Atisara /Diarrhoea
Dealing with diarrhea can be both physically and emotionally challenging, especially when it disrupts daily activities and leads to concerns about dehydration. Let's dive into understanding diarrhea, its causes, immediate remedies, and prevention tips
What is Diarrhoea?
Loose motions, commonly referred to as diarrhea, involve the frequent passage of loose, watery stools. This condition can vary in duration and severity, sometimes occurring as a single episode or recurring over a period.
We might take this disease very lightly, but it is crucial to treat the underlying cause. Diarrhea could also occur as a complication of another disease that needs grave attention.
Atisara is a condition, wherein loose watery stools are passed many times a day. Atisara is described as Diarrhoea in modern medical science, where three or more loose or watery stools occur a day.The general symptoms associated with diarrhea include abdominal pain especially cramping, bloating, thirst, dehydration, fatigue and weakness etc.
Atisaar means ati (excess) & saranam (flow); a condition where watery stools passes in excess.
Experiencing severe painful contractions from the stomach to the intestines during every bathroom session, which forces you to empty your gut until its very last content, is indeed distressing. This scenario describes a severe case of diarrhea, where the pain, discomfort, and frequent bowel movements lead to significant physical and emotional distress.
Let's dive into understanding diarrhea, its causes, immediate remedies, and prevention tips.
Diarrhoea Symptoms:
Diarrhoea symptoms differ according to the dosha involved in an Ayurvedic perspective. The general diarrhoea symptoms include:
Cramps in the abdomen.
Stomach pain.
Vomiting.
Frequent bowels.
Loose stools.
Bloody stool.
Stool mixed with mucus and phlegm.
Fever.
Dehydration.
Bloated tummy
Feeling nauseous
Loss of weight
Loss of appetite
Feeling uneasy
Causes of Diarrhea
· Bacterial infection
· Viral infection
· Ingesting contaminated food or water can lead to diarrhea, which requires specific ayurvedic treatment.
· Emotional distress
· Parasites and worms can also cause diarrhea.
· Lactose intolerance due to the absence of lactase enzyme which is essential for metabolizing the lactose, the absence of lactase in infant may cause diarrhea.
· Intestinal diseases and bowel Disorders
· Allergy to certain food items.
· Adverse effects of antibiotics and other medications. Diarrhea may also occur due to side effects of antibiotics, medicines used for blood pressure, drugs used for hyperacidity, cancer drugs, and excess doses of drugs used for constipation etc.
· Over indulgence in foods that are very heavy(hard to digest), very fatty, very dry, very hot, very watery, very hard, and very cold.
· Food which contains incompatibles, taken in large quantities very frequently, can lead to diarrhea caused by morbid matter.
· Food which is not cooked, and taken at unusual times.
· Excess or improper usage of therapies like oleation etc.
· Poisons.
· Changes in accustomed habits and seasonal features.
· Over – indulgence in water sports.
· Suppression of natural urges of the body.
· Fear.
· Sorrow.
Nidanas of Atisara(diarrhea) can be identified under four broad headings as
a. Aharaj(Food habits): guru(heavy), snigdha (unctuous), ruksha(dry), ushna (hot), drava (liquid), sthoola(Hard), sheetapadarthasevanana(too cold), sanyogaviruddha, samskara viruddhaaharasevana(combination of foods which are incompatible to each other), adyasana (eating before the digestion of previous meal), ajeerna, asathmyabhojana causes Atisara(diarrhea).
b. Viharaja(Lifestyle): Excess or improper administration of therapies like Snehana (oleation), Swedana (fomentation) etc. · Changes in accustomed habits (SatmyaViparyaya) and seasonal features (Ritu Viparyaya), · Ati Jala Krida (indulging too much in water sports), · Vega Vighata (suppression of natural urges) · Krimi Dosha (infestation of worms).
c. Manasika (Psychological): The mind also plays an equally important role in causing Atisara (diarrhea). Bhaya (fear) And shoka (grief) impair the digestive process causing indigestion(ajirna) ultimately causing diarrhea.
d. Samajika(Social): People with low living in developing countries concerning lack of hygiene causing different helminths, worms, protozoa etc. causing diarrhea.
