Nurturing Wellness: Unveiling the Harmony of Gut Bacteria, Veerya, and Vipaka in Ayurveda

Introduction: The intricate dance of health within our bodies involves a myriad of players, and chief among them are the trillions of microorganisms constituting our gut bacteria. This article embarks on a journey to unravel the mysteries of gut bacteria, delve into Ayurvedic concepts of veerya (potency), and explore the post-digestive effects of food known as vipaka, ultimately weaving a narrative that illuminates the profound correlations among these elements.

 

Understanding Gut Bacteria:

 

Gut bacteria, the microscopic inhabitants of our gastrointestinal tract, form a dynamic ecosystem with diverse roles. These microorganisms can be classified based on their modes of action, encompassing functions such as carbohydrate breakdown, protein digestion, and the synthesis of essential vitamins. This diversity mirrors the intricate orchestra that orchestrates the symphony of digestion within our bodies.

 

The undigested material that reaches the large intestine after completing chemical digestion in the small intestine serves as a crucial substrate for gut bacteria. These undigested compounds are often complex carbohydrates, fiber, and other substances that resist enzymatic breakdown in the earlier stages of digestion. As they reach the large intestine, they become a source of nutrition for various beneficial gut bacteria. Here are some examples of foods that serve as substrates for gut bacteria in the large intestine which mainly classified as prebiotics and probiotics

 

Prebiotics:

 

Definition: Prebiotics are non-digestible fibres or compounds that serve as a food source for beneficial gut bacteria, promoting their growth and activity.

Sources: Prebiotics are found in various plant-based foods, particularly those high in dietary fiber.

Roles:

1.    Feeding Beneficial Bacteria: Prebiotics pass undigested through the small intestine and reach the large intestine, where they serve as nourishment for beneficial bacteria.

2.    Enhancing Gut Health: By promoting the growth of beneficial bacteria, prebiotics contribute to a healthy and diverse gut microbiome.

3.    Short-Chain Fatty Acid (SCFA) Production: Fermentation of prebiotics by gut bacteria produces SCFAs, which have various health benefits.

 

Examples of Prebiotic Foods: cereals, pulses,

 

Probiotics:

Definition: Probiotics are live microorganisms, primarily beneficial bacteria, that confer health benefits to the host when consumed in adequate amounts.

Sources: Probiotics can be found in fermented foods and supplements. Common probiotic strains include various species of Lactobacillus and Bifidobacterium.

Roles:

1.    Balancing the Microbiome: Probiotics contribute to a balanced and diverse gut microbiome by introducing beneficial bacteria.

2.    Digestive Health: They assist in the breakdown and absorption of nutrients, and some strains produce enzymes that aid in digestion.

3.    Immune Support: Probiotics may enhance the immune system, promoting resistance to infections.

 

Examples of proboitcs – Kifire, Kimichi, Curd,

 

 

Mode of action of gut bacteria

 

Short-Chain Fatty Acid (SCFA) Producing Bacteria:

• Mode of Action: These bacteria are specialized in fermenting dietary fibers and complex carbohydrates that reach the large intestine. Through fermentation, they produce short-chain fatty acids (SCFAs) as byproducts.
• Examples:
• Bacteroides thetaiotaomicron: This bacterium is known for its ability to break down complex polysaccharides, contributing to the production of SCFAs.
• Firmicutes: Certain Firmicutes bacteria, such as Faecalibacterium prausnitzii, play a role in butyrate production through fermentation.

Fermentation-Stimulating Bacteria:

• Mode of Action: Lactobacillus bacteria are lactic acid-producing bacteria, and their primary mode of action involves the fermentation of sugars, particularly glucose and other carbohydrates.
• They utilize sugars as a substrate and convert them into lactic acid through fermentation.

 

• Examples:
• Lactobacillus bacteria.

Mucin-Degrading Bacteria:

• Mode of Action: Mucin-degrading bacteria specialize in breaking down mucin, a glycoprotein that forms the protective layer on the inner surface of the intestines.
• Examples:
• Akkermansia muciniphila: This bacterium is known for its ability to degrade mucin and is associated with maintaining the integrity of the gut barrier.
• Ruminococcus torques: Some strains of Ruminococcus are involved in mucin degradation, influencing the turnover of mucin in the gut.

