How To Manage Advanced Stage of Ulcerative Colitis With Ayurveda?

Abstract

Ulcerative colitis is a type of Inflammatory bowel disease (IBD) that inflames and causes ulcer in the colon. It occurs in 4 stages: mild, moderate, severe and advanced. The Advanced stage of Ulcerative colitis occurs when the disease has progressed over time leading to significant complications such as persistent loose stools associated with bleeding and mucus, weight loss, anemia, with a permanent change in the structure of the colon due to consistent inflammation. In this stage there is a high possibility of colorectal cancer. Ayurveda offers a holistic approach to Ulcerative colitis and offers wonderful and effective treatment solutions in all stages of Ulcerative colitis. Although treating an advanced stage of UC is challenging to manage, the availability of highly effective herbs that helps in controlling the loose stools, bleeding and mucus along with a wholesome diet plan mentioned in Ayurveda benefits the patients to combat this condition. In the present article we will explore the Advanced stage of Ulcerative colitis, its causes, the signs and symptoms, how to diagnose a case of advanced Ulcerative colitis and how to manage this condition with Ayurvedic approach.

Introduction

Ulcerative colitis as the name suggests is a condition where the mucosal layer of colon/ intestine is inflamed forming erosions and ulcers. It is a long-term disease that is believed to be an autoimmune condition where the immune system mistakenly attacks the mucosal layer of the intestines. The patient suffering from this condition has the signs and symptoms of increased bowel movements, associated with blood and mucus, abdominal pain etc. The patient experiences periods of remission and relapse making them suffer repeatedly with continuous inflammation in the intestines. The disease may start spontaneously or can start gradually developing from mild signs and symptoms to moderate to severe stages. If untreated it reaches an advanced stage with permanent damage in the colon leading to significant complications.

Modern system of medicine has no cure in any of the stages of this disease. However, it offers symptomatic relief and prescribes the corticosteroids and immunosuppressants which fail to address the root cause and heal the gut. Instead causes multiple side effects hence, the patient continues to suffer moving into further stages of the disease. Ayurveda, which is very much known to treat all digestive issues, offers a different perspective in understanding ulcerative colitis. It aims to heal the ulcers by focusing on a gut friendly diet, and herbs that help the ulcer to recover by reducing the inflammation. Ayurveda provides a number of herbs that have the medicinal properties to stop bleeding, mucus and control loose motion in all the stages of Ulcerative colitis.  Effectively managing the advanced stage of ulcerative colitis with Ayurveda may provide a promising path toward achieving a cure for this disease.

What is meant by the Advanced stage of Ulcerative colitis?    

An advanced stage of UC happens when the patient has suffered from the disease with many remissions and relapses with continuous inflammation in the colon. This stage is often referred to as fulminant colitis, which presents as a serious illness with significant complications. At this stage there is a significant structural change in the colon such as stricture, scarring, or sometimes even the development of precancerous cells leading to colo-rectal cancer.

Signs And Symptoms Of Advanced Stage Of UC

1. In the advanced stage the symptoms are most intense with frequent, uncontrollable and increased bowel movements ranging from 10-30 times a day.
2. Severe abdominal pain, cramps, gas and bloating.
3. There is increased urgency and inability to control the bowel movement.
4. Associated with increased rectal bleeding and mucus
5. Significant Weight loss associated with nutritional deficiency.
6. Anemia due to constant bleed loss
7. Severe weakness and dehydration
8. May suffer from fever due to increased inflammation
9. Severe Blood loss with Mucus

If this stage is not taken care of, then it leads to complications such as toxic megacolon where the colon dilates and loses its ability to contract leading to perforation or rupture. Anorectal conditions such as abscess, fissures, and fistula in Ano and a long-standing inflammation in the colon especially about 8-10 years may lead to malignant stricture and colon cancer. Apart from this it can also cause extraintestinal symptoms such as skin lesions, ulcers in the leg, colitic arthritis, infection in the eye and liver issues. 

How To diagnose An Advanced Stage Of UC

Blood test reveals

1. A low count of hemoglobin due to blood loss and anemia.
2. The C-reactive protein and ESR will be seen elevated due to ongoing inflammation.
3. The colonoscopy and sigmoidoscopy show the inflammation spread throughout the intestines with redness and swelling, loss of vascularity, fibrosis, may show pus and mucus due to secondary infection, presents of polyps and fibrosis confirms the advanced stage of UC.

