Managing Ulcerative Colitis grade-III, through diet correction and Ayurvedic medication

 Case experience series:

Ulcerative Colitis - Relevance of diet & thought process

We received a message from a friend who expressed concern about his friend's daughter, who had been receiving allopathic treatment for ulcerative colitis for a period of three years prior. She was admitted in the hospital. The doctors had now suggested surgery as the condition had worsened to the point of second-degree colitis, since she was weak they were considering to do the procedure or not. the Parents were looking for a medical specialty to treat this problem.

We connected with her through video call, she was born and raised in the Middle East. Her parents moved to India when she was 20 years old, and due to a change in climate and food, she had an episode of food poisoning. They were able to control the infection with antibiotics, but after one month, she once again experienced stomach problems with more than 20 toilet visits with green, watery stools and occasionally bloody stools, and she lost a lot of weight also. For last 3 years she is developing inflammation in the gut currently it became as second degree ulcerative colitis. She spent the previous week surviving on IV fluids because she was unable to eat anything due to nausea. 

 

What is ulcerative colitis? 

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine, also called the colon and rectum.

Her case is diagnosed as Ulcerative colitis, E3 (Severe disease -spontaneous bleeding, ulceration)

Image of her report:

Ayurvedic view:

Her digestive fire, or agni, is weak, and her Pitha dosh, or inflammation, increases in the lower abdomen, according to Ayurveda. We gathered a thorough history of her nutrition and way of life at the time in order to rule out the underlying causes of her increased Pitha/inflammation.

 

Her Diet and life style were as follows:

Waking up time: 7:0 

Breakfast time 8:00 AM, 

(Millet roti) Ragi roti Idli or dosa pancakes with fermented batter, spicy rice flacks with chillies, onions, and lime juice tea made with cow milk, toast with eggs, According to Ayurveda, foods like chicken egg toast, spicy poha, and fermented foods like idli cause inflammation. 

Lunch: 1:00 PM 

Wheat roti with vegetable curry: Since her digestive fire is weak, wheat may not digest properly and may trigger inflammation. 

Afternoon Snacks: 4:00 PM, 

primarily coffee with a few jaggery, spicy, and salty nibbles. All of these are foods that cause inflammation, especially jaggrey,  which is an iron-rich sweetener with a laxative effect. 

Dinner time  8:00 PM 

Wheat or rice with vegetable or mustard leaf curry Wheat and mustard leaves  both foods will aggravate inflammation. 

Sleeping  Time - 11:00 pm 

First set of management

As a first step, we need to stop the nausea and slowly increase her digestive fire so that she is able to eat properly. For that purpose, 

External treatment - we suggested to  wipe her body with lukewarm nalapamara water, as nalapamara is a combination of 4 herbs that have blood purification properties, asked them to do this two times per day during daytime for two days. and continue the IV,

Did not start any internal medication or diet due to nausea .

On the third day, we began giving her puffer rice /Lajja water, As puffed rice is consider to increase agni or digestive capacity .

Preparation:-we made by adding 1 teaspoon of puffed rice to 100 ml of water, boiling it, and then reducing it to 50 ml. This helped her feel less queasy. 

After the nausea subsided, we began the arrowroot decoration. Which will helps to reduce tiredness and helps the body to correct gut bacteria and enhance water absorption from intestine and reduce diarrhoea and gut inflammation .

Preparation :_For this, we added 1 teaspoon of arrowroot powder, 1/2 teaspoon of coriander seed, and a slice of dry ginger to 500 ml of water, then boiled it and reduced it to 50 ml. Gave this water for three days between 11:00 a.m. and 2:00 p.m. during the day. 

Around 4:00 p.m., we also suggested her 50 ml of coconut water mixed with crushed cardamom seeds, but she refused to drink that, so we stopped that 

Diet Pattern after 1 week :-

After a week, we began to feed plain ghee on an empty stomach with 50 ml of Lukewarm rice water. 

Between 1:00 pm and 5:00 p.m., she ate arrow root porridge with coriander and dried ginger water. At this stage, she was able to eat the food through the mouth. IV support is withheld.