 

Ayurvedic concepts on understanding how any herb or ingredients work in the body

 

Understanding these categories and examples sheds light on the diversity of gut bacteria and their essential roles in maintaining gut health. The interplay between these bacterial groups contributes to the overall balance of the gut microbiome and plays a crucial role in digestion, nutrient absorption, and maintaining the integrity of the gastrointestinal tract.

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Vipaka in Ayurveda:

 

Vipaka, an integral concept in Ayurveda, defines the post-digestive effects of food on the body. Categorized into madura (sweet), amla (sour), and kadu (pungent), vipaka influences the body's response to ingested substances. The main stage for vipaka's action is the large intestine, where the remaining unabsorbed food particles from the small intestine undergo post-digestive transformations.

 

Correlating Vipaka and Gut Bacteria:

 

Ayurveda unveils a fascinating correlation between vipaka and gut bacteria, both operating predominantly in the large intestine. Vipaka considered a specific form of digestion in this region, aligns with the action of gut bacteria fermenting undigested particles and producing Short-Chain Fatty Acids (SCFAs). This correlation forms the foundation for understanding the impact of specific vipakas on gut health.

 

veerya in Ayurveda:

 

Veerya, often referred to as potency, represents the inherent power of gastric enzymes active in both the stomach and small intestine. Ayurveda classifies veerya into two categories: ushna, generating heat in the body, and seetha, generating cold. This categorization reflects the dynamic interplay of digestive forces within us.

 

Correlating Gut Bacteria, Veerya, and Vipaka: & Diseasevb management

 

The synergy between gut bacteria, veerya, and vipaka unfolds in disease management and overall well-being. Specific vipakas, along with their corresponding veeryas, correlate with certain groups of gut bacteria, influencing digestive and metabolic processes.

 

 

1. Madura Vipaka and Seetha Veerya: - Short-Chain Fatty Acid (SCFA) Producing Bacteria

 

• Ingredients with madura vipaka and seetha veerya properties act as prebiotics, stimulating SCFA-producing gut bacteria. These substances, found in cereals, some lentils, organic milk, sweet fruits, and butter, contribute to reducing inflammatory diseases like Systemic Lupus Erythematosus (SLE), IBD, Hyperthyroidism, Pericarditis, Maniac disease

 

2. Amala Vipaka and Ushna Veerya: Fermentation-Stimulating Bacteria:

 

 

• Sour fruits, fermented foods like buttermilk, kefir, idly dosa, and batter kimchi, characterized by amala vipaka and ushna veerya, introduce live bacteria like lactobacillus, act  as  probiotics.
• This supports disease management by enhancing fermentation processes, and reducing metabolic disorders like being overweight and having high cholesterol, due  to lack of proper nutrients,PCOD in a lean person
•  
2. Kadu Vipaka and Ushna Veerya: Mucin-Degrading Bacteria

 

• Ingredients such as spices, animal protein, lentils like horse gram, and various millets, classified under kadu vipaka and ushna veerya, stimulate mucin-degrading bacteria. This correlation points to their potential to manage fat absorption and reduce kapha-related diseases like obesity and cholesterol due to overeating. Hypothyroidism, Arteriosclerosis. Diabetes due to overeating and sedentary life style, Depression,PCOD in obese person.

 

Combined use of all 3 types of bacteria in degenerative disease –

 

As per  Ayurveda degenerative diseases are mainly classified into two based on it s origin   

 

1. Due to lack of  proper nutrient intake  ( Dahtukshaya)

2, Due to obstruction ( Avarana – where nutrients do not reach in the appropriate site due to some obstruction in the metabolic pathway.)

1.    Degenerative disease due to lack of proper nutrient intake ( Dhatukshaya)

 

.Madura vipaka and ushna  veerya – Combination of Prebiotic & probiotic

 

• Diseases like Osteoarthritis in a lean person, Anxiety disorders, diabetes with somogyi effect, Alzheimer’s disease,.PCOD in lean person etc indicates the there is a lack of nutrients in this situation to provide ingredients like ghee, Ginger which as madura vipaka, and ushna veerya (A combination of prebiotic and probiotics together)

 

2.    Degenerative disease due to obstruction – Where combination of 3 types of bacteria needs to be used.

•  

First step - Kadu vipaka and Ushna veerya –Mucin degrading bacteria

 

For diseases like osteoarthritis in obese people, first, we need to provide kadu vipaka usha veerya drugs ( mucin degrading ) and reduce the excess fat, example ingredients like garlic, black pepper

 

The second step - madura vipaka and ushna veerya  - Combination of Prebiotics & probiotics like ginger, ghee, butter milk

 

 

Conclusion: In unravelling the intricate interplay of gut bacteria, veerya, and vipaka, we gain profound insights into the holistic mechanisms that influence our digestive health and overall well-being. This synergistic dance of ancient wisdom and contemporary understanding provides a roadmap for nurturing our bodies, fostering optimal health, and achieving a harmonious balance within.

