Open Access Open Access  Restricted Access Subscription Access

Traditional Kerala Ayurvedic Formulations as a Guideline for the Management of Inflammatory Bowel Disease (IBD) – A Review


Affiliations
1 Department of Rachana Sareera, Vaidyaratnam P. S. Varier Ayurveda College, Malappuram - 676501, Kerala, India
2 Ambady, Kottakkal, Malappuram - 676503, Kerala, India
 

Inflammatory Bowel Disease (IBD) refers to conditions characterized by the presence of idiopathic intestinal inflammation. The main challenge in the management of IBD is the adverse effects associated with the currently available drugs. Also, not all patients respond completely to the conventional treatments of IBD and its efficacy wanes over time. Thus, the use of complementary and alternative medicine is increasing, as a safer alternative. Certain traditional Ayurveda literature of Kerala describe a condition termed ‘jatara vrana’ (ulcer of the gastrointestinal tract), which, along with its associated clinical features, resembles IBD. Due to the similarity in pathology and presenting features, the line of treatment adopted in the management of jatara vrana may be extended to that of IBD. A close observation of the formulations described in the management of jataravrana described in Chikitsamanjari (a regional Ayurvedic literature of Kerala) reveals that in each formulation individual drugs with varying mechanisms of action, including anti-ulcerative (vranaropana), anti-diarrheal (atisaraghna), anti-inflammatory (sophahara), anti-pyretic (jwarahara) or analgesic (vedanahara) activities, have been logically selected and combined. The active components of some of these drugs have been proven to have various effects in IBD pathology. Though these treatment principles have been used traditionally and Ayurvedic management is promising in many experimental models, it is essential to supplement it with well-designed clinical trials to define the exact role of each of these formulations in the prevention or management of IBD

Keywords

Chikitsamanjari, Inflammatory Bowel Disease (IBD), Jataravrana, Kerala Ayurveda Literature.
Font Size