Second step of Treatment approach as per Ayurveda:

After one week once she able to eat properly we prepare the line of approach for her treatment as 3 stages 

         First phase: boost metabolism and lessen diarrhoea 

Second stage: Repair the inflamed colon and streamline stool production.

Third stage: strengthen the gut bacteria and improve gut-brain axis function.

The key changes made in diet and lifestyle in the first stage

For 21 days, she  should follow a very strict  diet with few components, staying away from the majority of fibre-rich fruits, vegetables, grains, legumes, and sweeteners like honey and agave nectar.

First stage:

7:00 a.m.: Wakeup.

Early morning rice water with ghee: Soak 1 teaspoon white rice overnight in 500 ml of water. The next morning, boil this water and reduce it to 50 ml. Add 1 or 2 teaspoons of plain ghee and drink.

7:30: Slight breathing exercise and chanting of Vishnu Manthra, which helps her reduce inflammation.

8:00 a.m.: Breakfast

Arrow root porridge with coriander, dry ginger water, and white sugar.

10:30 p.m.: No snacks or beverages

1:00 PM: Lunch

Carbohydrate –

Use: white rice, jowhar roti, and Arrow root powder roti.

Avoid millets like foxtail, Indian millet, ragi, etc.

Protein

Plant protein: use green or orange lentils.

Avoid: all other lentils and kidney beans.

Milk protein (Paneer): once every 2 weeks

Avoid fermented milk products.

Vegetables –

Use: snake gourds, bitter gourds, raw banana.

Avoid: leafy vegetables, tomatoes, small onions, cabbage, egg plant , pumpkin cauliflower, garlic, chilli pepper, and all other vegetables.

Fat

Use: butter, ghee, coconut oil, or olive oil (12 to 1 teaspoon per day).

Avoid mustard oil, sunflower oil, and pumpkin seed oil.

Spices –

Use: coriander seed, cardamon, fennel, dry ginger

Reduce: clove, bay leaf, fenugreek, turmeric, black pepper,

Avoid: red chilli, cumin, asafoetida, coriander powder, ginger, red pepper, fish sauce, sour Chinese sauce, cinnamon, star anise, and ajwain.

Evening snack time 4:00 PM:

Use sweet fruits, like poached apple or steamed banana, Coconut water with crushed cardamon 

Reduce spicy snacks. If needed puffed rice with salt and pepper

Dinner time - 7:00 pm: 

Carbohydrates with vegetables were recommended, like well-cooked vegetable rice or rice roti with vegetable curry.

avoided soup, salads, cheese, and fermented food for dinner.

Bed time  10:00 pm 

Medication for the first stage:

1. Guluchyadi Kashayam Tablet

Dosage: 2 tablets after dinner.

2. Indukantham Kashayam Tablet

Dosage: 2 tablets after lunch.

External treatment: a herbal bath with lukewarm nalpamaradi water.

After the first phase of treatment, she was able to take food, the blood in the stools were stopped, stool colour changed to brown, she experiences pain in her stomach during  defecation, and she showed physical and mental weakness.

In the second stage:

Further changes in diet

Morning rice water with ghee : -  instead of plain ghee, introduce indukantham gritham.

Morning 10:00 am ;- advised to take  medicated pomegranate juice three times time / week.

After lunch: - medicated buttermilk after lunch, 2 times per week.

Medication for the second stage:

1. Indukantha Gritham

Dosage: 12 teaspoon with lukewarm 50 ml rice water.

2. Kutajavaleham

1/2  teaspoons after lunch and dinner for 4 days a week.

3: Guluchyadi Kashayam Tablet

Dosage: 2 tablets after lunch, 2 times per week.

External treatment:

Continue the herbal water bath with Nalapamaram choornam 

Jadamayadi paste application: make a paste of jadamayadi choornam with boiling water and apply it on the tummy for 5 minutes.

After the second stage, bathroom visits are reduced to 6 to 8 times, in which 3 or 4 times the stool were normal with a yellow colour without any signs of inflammation.

Third Stage: 

Continued the same schedule and diet

Medication for the third week:

1.Chargerayadi Gritham

Dosage: 1/2 teaspoon with lukewarm 50 ml rice water.

