Title : Ayurvedic management of severe ulcerative colitis through staged dietary and herbal interventions: A case report
Abstract:
Ulcerative colitis (UC), classified under Pittatisara in Ayurveda, represents a chronic inflammatory condition of the colon characterized by recurrent diarrhoea, rectal bleeding, and ulceration. Conventional management relies on corticosteroids, immunosuppressants, or colectomy, which may be limited in refractory cases. This case report highlights the role of staged Ayurvedic management in a 23-year-old woman with severe UC (E3, spontaneous bleeding and ulceration) who was considered unfit for surgery. On admission, she presented with nausea, inability to tolerate oral food, >20 bloody diarrhoeal episodes/day, and weight loss, dependent on IV fluids. Ayurvedic assessment revealed aggravated Pitta dosha with Agnimandya, compounded by inappropriate diet (fermented batters, millets, stimulants) and lifestyle (late nights). A three-stage protocol was implemented: Stage 1 (Stabilisation): Laja jala with ghee, arrowroot-based preparations, and external Nalapamara kvatha parisheka controlled diarrhoea and reduced bleeding. Stage 2 (Colon Repair): Indukantha ghrta, Kutajavaleha, and Gulucyadi kasaya were introduced with a simplified diet (rice, jowar, snake gourd, raw banana) alongside Jadamayadi lepa for local relief. Stools reduced to 6–8/day with partial normalization. Stage 3 (Gut Strengthening): Carceeradi ghrta, intermittent Indukantha kasaya, and Pichu with Ksirabala taila restored digestion and reduced spasm. Colonoscopy after six weeks revealed mucosal healing with downgrading to Grade 1–2 UC. Key learnings included the primacy of Agni dipana before Rasayana, strict avoidance of hot-potency and incompatible foods, water moderation to prevent Agnimandya, and stepwise progression from stabilisation to repair and strengthening. This case demonstrates that a personalised Ayurvedic regimen combining dietary discipline, staged herbal formulations, and lifestyle correction can achieve significant recovery in severe UC cases where surgical options are limited, thereby underscoring Ayurveda’s role in addressing Nidana and Samprapti-ghatakas in chronic colonic disorders.
