guda (jaggery) and dhataki (fire flame bush).
  • Kutaja is useful in the treatment of kapha atisara. Its antibacterial activity helps to cure diarrhoea caused due to infection.
  • Dhataki has digestive and astringent properties, hence, is useful in the treatment of diarrhoea.
  • Draksha helps in digestion and balances the tridoshas.
• Sanjivani vati
  • It contains triphala, gomutra (cow urine), guduchi (heart-leaved moonseed) shunthi, vidanga (false black pepper), vacha (calamus), pippali, shuddha vatsanabha (pure Indian aconite) and shuddha bhallataka (pure Indian nut tree).
  • Triphala removes the tridoshas and also has digestive properties.
  • Shunthi removes kapha dosha and aids in digestion.
  • Pippali and vidanga both remove kapha and vata doshas and possess krimighna (worm-destroying) properties.
  • Vatsanabha and bhallataka remove vata and kapha doshas and have digestive properties.
• Bilwadi leha
  • This is a semisolid preparation with the roots of bilwa as its main constituent.
  • It also contains mustaka, guda, ela, dhanyaka, jeera, nagakeshar, shunthi, pippali and maricha.
  • This preparation is used to control diarrhoea symptoms, especially when it is associated with irritable bowel syndrome.
  • Bilwa is useful in controlling the frequency of stools and stops the formation of watery stool.
  • All other ingredients are also proven to have anti-diarrhoeal activities due to their deepana and pachana properties, thus, removing ama and further preventing toxin formation.

Do’s

• Consume old shali rice, daliya (porridge), masura (red lentils) and mudga (green gram).
• You can eat fruits and vegetables such as jamun (Indian blackberry), bilwa, banana, dadima, bottle gourd, and patola (sponge gourd).
• Consume coriander, honey, cumin, buttermilk or goat milk.
• Take proper rest,
• Take enough sleep.

Don’ts

• Do not consume maida (refined flour), peas, udada (black gram) or chana (chickpeas).
• Do not eat pumpkin, plums, cucumber or beans.
• Do not consume alcohol. (Read more: Effects of alcohol on the body)
• Avoid consuming excess water, curd, sugarcane juice.
• Do not go for snehana, swedana or nasya.
• Do not have a tub bath.
• Avoid exercise.
• Avoid day sleeping, having sex and night awakening.
• Do not suppress natural urges such as urinating and bowel movements.

The Ayurvedic medicines used to treat atisara are useful in controlling the symptoms and avoiding recurrences; thus, they have a long-lasting effect and are reported to be safe for use.

In a research study, 40 patients who had diarrhoea associated with irritable bowel syndrome were given treatment with sanjivani vati and lashunadi vati for 60 days. They were also kept on a light diet. All the patients were evaluated for abnormal stool form, mucus in stool, abdominal pain and frequent stools. Symptoms were found to be completely cured after 60 days. All patients were also called for a follow-up after a month and no side effects of the treatment were seen. There was no recurrence of the condition.

In another study, 46 patients were given bilwadi leha for 12 weeks. They were regularly monitored at an interval of 12 days for abdominal pain, discomfort and bowel habits. The consistency and frequency of stool were also noted. Symptomatic improvement was reported after complete treatment. Pathological studies of stools also showed the absence of infection after the treatment. No adverse reaction was seen or experienced by any patient during the treatment.

The Ayurvedic treatment for atisara is safe and highly efficacious. It not only controls the symptoms but also gives long-term relief and avoids recurrence. Care should be taken to avoid swedana and snehana as a preparatory treatment before panchakarma, as these treatments cannot be given unless all the ama has been removed from the body. Virechana and basti should be done with care so that to avoid the excessive loss of water and electrolytes from the body. Adherence to the do's and don’ts as advised by your Ayurvedic practitioner can also be of great help.

Diarrhoea is a common digestive disorder affecting a wide range of population. Ayurvedic approach to disease aims at the removal of the root cause of the disease. In case of diarrhoea, this is achieved with panchakarma and herbs like kutaja, pippali, bilwa, dadima in churna, arishta, or vati form. Ayurvedic medicines are very effective in controlling diarrhoea symptoms and improving the digestive capacity of your body. Timely and proper treatment from an Ayurvedic practitioner can help in curing the condition completely.