2. Kutajavaleham

12 teaspoons after lunch and dinner for 4 days a week.

3: Indukantham Kashayam Tablet

Dosage: 2 tablets after lunch, 2 times per week.

External treatment:

Continue the herbal water with nalpamaradi water.

Instead of Jadamayadi Choornam, ask her to do Pichu with Ksheerabala Thailam.

Note:"Pichu" involves placing a piece of cotton soaked in oil on a particular area of the body for a period of time depending on the site and condition. Benefits. It is used for localised pain and inflammation.

Result :

After the 3^rd  stage of treatment done a colonoscopy , result as follows :

The ulcerative colitis improved to Grade1-2, with signs of colon recovery.

Observations:

• Avoiding foods and lifestyle choices that cause inflammation is necessary to minimise inflammation.
• Avoid hot, potent foods like seeds, millets, and red meat.
• While using antibiotics, be mindful of the increased inflammation noted in Pitta type personalities.
• Reduce the number of insoluble dietary fibres, multigrain foods, leafy vegetables, etc.; add more readily digestible simple starch foods; and drink no more than 800 ml to 1 litre of water each day to stop diarrhoea.

 

Prepared by 

Dr. Poornima Sreelal

BAMS. M.Sc. Clinical Nutrition and dietetics. 

The author can be contacted through info.ayurdiet.in@gmai.com or +91-9447762555 

 

 

 

 

Managing anorexia nervosa, maintaining optimum body weight without getting overweight through Ayurvedic medication, diet and life style.

 

Clinical experiences 

Anorexia nervosa in a teenage Girl

In February 2023, we got a message from early teen girl’s parent as follows 

 

“Good evening. From last couple of months my daughter is not eating properly and lost 18 kg weight (her weight was around 52 kg earlier and now 34 to 35 kg). She is 14 years 10 months old and her height is 5'4". 

 

“Regular allopathic family doctor suspected this as a case of anorexia nervosa and asked us to consult both psychologist and psychiatrist. We consulted both and she is currently under medication, last week she improved a bit but this week she again went back to not eating properly. Kindly advise and give your appointment at the earliest, thank you”

 

“We forgot to inform one more point sir. Most of the time she is in standing position or walking here and there but not sitting in one place”

 

When we asked about any particular reason behind this change, they mentioned the following three points as the possible reasons - 

 

1. Six months back, she got braces to align her teeth, she become more conscious about physical looks. 

2. She also mentioned that she feels bad when someone comments her as chubby 

3. Her sister moved out of the house for higher studies hence she felt disturbed. 

 

We had the first consultation through video call, the teen girl was not at all corporative in the initial consultation. In fact she was more irritated. From the parents, we came to know currently she is under the medications like antidepressant, laxative, supplements like Vitamin B-complex, Vitamin D and calcium.   She was eating very little foods, mostly some fruits. juice and salads. As she’s concerned of gaining weight. 

 

Our ayurvedic perspective on her condition.  

            Her digestive capacity, Agni, is disturbed due to emotional disturbance. Due to this, her gut brain axis wasn’t working properly. The intake of laxative and anti-depressant, again reduce the natural intestinal serotonin production. Due to low digestive capacity, her body was unable to absorb the nutrient supplements which worsened the case. 

 

Our line of approach – 

 First, we needed to win the confidence of the teen girl and make her believe eating right will not lead to overweight, as she is very particular not to gain any weight. 

 

We did not start any medication, just asked her to eat as per her wish and drink Coriander and dry ginger water whenever she feel thirsty. Also asked her to stop the supplements and laxative. These steps will help her to stabilize the metabolism.

 

Preparation of herbal water: Take 1 teaspoon coriander seed , 1/4 teaspoon of dry ginger powder, put it in 1 lit of water and boil for 15 minutes,

 

To stabilize her emotions and nature being all around and hyper, which is considered as the increase Vata  dosha,  we asked her to apply Lakshadi kerathailam on head crown, ear lobes, palm and feet  for 5 minutes every day  between evening   4:00 PM to 5:00 pm.

 

In the second consultation after 2 weeks –

This time, she was much calmer and was ready to listen. Here we explained her how the body is working as per Ayurveda and give some information about sapthadhatu concept - 7 tissue functional units of body which are transformed or nourished in sequential manner. 

