Role of Snigdha Virechana with Chinchalavan Taila in the Management of Malavastambha: A Case Report

Background: Malavastambha (Constipation) is defined as the infrequent and difficult passage of stool. The main features of Constipation are infrequent or hard stool, abdominal pain, bloating, and feeling of unsatisfactory bowel evacuation. Contemporary laxatives, which are generally used in Constipation, become habitual after some duration and only symptomatic relief. Moreover, these medicines never alter the pathogenesis of the disease. So, it is a need of hour to search effective, safe & alternative formulations in Ayurveda, which can completely break the pathogenesis of Constipation. As per Ayurveda, Vata Dosha is the main factor involved in this condition. Therefore, the prime treatment principle recommended by Ancient Acharyas is to pacify Vata by using Vatahara herbs medicated with Snigdha Dravya, Amla, and Lavana Varga. The Chincha Lavana Taila is one such combination that possesses the above principle & so; it can be effective in Malavastambha. Aim: This case study is primarily carried out to study the role of oral administration of Chincha Lavana Taila in Malavashtambha Objectives: To evaluate the efficacy of oral consumption of Chincha Lavana Taila in Malavastambha. Methods: A single case study. A 50 years old male patient approached Panchakarma O.P.D. with Malavsthambha for one year; he was advised to intake 15ml Chincha Lavana Taila orally at bedtime lukewarm water for consecutive 15 days. Observation and Results: The patient got 100% relief in his all chief & associated complaints and had regular and satisfactory bowel habits after 15 days. Conclusion: Chincha Lavana Taila is one of the best effective oral medicine for Constipation.

The Addition of Transdermal Delivery of Neostigmine and Glycopyrrolate by Iontophoresis to Thrice Weekly Bowel Care in Persons with Spinal Cord Injury: A Pilot Study

Persons with spinal cord injury (SCI) have neurogenic bowel disorders characterized by difficulty with evacuation (DWE), fecal incontinence, and discoordination of defecation. Six medically stable in-patients with SCI with a mean age of 57 ± 10 years (range: 39–66 years) and time since injury of 18 ± 17 years (range: 3–47 years) were investigated. Standard of care (SOC) for bowel care was followed by two weeks of SOC plus neostigmine (0.07 mg/kg) and glycopyrrolate (0.014 mg/kg) administered transcutaneously by iontophoresis thrice weekly for two weeks while patients continued to receive SOC. The primary endpoint was time to bowel evacuation. Body weights and abdominal radiographs were obtained. Ten questions related to bowel function and the Treatment Satisfaction Questionnaire for Medication were acquired after each arm. Bowel evacuation time decreased after the dual drug intervention arm (106.9 ± 68.4 vs. 40.8 ± 19.6 min; p < 0.0001). Body weight decreased (2.78 ± 0.98 kg; p < 0.0001), a finding confirmed on abdominal radiograph. Both questionnaires demonstrated improvement after the dual drug intervention arm. No major adverse events occurred. The addition of neostigmine and glycopyrrolate by transcutaneous administration to SOC for bowel care in persons with SCI and DWE resulted in the safe, effective, and predictable bowel evacuation with subjective improvement in bowel care.

Large bowel obstruction during pregnancy: the efficacy of dietary fibers

Aim: to evaluate the clinical efficacy of dietary fibers and lactulose in pregnant women with large bowel obstruction. Patients and Methods: this prospective study included 60 pregnant women (20–24 weeks of pregnancy) with large bowel obstruction occurred during pregnancy and persisted for at least 3 months. All women were randomized and divided into two groups. Group 1 received soluble fibers and group 2 received group 2 received lactulose. Clinical efficacy of treatment was evaluated using a specialized questionnaire filled at baseline, 48 h, 4 days, and 14 days after starting treatment. Results: mean age was 27.1±4.0 years in group 1 and 28.3±5.0 years in group 2. Bowel evacuation less than 3 times a week occurred in 87% and 77%, respectively, the duration of pushing occupied more than 25% of defecation in 70% and 60%, respectively, hard stool occurred in 100%, anal fissures and a feeling of incomplete evacuation were reported in 47% and 57%, respectively. Comfort bowel evacuation 48 h after starting treatment was reported in 63% of women who received dietary fibers and 47% of patients who received lactulose. Normal defecation by day 4 was observed in 80% of women in group 1 and 53% in group 2. Treatment effect was achieved by day 14 in 87% in group 1 and 70% in group 2. The most common complaint was abdominal distension that occurred 3.5 times more common after treatment with lactulose (р<0.05). Conclusions: dietary fibers were more effective in terms of achieving the desired outcome and patient satisfaction. KEYWORDS: large bowel obstruction, defecation, pregnancy, dietary fibers, OptiFibere, lactulose. FOR CITATION: Dobrokhotova Yu.E., Borovkova E.I., Simonyan T.D., Selimshaeva D.S. Large bowel obstruction during pregnancy: the efficacy of dietary fibers. Russian Journal of Woman and Child Health. 2021;4(1):36–41. DOI: 10.32364/2618-8430-2021-4-1-36-41.

EFFECTIVENESS OF MUSTA-TAKRA BASTI IN THE MANAGEMENT OF ULCERATIVE COLITIS (PITTAJA GRAHANI) – A CASE REPORT

Ulcerative colitis is an idiopathic inflammatory bowel disease causing inflammation and ulcers in the rectum and colon. Ulcerative colitis affects approximately 5,00,000 individuals in US with an incidence of 8-12 per 1,00,000 population per year. It is manifested as ano-rectal bleeding with increased frequency of bowel evacuation, general debility. In the contemporary science treatment is Corticosteroids, 5-Aminosalicylates, Anti-TNF therapy which results in other complications and the disease may even relapse after a period of time. A 62 years old female Patient attended OPD with diffuse abdominal pain, loose stools 10-15 times a day with blood, debility and weight loss. Patient was known case of ulcerative colitis since 6 years receiving treatment from contemporary science but she was not getting any satisfactory relief. Patient was treated with the concept of Pittaja Grahani in Ayurveda. Objective: To improve the signs and symptoms of the ulcerative colitis, to prevent from all possible intestinal and extra-intestinal complications related to ulcerative colitis finally to cure the disease. Method: Musta-Takra Basti was administered for 16 days along with other Ayurvedic drugs and signs and symptoms were evaluated daily. Result: Patient responded well with much improvement in her general condition. Frequency of defecation is decreased, no bleeding per rectum and other signs and symptoms were relieved. Conclusion: This study can be useful for reducing the need of steroids and surgical procedures in the patient of ulcerative colitis Hence Ayurveda treatment can be a promising alternative, safe and convenient treatment in the management of Ulcerative colitis.