User

Notifications
JOURNAL COVERS
  

  • Williams NS, O’Connell PR, McCaskie A, Editors. Bailey and Love’s short practice of surgery. Florida: CRC press. 2018; 1266.
  • Kedia S, Ahuja V. Epidemiology of inflammatory bowel disease in India: the great shift east. Inflamm Intest Dis. 2017; 2(2):102-15. https://doi.org/10.1159/000465522
  • Jain M, Venkataraman J. Inflammatory bowel disease: An Indian perspective. Indian J Med Res. 2021; 153(4):421-30. https://doi.org/10.4103/ijmr.IJMR_936_18
  • Ralston SH, Penman ID, Strachan MW, Hobson R, Editors. Davidson’s Principles and Practice of Medicine E-Book. Edinburgh: Elsevier Health Sciences. 2018; 816.
  • Matsuoka K, Kobayashi T, Ueno F, Matsui T, Hirai F, Inoue N, et al. Evidence-based clinical practice guidelines for inflammatory bowel disease. J Gastroenterol. 2018; 53(3):305-53. https://doi.org/10.1007/s00535-018-1439-1
  • Catanzaro D, Rancan S, Orso G, Dall’Acqua S, Brun P, Giron MC, et al. Boswellia serrata preserves intestinal epithelial barrier from oxidative and inflammatory damage. PLoS One. 2015; 10(5). https://doi.org/10.1371/journal.pone.0125375
  • Yeshi K, Ruscher R, Hunter L, Daly NL, Loukas A, Wangchuk P. Revisiting inflammatory bowel disease: Pathology, treatments, challenges and emerging therapeutics including drug leads from natural products. J Clin Med. 2020; 9(5):1273. https://doi.org/10.3390/jcm9051273
  • Ben-Horin S, Mao R, Chen M. Optimizing biologic treatment in IBD: Objective measures, but when, how and how often? BMC Gastroenterol. 2015; 15:178. https://doi.org/10.1186/s12876-015-0408-x
  • Coelho MR, Romi MD, Ferreira DM, Zaltman C, Soares-Mota M. The use of curcumin as a complementary therapy in ulcerative colitis: A systematic review of randomized controlled clinical trials. Nutrients. 2020; 12(8):2296. https://doi.org/10.3390/nu12082296
  • Triantafyllidi A, Xanthos T, Papalois A, Triantafillidis JK. Herbal and plant therapy in patients with inflammatory bowel disease. Ann Gastroenterol. 2015; 28(2):210-220. PMID: 25830661. PMCID: PMC4367210.
  • Aggarwal B, Prasad S, Reuter S, Kannappan R, Yadav V, Park B, et al. Identification of novel anti-inflammatory agents from Ayurvedic medicine for prevention of chronic diseases: “reverse pharmacology” and “bedside to bench” approach. Curr Drug Targets. 2011; 12(11):1595-653. https://doi.org/10.2174/138945011798109464
  • Khanal H, Krishniya K, Joshi RK. Ayurvedic perspective of Ulcerative colitis and its management. World J Pharm Res. 2020; 9(9):461-78. https://doi.org/10.20959/wjpr20209-18383
  • Pooja BA, Bhatted S. Ayurvedic management of Pravahika- A case report. Ayu. 2015; 36(4):410-12. https://doi.org/10.4103/0974-8520.190701
  • Patange GP, Giri SR, Kharat JS. Crohn’s disease: A review based on Ayurveda and Modern perspective. World J Pharm Res. 2019; 8(10):1638-45. https://doi.org/10.20959/wjpr201910-15616
  • Gopalapillai KG (editor). Chikitsamanjari. Part I (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 1/197-8.
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 51/30-6.
  • Sreeman Namboodiri D (editor). Yogamrutham (Malayalam). Alappuzha: Vidyarambham Publishers. 2014; 1/79-80.
  • Ramavarier Kaikulangara. Arogyakalpadrumam (Malayalam). Thrissur: Sahithi Books. 2011; 19/19-20.
  • Wenzl HH. Diarrhoea in chronic inflammatory bowel diseases. Gastroenterology Clin North Am. 2012; 41(3):651-75. https://doi.org/10.1016/j.gtc.2012.06.006
  • Anbazhagan AN, Priyamvada S, Alrefai WA, Dudeja PK. Pathophysiology of IBD associated diarrhoea. Tissue barriers. 2018; 6(2):e1463897. https://doi.org/10.1080/21688370.2018.1463897
  • Ralston SH, Penman ID, Strachan MW, Hobson R, Editors. Davidson’s Principles and Practice of Medicine E-Book. Elsevier Health Sciences. 2018; 817.
  • Szigethy E. Pain management in patients with inflammatory bowel disease. Gastroenterol Hepatol (NY). 2018; 14(1):53-6. PMID: 29491764.
  • Ribaldone DG, Brigo S, Mangia M, Saracco GM, Astegiano M, Pellicano R. Oral manifestations of inflammatory bowel disease and the role of non-invasive surrogate markers of disease activity. Medicines (Basel). 2020; 7(6):33. https://doi.org/10.3390/medicines7060033
  • Elahi M, Telkabadi M, Samadi V, Vakili H. Association of oral manifestations with ulcerative colitis. Gastroenterol Hepatol Bed Bench. 2012; 5(3):155-60. PMID: 24834217.
  • Chad T, Brown J. Chronic cough in a patient with stable ulcerative colitis: a rare but important extraintestinal manifestation of inflammatory bowel disease. BMJ Case Rep. 2019; 12(1):bcr-2018-227066. https://doi.org/10.1136/bcr-2018-227066