 

Saptha dhatu  concept: - 

 

 

We were able to convince her that the Ayurvedic medication which we are providing will help to correct her metabolism and form healthy blood tissue which is very essential to maintain healthy life. As per the dhathu concept, if raktha or blood is not formed properly she cannot sustain her life, and these medications will not make her obese. As per ayurvedic concept if all the seven dhathus are working efficiently there won’t be any over accumulation of any particular tissue in the body. So theoretically even the fat will also won’t be there. 

 

Once she understood the concept, she agreed to take medications which are listed below.  

I. Indukantham Grutham

Dosage: 1/4 teaspoon with warm rice starch water, morning, in empty stomach.

( Which will helps to increase metabolism, digestive capacity)

 

2. Dasamoolarishtam + Abhayarishtam

Dosage: take 5 ml from each, mix, 10ml at bedtime.

(Which will helps to regulate gut brain axis)

 

External applications: Continue the Lakshadi kera thailam  application.

 

Diet: Continue coriander dry ginger water, Eat as she likes, avoid raw salads. 

In the 3^rd Consultation  after 2 weeks

 

She was responding positively to the corrections. So continue the same medication and asked her to  slowly increase the amount  of food she is eating, as she was willing to took rice , roti and vegetable etc .

 

But after 1 week she develop fever  and stomach pain , as she ate heavy foods and  ice cream, so we stopped the above medications (Gritham and arishtam for 5 days) and oil application.

 

Asked her to take 1 Danwantharam guika tablet after lunch ( to enhance digestive movements and reduce stomach pain), Indukantham kwatham tablet after dinner (to reduce fever due to indigestion).

 

After 5 days, we restarted the  above mentioned  internal medications. We changed oil massage with podikizhi (Pouch/bundle massage with pulses) on alternate days to ‘open-up’ the channels of her body which will help her to correct her metabolism.

 

4^th consultation: after 2 weeks 

She was responding positively with  internal and external medication, so continued the same for 1 more week.

 

5th  consultation – After 1 week,

For Internal medication , - 

Continue the indukantham grutham 

 Instead of abayarishta we prescribe Dasamoolarishta and Balarishta, 10 ml after dinner  

External Treatment -

Instead of pouch massage, we asked her to do full body massage with Narayana thalian which helps her to stabilize her Vata in to proper direction.

 

Continued the Lakshadi  kera thailam Application

Along with internal and external medication we asked her to start some loosening exercise,  breathing exercise and classical dance practise .

 

By the end of the May her condition improved, she was feeling better. We didn’t encouraged her to check weight as it an trigger stress in her. 

 

Her parents sent the following message on  May 2023

“She has improved sir, she is listening to us and also her irritation instances have come down. She is going to the school regularly and also improved on studies” 

Key observations

-        It. Is very critical to manage the teenage brains during the their pre-frontal development phase. We need to be careful on what to feed, and how to handle the situations. 

-        When you treat symptomatically , it may not resolve what body is trying to solve. 

-        By appropriate day routine and  simple dietary pattern, we can build normalcy in our body without going to complicated procedures. No need to medicalise life.

-        Understanding once’s digestive capacity and what are the right nutrients s more important than taking or not taking nutrients by comparing what others need. 

-Dr. Poornima Sreelal

(BAMS, M.Sc. CND) 

Ayurvedic Physician & Clinical Nutritionist. 

The author can be contacted over  mail infoayurdiet.in@gmail.com or +91-9447762555. 

 

Improving sperm quality and weight reduction through Ayurveda diet and lifestyle correction

 Clinical experience:

Asthenozoospermia to normospermia, 20 kg weight loss, all just by correcting lifestyle and diet in 30 days. 

 

45-year-old gentleman with sedentary life style from Europe approaches us to reduce the weight and increase the quality of sperm. His BMI 34.2 (Hight 188 cm, weight 121 kg ) and sperm count  showed.

Asthenozoospermie: otal sperm count – 272, sperm concentration 68 mil/ml. motility 40% - report on 22.3.2021.