Samprapthi of atisara
Atisara is caused by an impaired bio-fire, or Jatharagni, driven by what we call the triggers of our gut, such as bacteria, certain foods, etc. As a result of impaired Agni, indigestion and resultant endotoxin build-up occurs, known as 'Ama,' which necessitates ayurvedic treatment. This endotoxin build-up aggravates Vata dosha (The air element in our body), and the excess fluid in the body's tissues is reduced and sent into the abdomen. Accounting for the frequent bowel movements caused by Pitta dosha (the fire element), the fluid contents combine with the stools to form loose feces. This is loose motion or, in intense cases, Diarrhoea.
Types of Atisara
In Ayurvedic literature Atisara is classified into six types, which are as follows:
Vataja
Pittaja
Kaphaja
Sannipataja
Bhayaja
Aamaja
Diarrhea is categorized into acute or chronic and infectious or non-infectious based on the duration and type of symptoms.
Acute diarrhea is defined as an episode lasting less than 2 weeks. An infection most commonly causes acute diarrhea.
Chronic diarrhea is defined as a duration lasting longer than 4 weeks and tends to be non-infectious. Common causes include malabsorption, inflammatory bowel disease, and medication side effects.
1. Vataja Atisara:
· Dagdha Gudabhasa (colour like burnt jaggery)
· Aruna Varna (slightly brown in colour)
· Frequently passes small amount of faeces (Alpa Varcha) often mixed with froth (Phena), dry in nature (Ruksha) and accompanied with pain (Shula), sound (Sashabda) and associated with Parikartika (fissure in anus)
· Sakta Mutra (retention of urine) AntraKujana (intestinal gurglings)
· Strastapana (loss of tone in the anorectal regions)
· Feeling of tiredness in the Kati (waist), Uru (thigh) and Jangh (calf region)
· Shushkasya (dryness in mouth)
· Bhrashta Payu (anal prolapse)
2. Pittaja Attisara:
· Haridra, Harita and Krishna or Asita Varna (yellow, green and blackish in colour)
· Lohita Varna (slightly red in colour)
· Associated with Rakta (blood) and Pitta
· Durgandhit (bad smell)
· Ushna (hot), Comes out with Vega (force), Mamsa Dhovan Vata (resembles mutton wash) and Bhinna (broken)
· Trishna (thirst)
· Daha (burning sensation)
· Sweda (sweating)
· Murchha (fainting)
· Udar Shula (pain in abdomen)
· Guda Santapa& Paka (inflammation and suppuration in anus)
· Jwara (fever)
3. Kaphaja Atisara:
· Sweta Varna (white in colour)
· Snigdha (unctuous), Pichhila (slimy) and Tantuvata (thready)
· Ama (undigested) and Guru (heavy) in nature
· Mixed with Sleshma (mucous)
· Associated with Shula (pain) and Pravahika
· Sandra or Ghana (thick)
· Sheetal (cold)
· Krite Api Akrite Sangya or Vega Shanki (even after passing stools, he feels he has not evacuated stools)
· Ni-swana (without any sound)
· Heaviness in Udara (abdomen), Guda (anus), Basti (bladder) and Vankshana (groin region)
· Lomaharsha (horripilation)
· Utklesha (nausea),Nidra (over sleep), Alasya (idleness) ,Sadana (lassitude),Annadweshi (aversion of food) ,Tandra (stupor),Gaurava (feeling heaviness in body)
4. Sannipatika Atisara
· Tandra (stupor)
· Moha (delusion),
· Sada (debility)
· Mukha Shosha (dryness of mouth)
· Vividha Varna Varcha (eliminates faeces of all colours)
· Trishna (thirst) and has the appearance of specific symptoms of all the Doshas
5. Shokaja or Bhayaja Atisara
· Accompanied with Rakta (blood)
· Rakta resembles Kakananti (Gunja - Abrus precatorius) in colour (bright red) either mixed with stool or without stool with bad smell or without smell
· Faeces is eliminated with difficulty.
