A CASE STUDY ON VIBANDHA W.S.R. TO CONSTIPATION IN CHILDREN

About Author

Correspondence Address

Balrog Department ,Shri Ayurved Mahavidyalaya, Nagpur
Contact No. : 9325794225, Email : d_mahalle@rediffmail.com

Date of Acceptance : 28 Mar 2025

Date of Publication : 30 Mar 2025

Article ID : SD-IJAY_126

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3106

Abstract

One of the primary causes of the rise in parental concerns is the prevalence of vibandha in children. It happens as a result of a blockage to Apana Vayu's ability to function. In addition to being a disease in and of itself, it can also be a consequence of other illnesses, leading to low quality of life and physical and psychological morbidity. It is characterized by delayed feces or infrequent, painful, and difficult stool transit. The main goals of managing constipation include behavioral training, nutritional changes, and addressing the underlying cause.

A 12-year-old girl was brought to the IPD of Kaumarbhritya, Shri Ayurved College and Hospital Nagpur, complaining of hard stools every eight to ten days and trouble passing regular bowel movements. For three to four months, I have experienced intermittent abdominal discomfort, bloating, a burning sensation throughout my body, headaches, appetite loss, and general weakness. For the previous five to six months, these issues persisted. Vibandha is one way to conceptualize this situation. Following a comprehensive clinical assessment and laboratory analysis, Panchakarma treatment, which included Abhyanga, Swedan, and Matra Basti, was initiated along with appropriate internal medications. Significant progress was made in the patient's condition. She was later sent home with medication and dietary instructions to follow.

KEY WORDS:-  Vibandha, Constipation, Basti, Apana vayu.

Introduction

Constipation is a symptom of  an underlying disorder seen in approx 10 to 25% of all patient presenting in a pediatric Gastroenterology clinic . A normal bowel pattern  is considered as a sign of good health .Constipation in children is common; often chronic (persisting for more than 2 weeks) and associated with consequences such as chronic abdominal pain, fecal soiling, voiding dysfunction, psycho-social stress and behavioral problems resulting in poor quality of life¹. Constipation is related to vibandha in Ayurveda. The Ayurvedic samhitas do not explicitly and directly describe the illness known as vibandha. In most Annavaha And Purishvaha Srotovikriti, it is seen as a symptom2.

constipation is defined as Infrequent defecation, painful defecation, or both; In most cases stools are too large, too hard, not frequent enough. and/or painful to pass. The North American Society of Gastroenterology, Hepato-logy, and Nutrition (NASPGHAN) defines constipation as "a delay or difficulty in defecation, present for 2 weeks or more, and sufficient to cause significant distress to the patient".

According to Rome III definition of chronic constipation, symptoms must include at least two of the following for the past two months:

1. Two or lewer defecations per week <2/wk
2. At least 1 episode of fecal incontinence per week in a toilet-trained child
3. History of excessive stool retention or retentive posturing
4. History of painful or hard bowel movements
5. Presence of large fecal mass in the rectum
6. History of large diameter stools that may obstruct

According to Ayurveda, the main causes of constipation include Purishaja Vegadharana (with holding of stool, Children nowadays are spending too much time on devices like smart phones and televisions, which causes them to neglect their daily hygiene routines.), Akal or Asamay purish tyag , a lack of water consumption and a lack of fiber-rich foods, eating fast food, which is typically composed of maize flour eg: eg:pizza, burger, momos etc³ . Metabolic or endocrine abnormality- Hypothyroidism, Hypercalcemia, Hypokalaemia, Diabetic mellitus, Vit. D intoxication also causes constipation.

Ayurveda offers wonderful treatment modalities for vibandha with effective results

and minimal to nil side-effect.

Discussion

Laxatives, which are generally used for constipation, become habitual after some duration and only provide symptomatic relief.

Moreover, these medicines never alter the pathogenesis of disease. So, it is a need of the hour to search for effective, safe & alternative formulations in Ayurveda, which can completely break the pathogenesis of malavshtambh.

As per Ayurveda, Vata Dosha is the main factor involved in this condition. Therefore, the prime treatments recommended by ancient acharyas are snigdha ahar, anulomak dravya, dipak pachak dravya, and basti kriya. Apana vata is the primary factor in constipation in children. Externally, Abhyanga and Nadi sweda were done for 30 days. Abhyanga, being a Bahya Snehana Chikitsa along with Swedana, did the Vataharana. Bala taila was selected for Abhyanga as it is Balya as well as Brumhana by its nature. Since Vata is the main Prakupita dosha here, Basthi chikitsa was planned in order to provide Samyak Anulomana, and Matra basthi was administered with Dhanvantar taila for 30 days, and alternate Anuwasan Basti with Bala Taila + saidhav + madhu and Niruh with Erandmuladi kwath + erandmul churnakalka + Bala Taila + saidhav + madhu was given for 30 days .