Manging Trigeminal neuralgia with Ayurvedic diet and lifestyle

 Clinical experience series

Considering the inflammatory aspects of Pitta aspect in managing Trigeminal Neuralgia. 

A 39-year-old woman from the middle east who lives a sedentary lifestyle came to see us with terrible headaches that had been bothering her for a week. She had a history of lengthy flights during the previous two weeks, and the doctor prescribed antibiotics to treat her headache as a sinusitis attack. However, the pain persisted after taking the medications, and now it radiates to her neck and face as well as the left side of her head.

We saw her via a video conference, and based on the location and type of discomfort, we believe she has trigeminal neuralgia rather than sinusitis.

What is Trigeminal Neuralgia? 

Trigeminal neuralgia (TN), commonly known as tic douloureux, is a chronic pain illness characterised by intense facial pain that occurs suddenly. It affects the trigeminal nerve, also known as the fifth cranial nerve, which supplies sensation and nerve signals to various areas of the head and face.

Source site

According to Ayurvedic, her body's hotness, or pitha dosha, is enhanced, causing inflammation of the trigeminal nerve, which aggravates the pain after antibiotics. 

Theoretically, antibiotics that reduce upper respiratory tract infection can be considered kapha reducing / infection reducing. This hot potency may increase the heat of the body, and if there is any increase pitha/inflammation, the intake of hot potent antibiotics will worsen the increased pitha/inflammation. The same thing happened in her situation.

The next step was to figure out the underlying reason for the elevated pitha characteristics, so we examined her current food and way of living.

 

The existing diet and way of life were as follows:

She woke up at 10:00 AM. (According to Ayurveda, the morning hours between 10:00 AM and 2:00 PM are known as pitha time, during which the body's natural temperature will be high. Since she was up during this period, it may have contributed to her body's elevated pitha or inflammation.)

Breakfast at 11:30 a.m. includes fermented food iddli, spicy poha, toast with eggs, and tea with oat milk.

Lunch is taken around 2:30 PM and consists of roti or rice with ghee, kidney beans, and vegetables. (Kidney beans are not recommended since they stimulate inflammation, and lunch is served at a late hour, which could interfere with digestion and promote inflammation.)

Evening snacks about 6:00 PM are typically coffee, spicy and salty snacks, cheese, occasionally fruits. (All  these foods can cause inflammation.)

8:30 pm to 9:30 pm for dinner 

Chinese-style noodles with spicy sauces, shawarma wraps with hummus, mixed veggie tikki with a turi, broccoli soup, or rice with chicken combined with yogurt.

(Yogurt, sauerkraut, and other inflammatory foods are consumed at night.)

12:30 AM to 1:00 AM: Sleep. (Sleeping late at night might worsen vata and pitta imbalances.) 

Analysis of digestive capacity (Agni) 

Her tongue was red with inflammatory symptoms, she craved semi-solid foods with spicy flavours, was ok with sweet and bitter tastes, and detested salty, sour, and acidic flavours. 

Observations: 

Her preference for spicy food indicates that her digestive fire in her stomach is weak, which is why it disturbs her digestion. As a result, the blood formed in her body becomes inflamed, which is why she has inflammatory signs in her body like rosacea in her face and red patches on her body. To reduce this inflammation, her body prefers sweet and bitter tastes because they reduce the inflammation.

Source site

Spicy food contains a fire element, which may be beneficial for digestion, but raising body temperature causes inflammation.

 The main challenge we encountered in this case was how to increase digestive capacity without increasing inflammation. To address this, we chose a bitter-tasting drug called guluchayadi kashayam, which is based on plant Guduchi (Tinospora cordifolia) and has both digestive fire-increasing and inflammation-reducing properties. Ghee was also included, which has the similar virtue.

