Article by: Dr. MS Krishnamurthy MD (Ayu), PhD (Ayu).
In Ayurveda we find explanation of various diseases which are now considered as just symptoms. And there is explanation of many symptoms, which are now, categorized as diseases. A few of the symptom complexes are also named with different terminologies too. Such an example is – fullness of abdomen or abdominal distension (Anaha / Admana).
Fullness of abdomen / abdominal distention is found as a symptom in various diseases. But Ayurveda refers it as a separate disease entity. This is referred so based upon the causes, patho-physiological factors and line of treatment.
First let us learn the few difference between the closely resembling entitles :
1) Anaha- distention of abdomen with stools and often gas
2) Adhmana – distention of abdomen with gas
3) Atopa – distention of abdomen followed with gurgling sound
4) Udavarta – distention of abdomen caused due to suppression of natural urges.
Here, I cover both the terms ‘Anaha’ and ‘Adhmana’ as both are having similar patho-physiology as well as symptom complexes.
Causes for abdominal distension / fullness
1. Indigestion (Ajeerna Ahara)
2. Improper diet Visha Ahara (improper diet)
3. Taking wholesome and unwholesome foods together (Samashana)
4) Excessive food intake (Atyashana)
5) Incompatible food combinations (Viruddhashana)
Manifestation of the disease
When the undigested food particles are accumulated in stomach / intestines or un-evacuated feces is collected in the large intestine, there will be obstruction of channel. This leads to Vata Dosha aggravation. This is because, large intestine is the natural place of Vata Dosha. Whenever there is obstruction to path, usually the first Dosha to get imbalanced is Vata Dosha, because Vata is the cause for movement. This further discourages the free flow of the faeces and flatus through normal routes, thus the fullness of abdomen is caused.
Based upon the site of manifestation, there are 2 types –
a. Amaja Anaha and
b. Purishaja Anaha
Ama refers to a process of indigestion and weak metabolism complex. This type of abdominal distension is caused by weak digestion strength.
Features of Amaja anaha
Thirst, common cold, burning of the scalp, pain abdomen, heaviness, discomfort in the chest /heart, suppressed regurgitation etc.
Features of Purishaja anaha-
Pureesha refers to faeces. This type of distension is caused due to constipation.
Symptoms: Stiffness, pain in the waist and flanks, constipation, urinary retention, unconsciousness, faecal vomiting, dyspnoea, laziness, indigestion, lethargy, etc.
Ayurvedic line of treatment
Management of Anaha (distention of abdomen ):
Acharya Chakrapani explains to manage this condition with the line of treatment of Udavarta.
In general, for the treatment of both the types of Anaha, below line of treatment is recommended.
Snehakarma – oleation,
Swedana – sudation,
Virechana – purgation,
Asthapana Basti – decoction enema,
Guda Varti – anal suppositories and
unctuous, fresh and wholesome diet are recommended.
Specific treatment for Amaja Anaha
Here, since the cause is indigestion complex, efforts are made to improve digestion strength.
Upavasa – fasting,
Pachana And Deepana – carminative and digestive medicaments and
Vamana – Emesis Panchakarma treatments are followed.
Specific treatment for Purishaja Anaha
Since the cause lies in constipation, efforts are made to clear the feces out.
mild purgation is carried followed by oleation and sudation .
Single drugs recommended in distention of abdomen are-
1. Aragwada- Cassia fistula Linn.
2. Haritaki– Terminalia chebula Retz.
3. Draksha -Raisins- Vitis vinifera Linn.
4. Bilva – Aegle marmelos Corr.
5. Snuhi- Euphorbia neriifolia Linn.
6. Ajamoda- Trachyspermum roxburghianum (DC.) Sprague.
7. Jeeraka – Cumine seeds- Cuminum cyminum Linn.
8. Lashuna -garlic- Allium sativa Linn.
9. Saindhava – rock salt
10. Hingu-asafetida- Ferula narthex Boiss.
11. Devadaru- Cedrus deodara (Roxb.) Loud.
12. Punarnava- Boerhavia diffusa Linn.
13. Patola – Trichosanthes dioica Roxb.
14. Katukarohini- Picrorhiza kurroa Royle ex. Benth.
15. Chavya – Piper chaba Hunter.
16. Karaskara- Strychnos nuxvomica Linn.
17. Changeri – Oxalis corniculata Linn.
1. Lashunadi vati
3. Naracha choorna
4. Icchabedi rasa
5. Ajamodadi vati
6. Chitrakadi vati
8. Sukha virechaka vati
9. Mridu virechaka choorna
10. Lavana bhaskara choorna
12. Pathyadi choorna
13. Yavakshara yoga
14. Trivrit lehya
15. Abhaya modaka etc
Unwholesome diet and habit
1. Guru Ahara (heavy food intake)
2. Vishtambhi ahara ( constipating food)
3. Viruddhara (incompatible food)
4. Aluka kanda( potato)
5. Jambu (blue berry)
6. Mula-kanda -shaka (raw underground vegetable)
7. Suppression of the natural urges
8. Vati aggravating food and habits
9. Sleepless nights
10. Dry and pungent food etc
Wholesome diet and habits
1. Manda (gruel)
2. Mudga yusha (soup of green gram)
3. Kharjoora (date fruits)
4. Draksha (raisins)
5. Kshara (alkalis)
6. Ajamoda (celery)
7. Dhanyaka (coriander)
8. Shatapushpa (dil seed)
10. Ushtra dugdha (milk of the camel)
11. Ardraka (ginger)
12. Vyayama (proper exercise)
13. Dugdha (warm milk)
14. Jala (plenty of water) etc
Distention of abdomen or feeling of fullness of abdomen is a very common complaint. As it disturbs the routine activities, people are much worried due to repeated episodes. Even though carbonized drinks (as they possess anti flatulents like acidic or alkaline constituents) give momentary relief, to get complete relief it is mandatory to avoid the causative factors and to involve in wholesome diet.
Regular food intake, proper or fixed quantity of food at proper time, adoption of carminative and digestive substances (like cumine, rocksalt, ginger, garlic, clove, pepper etc) will help to avoid the incidences.
Further, buttermilk, lemon or cocum juice, medicated milk of cumin seeds or coriander will reduce the incidence of distention of abdomen significantly.