Ayurvedic management of chronic constipation in Hirschsprung disease - A case study

Hirschsprung disease (HSCR) or congenital intestinal aganglionosis is characterized by complete absence of neuronal ganglion cells from a portion of the intestinal tract, most commonly in the large intestine. The main sign or symptom of HSCR is constipation usually appearing shortly after birth. This constipation is chronic in nature and usually not relieved with laxatives. The present case is of a patient having HSCR which was successfully managed with Ayurvedic treatment. A four year old boy with complaint of severe constipation, abdominal pain, abdominal distension and occasional vomiting was treated with Panchakarma procedures and Ayurvedic oral drugs. The Ayurvedic diagnosis of the case was Pakvasayagata vata. Shashtikashali pinda swedana (sudation with medicated cooked bolus of rice) and Matra basti (enema with medicated oil) with Ashwagandha taila (Ayurvedic medicated oil) was given for first 16 days. From the 2nd month of treatment, Matra basti was administered daily for 3 months in the dose of 25 ml. In 5th and 6th month Matra basti was administered on alternate days in the dose of 25 ml. From the 7th month Matra basti was administered once weekly in the dose of 25 ml. In 14th month Shashtikashali pinda swedana and Erandmooladi yapna basti (medicated enema) was given for 16 days. Eight scales based Medical outcome study (MOS) - 36 item short form - health surveys was periodically assessed for outcome which shows good improvement. Experience of this case showed that HSCR may satisfactory be managed with Ayurvedic treatment.