The Ayurvedic Approach to IBS
IBS (Irritable Bowel Syndrome), or Grahani in Ayurvedic terms, is something that affects more people than we can even really lay a number on.
A google search will give websites that quote between 25-45 million in the United States alone, 20% of the population, etc., but those are numbers based on people who actually go to the doctor for their digestive issues. I can honestly say that in the last few years, about 1 out of every 2 people I have met regularly experience some symptoms of IBS. Because of the “embarrassing” nature of the common symptoms, it's not something people generally like to talk about. But because I'm quite open about my own issues and history with IBS, and will freely use the words “gas,” “diarrhea,” and talk about having had to make myself throw up on a fairly regular basis (not out of desire but necessity), people feel they can open up about their own digestive problems, and are often VERY relieved to do so. So I think that this number is much much bigger, and because it's not a disease or an illness, I think it's a pretty reasonable assessment.
From an Ayurvedic standpoint, IBS is an imbalance. When we experience it, we just experience the symptoms. We experience the belching, the acidity, the reflux, the vomiting, the bloating, the gas, the constipation, the diarrhea, the cramping, the pain, the weakness, the fatigue, the depression, any number of the whole gamut of signs and symptoms of IBS. Something is wrong, and we see it as a sign of illness, because that's what we've learned in our western lives- that when something is going wrong it means we are sick, there is an invader in our bodies, there is something to battle. So we go to the doctor, and the allopathic doctor gives us pills to arm ourselves with against this enemy, IBS, and with which to go into battle.
The problem is though, that the root of all of these dreaded enemy symptoms, is our own body. The “enemy” that we are fighting, is us.
The pills that fight acidity, the pills that fight gas, that fight diarrhea, are only attacking our own body, because that it the source of these problems. These symptoms are indeed our bodies telling us that something is wrong, but not because of an invader... because of an imbalance. An imbalance that is due to our own diet and lifestyle, that is due to the way we live. We have become our own enemy, and these symptoms are our bodies' efforts to tell us just that.
So how do we become our own ally again?
The first step, is to figure out where the imbalance lays. Just as IBS is Western medicine's blanket term for “digestive issues”, Grahani is a sort of blanket term in Ayurveda as well. The nice thing about the Ayurvedic approach though, is that there are different categories of Grahani that merit different approaches. There are more than just one type of Grahani, and we need to find out what type we have in order to begin our shift back into balance.
The type depends on what dosha is being aggravated, causing the imbalance. There are four types of Grahani- Vata, Pitta, Kapha, and Tridoshic.
(Please read on for informational purposes, but if you have IBS and are interested in working to manage it through Ayurvedic methods, please contact a good Ayurvedic Health Counselor or Practioner to help guide you through it, as it's not the easiest thing to do, and depending on what's happening in your body, can be quite complex)
Vata Grahani presents with the digestive symptoms of vitiated Vata, ie, gas, bloating, constipation, or an uncomfortable dance between constipation and diarrhea. Because Vata is out of balance though, other symptoms of aggravated Vata may also be present, such as dryness, thirst, back pain, insomnia, anxiety, and nervousness.
Pitta type Grahani will generally cause hyperacidity, bringing about a hot-feeling stomach, acid reflux, heartburn, belching, and a burning sensation in the intestines. True to Pitta aggravation, diarrhea is also experienced, and will often be completely liquid, yellowish, greasy, and have a foul smell. Again here, other signs of Pitta imbalance may be present, including inflamation, skin problems, feeling hot, intense body odor, irritability and a sharp tongue.
Kapha type Grahani presents with a slowing of digestion, sometimes coming to an almost full stop- food eaten may sit in the stomach for hours, leading to intense pain in the stomach, nausea, and/or vomiting. Belching, foul smelling breath, excess saliva and mucous in the mouth and throat, and mucous in the stool are also present. Lethargy, dullness, and other signs of Kapha imbalance may also present.
Complex or Tridoshic Grahani is what we get when two or three Doshas are aggravated, presenting the symptoms of more than one Grahani type. Tridoshic Grahani is probably the most difficult type to have, as well as the most difficult type to treat.
Keep in mind that these types don't necessarily have anything to do with the person's predominant dosha- a Vata person can easily have Pitta type, Kapha type, or Tridoshic Grahani.
The type just has to do with what's being upset in the body. It generally starts with the person eating incompatible foods for their dosha, but may also be simply too much of a food that is compatible. A Kapha person who eats too much spicy food, though spicier foods are generally compatible with Kapha, can develop Pitta type Grahani if they ignore signs that their digestive fire is running too hot from all the spicy food. We receive gentler signs from our bodies letting us know that something is off before things get really bad, but we often don't listen.