  • Gordon M, Sinopoulou V, Iheozor-Ejiofor Z, Iqbal T, Allen P, Hoque S, et al. Interventions for treating iron deficiency anaemia in inflammatory bowel disease. Cochrane Database of Syst Rev. 2021; 1(1):CD013529. https://doi.org/10.1002/14651858.CD013529
  • Gopalapillai KG (editor). Chikitsamanjari. Part I (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 1/200.
  • Bindu KK, Joshi Mrudula Vinayak. Critical study on Chikitsamanjari with special reference to regional contribution to the therapeutic tradition of Ayurveda. Pune: Tilak Maharashtra Vidyapeeth. 2019. http://hdl.handle.net/10603/312377
  • Pallie MS, Perera PK, Kumarasinghe N, Arawwawala M, Goonasekara CL. Ethnopharmacological use and biological activities of Tragia involucrata L. Evidence-Based Complementary and Alternat Med. 2020; 8848676. https://doi.org/10.1155/2020/8848676
  • Gobalakrishnan R, Kulandaivelu M, Bhuvaneswari R, Kandavel D, Kannan L. Screening of wild plant species for antibacterial activity and phytochemical analysis of Tragia involucrata L. J Pharm Anal. 2013; 3(6):460-5. https://doi.org/10.1016/j.jpha.2013.07.001
  • Velu V, Banerjee S, Radhakrishnan V, Gupta G, Chellappan DK, Fuloria NK, et al. Identification of Phytoconstituents of Tragia Involucrata leaf Extracts and Evaluate their Correlation with Anti-inflammatory and Antioxidant Properties. Antiinflamm Antiallergy Agents Med Chem. 2021; 20(3):308-15. https://doi.org/10.2174/1871523020666210126144506
  • Islam MS, Sana S, Haque ME, Rahman SMM, Samad A, Al Noman A, et al. Methanol, ethyl acetate and n-hexane extracts of Tragia involucrata L. leaves exhibit anxiolytic, sedative and analgesic activity in Swiss albino mice. Heliyon. 2021; 7(1):e05814. https://doi.org/10.1016/j.heliyon.2020.e05814
  • Dhara AK, Pal S, Nag Chaudhuri AK. Psychopharmacological studies on Tragia involucrata root extract. Phytother Res. 2002; 16(4):326-30. https://doi.org/10.1002/ptr.891
  • Sarkar PK, Mukhopadhyay CD. Mechanistic insights from the review and evaluation of ayurvedic herbal medicines for the prevention and management of COVID-19 patients. J Herb Med. 2022; 32:100554. https://doi.org/10.1016/j.hermed.2022.100554
  • Liu S, Li Q, Liu F, Cao H, Liu J, Shan J, et al. Uncovering the mechanism of curcuma in the treatment of Ulcerative colitis based on network pharmacology, molecular docking technology, and experiment verification. Evid Based Complement Alternat Med. 2021; 6629761. https://doi.org/10.1155/2021/6629761
  • Chandan S, Mohan BP, Chandan OC, Ahmad R, Challa A, Tummala H, et al. Curcumin use in ulcerative colitis: Is it ready for prime time? A systematic review and meta-analysis of clinical trials. Ann Gastroenterol. 2020; 33(1):53-58. https://doi.org/10.20524/aog.2019.0439
  • Karthikeyan A, Young KN, Moniruzzaman M, Beyene AM, Do K, Kalaiselvi S, et al. Curcumin and its modified formulations on Inflammatory Bowel Disease (IBD): The story so far and future outlook. Pharmaceutics. 2021; 13(4):484. https://doi.org/10.3390/pharmaceutics13040484
  • Coelho MR, Romi MD, Ferreira DMTP, Zaltman C, Soares-Mota M. The use of curcumin as a complementary therapy in Ulcerative colitis: A systematic review of randomized controlled clinical trials. Nutrients. 2020; 12(8):2296. https://doi.org/10.3390/nu12082296
  • Basu S, Hazra B. Evaluation of nitric oxide scavenging activity, in vitro and ex vivo, of selected medicinal plants traditionally used in inflammatory diseases. Phytother Res. 2006; 20(10):896-900. https://doi.org/10.1002/ptr.1971
  • Gopalapillai KG (editor). Chikitsamanjari. Part I (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 1/201.
  • Umamaheswari M, Asokkumar K, Rathidevi R, Sivashanmugam AT, Subhadradevi V, Ravi TK. Antiulcer and in vitro antioxidant activities of Jasminum grandiflorum L. J Ethnopharmacol. 2007; 110(3):464-70. https://doi.org/10.1016/j.jep.2006.10.017
  • El-Shiekh RA, Hussein D, Atta AH, Mounier SM, Mousa Shiekh MR, Abdel-Sattar E. Anti-inflammatory activity of Jasminum grandiflorum L. subsp. floribundum (Oleaceae) in inflammatory bowel disease and arthritis models. Biomed Pharmacother. 2021; 140:111770. https://doi.org/10.1016/j.biopha.2021.111770
  • Mortazavi H, Mashhadiabbas F, Mortazavi SAR, Rezaeifar K, Farhangi M. Formulation of a Jasmine Grandiflorum containing mucoadhesive and evaluation of its healing effect on oral biopsy ulcers. Clin Oral Investig. 2020; 24(4):1591-7. https://doi.org/10.1007/s00784-019-03171-w