The treatment approach: 

We devised a 28-day treatment for her in three phases. 

• The first week, we used ghee and guluchi to try to manage her metabolism and reduce inflammation.
• The second and third weeks are spent attempting to directly address the inflammation of the trigeminal nerve.
• Fourth week - After the nerve inflammation has subsided, we will focus on treatments that will increase the nerve's strength.

The main dietary and lifestyle modifications First week:

The time for waking up has been adjusted to 7:00 a.m. 

Practise cleansing your bowels first thing in the morning.

7:30 - 7:45 a.m. Take rice water with ghee - Soak 1 teaspoon white rice overnight in 500 ml water, then boil this water and reduce it to 50 ml, add 1 /2 teaspoon simple ghee, and drink. Mild loosening exercises, attempting to move all joints in all directions.

Breakfast - Points considered at 8:00 a.m. 

Avoid fermented and spicy foods, and limit your intake of animal protein. 

If your appetite is strong, go for toast with white bread and butter. Avoid whole wheat and millet bread.

If you have a regular appetite, eat white rice porridge with coconut milk, ghee, and sugar candy.

Skip breakfast or take a poached apple if your appetite is low.

10:30 am. - No juice time; she may have sweet berries if necessary. Avoid eating sour fruits.

Lunch - 1:00 PM  

Can continue the balanced meal as needed by the body for the day: White rice rice/gluten-free roti and millets should be avoided. 

 

Plant protein – green or yellow lentils (avoid brown lentils and kidney beans).

Protein derived from animals:

Whitefish, lamb, and duck eggs can be used.  

Chicken, chicken egg, and

Avoid eating turkey, pork, beef, and redfish. 

Milk protein - Avoid fermented milk products, Panner. 

 

Vegetables:

Gourds, bitter-tasting veggies, broccoli, carrots, etc. 

Reduce the amount of green vegetables, tomatoes, and small onions. 

Avoid eating cabbage, cauliflower, garlic, and chili peppers.

 

Use butter, ghee, coconut oil, or olive oil for fat. Sunflower and pumpkin seed oils should be reduced. Mustard oil should be avoided. 

Spices: Turmeric, black pepper, coriander seed, cardamon, fennel, dry ginger, yellow pepper

Reduce the use of clove, bay leaf, and fenugreek.

4:00 PM - Eat fresh fruits, steamed veggies, cucumber, and coconut water. 

Reduce your intake of spicy foods. 

7:00 p.m. - Her instinct told her to favor protein with veggies or carbs with vegetables. 

For dinner, I avoided soup, salads, seafood, cheese, and fermented foods.

9:00 p.m.- 5 soaked almonds (skinless) & 5 soaked resins 

11:00 p.m. - Time for bed.

First week's medication: 

Tab. Guluchyadi kashayam 2 pills should be taken after breakfast and dinner.

Made a paste of coriander leaves without any water and applied it to the painful area in the daytime before 10 am or after 3 pm. Once it has dried, wipe it off with a soft tissue.

continued with the same routine and food for the second week. 

Second week of medication: 

1. Tab. Guluchyadi kashayam 

Two pills should be taken after breakfast and dinner.

2. Take a half-teaspoon of thikthakam gritham with 50 ml of rice water on an empty stomach.

Continued using the coriander paste on alternate days for external use.

Making a paste of jadamayadi choornam with boiling water on alternate days, applying it to the affected regions once it has cooled, and wiping it off with a soft cloth once it has dried.

Third week:  maintained the same routine and diet.

Guluchyadi kashayam, tab 

2 pills after lunch; 

2 teaspoons of thikthakam gritham mixed with 50 ml of rice water when taken on an empty stomach.

3. A half-teaspoon of avipathi choornam before bedtime on alternate days is recommended. 

Continue using jadamayadi on alternate days for external treatment 

Nasyam: After cleaning your teeth in the morning, put one drop of Anuthailam in each nostril.

Fourth week - Followed the same schedule and diet as the previous week Medication during the second week - 

1.Thikthakam gritham half teaspoon with 50 ml rice water on alternate days on an empty stomach 

Stop taking Guluchyadi kasahayam and avipathi choornam. 

External therapy - Nasyam - After brushing, put 2 drops of Ksheerabala in each nostril.

We stopped the medicine and advised her to follow the eating pattern for another two weeks when the discomfort had fully vanished after four weeks of treatment.

