Introduction
Irritable Bowel Syndrome (IBS) is a chronic functional disease of the digestive tract characterized by symptoms such as irregular bowel habits, abdominal pain, bloating, and discomfort. Living with IBS can be overwhelming, as it can affect digestion and generally impact the quality of life. Everyday living is difficult because of the constant discomfort, irregular bowel habits, and fear of flare-ups.
In Ayurveda, IBS is considered Grahani Dosha or Grahani Roga, which is defined by deranged Agni (digestive fire) and the decreased capacity of the duodenum to hold and assimilate ingested food.
The complete cure of this condition requires understanding irritable bowel syndrome types, symptoms and identifying what causes IBS. Ayurveda offers natural and personalized treatment for IBS, addressing the root cause while restoring digestive balance. This blog elaborates deeply on the cause, types, and treatment of IBS.
Irritable Bowel Syndrome – Types
The classification of IBS is mainly based on bowel characteristics:
- IBS with Diarrhea(IBS-D): Characterised by frequent stool with watery consistency. It is associated with increased urgency and incontinence.
- IBS with Constipation (IBS-C): Less frequent bowel movements are experienced, with straining while passing stool. Patients frequently complain of severe bloating along with discomfort.
- Mixed IBS (IBS-M): Alternating episodes of diarrhea and constipation characterize this subtype, which is characterized by higher anxiety levels.
- Unclassified IBS (IBS-U): These patients do not fit into the discussed categories. They show symptoms that are not in line with classic presentations of IBS-D, IBS-C, or IBS-M.
Ayurveda classifies the four main types based on the predominance of Dosha imbalance: Vataja, Pittaja, Kaphaja, and tridoshaja. Vataja is characterized by abnormal bowel movements, abdominal pain, and bloating; Pittaja is associated with diarrhoea and inflammation. Kaphaja is characterized by constipation, heaviness, and lethargy. Tridosha type will have mixed symptoms.
These subtypes reflect the heterogeneous nature of IBS, influencing treatment approaches and patient management. It also helps in tailoring Ayurveda treatments and provides personalised care.
What Causes Irritable Bowel Syndrome?
The causes of IBS can be summarized as follows:
- The brain-gut axis is indeed one of the important parameters; changes in the nervous system result in symptoms such as visceral hypersensitivity and motility disorders.
- Low-grade chronic inflammation and a more subtle immune response occurring in the gut are now being thought of as possibly relevant in the pathogenesis of this disease.
- An altered composition of the intestinal microbiota could modify the symptoms of IBS, indicating a host-gut microbiota relationship that imposes on gastrointestinal health.
- Social abuse, anxiety, stress, and past psychological trauma or physical abuse during childhood could cause IBS.
- Genetic predisposition and environmental factors can also contribute to IBS.
As per Ayurveda, the causative factors are considered to be a combination of dietary, lifestyle, and psychological factors. They are –
- Irregular eating patterns (Vishamashana/Abhojanat/Ajeernati Bhojanaat): Irregular eating times can greatly affect the circadian rhythms of the gut, which are responsible for controlling the secretion and motility of digestive enzymes. Fasting and then overeating can disturb the digestive operations and alter the gut microbiota composition.
- Food Sensitivities (Asatmya/unwholesome foods): The hypersensitivity felt by the patients renders them more reactive to selected foods. This includes FODMAPs, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. They may trigger symptoms by bacterial fermentation. Food components that increase intestinal permeability can cause immune responses and inflammation.
- Specific food properties: Pungent/spicy foods contain capsaicin that can activate TRPV1 receptors, increasing gut sensitivity. Cold foods may slow digestion and alter gut motility. Heavy foods can delay gastric emptying, promoting bacterial overgrowth.
- Physical exhaustion: This diverts blood flow from digestive organs, impairing their function. It also disturbs the immune response and the regulation of inflammation.
