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Dr. GUJAR BROTHERS
6 days ago5 min read

Irritable Bowel Syndrome (IBS): A Comparative Analysis of Modern and Ayurvedic Perspectives

Updated: 5 days ago


Abstract

Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder that significantly impacts the quality of life. The article explores the pathophysiology, diagnostic approaches, and therapeutic interventions for IBS from both modern medical and Ayurvedic perspectives, highlighting the strengths of an integrative approach. In modern medicine, pharmacological therapies and dietary modifications form the cornerstone of IBS management, while Ayurveda emphasizes balancing bodily doshas through dietary, lifestyle, and herbal interventions. This review also investigates the potential for integrating Ayurvedic principles into conventional IBS treatment to improve patient outcomes.


Introduction

IBS is a functional disorder of the gastrointestinal tract, characterized by chronic abdominal pain, bloating, and altered bowel habits without any identifiable structural abnormality1-3. Affecting approximately 10-15% of the global population, IBS imposes a considerable burden on healthcare resources and patients' quality of life4. The etiology of IBS remains elusive, with multiple contributing factors, including motility disturbances, visceral hypersensitivity, and gut-brain axis dysfunction5. In Ayurveda, IBS aligns with conditions like Grahani and is considered a result of imbalances in Vata, Pitta, and Kapha doshas6.


Pathophysiology of IBS

Modern Medical Perspective

The pathogenesis of IBS involves several interconnected mechanisms:

  • Gut-Brain Axis Dysfunction: Central to IBS pathophysiology, disruptions in communication between the enteric nervous system and central nervous system can lead to dysregulated gut motility and sensitivity7,8.

  • Visceral Hypersensitivity: Increased sensitivity to gut stimuli contributes to symptoms such as abdominal pain and bloating9.

  • Altered Gut Microbiota: Dysbiosis is frequently observed in IBS patients, with an imbalance in microbial composition linked to inflammation and motility changes10.

  • Genetic and Environmental Factors: Genetic predispositions, infections, and psychosocial stressors can exacerbate IBS symptoms11,12.

Ayurvedic Perspective

In Ayurveda, IBS correlates with Grahani, a disorder stemming from impaired digestion and assimilation attributed to imbalances in Agni (digestive fire) and doshas:

  • Vata Dominance: Characterized by bloating, constipation, and irregular bowel movements.

  • Pitta Dominance: Marked by loose stools, burning sensations, and inflammation.

  • Kapha Dominance: Linked to mucus-laden stools and sluggish digestion13-15. Ayurvedic texts emphasize lifestyle, dietary modifications, and herbal remedies to restore balance and strengthen digestion16.


Diagnosis of IBS

Modern Diagnostic Criteria

The Rome IV criteria are widely used to diagnose IBS, requiring recurrent abdominal pain at least one day per week for three months, associated with two or more symptoms: related to defecation, altered stool frequency, or form17. Diagnostic tests aim to rule out organic diseases, including inflammatory bowel disease, celiac disease, and infections18.


Ayurvedic Diagnosis

Ayurvedic diagnosis involves assessing the patient’s prakriti (constitution), vikriti (imbalance), and symptoms. The condition is classified according to dosha dominance, with specific examination methods, including pulse diagnosis (nadi pariksha) and abdominal palpation, guiding treatment strategies19.


Treatment Approaches

Modern Therapeutic Interventions

  • Pharmacological Management: Treatments for IBS are symptom-based:

    • Antispasmodics (e.g., hyoscine) to alleviate pain and spasms20.

    • Laxatives (e.g., polyethylene glycol) for IBS with constipation (IBS-C)21.

    • Antidiarrheals (e.g., loperamide) for IBS with diarrhea (IBS-D)22.

    • Tricyclic Antidepressants (TCAs) to reduce visceral hypersensitivity23.

  • Dietary Interventions: The low FODMAP diet has shown efficacy in reducing IBS symptoms24,25.

  • Behavioral Therapies: Cognitive Behavioral Therapy (CBT) and gut-directed hypnotherapy are beneficial in addressing gut-brain dysfunction26,27.

Ayurvedic Interventions

Ayurvedic treatment targets balancing the doshas, strengthening Agni, and supporting digestion:

  • Herbal Formulations: Traditional herbs like Haritaki, Triphala, and Amlaki are used to regulate bowel movements and enhance digestion and much more according to dosha involvement28.

  • Dietary Modifications: Patients are advised to consume light, warm, and easily digestible foods, avoiding incompatible foods that may aggravate symptoms29.

  • Panchakarma Therapy: Detoxification therapies like Virechana (therapeutic purgation) and Basti (medicated enemas) are recommended based on dosha imbalance30.

  • Lifestyle and Mindfulness: Practicing yoga, meditation, and maintaining a routine help alleviate stress, a known trigger for IBS symptoms31.


Conclusion

IBS is a complex disorder with diverse etiological factors and requires a comprehensive approach to management. While modern medicine offers effective symptom control, Ayurveda provides a holistic framework focusing on balancing bodily energies and promoting digestive health. Combining these systems may enhance treatment outcomes, reduce symptoms, and improve the quality of life for IBS patients.