Key Notes: 

• To minimise inflammation, we must avoid pro-inflammatory foods and lifestyle patterns. 
• We must include more bitter-tasting foods.
• Avoid hot powerful foods such as red meat, millet, and seeds. 
• While using antibiotics, be mindful of the inflammatory triggering points displayed by the body and modify the drug and antibiotic dosages accordingly.

 

Constipation- Does it really need laxatives?

Clinical experiences series:

Ayurvedic considerations in management of constipation. 

According to Ayurveda, the food you eat is transformed into three categories by digestion:

1. Sara/Nutrients: are necessary for healthy physiological processes including bodily movements, digestion, etc. These are nutrients the body utilities its metabolic functions. 
2. Kitta/Waste: These are the bye products of cellular metabolism. These are ultimately discharged feces, urine, perspiration, etc., 
3. Mana/Mind: In order to maintain a sound mind, pleasant chemicals like serotonin and dopamine need to be produced. When this path is affected, it may affect the thoughts and sleep.

Whenever we address a constipation problem, we need to understand whether the constipation is caused by a lack of adequate nutrients like dietary fibre, magnesium, etc., is it by stress, or by any other problem with the intestine's peristaltic movements and water reabsorption.

This article narrates a 35-year-old woman with heavy job pressure, has experienced constipation for the past five years along with an under active thyroid function.

Her existing diet and life style was as follows :

Waking up: 6:00 AM

Diet pattern

Drink 1.5 litter, warm water - This much water in empty stomach will reduce the digestive capacity, which may leads to bloated feeling, constipation, etc.

Breakfast time 8:00 AM,

Egg - (Chicken egg increase constipation)

Dosa- fermented pan cake – (Regular use of Dosa will increase acidity of stomach leads to allergies)

Snack – 11:00 AM

Boiled Egg – (Not good for constipation)

Lunchtime: 2:00 PM

White rice, chicken, Dal, Spinach, (White rice and chicken may increase constipation.)

Afternoon Snacks: 4:00 PM,

Fruits & water with honey – (Honey not good for constipation.)

Dinner time 8:00 PM

Grilled chicken with yogurt, salads, - (Yogurt and chicken increase constipation , salads may produce bloated feeling.)

Sleeping Time - 11:00 pm

In our observation, her current diet contains less fibre, so even if she ate salads for supper, they could not have been adequately digested because digestion is often slower at night.

In addition, she often consumes chicken, chicken eggs and yogurt since they have the grahi characteristic, which means they will restrain bowel movements. This lessens the peristaltic action, which causes constipation.

Guidelines

How much quantity you should eat?

Quantity of food: Generally, you need to fill half of the stomach’s capacity with solids; one-fourth with liquids and rest has to be kept empty for the free movements of body humors. You should not feel heavy after any food, especially after dinner.

How much to drink?

Your water intake should be decided by your urine color. Normal urine is light yellow in color, if it is too much clear, reduce the water intake and if it is on the darker side or there is a strong smell, increase the water intake.

How you need to eat food?

While you are eating, give your full concentration on eating. Do not watch mobile or do not talk with your friends. Pray before having meals.

Sample Diet for 21 days.

Empty stomach – Mix ½ teaspoon melted ghee with rice water

(To prepare rice water – Soake 1 teaspoon of white rice in 200 ml of water for overnight, Moring boil it for 10 minutes)

Breakfast - (Avoid chicken egg it will increase constipation)

Coffee with jaggrey ( which will help to reduce constipation. Avoid honey and white sugar)

If appetite is excellent,

• Prefer like gluten free bread toast / foxtail millet roti (thina)with butter (which will help to produce serotonin in intestine).

If appetite is normal,

·       Prefer some porridge with warm nut milk (rice, foxtail millet)

·       Any of your traditional breakfast can also include (reduce the intake of fermented food – 1or 2 days/ week, instead of take green gram chila with chopped leafy vegetables like coriander, fenugreek, etc.)

If appetite less.

Prefer pouched apple with cinnamon. Any seasonal fruits. (avoid mango and pomegranates both of them increase constipation).

Snack 11:30 – Try to include vitamin C fruits like berries, mint lime juice, orange, etc. which will helps you to increase your metabolism.

