Ayurvedic management of Irritable Bowel Syndrome (Grahani Roga): A case report

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterised by irregular bowel movements and abdominal discomfort in the absence of detectable structural abnormalities. This condition significantly affects both physical and mental health. Although the precise etiology remains unclear, factors such as abnormal gut motility and sensory function, central nervous system disturbances, psychological stress, and luminal changes are implicated. IBS affects approximately 10-15% of the population, yet only 10% of those affected seek medical care. The prevalence is highest between ages 15 and 50, ranging from 3% to 22%, with young women more frequently affected than men. Conventional management primarily involves dietary modification, pharmacotherapy, and stress reduction, but these approaches rarely provide complete relief. Evidence indicates increased mortality risks associated with antibiotics and antispasmodics, highlighting the need for adjunctive therapeutic strategies. In Ayurveda, IBS is analogous to Grahani Roga, which is characterised by Muhurbaddha-muhurdrava Mala Pravritti (alternate formed and loose stools), Udara Shoola (colicky abdominal pain), Adhmana (abdominal distention), and Dourbalya (weakness). This report presents a 71-year-old female with frequent evacuation of stools of varying consistency (4-5 times daily), abdominal pain, bloating, generalised weakness, and reduced sleep for three years. The diagnosis of Grahani Roga was established based on clinical features, and the Rome IV criteria confirmed IBS with predominant diarrhea. The patient experienced minimal relief from three years of conventional therapy. She subsequently received Piccha Basti (enema) for 16 days and Shamana (pacifying) medicine for four months. Improvements were observed on the IBS-GAI, IBS-SSS, IBS-AR, and IBS-QoL scales, suggesting the potential benefit of Ayurvedic interventions in the management of IBS.