References

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  2. Ford AC, Talley NJ. Irritable bowel syndrome. BMJ. 2012;345.

  3. Cash BD, Chey WD. Irritable bowel syndrome—An evidence-based approach. Clin Gastroenterol Hepatol. 2004;2(6):522-8.

  4. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80.

  5. Mayer EA, Savidge T, Shulman RJ. Brain–gut microbiome interactions and functional bowel disorders. Gastroenterology. 2014;146(6):1500-12.

  6. Sharma PV. Charaka Samhita. Varanasi: Chaukhamba Orientalia; 1994.

  7. Fukudo S. Stress and visceral pain: focusing on irritable bowel syndrome. Pain. 2013;154.

  8. El-Salhy M. Gut microbiota and irritable bowel syndrome: The potential role of probiotics. World J Gastroenterol. 2012;18(39):5507-15.

  9. Camilleri M, Bharucha AE. Mechanisms and treatment of irritable bowel syndrome: Beyond gut instinct. Lancet Gastroenterol Hepatol. 2017;2(10):798-812.

  10. Barbara G, Cremon C, et al. Microbiota in irritable bowel syndrome: A 2019 update. J Neurogastroenterol Motil. 2019;25(4):563-75.

  11. Saito YA. The role of genetics in IBS. Gastroenterol Clin North Am. 2011;40(1):45-67.

  12. Rodiño-Janeiro BK, Vicario M, et al. The role of enteric glial cells in gut-brain axis communications. J Cell Physiol. 2018;233(4):2327-41.

  13. Talley NJ, Holtmann G, Walker MM. Role of the immune system in functional gastrointestinal disorders. Gastroenterology. 2020;158(4):1199-212.

  14. Bhat S. Essentials of Medical Physiology. 4th ed. New Delhi: Jaypee Brothers Medical Publishers; 2020.

  15. Bharati AC. Ayurvedic approach to irritable bowel syndrome. J Res Ayurveda Siddha. 2015;36(3):145-52.

  16. Gupta V, Sharma P, et al. Traditional and modern views on the pathophysiology of IBS. Ayu. 2013;34(2):146-54.

  17. Drossman DA, Chang L, Chey WD. Rome IV criteria for the diagnosis of functional GI disorders. Gastroenterology. 2016;150(6):1393-407.

  18. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: A clinical review. JAMA. 2015;313(9):949-58.

  19. Kaptchuk TJ. The web that has no weaver: Understanding Chinese medicine. 2nd ed. New York: McGraw-Hill; 2000.

  20. Spiller RC, Humes DJ. Antispasmodic drugs in IBS. Neurogastroenterol Motil. 2009;21(6):598-612.

  21. Andresen V, Camilleri M. Laxatives in IBS with constipation. Gastroenterol Clin North Am. 2011;40(1):117-36.

  22. Lacy BE, Patel NK. Rome criteria and a low-FODMAP diet. Gastroenterol Clin North Am. 2017;46(1):27-45.

  23. Ford AC, Moayyedi P. Efficacy of antidepressants in IBS: A systematic review. Gut. 2019;68(7):1374-82.

  24. Halmos EP, Power VA, Shepherd SJ, et al. A diet low in FODMAPs reduces symptoms of IBS. Gastroenterology. 2014;146(1):67-75.

  25. Shepherd SJ, Gibson PR. The complete low-FODMAP diet. New York: The Experiment; 2013.

  26. Lackner JM, Jaccard J, Radziwon CD, et al. Cognitive-behavioral therapy for IBS. Gastroenterology. 2018;155(1):47-57.

  27. Miller V, Peltier A. Gut-directed hypnotherapy for IBS. Aliment Pharmacol Ther. 2015;41(9):844-55.

  28. Tirtha S. Ayurvedic healing: A comprehensive guide. Twin Lakes: Lotus Press; 2001.

  29. Pole S. Ayurvedic medicine: The principles of traditional practice. Edinburgh: Churchill Livingstone; 2006.

  30. Lad V. Textbook of Ayurveda: Fundamental principles. Albuquerque: The Ayurvedic Press; 2002.

  31. Klatt MD, et al. Mindfulness in motion in IBS. Behav Med. 2016;42(1):1-12.


Contact Us Now

To book your appointment or learn more, contact us at 08352318471, 9538140510, 9538140520, 9110604310, or visit for personalized guidance on IBS.

  1. Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital 

    Address: No.2, Bengaluru Road, near Ganesh Nagar Bus Stop, Ganesh Nagar, Vijayapura, Karnataka 586109. https://g.co/kgs/PrwoRhk

  2. Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital

    Address: Shri Siddheshwara Main Road(S S Road), Opposite Dharwadakar Ayurvedic Medical Shop, beside Masjid, Vijayapura, Karnataka 586101. https://g.co/kgs/BpFWyfo

  3. Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital

    Address: 6th cross, Malleshwaram circle, sampige road, Bangalore​, Karnataka 560003. https://g.co/kgs/3HtK4DR

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