Ulcerative colitis is a type of inflammatory bowel disease (IBD). It is an immune mediated chronic intestinal condition. UC is a mucosal disease that usually involves the rectum, and extends proximally to involve all or part of the colon. The major symptoms of UC are diarrhea, rectal bleeding, tenesmus, and passage of mucus and crampy abdominal pain. In modern medicine so many drugs and even surgery are mentioned for treatment of ulcerative colitis but, these drugs only control the episodes of the disease and not cure them; moreover these modern drugs have a huge list of possible side effects like intolerance and toxicity to other organs like liver, kidney, pancreas, eyes, etc.
In Ayurveda, UC can be considered under the heading Raktaja Pravahika. According to Ayurvedic classics people with Atisar have tendency to develop Raktaja Pravahika when they do not follow pathya (aahara and vihara). Again consumption of hot, spicy and fried food along with stress, anxiety etc leads to Raktaja Pravahika which is a serious condition and needs serious attention. Ayurveda gives the physicians opportunity to incorporate new medication in the explained conditions and name the newly diagnosed condition based on Dosha and Dushya.
MAIN SYMPTOMS OF UC INCLUDE :
Rectal urgency (Sensation of incomplete evacuation despite an empty rectal vault)
Other associated symptoms of UC include: Anemia due to blood loss, fatigue, fever, nausea, weight loss, loss of appetite, abdominal sounds, mouth ulcers, loss of body fluids and nutrients, skin lesions, and growth failure in children
TYPES OF ULCERATIVE COLITIS:
A) Classification according to severity of symptoms:
- Mild: When the person passes < 4 stools daily (with or without blood) and no evidence of systemic toxicity;
- Moderate: When the person passes > 4 stools daily with minimal systemic toxicity;
- Severe: When the person passes > 6 bloody stools per day with signs of systemic toxicity, which may include fever, tachycardia (increased heartbeat) and anemia.
- Fulminant: When the person passes > 10 stools per day, continuous rectal bleeding, tenderness of abdominal area along with systemic toxicity.
B) Classification of Ulcerative colitis according to affected site of colon:
- Ulcerative proctitis (mildest form that affects the rectum only) In many patients with ulcerative proctitis, mild intermittent rectal bleeding is the only symptom. Sometimes other associated symptoms like rectal pain, urgency (sudden urge to defecate and to immediately rush to the bathroom is felt) and tenesmus.
- Procto-sigmoiditis (inflammation of sigmoid colon and rectum only). Main Symptoms of procto-sigmoiditis are similar to proctitis, like rectal bleeding, urgency, and tenesmus. Some patients with procto-sigmoiditis also develop bloody diarrhea and abdominal cramps.
- Left-sided colitis (affects descending colon and rectum) In this type inflammation starts at the rectum and extends up the sigmoid colon and descending colon. Symptoms of left-sided colitis include bloody diarrhea, abdominal cramps, and abdominal pain on left side.
- Pan colitis (affects the whole colon and causes persistent bloody diarrhea). It is also called universal colitis which refers to inflammation of the entire colon (ascending colon, transverse colon, descending colon and the rectum). Main Symptoms of pan colitis include bloody diarrhea, abdominal pain and cramps, loss of weight, fatigue and fever.
- Fulminant colitis is a rare but severe form of ulcerative colitis involving entire colon like pan colitis. Patients with fulminant colitis may suffer from persistent diarrhea with bleeding, severe dehydration due to loss of body fluids and severe abdominal pain. It is an acute severe form of ulcerative colitis.
DIAGNOSTIC TECHNIQUES / METHODS FOR ULCERATIVE COLITIS:
- Blood test – complete blood count.
- Stool test – (To detect infection in colon or rectum due to presence of bacteria, virus or parasite).
- Colonoscopy, Flexible Sigmoidoscopy, In Sigmoidoscopy and colonoscopy examination.
- CT Scan.
- Barium enema X-ray
AYURVEDIC TREATMENT REGIMEN FOR ULCERATIVE COLITIS
Known as Raktaja Pravahika in Ayurveda, Ulcerative Colitis is primarily a disease of Pitta Dosha, with varying degrees of Vata involvement in some cases. The excessive consumption of Pitta-aggravating foods and lifestyle initially damages both rakta dhatu (blood tissue) and mamsa dhatu (muscle tissue), leading to formation of ama that gets deposited between the villi in the intestines, forming a smooth coating that impairs the normal function and immunity of the intestines. Vata Dosha in the lower colon is also aggravated and in the early stages blocks the Pitta and Kapha channels, causing inflammation, mucous accumulation and edema.
Apart from herbal medicnes, Tikta-ksheer basti and Picha- Basti are two main Panchakarma therapies of ayurveda, which are beneficial in Ulcerative colitis treatment.
Ayurvedic treatment of Ulcerative Colitis involves gently eliminating the ama, restoring healthy digestion and creating a bacterially-friendly environment in the body. After the basic strength and immunity of the body is restored, the treatment focuses on natural healing of the ulcers. So one can avoid surgery completely by ayurveda treatment.
SOME BENEFICIAL YOGA POSES:
- Pashimotanasana, Bhungaasana, Marjar asana (cat pose), Ardhmatsyendra asana, Shava-asana (Relaxation).
- Pranayam- Bhastrika (Deep breathing)
These yogasans are to be performed according to condition of your disease under expert’s guidance.
DIET IN ULCERATIVE COLITIS:
The following specific foods are generally recommended in Ayurveda for patients of ulcerative colitis. Sometimes, many patients cannot tolerate all of these food items. Ayurvedic Physician’s opinion is very important for one’s individualized diet plan. General Dietary Recommendations:
- Food items which can be taken generally by all Anaar (Pomegranate), buttermilk, apple, papaya, guava, chikoo, munakka, mulethi, saunf.
- Unlike modern thinking, According to Charak Smahita Goat’s milk (having low fat content and is easily digestible) is recommended for Pittaj Atisara and Raktaja Pravahika. So milk consumption must be encouraged.
- Avoid consumption of coffee, tea, milk, ice cream, cheese and dairy products except milk, and ghee.
- Limit the consumption of non-vegetarian food items.
- Consume plenty of coconut water.
- Inhibit the consumption of food items, which aggravate Pitta. These food items include green leafy vegetables, spices, pineapple, lemons and other citrus fruits. Tomatoes are also not recommended.
- Eat foods like pumpkin, bitter gourd, ash gourd etc. These are bitter in taste and are highly beneficial for the health.
- Avoid smoking and alcohol.