Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Most of the conditions which fit into Gastro-Intestinal Bleeding including upper gastrointestinal bleeding and lower gastrointestinal bleeding are included under a condition called Raktapitta explained in Ayurveda.
Raktapitta is a condition in which the blood which has been contaminated by Pitta and gained increase in volume tends to move either upwards or downwards or in both directions and bleed from different passages (openings) therein.
Read related: Raktapitta: Cluster Of Bleeding Disorders: Meaning, Definition
Urdhwaga Raktapitta – When the bleeding occurs in an upward direction and from the openings in the upper parts of the body, it is called Urdhwaga Raktapitta. This condition includes Upper GI Bleeding. All conditions or diseases which cause upper gastrointestinal bleeding can be included under Urdhwaga Raktapitta or considered to be causative of Urdhwaga Raktapitta. Bleeding from the upper tracts including peptic ulcer disease, esophageal varices due to cirrhosis of liver, cancer etc are included under Urdhwaga Raktapitta.
Adhoga Raktapitta – When the bleeding occurs in a downward direction and from the openings in the lower parts of the body, it is called Adhoga Raktapitta. This condition includes Lower GI Bleeding. All conditions or diseases which cause lower gastrointestinal bleeding can be included under Adhoga Raktapitta or considered to be causative of Adhoga Raktapitta. Bleeding from the lower tracts including hemorrhoids, cancer, inflammatory bowel diseases etc are included under Adhoga Raktapitta.
Read related: Treatment Principles Of Raktapitta – Bleeding Disorders
Other conditions causing GI bleeding
Other conditions which could be considered as causative towards GI Bleeding through Ayurvedic perspective
Apart from Raktapitta, the below mentioned conditions can be considered as differential diagnosis of GI Bleeding. The treatment strategies of the mentioned conditions shall be adapted for treating GI Bleeding.
Read related: Gastro intestinal Bleeding Causes, Symptoms, Differential Diagnosis
Atisara means diarrhea. Shokaja means that which is caused by grief or stress. Thus Shokaja Atisara means ‘diarrhea caused by excessive or long-standing grief or stresses’. This is one of the types of Atisara mentioned by Sushruta (Bhayaja Atisara – Charaka, diarrhea caused by fear). Among many symptoms of Shokaja Atisara, bleeding from rectum is mentioned. Sushruta tells that the blood may be either mixed with stools or frank blood may be discharged from anal route. This condition includes Inflammatory Bowel Diseases which also has stress component among the causative or trigger factors.
Treatment – Shokaja Atisara may be treated on the lines of Atisara Chikitsa (general principles of treating diarrhea). Along with this, since shoka and bhaya are the chief causes, counseling and assurance is needed. External treatments like Shirodhara (stream pouring of medicated oils, milk etc over the head), Shiro Vasti (oil pooling over the head / scalp), Abhyanga (herbal oil massage), etc will help soothe the disturbed nerves and calm the mind. Nabhi Vasti (pooling of medicinal juices in the navel button) will help in regularizing the metabolism. Effective disease modifying medicines and immune-modulators will also help.
Rakta Atisara is a condition in which there is bloody diarrhea. This is said to be a superseded condition developed on the backdrop of Pittaja Atisara. When Pittaja Atisara (diarrhea caused by vitiated pitta) is neglected or not treated properly or if the person suffering from pittaja atisara keeps taking pitta aggravating foods, the pitta further aggravates and causes Rakta Atisara. This condition includes Inflammatory Bowel Diseases like Crohn’s Disease and Ulcerative Colitis.
Treatment – Treatment of Rakta Atisara should be done on the lines of Atisara Chikitsa added with special formulations which help in reducing bleeding and related conditions of Rakta Atisara (Rakta Atisara Chikitsa).
Read related: Gastro Intestinal Bleeding: Prevention and Home Remedies
Pravahika means dysentery. Raktaja Pravahika means pravahika which is caused by vitiated Rakta or blood. Even in this condition there is bleeding from the rectum or bloody diarrhea.
Treatment of Raktaja Pravahika – Raktaja Pravahika can be treated on the lines of Atisara and Pravahika Chikitsa.
Raktaja and Pittaja Arshas
Arshas means Piles or hemorrhoids. Among the types of Arshas, Pittaja Arshas (piles caused by vitiated pitta) and Raktaja Arshas (hemorrhoids caused by vitiated rakta or blood) are the 2 conditions in which there are bleeding from the anal route, more bleeding occurs in Raktaja Arshas.
Treatment of Raktaja and Pittaja Arshas – Raktaja Arshas and Pittaja Arshas may be treated on the lines of Arshas Chikitsa. Specific formulations mentioned for Raktaja and Pittaja Arshas may be used for better disease modifying effect and to check bleeding and also to control the vitiated doshas.
Chardi means vomiting. Tridoshaja Chardi is a type of vomiting caused by all 3 vitiated doshas. Rakta pravritti or bloody vomiting (vomiting of blood) is one of the symptoms of Tridoshaja Chardi.
Treatment of Tridoshaja Chardi – Tridoshaja Chardi shall be treated on the lines of Chardi Chikitsa.
Arbuda means tumors or cancer. Raktaja Arbuda is a type of arbuda caused by vitiated blood. Achira Rudhira Pravritti or bleeding in quick time and excessive bleeding from upper or lower passages is one of the main symptoms of Raktaja Arbuda. This can be compared to blood cancer or tumors which are associated with upper GI or lower GI bleeding.
Treatment of Raktaja Arbuda – Raktaja Arbuda should be treated on the lines of treatment of Arbuda and Raktaja Arbuda Chikitsa.
The above mentioned conditions explained in Ayurveda gives us a gross picture of upper and lower gastrointestinal bleeding. Gastrointestinal bleeding is most often a secondary symptom or presentation of a chronic or acute illness or a complication of some disease. Probably we cannot find the root cause (causative disease) being mentioned in Ayurvedic texts as responsible for causation of bleeding from upper or lower passages. The gross symptom i.e. bleeding should be considered in this context. All diseases causing bleeding in upward direction (upper GI Bleeding) should be considered under Urdhwaga Raktapitta or Raktaja Chardi. Similarly all diseases causing bleeding in downward direction (lower GI Bleeding) should be considered under Adhoga Raktapitta, Rakta Atisara, Raktaja Pravahika, Pittaja Atisara and Raktaja Atisara.
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