So how do we know what steps to take after figuring out which Grahani type we have?
In Ayurveda, we have a saying : “Like increases like.” So logically, we can say that opposite decreases opposite. Makes sense right? Just like you can't fight fire with fire, you can't fight earth with earth or air with air or any of the elements with themselves! You will just end up with more of that element, and a higher imbalance. So we have to look at the properties, or characteristics of the element, and introduce their opposites. Ayurveda is all about maintaining balance, and this is how we balance.
If there is ama, or toxins, present, the first thing we must do is eliminate the toxins in the body by going on an ama-cleansing diet with digestive and carminative herbs and spices and plenty of warm freshly-boiled water. Once ama is cleared, the job is to balance the aggravated doshas. Takra, or buttermilk, is effective in all three doshas, as it stimulates digestive fire without throwing Pitta our of balance. It will help to rebalance the gut flora, which is always an issue in IBS. Gut flora plays a huge part in our mental and emotional wellbeing, so rebalancing gut flora will also aid in the rebalancing of the mind and spirit.
Vata, Pitta, and Kapha type IBS present with different symptoms.
Vata type Grahani is all about too much air and space, so we must introduce a qualities that are opposite to the qualities of air and space. Vata is light, dry, mobile, rough and cold, so oleation therapy is one of the first things introduced. We add ghee or a warming oil to the diet, which introduces the opposite properties of heavy, dense, oily, static, and warm. The ghee or oil is often medicated with herbs prescribed for that specific person. Oil enemas, or Basti, are also utilized, to bring these qualities and nourishment directly to the colon, where Apana Vata vitiation occurs. Each dosha has five subdoshas, all with different seats throughout the body, and we must address each of these to ensure proper balance. A Vata-balancing diet and warming and carminative herbs and spices like ginger, cinnamon, hingu, fenugreek, caster oil,
Pitta type Grahani has to do with too much Pitta, which is Fire and (oily) Water, and overactive Agni, or digestive fire. It is hot, sharp, oily, light, and liquid, and is balanced with opposite qualities of heavy, cool, dull, dense, etc. Pitta type Grahani is often also treated with emesis, as there is too much acid in the stomach. Cooling foods and herbs like mint, cilantro, aloe, cucumber, fennel, cumin, lemongrass, and coriander are given, and a Pitta-pacifying diet is followed.
Kapha Grahani presents with excess mucus in the stomach, as Kledaka kapha, which produces the mucosal lining of the stomach, is aggravated and overactive. Emesis here is also somewhat helpful, especially when there is fermented food in the stomach. Here we need to balance the qualities of Kapha, which are heavy, dull, sticky, gross, cold, and static, with the opposite qualities of hot, light, clear, mobile, liquid, etc. A Kapha-balancing diet, along with heating and digestive herbs and spices like black pepper, pipalli, cardamom, turmeric, tulsi, dry ginger, haritaki, amalaki, and natural laxatives are given here.
For all the doshas, a lighter Ayurvedic diet should be followed while treating Grahani. From here, a dosha-appropriate diet should be followed, always cooking food well, washing produce, using quality ingredients. Maintaining a regular eating schedule is also key to a happy digestive system; Not skipping meals, having 3 meals a day, eating an appropriate portion, and not eating too close to bedtime. Dosha-approriate exercise, especially yoga, should also be in the daily routing, a minimum of 30 minutes a day to aid the proper maintenance of agni.
Grahani, or IBS, is not just a physical disorder with physical causes and symptoms. It can also be incited and exacerbated by mental and emotional issues.
Taking care of our whole selves is incredibly important in the prevention and/or management of Grahani. Introducing meditation, pranayama (breathwork), and massage are also crucial for the mental wellbeing. Getting plenty of sleep is crucial, and aromatherapy can also be helpful. Once ama is gone, mental support herbs like Bramhi and Ashwagandha can be taken according to recommended dose. If mental and/or emotional issues are at the root of the problem, talking to a holistic psychologist, counselor, or yoga therapist can also be of great help.
Those of us experiencing IBS symptoms as adults will likely never be “cured” of it....we may never be able to eat the things we once could, but we can certainly manage our symptoms to live more comfortably through Ayurvedic practices. It's often a little more difficult than the western approach, because instead of just taking a few pills (5-10 pills every day that are expensive and have multiple short and longterm side effects mind you) it's often a total change of lifestyle. But it's a change of lifestyle that can improve your life on pretty much every level, so really it's a win-win situation here. And who doesn't love a win-win?! I mean really <3