Avoid egg

Lunch -12:30 to 1:30pm

Try to include all six tastes for lunch like

Sweet- carbohydrate, (rice /than millet/noodles/pasta)

Sour -vitamin (vegetables – lime)

Salty - mineral, (salt)

Spicy - minerals, (spices, animal protein )

Bitter – protein and vegetable (dhal, vegetables)

Astringent – protein and vegetables (dhal, vegetables)

Vegetables 

• Green vegetables, like spinach 3-4 day/ week (cooked with ginger, small onion turmeric)
• Leafy vegetables that are rich in iron, magnesium, selenium, etc. it will help for constipation, your mental thoughts and increase immunity.

Fruit vegetables – gourds like snake gourd , ridge gourd, ash gourd , bitter gourd, tomato, okra , broccoli, etc. take 3-4 days steamed as it is rich in antioxidants. 

• Reduce – Cabbage, cauliflower, Brussel sprouts. Bottle gourd, pumpkin. (all of them are difficult to digested by your body).
• Roots & stems- Carrots – (Rich in antioxidants) always prefer in the steamed form for better absorption. 2-3 days/week
• Beet root –1-2 days per weeks. (good to reduce constipation)
• Potato or sweet potato – (Try to add little cumin to avoid gas formation.) 2-3 days/week.

Protein (Take one type of Protein at a time)

• Plant protein - Green gram/ tur dal/masoor dhal- (Soaked and discard the water in which it is soaked, add turmeric, cumin and ginger while cooking. Reduce the intake of soya, Rajma, chickpea,
• Milk Protein –
• Paneer – 1-2 days/ week
• Cheese- 1-2 days/ 14 days
• Reduce yogurt and butter milk (both may cause constipation)
• Animal protein – Mutton, white fish, Duck egg, quail egg,
• Reduce red fish, red meat, chicken, chicken egg

Take Carbohydrates such as brown rice, pasta, Roti, Noodles, spaghetti etc.

• Brown rice OR whole grain cereals 2-3 days/week.
• Foxtail millet (thina)- 1-2 day/ 10 days.

Seeds/ nuts

Ayurveda believes in having a small quantity of fat is essential for body functions especially the neurological functions. Take a maximum of 1 teaspoons of oil per day.

Take olive or coconut oil with your food.

Or ½ teaspoon of ghee or 1 teaspoon of butter with lunch.

Afternoon Snacks. 3:00 to 5:00 PM

If you are hungry, take any home-made snack like rice cake, gluten free snacks, steamed vegetables with nuts.

Fruits: seasonal locally available fruits are recommended.

Avoid coffee in the afternoon.

Dinner - 6:00 -7:00 PM

Avoid salads, cheese, brown lentil, chickpea, pumpkin and animal protein like chicken and red fish in the night time.

Normally digestive fire is weak after sun set, it’s better to have light and easily digesting dinner. If you ate more for dinner, try to avoid your breakfast or have lighter breakfast.

Try to take an early light dinner with mainly carbohydrate and vegetables, which helps repairing process of body and to get a good sleep. This will pacify your Vata. You can try any of the following combinations.

Kichadi with vegetable

Sweet potato with steamed vegetables

Soup with barley and vegetable 2-3 day/ week. ( which will help you to increase bulkiness in stool)

Green gram chilla with leafy vegetables.

If you having late night dinner -reduce the next day’s breakfast.

Bed Time

5 -8 soaked almond without skin (helps to induce good sleep)

On alternate days -

Take 16 to 21 soaked black raisin for 21 days. (act as magnesium supplement helps to reduce constipation)

Herbal water:

Make herbal water with ¼ teaspoon coriander seed, 2 harad (Terminalia chebula) and three cardamoms. Boil this in 2 litres of water and reduce it to 1 and ½ litter and drink this lukewarm during the day.

Medicine:

1. Tab. Gandharavahasthadi Kwatham/Kashayam  

Dosage: 1 tablet before dinner.( if you get tablet or kwatham)

2. Thriphaladi choornam   - Add 20 gm powder with 4 lite water and boil it of 20 minutes and then do stiz bath with this water ( once in a week)

Result after 21 days

She is having regular bowel movements and her constipation has decreased, advised to stop taking the Gandarwahasthadi tab and to keep up with her diet and Sitz Bath.

Prepared by 

Dr. Poornima Sreelal 

The authour can be contacted through info.ayurdiet.in@gmail.com or connect through whatsApp +91-9447762555.