Ayurvedic Perspective Of Advance Stage Of UC

Present day Ayurvedic scholars compared and contrasted few conditions mentioned in Ayurveda such as Pitta Atisara, Raktha Atisara and Raktaja Pravahika to all stages of UC

1. Pitta Atisara is the name given to a condition where the patient passes yellow, green, black colored stools, resembling flesh with foul smell, associated with burning sensation, abdominal pain, inflammation in the anal region and fainting.
2. Rakta Atisara is the name given to a condition where increased number of bowel movements occur along with blood.
3. Raktaja Pravahika is the name given when there is an increased number of stools with urgency, bleeding along with stools and passing of mucus associated with severe abdominal pain, gas and bloating.

All these conditions occur due to the imbalance in Pitta Dosha and disturbed Jathar Agni. Amongst these conditions Raktaja Pravahika seems more comparable to advanced stages of UC.  Ayurveda says that when a person of Pitta constitution indulges in food and lifestyle then it increases Pitta further in the body. The increased Pitta disturbs the functioning of JatharAgni(the digestive fire ) causing excessive Pitta to settle in the intestine leading to inflammation and signs and symptoms of UC.

Causes

1. Dietary causes: consuming milk and milk products, alkaline, hot, spicy, pungent, sour and salty foods, deep fried and oily food, heavily spiced meat, alcohol and smoking, citrus fruits, foods that are heavy to digest and incompatible foods such as fish and milk, mixing fresh milk to curds, curds and fruits, milk and fruits etc.
2. Lifestyle causes: Over eating, untimely eating, excessive physical activity, constantly exposed to heat and sun.
3. Emotional causes: constant experience of grief, anger, and worry.

When a patient suffering from mild to moderate signs and symptoms of UC indulges consistently with the above said unwholesome food and lifestyle then the condition progresses towards advanced stage of UC.

Treatment

The aim of treatment in the Advance stage of UC with Ayurveda is to reduce the inflammation, promote healing, control the number bowel movements, control the bleeding and mucus, restore the energy, reduce the abdominal pain, and prevent complications. All these can be achieved by using appropriate Ayurvedic herbs and formulations and following a specific diet that balances JatharaAgni and Pitta Dosha.

Dietary changes: the food which balances pitta and JatharAgni are those which are cooling in nature, easy to digest, light and nourishing foods. Tender coconut water, pomegranate juice, apples, banana, yellow split moong dal, whole moong dal, ghee, white rice etc. Causes least irritation to the intestines and accelerates the healing of ulcer and helps in reducing the inflammation. 

Herbal Remedies For Managing Advanced Stage Of Ulcerative Colitis By Planet Ayurveda

Planet Ayurveda is an established Ayurvedic company that manufactures and distributes Ayurvedic products and supplements since 1990. This company was founded by Dr. Vikram Chauhan, a renowned Ayurveda practitioner and herbalist. He is the CEO of Planet Ayurveda and has over 30 years of practice in the field of Ayurveda. Planet Ayurveda aims to reach out to the entire planet by spreading the knowledge of Ayurveda and helping patients with their authentic and all natural Ayurvedic herbs and products. Based in Chandigarh, India, the products are shipped and are available worldwide with its branches spread across India. Planet Ayurveda focuses on providing authentic and natural Ayurvedic solutions for various health conditions through traditional Ayurvedic approach. Planet Ayurveda offers a wide range of products including single herb and formulations for various disease conditions, prevention of the diseases, and rejuvenation. The products include tablets, capsules, syrups, powders, herbal juice extracts, oils, herbal teas, ointments. This company adheres to holistic healing providing the best quality products for safety and efficacy of healing. The best Ayurvedic formulation that are very effective and beneficial in controlling advanced stages of UC are

1. Vatsakadi Churna
2. Pitta Balance
3. Arjuna Capsules
4. Motion Stop Tablets
5. Coolstrin-A Capsules
6. Coolstrin-B Capsules
7. Vasaka Capsules

Product Description

1. Vatsakadi Churna

Vatsakadi churna is a blend of herbs which is prepared using kutaja (Holarrhena antidysenterica), Bilva (Aegle marmelos),  Saunf (Foeniculum vulgare), Dhania (Coriandrum Sativum) and many others. These amazing combinations of herbs have the property to control loose stools and bleeding. Kutaja, Bilva, and Dadima are known for their anti-diarrheal, anti-inflammatory effect, carminative property and to improve digestion and JatharAgni. Synergistically this combination helps in controlling the number of stools and bleeding along with relieving the patients from abdominal discomfort, gas and bloating by reducing the inflammation in the colon.

Dosage : 1 teaspoonful to 1 tablespoon full of this powder is taken with 1 cup of warm water twice daily after food.