6. Amaja Atisara
· In persons whose food is not properly digested, the Doshas get increased by combining with undigested food, travel in wrong channels, vitiate the Dhatus and Malas and gives rise to Amaja Atisara.
· Their signs and symptoms are similar to those of VatajaAtisara.
Diarrhoea Diagnosis:
Diarrhoea can be easily diagnosed from symptoms alone, but the reason needs to be thoroughly investigated.
Fresh stool examination.
Stool culture.
Serum antibody test.
Tests to look for the presence of parasites also need to be carried out.
Blood test: A complete blood count test, measurement of electrolytes and kidney function tests can help indicate the severity of your diarrhea.
Management of diarrhea as per modern science:
Antibiotics are used in case of bacterial infection.
Use of medicine for cramps & vomiting.
Maintenance of hygienic conditions.
Intake of water and salts.
Management of fever if persisted.
Consumption of light and digestible liquid diet.
Probiotics containing; lactobacillus or acidophilus may be helpful.
Principles of Ayurveda treatment in Diarrhea / atisara
In the case of atisara, after analyzing the condition of the dosha and the strength of the patient, the physician prescribes the ayurvedic treatment. The treatment specific to each dosha is as follows :
In Vata predominant atisara, firstly the type of feces expelled is assessed. If the undigested matter is expelled then the flow is not stopped and remedies for diarrhoea are considered. Instead, drugs like haritaki (Terminalia chebula) can be used to propel it out of the body, and serve as remedies for diarrhoea.
Drugs that cause stambhana (stop the flow) are used if the digested matter is expelled. Meat soup can be used for this purpose.
In pitta dosha and Kapha dosha, fasting and also drugs that stimulate digestion are used. In the case of pitta, if the patient is strong then virechana (purgation) can be done.
In bhayaja and shokajaatisara, the treatment protocol of vata dosha can be adopted.
In the initial state i.e. ama (primary) stage of diarrhea, stopping or binding therapies are never indicated.
Moderately aggravated dosha should be managed by pramathya (a type of decoction of drugs) which stimulates the power of digestion (dipana) and is carminative (pachana) should be administered.
Slightly aggravated dosha should be managed by langhana (fasting therapy).
Laja Manda (scum of parched paddy) is one of the famous and routinely used pathyakalpana in diseases like atisara (diarrhea), chhardi (vomiting), jvara (fever). Laja manda is prepared by adding laja to Water in a ratio of 1:14 and cooking on low flame till Lajas get cooked.
Common herbs used in Diarrhea / Atisara treatment according to Ayurveda
· Kutaja (Holarrhena antidysenterica)
· Musta ( Cyperus rotundus)
· Bilva (Aegele marmelos)- The pulp of this fruit can be consumed with warm water twice for relief.
· Ativisha (Aconitum heterophylum)
· Chitraka (Plumbago zeylanica)
· Fenugreek seeds: Powdered fenugreek seeds can be consumed with buttermilk for quick relief.
· Pomegranate- Pomegranate has been traditionally used in Ayurveda to treat diarrhoea. The fruit can be boiled in water, strained and served in diarrhoea. Alternatively, boil 50g of Pomegranate rind in 250 ml of milk or reduce it to one-third. This can be taken in 3 doses for maximum effectiveness.
· Nutmeg seeds: Dried nuts can be crushed and administered with honey for prompt results.
· Lemon and mint: 1 teaspoon of lemon juice can be mixed with one teaspoon of mint juice and administered with honey to relieve Diarrhoea.
· Whey and Buttermilk: Whey and buttermilk are recognised as effective diarrhoea remedies. The liquid portion of the curd is called whey, and buttermilk is created by churning the curd after the fat has been removed. Take any one of these at regular intervals in a moderate dose.