Along with these issues his energy level was very low, snoring and mentally exhausted 

Diet & life style was as follows:

Waking up time – 9:00 – 10:00 

• Exercise – Nil 
• Early morning water practice – 500 ml warm water 
• Breakfast at 10:00 AM, takes two slices bread with marmalade, Croissant, 1 cup of tea with milk and honey
• Lunch 3:00 PM - Soup, Salad, Sandwich -Sometime he skips his lunch due to work schedule Evening Snacks – 6:00PM, mostly a Tea and Cake,
• Dinner – Late night heavy dinner most of the time between 8:30 PM to midnight
• He takes meat, chicken, Pork, beef, potato, desserts etc. 
• Sleep – 12:30 – 1:00 AM. 

Digestive capacity Analysis (Agni) 

His tongue was coated and always feel bloated and heaviness, after food and crave for dry food with spicy, sour salty taste 

Observations and Ayurvedic view:

As per ayurvedic view point his jadaragni whch is the digestive capacity of his body is weak. That is why he is craving for the spicy, sour and salty foods. As per Ayurveda these tastes have higher content of fire element, which enhances the digestion of the foods, that’s why we add spices and salt n foods. The other observation is that his medodhatu (fat metabolism) is malfunctioning that is why he is got excess fat accumulation and is on the obese side. As per Ayurveda physiology the gametes are ‘nourished’ after ‘fat tissues’ are nourished (you may refer to the Ayurveda physiology for details) the disturbed fat metabolism / medodhatu agni impairs the quality of his sperm.  

Remedial plan as per Ayurveda: 

    We planned 21 days treatment for him with 3 stages of 1 week.

First week we tried to open the srothas (metabolic channels) of his body through some rearrangement in diet and daily routine. In the second phase, we focused on fat metabolism and in third week, give diet to improve sperm quality.

Dietary and rouitne changes 

The key changes made in diet and life style 1^st week. 

• Waking up is changed to 7:00 am. 
• Practice clearing the bowels as the first thing to do after waking up.
• Early morning water – Instead of his regular warm water, we recommended him to drink 200 ml herbal water prepared by adding ½ teaspoon coriander seed, fenugreek, cumin seed 3 cardamoms, 3 cloves, a small piece of cinnamon in to 500 ml water, boil it in to 200 ml and drink in lukewarm temperature.
• 7:30 -to 7:45 – Mild loosening exercises, try to move all the joints in all possible direction. 
• 8:30 AM– Breakfast – Included more protein rich breakfast like omelet with vegetables, grilled chicken with vegetables, instead of carbohydrate
• 10:30 AM – Juice time – Vitamin C rich juice like lime /orange/ berries etc.
• 1:00 PM – Lunch – 
• Avoided salads and soup as his digestive power is week. Soup, salads makes digestion weaker, that is why we avoided soup and salads in the first week.
• Recommended a balanced meal with carbohydrate, protein, fat and vitamins like pasta/ noodle/ rice/ bread with meat and vegetables.
• 4:00 PM - Evening snack with nuts/ fruits/ twice in a week.
• 7:00 pm – Based on his instinct, prefer either protein with vegetables or carbs with vegetables was recommended. Avoided soup, salads, fish, cheese and fermented food for dinner.
• 9:00 PM–  Five soaked almonds & two soaked walnuts.
• 11:00 pm – Bed time. 

In the second week:

• Continued the same schedule.  Made him to get up and go to be 1 hour earlier whenever possible.  
• Physical exercise  - Increased the morning exercise time from 15 minutes to 30 to 45 minutes in morning. Added 15 minutes walking at 4:30 PM after evening snacks.
• Diet: Salads were included twice a week with steamed sprouted green lentil, cabbage, onion, tomato, green chili, cumin powder and lime juice.
• Prefer more millets instead of rice or grains. 

Third week –

• Continued the same time tables 
• Exercise – Included more aerobics in morning and sports or games in evening time.
• Diet – continue the second week diet.
• For sperm quality - Include caviar, shell fishes, drumstick, Lamb for lunch time.