2. Pitta Balance Capsules

This capsule preparation is prepared using Shanka basma (Conch Shell Ash), Pravala bhasma (Coral Calcium Ash), Jaharmohar pishti (serpentine stone powder) etc. This herbo-mineral formulation is a unique product in Planet Ayurveda that is made by combining most of the cooling minerals and herbs. This is most beneficial in cooling the body and reducing Pitta or heat. As the advanced stage of UC is associated with high inflammation, this combination of ingredients help to reduce the ongoing inflammation in the colon thereby accelerating the healing process and reduce the loose stools and bleeding.

Dosage: 1-2 capsules once or twice daily taken after food with a cup of water.

3. Arjuna Capsules

Arjuna capsules contain 500mg of pure extract of Arjuna (Terminalia arjuna) bark. This herb is known for its cardioprotective property. However, it also has a potential effect in controlling the bleeding which is seen as very beneficial in controlling the bleeding in the advanced stage of Ulcerative colitis. The astringent property of Arjuna acts as a haemostatic and reduces the bleeding by constricting blood vessels in the intestines. It also possesses the quality of wound healing which helps in repairing the damaged tissues and promotes healing of ulcers in the colon.  Its anti-inflammatory effect helps reduce the inflammation in the colon which further helps in fast healing of the ulcer.  Its antioxidant effect protects the cells from oxidative stress and supports tissue repair in the colon.

Dosage: 1 to 2 capsules once or twice daily taken with water after food.

4. Motion Stop Tablets

They are prepared using Kutaja (Holarrhena antidysenterica), Bilva (Aegle marmelos), Nagaramotha (Cyperus rotundus) etc. Motion stop as the name suggests helps in controlling the frequency of stools in the Advanced stage of UC. The combination of ingredients synergistically act as carminative or improving JatharAgni (Nagaramotha), controlling inflammation (Haridra) and controlling the number of loose stools. Together this combination helps in reducing the frequency and urgency in patients suffering from UC.

Dosage: 1-2 tablets twice daily, consumed after food with a cup of water.

5. Coolstrin A Capsules

These polyherbal capsules are prepared using Sheesham (Dalbergia sissoo), Vasaka (Adhatoda vasica), Zandu (Tagetes erecta) and many more. All the herbs in this formulation contain anti-inflammatory properties, hence it helps in reducing inflammation and cooling the Pitta Dosha down. It helps in tissue repair and promotes wound healing of ulcers and protects the mucosal layer of the colon. Also the herbs with their astringent property helps in controlling the bleeding and  improving gut health by reducing abdominal pain and cramps, and controlling the mucus.

Dosage: 1 to 2 capsules twice daily after food with a cup of water.

6. Coolstrin B Capsules

These polyherbal capsules are prepared using Nagakesara (Mesua fera), Mochras (Salmalia malabarica), Lodhra (symplocos racemosus) and various other herbs. Coolstrin B capsules are formulated with cooling and astringent herbs that help to reduce abdominal cramps, gas and bloating and promote gut health in ulcerative colitis. This combined formulation helps boost the immune system so that the disease does not relapse. The Mochras present in this combination is a best herb that helps in reducing the inflammation, controlling the mucus and promoting wound healing.

Dosage: 1 to 2 capsules twice daily after food with a cup of water.

7. Vasaka Capsules

Vasaka capsules contains pure extract of Vasaka (Adhatoda vasica). Vasaka is an ancient herb known for its haemostatic action. It is The herbal formulation recommended in any type of bleeding disorder as it has the ability to control the bleeding. Its astringent property and cooling effect help cool down Pitta and control rectal bleeding in the advanced stage of UC. It is also known for its immunomodulatory action which helps balance the immune system response which proves beneficial in autoimmune diseases like UC. Apart from these effects it has the property of anti-inflammatory, anti-oxidant, ulcer healing and mucoprotective effects which further help in reducing the inflammation, healing the ulcer, prevents tissue damage and protects the inner mucosal layer of the colon.

Dosage: 1-2 capsules once or twice daily taken with a cup of water after food.

Conclusion

The Advanced stage of Ulcerative colitis presents itself with critical conditions associated with increased urgency and frequent loose stools with bleeding, and increased fatigue which greatly disturbs the patient’s way of living. With no cure in the conventional system of medicine, Ayurveda serves as a ray of hope to the patients in helping them to heal holistically with no side effects. The reason for Ayurveda to effectively show its results in the Advanced stage of UC is that it addresses the root cause of the disease and manages the diseases by incorporating proper diet that are gut friendly, implications of medicines that bring about healing the ulcer and boosting the immunity.