· Ginger & Honey: Take some honey and some ginger that has been finely grated. Wait 10 minutes before consuming any water after that.
· Cumin Water: Prepare ground cumin that has been toasted. In a glass of water, mix this with a piece of candy sugar. Additionally, drinking this can assist with diarrhoea.
Management of Mild Diarrhoea:
Management of Moderate Diarrhoea:
Ayurvedic Formulations: Certain Ones may be recommended based on individual constitution and symptoms.
Some common formulations from Kerala Ayurveda traditional medicine:
Vilvadilehya, kutajaristam, mustharistam, hreberadikashyam, nagaradikashyam, dadimastaka choornam, vilvadi Gulika etc
Management of Severe Diarrhoea:
Ayurveda acharyas advises that Diarrhoea destroys digestive fire; hence, Langhana (fasting) is the primary and ideal remedy. It is followed by emesis if the patient suffers from excess salivation, flatulence and abdominal pain. Acharya also advises that a patient having severe purgation shouldn't be given sthambhana or sangrahana (drugs that stop purgation) in the initial stages of treatment as the medicine wouldn't be digested to bring the effect.
To curb the doshas blocking the channels, it's advised to administer herbs like Haritaki, which will restore doshic balance and serve as remedies for diarrhea. The patient will be made to abstain from heavy foods, and it is recommended to take with the decoction prepared from remedies for diarrhoea like digestive-herbs like pippali (Long pepper), sunthi (Dry ginger) or Zingiber Officinale, bilva (Aegle marmelos), musta(Cyperus rotundus), etc can be used as part of the ayurvedic treatment.
Q: What is Ayurvedic AtisaraChikitsa?
A: Ayurvedic AtisaraChikitsa is a traditional approach to treating diarrhea using natural remedies and Ayurvedic medicines.
Q: What are the main causes of diarrhea according to Ayurveda?
A: Diarrhea in Ayurveda is mainly caused by vitiation of doshas, especially Vata and Pitta, leading to disturbed digestion and bowel movements.
Q: What are the common symptoms of VatajaAtisara?
A: Common symptoms of VatajaAtisara include loose motions, colic pain, and dryness of the mouth due to aggravated Vata dosha.
Q: How does Ayurveda differentiate between acute and chronic diarrhea?
A: Ayurveda differentiates acute diarrhea as a sudden onset, while chronic diarrhea persists over a longer period, often due to underlying imbalances in the body.
Q: What are the Ayurvedic remedies for treating PittajaAtisara?
A: Ayurvedic remedies for PittajaAtisara may include herbs like Haritaki and dietary modifications to balance the aggravated Pitta dosha.
Q: How does Ayurvedic Basti therapy help in the treatment of diarrhea?
A: Ayurvedic Basti therapy involves administering medicated enemas to balance doshas and improve digestive functions, aiding in the treatment of diarrhea.
Q: Can Ayurvedic remedies effectively manage chronic diarrhea?
A: Yes, Ayurvedic remedies like AtisaraChikitsa and personalized treatment protocols can effectively manage chronic diarrhea by addressing the root causes and imbalances in the body.
Which Ayurvedic herb is good for diarrhea?
Bilva is a very effective herb for diarrhoea
Which dosha causes loose motion?
What are the types of Atisara according to Charaka?
Vataja
Pittaja
Kaphaja
Sannipataja
Bhayaja
Aamaja
What herbal medicine is good for watery stool?
Dadimastakachoornam, vilvadi Gulika etc
Is Triphala good for diarrhea?
It has laxative properties
Can bloody discharge be treated or is it the last stage of diarrhea?
Yes, provided you follow proper medical advice and dietary regulations.
Can diarrhea be life-threatening?
If it's left untreated,it can cause dehydration
How do I know if diarrhea is getting worse?
You may experience symptoms like fever, severe dehydration, stomach cramps, black stools, vomiting etc
Is diarrhoea chronic or acute ?
It can be acute, chronic, or even persistent based on the duration of illness.