- Sleeping after meals: After-meal lying may cause reflux and delay gastric emptying. This practice interferes with natural digestion by working against gravity and natural posture.
- Stress: The gut-brain axis reflects bidirectional communication. The psychological stressors activate the HPA axis (hypothalamic-pituitary-adrenal), releasing stress hormones (cortisol, CRF) that can directly affect motility, secretion, and gut permeability. Gut microbiota composition and diversity are altered in chronic stress.
- Psychological factors: They can enhance visceral sensitivity by modifying central pain processing. Anxiety and depression are coupled with altered serotonin signaling, which is a regulatory signal for gut function (serotonin is produced in the gut 90% of the time).
Irritable Bowel Syndrome – Symptoms
In Ayurveda, Grahani Dosha is characterised by altered bowel activities with abdominal pain, smelly stool, bloating, loss of appetite, thirst and dry mouth, fatigue, and weakness, incomplete evacuation, fatigue, sleep disturbance, and food intolerance, very similar to IBS; these symptoms represent the disturbance of Agni and the imbalance of Tridoshas in the body that lead to derangement of digestive functioning. These symptoms may significantly interfere with an individual’s quality of life and may have an association with anxiety and depression.
The general approach to treating IBS involves the restoration of Agni (digestive fire) and balancing the respective doshas involved in Grahani.
- Langhana (Fasting): Fasting is prescribed for digesting the accumulated Ama (metabolic waste).
- Deepana (Digestive stimulants): Agni is stimulated with the help of herbs and formulations.
- Snehana (Oleation) and Swedana (Fomentation): This treatment softens the stool in IBS-C type, reduces abdominal pain, bloating, etc.
- Shodhana (Elimination/Purification) Therapies: Vamana (emesis) and Virechana (purgation) are undertaken to eliminate the vitiated doshas based on their predominance.
- Vasti (Enema): Niruha, Picha, and Anuvasana Vasti are used for Ama elimination, improperly evacuated stool, correct stool consistency, and pacification of Vata dosha.
These therapies are combined with internal medicines, lifestyle changes, and dietary modifications, based on the individual’s particular dosha imbalance and digestive power. Treatment methods will differ according to the dosha involved and the condition of Agni.
Conclusion
Contemporary research aligns with the Ayurveda concept of Grahani Dosha, acknowledging the role of Agni or digestive fire, dosha imbalances, and the gut-brain connection in the pathology of IBS. Ayurveda thus provides a comprehensive approach to managing the disorder with personalized treatment protocols that include Panchakarma procedures, herbal formulations, and various lifestyle and diet modifications that treat the root cause rather than just the symptoms. The mind-body connection in digestive health fostered by the traditions is now gaining confirmation through scientific research on the gut-brain axis. For those suffering from IBS, the integrative approach to healing gut-oriented digestive harmony and general wellness would be to blend the wisdom of Ayurveda with contemporary medical understanding.
References
- Nagasako, C K et al. (2016). Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva, 108(2), 59-64. https://doi.org/10.17235/REED.
2015.3979/2015 - Bhinder, G et al. (2023). Irritable Bowel Syndrome Patient Experience: A Survey of Patient-Reported Symptoms by Irritable Bowel Syndrome Subtype and Impact on Quality of Life. Journal of the Canadian Association of Gastroenterology, 6, 219 – 228. https://doi.org/10.1093/jcag/gwad028
- Yuan, Y et al. (2023). Low-level inflammation, immunity, and brain-gut axis in IBS: unraveling the complex relationships. Gut Microbes, 15. https://doi.org/10.1080/1949097
6.2023.2263209 - Ionescu, V et al. (2024). The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome. Journal of Clinical Medicine, 13. https://doi.org/10.3390/jcm13175124
- Das, R et al. (2025). A case study of Ayurvedic treatment of Grahani Roga. Journal of Ayurveda and Integrated Medical Sciences. https://doi.org/10.21760/jaims.9.10.42
