Abstract

Ulcerative Colitis is an autoimmune condition in which there is inflammation and ulcers inside the colon. It is characterised by recurrent and remitting episodes of mucosal inflammation that begin in the rectum and spread to proximal segments of the colon. It is the most common type of IBD. It mostly affects adults of the age of 30 to 40 years. The main symptoms of ulcerative colitis are diarrhoea, blood and mucus in stool, abdominal cramps. The annual incidence is 10–12 cases per 100,000 people, and the prevalence rate is 35–100 cases per 100,000 people. Ulcerative colitis is three times more common than Crohn's disease. 8–14% of patients with ulcerative colitis have a family history of inflammatory bowel disease and first-degree relatives have a fourfold increased risk of developing the disease. Modern science has no effective treatment for ulcerative colitis. It is associated with Raktatisar in Ayurvedic diagnosis.

Symptoms

Symptoms may vary from patient to patient depending on the severity and inflammation and where it occurs.

  • Diarrhea
  • Blood in stool
  • Mucus in stool
  • Abdominal cramps
  • Urgency to defecate
  • Fever
  • Weight loss
  • Fatigue
  • Weakness
  • Burning sensation in anal region

Types of Ulcerative Colitis

There are mainly 4 types of Ulcerative colitis and they are:

  1. Pancolitis: This type of Ulcerative colitis affects the entire colon and cause bloody diarrhea, abdominal pain, fatigue and weight loss.
  2. Ulcerative Proctitis: In this type of Ulcerative colitis, the inflammation affects the rectum area and cause rectal bleeding only.
  3. Proctosigmoiditis: This type of Ulcerative colitis affects the rectum and sigmoid colon and may cause rectal bleeding, abdominal cramps and urgency to defecate.
  4. Left Side Colitis: In this type of Ulcerative colitis, inflammation extends from rectum through the descending and sigmoid portion of the colon and it may cause bloody diarrhea, abdominal cramps, and pain in the left side.

Causes

The exact cause of Ulcerative colitis is unknown but diet, lifestyle, stress and overactive immune system could be the reason of Ulcerative Colitis. 

Complications

  • Severe dehydration
  • Severe bleeding
  • Swelling in colon area, or also called toxic megacolon
  • Perforated colon (hole in the colon)
  • Increased risk of clotting of blood in arteries and veins
  • Increased risk of Colon Cancer

Diagnosis

Endoscopic procedures are the definite way to diagnose Ulcerative colitis. 

Tests and procedures include

  • Blood test to rule out anaemia
  • Stool test
  • Endoscopic procedures like: Colonoscopy or Sigmoidoscopy

Ayurvedic View of Ulcerative Colitis

In Ayurveda it may be linked to Rakta-Atisara. Ayurveda describes Raktatisara as a type of hemorrhagic diarrhea that has some symptoms similar to ulcerative colitis, including Shoola (abdominal pain), Gudapaka (burning sensation in the anus) and Trishna (excessive thirst). The treatments also helped the overall health of the patient. Ulcerative colitis is a disease of the Purisha Vaha Srotas. This disease is caused by Pitta pradhan Vata doshas. Ayurveda describes Raktatisara as a more advanced stage of Pittasara. Ulcerative colitis and this condition may be related.

Various herbs that helps to pacify the Ulcerative Colitis

  1. Kutaj
  2. Bael
  3. Vacha
  4. Mulethi
  5. Giloy
  6. Arjuna

Treatment

The Ayurvedic way of treating ulcerative colitis is to restore the balance of Vata dosha and Pitta dosha in the body as the imbalance of these doshas in the body makes the disease worse. These treatments include promoting Pachaka Pitta through the use of herbs and dietary modifications, purifying AMA from the body through Panchakarma therapy, purifying the blood, regulating the intestines and treating ulcers with various natural herbal preparations.

Herbal Remedies for Ulcerative Colitis

  1. Kutaj Ghan Vati: It helps to control the loose stools by improving the digestive fire because of its deepana (appetizer) and pachana (digestive) properties. It also helps in making the stool thick due to its grahi (absorbent) properties. 
  2. Belgiri Churna: It helps to balance the tridosha thus helps in managing the symptoms of Ulcerative colitis. It also enhances the digestive fire and has anti-microbial, anti-inflammatory properties. 
  3. Vatsakadi Churna: It consists of various herbs like bael, fennel seeds, Coriander etc. It helps in healing the ulcers. 
  4. Arjuna Powder: It is beneficial in ulcerative colitis because of its anti-inflammatory, antidiarrheal and antioxidant properties.

Conclusion

Ayurvedic management is successful in the management of ulcerative colitis. Ayurvedic management with oral herbs and basti along with dietary modifications is very beneficial. It is safe, cost-effective and has no adverse effects. This disease is a challenging medical problem. The continuous deterioration in health affects the daily life and mental health of the patient. The goal of treatment is to improve the quality of life, reduce the risk of colon cancer and achieve steroid-free remission from ulcerative colitis disease.