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Ayurveda > Ayurveda Case Notes > Gud-Bhransh-Chikitsa By Dr. Satish Kulkarni I asked Ms. Molly Keller what her complaints were. This was her first visit to me. She explained that she had been bleeding through the anus since the past six months. She said that she had taken some treatment from her family doctor due to which she had temporary relief, but that the problem recurred. Medical science says that these types of problems are increasing in modern society. They generally occur when the human digestive tract is subjected to neglect and abuse. Our digestive tract is designed to digest food that nature recommends. When we eat unnatural food or when we don’t eat food recommended by nature, our digestive tract rebels. As a result, we face problems like anorexia, distensions of the abdomen i.e. gases, indigestion, hyperacidity, food intolerance, vomiting and loose motions. If we further neglect these warning signs, then we experience problems like bleeding per anum. In short, all these problems are related to our faulty food habits and/or our unhealthy life style like avoiding proper exercise, driving for a long time, being in jobs where one sits for a long time, not controlling stress and strain, etc. One of the three conditions, piles or haemorrhoids, fissure and fistula are most likely to be present if there is a history of bleeding per anum. When I examined Molly, I found that she had fissures (multiple lacerations in the rectal mucosal lining) which were the cause of bleeding per anum. We started an ayurvedic regime and integrated some allopathic techniques like Seitz’s bath (sitting in a warm water tub for a certain period.) I told Molly that the first corrective measure would be to change her dietary habits. Molly was fond of oily and spicy food. I asked her to reduce or preferably stop eating such food and reduce the amount of tea and coffee she consumed. In addition to this, I advised her to add an adequate amount of fibrous food in her diet. I suggested cucumbers, tomatoes, carrots, radishes, cabbage and cauliflower since they contain a lot of fibers. I also advised eating plenty of leafy green vegetables and fruits. Molly agreed to incorporate these changes in her diet. I also suggested having buttermilk since it enhances the results of the treatment. Molly is of the pitta prakruti (pitta dominated constitution). This indicates increased chances of acquiring diseases related to the rakta dhatu (blood tissue) and pitta dosh (one of the basic body constituents, commonly known as bile.) Thus, I advised against meat, smoking and alcohol, all three of which irritate the rakta dhatu (blood tissue) and aggravate the pitta dosh. Molly was advised to take trifala churna {a powder consisting of haritaki (termilania chebula), bibhitak (terminalia bellerica) and amalaki (emblica officinalis)} at bed time. This helped in avoiding hard stools and provided relief from bleeding as a result of that. I also recommended Seitz’s bath every morning and if possible in the evening as well. This is recommended by both allopathy and as well as ayurved. It is good swedan (fomentation therapy) according to ayurved. I prescribed sarjaras malam (ayurvedic ointment for fissures, piles and fistula). I suggested applying shatdhaut grut (specially prepared ghee) if the prescribed ointment was unavailable. This was to be applied locally, in and around the anus and rectum, two to three times a day after the Seitz’s bath. I also prescribed praval tablets and kamdudha tablets (ayurvedic medicines for cooling the aggravated pitta); three tablets each, three times a day, for one month. Now about a month has passed since we started the ayurvedic regime, and Molly is much better than before. We are now thinking of bruhan basti (nutritional enema) treatment, which, I believe, will improve the condition of the rectum. We will introduce cold milk with some real ghee per anum and will ask the patient to hold it for ten minutes. This type of enema will be given once a week for about a month. It also will help in avoiding recurrence.
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