Medicine with properties of Ushna, Madhur, and Snigdha was administered to the patient. Ushana guna 4 acts as a dilator of Srotas and the alimentary canal, increases the secretion of glands, generates spasms in sphincteric muscles, and helps feces remove from obstructive paths. These drugs improve digestion by stimulating Pitta and correcting metabolic activities inside the body. Madhur guna 5 of the drug provides strength to the muscles. Because Prthvi and Jala Mahabhuta predominate in medications with Madhura Rasa, these compounds might be characterized as having an unctuous quality and moistening the body's channels. Snigdha Guna 6 provides the viscosity necessary for easy expulsion as well as softening and lubricating the feces in the alimentary canal.

Internally, Laghusutashekhar ras , Paripathadi kwath, Shankh vati, Hingwashtak churna, Lavabhaskar churna, Cap mishrak sneh, Cap Murchhit erand tail, Abhayarishta, Panchkolasav + kumariasav, and Aragwadh + Panchsakar + Esabgol + Yashtimadhu + Erandmul churna were administered.

7Hingwashtak churna is a blend of Trikatu (Shunthi, Pippali, and Maricha), Ajmoda/Yavani, Saindhav Lavana, Jeeraka, Krishna Jeeraka, and Hingu. Sunthi, due to its Katu Rasa and Ushna Veerya properties, increases the Agni (digestive fire), thereby relieving Mandagni (low fire). Sunthi is known to stimulate digestion beneficially. The Sunthi Churna, due to its Katu Rasa and Agnidiptikara Karma, does the Agnidipana, and due to Katu Rasa and Tikshna Guna, does the Pachana of Amadosha. Due to Katu Rasa and Laghu, Tikshna Guna causes Srotoshodhana. 8 Maricha, by its Ushna and Katu Vipaka, increases Agni; by Tikhna Ushna Guna, it expels the vitiated Doshas, which are in sanchaya avastha (accumulated stage). Pramathi Guna of Maricha helps in Srotoshodhana. It is useful for Agnimandya, Ajeerna, Shula, and Adhyamana. Pippali increases Agni by its Deepana action. Saindhav Lavana is rock salt, which acts as a catalyst during the digestive process. Shuddha Hing is one of the well-known herbs for digestion and relieves the gases produced during the digestive process. Ingredients like Shankha Bhasma, Hingu, Kshara, Lavanus, Trikatu, Vatsanabha, Shuddha Parada, and Shuddha Gandhaka are found in the majority of the Shankha Vati. Ingredients like hing (asafoetida) and ajwain (carom seeds) enhance Agni (digestive fire) and clear digestive blockages, preventing Ama (toxins) accumulation that can cause constipation. Laxatives such as black salt and rock salt act as mild laxatives, drawing water into the intestines, softening stools, and promoting peristalsis. The Ushna (hot) nature of Shankh Vati stimulates digestion, balances Vata (which is responsible for dry, hard stools), and promotes intestinal motility.

The Katu Vipaka of Shankh Vati helps in scraping off Ama (toxic undigested material), promoting a clear digestive tract. Ingredients of Paripathadi kwath, like Parpat (Fumaria indica) and Guduchi (Tinospora cordifolia), by its tikta ras, help in removing Ama (toxins) and clearing the digestive tract. Kashaya Rasa Herbs like Musta (Cyperus rotundus) absorb excess fluid, regulate bowel function, and support intestinal health. Mishrak sneh capsule contains goghrit, erand tail, til tail, and shyamadi gan dravya. Erand tail by its Madhur ras helps in lubrication of the intestine, tikta, and katu ras stimulates digestion and clears Ama & Ushna virya of erand tail helps in Anuloman of Apan vayu. Madhur vipak provides a gentle laxative effect without irritation. Erand's tail is best. Virechan dravya.

Abhayarishta is a formulation used in chronic constipation; it helps in Vatanuloman by haritaki, ajawain, and shunthi. It helps in the stimulation of Agni by Sunthi, Saunf, and Ajwain. Dhataki and jaggery aid fermentation, promote gut-friendly bacteria, and thus provide a probiotic effect.

Conclusion

Vibandha can be understood as a Swatantra vyadhi or as an Upadrava of other dis-eases. Treatment of Vibandha is mainly focused on the Anulomona of Apana vata which results in Samyak mala pravrutti. Hence in this case Vibandha is diagnosed as a Swatantra vyadhi and Anulomana and Brumhana chikitsa were adopted internally and externally. Along with Chikitsa, proper dietary plan with fibre rich diet and adequate intake of lukewarm water were also advised.Significant reduction in the complaints was observed after 60 days of treatment. Even after completion of treatment since 6 months completed no any complaints repeated with accompanied of life style change & diet plan.

References

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