Result

Before

After  

• He lost 20 Kg 
• Asthenozoospermia become normal. 
• Sperm count concentration increased from 68 million/ml to 90 million/ml
•  
• Sperm count 272 million to 315 million
• Sperm motility increased from 40% to 52%

 

His wife’s mail on 2th May 2021

“..his weight dropped now by 20kg. He feels good, he does not snore.” 

Notes: 

-       We need to consider the Agni or digestion capacity for all cases be it losing weight or gaining weight

-       Regulating fat metabolism reduces the weight and can improve sperm qualities. 

Prepared by 

Dr. Poornima Sreelal 

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

 

 

 

 

 

 

Medicated Butter Milk

Health benefits

• This act as a probiotic and helps to improve healthy gut flora.
• Improves the digestive capacity of stomach by increasing gastric enzymes secretion.
• Helps in reducing cholesterol and diabetes mellitus.
• Good for hemorrhoids

Ingredients

•     Plain butter milk -2cup (1: 5; yogurt: water)
•     Mustard   seed -1 pinch
•     Fenugreek -1 pinch
•     Turmeric powder - ¼ teaspoon
•     Salt - to taste
•     Chopped ginger - ½ teaspoon
•     Cumin seeds - 1 pinch
•     Coconut Oil - 1 teaspoon
•     Curry leaf - few
•     Water   - ¼ cup

Method of preparation:

• 
  
• Heat a vessel with coconut oil. 
• When the oil gets heated add mustard, fenugreek and Cumin.
• When mustard is crackled add ginger, turmeric, add some warm water to boil for few seconds.
• Remove the pan from the flame, add buttermilk, and curry leaf and salt.
• Stir well cool it and serve.  

​

Caution: Avoid if you feel acidity, when too hungry and also if there are bleeding issues. 

For more diet related queries, contact the author Dr. Poornima Sreelal (BAMS, M. Sc. CND), Ayurvedic physician and clinical nutritionist. 

info.ayurdiet.in@gmail.com

+91-9447762555

Prameha Chikitsa - Diabetes Management

Premeha - Diabetes 

In this Acharya (the scholar who wrote Ayurvedic texts) explain how to deal with disease related with over nutrition and sedentary life which leads to metabolic disease, kidney failure, neuropathy and retinopathy. Etc,

Premeha literally means excessive flow "nutrients/essence" through urine. The flow of unusual nutrients like glucose, blood nutrients, etc. through urine is considered as Premeha. Similarly, the excessive flow of water is also called Diabetes Insipidus. It can be noted that there can be common root to the functions related to kidneys in both diabetes mellites (sugar) and insipidus (water). It is known fact that the late-stage complications of diabetes are mostly kidney related.  

The premeha is divided into three broad categories based of Dosha predominance for easy understanding and classification in common clinical approach. 

Kapha prameha - Early stage of diabetes which is controllable with diet and lifestyle changes. The following symptoms do coexist or similar with symptoms of Kaphaja prameha 

    Overweight/Mild hypoglycemia- BMI generally above 25 Kg/m2

    High cholesterol - Triglyceride (above 200 mg/DL), LDL

    Insulin resistance 

    Hypertension -Blood pressure above 140/90 mm of Hg

    Poly urea - Urinating more than 3 time in 3 hours.

    Glycosuria

Pitha Prameha - Can be classified as the middle stage of diabetes, need medication along with diet and lifestyles. This is a phase in which inflammatory changes mainly happens. 

    Hyperglycemia

    Retinopathy

    Initial stage of nephropathy

    Loss of weight stage of diabetes

    Diabetic ulcer first stage.

    Somogyi effect of diabetes.

Vata Prameha - Third stage of diabetes mellitus with more complication, mostly need proper inpatient treatments, diet, medication also lifestyle corrections. In this stage, most of the irreversible stages happens, then the focus of the treatment is to reduce the degenerative changes. 

    Neuropathy

    Sever stage of nephropathy

    Cachexia

    Cardiorespiratory complications

    Gangrene and its complications

The treatment approach to manage sugar level is decided based on the pattern of blood sugar level spike. That is, when do you notice the spikes and reduction in relation to the diet, activity and medication. We need to understand the dynamics involved in the blood sugar levels in each individual. 

For know more about treatment options and consultation, click here AYURDIET