  • Wangensteen H, Klarpås L, Alamgir M, Samuelsen AB, Malterud KE. Can scientific evidence support using Bangladeshi traditional medicinal plants in the treatment of diarrhoea? A review on seven plants. Nutrients. 2013; 5(5):1757-800. https://doi.org/10.3390/nu5051757
  • Maniyar Y, Bhixavatimath P, Agashikar NV. Antidiarrhoeal activity of flowers of Ixora Coccinea Linn. in rats. Journal of Ayurveda and Integrative Medicine. 2010; 1(4):287-91. https://doi.org/10.4103/0975-9476.74422
  • Adnan MS, Al-Amin MM, Uddin MM, Shohel M, Bhattacharjee R, Hannan JM, et al. Analgesic, anti-inflammatory and antipyretic effects of Ixora coccinea. J Basic Clin Physiol and Pharmacol. 2014; 25(4):423-8. https://doi.org/10.1515/jbcpp-2013-0125
  • Mukherjee S, Koley H, Barman S, Mitra S, Datta S, Ghosh S, et al. Oxalis corniculata (Oxalidaceae) leaf extract exerts in vitro antimicrobial and in vivo anticolonizing activities against Shigella dysenteriae 1 (NT4907) and Shigella flexneri 2a (2457T) in induced diarrhoea in suckling mice. J Med Food. 2013; 16(9):801-9. https://doi.org/10.1089/jmf.2012.2710
  • Kumar A, Agarwal K, Maurya AK, Shanker K, Bushra U, Tandon S, et al. Pharmacological and phytochemical evaluation of Ocimum sanctum root extracts for its anti-inflammatory, analgesic and antipyretic activities. Pharmacogn Mag. 2015; 11(1):S217-24. https://doi.org/10.4103/0973-1296.157743
  • Kamyab AA, Eshraghian A. Anti-Inflammatory, gastrointestinal and hepatoprotective effects of Ocimum sanctum Linn: an ancient remedy with new application. Inflamm Allergy Drug Targets. 2013; 12(6):378-84. https://doi.org/10.2174/187152811266131125110017
  • Lee J, Choi HS, Lee J, Park J, Kim SB, Shin MS, et al. Preparation of herbal formulation for inflammatory bowel disease based on In Vitro screening and In Vivo evaluation in a mouse model of experimental colitis. Molecules. 2019; 24(3):464. https://doi.org/10.3390/molecules24030464
  • Lal UR, Singh IP. Review and implications of traditional indian medicine for inflammatory bowel disease. Translational Studies on Inflammation. 2019. https://doi.org/10.5772/intechopen.89465
  • Gopalapillai KG (editor). Chikitsamanjari. Part I (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 1/202.
  • Sahoo HB, Sahoo SK, Sarangi SP, Sagar R, Kori ML. Anti-diarrhoeal investigation from aqueous extract of Cuminum cyminum Linn. Seed in Albino rats. Pharmacognosy Res. 2014; 6(3):204-9. https://doi.org/10.4103/0974-8490.132596
  • Deshmukh CD, Veeresh B, Pawar AT. Protective effect of Emblica officinalis fruit extract on acetic acid induced colitis in rats. J Herb Med Toxicol. 2010; 4(2). https://doi.org/10.3923/rjmp.2010.141.148
  • Kostoff RN, Briggs MB, Shores DR. Treatment repurposing for inflammatory bowel disease using literature-related discovery and innovation. World J Gastroenterol. 2020; 26(33):4889-4899. https://doi.org/10.3748/wjg.v26.i33.4889
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 51/30.
  • Seo JY, Lee C, Hwang SW, Chun J, Im JP, Kim JS. Nimbolide inhibits nuclear factor-КB pathway in intestinal epithelial cells and macrophages and alleviates experimental colitis in mice. Phytother Res. 2016; 30(10):1605-14. https://doi.org/10.1002/ptr.5657
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 51/31-2.
  • Li H, Chen X, Liu J, Chen M, Huang M, Huang G, et al. Ethanol extract of Centella asiatica alleviated dextran sulfate sodium-induced colitis: Restoration on mucosa barrier and gut microbiota homeostasis. J Ethnopharmacol. 2021; 267:113445. https://doi.org/10.1016/j.jep.2020.113445
  • Yun X, Fang Y, Lv C, Qiao S, Tao Y, Dai Y, et al. Inhibition of the activation of γδT17 cells through PPARγ-PTEN/Akt/GSK3β/NFAT pathway contributes to the anti-colitis effect of madecassic acid. Cell Death Dis. 2020; 11(9):752. https://doi.org/10.1038/s41419-020-02969-x
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series. 1934; 51/34.
  • Zulaikhah ST. Health benefits of tender coconut water (TCW). Int J Pharm Sci Res. 2019; 10(2):474-80.
  • Fu L, Pei D, Yu M, Shang H, Si JG, Zhang HW, et al. New phenolic acids from the whole herb of Elephantopus scaber Linn. and their anti-inflammatory activity. Nat Prod Res. 2021; 35(21):3667-74. https://doi.org/10.1080/14786419.2020.1723086
  • Hiradeve SM, Rangari VD. A review on pharmacology and toxicology of Elephantopus scaber Linn. Nat Prod Res. 2014; 28(11):819-30. https://doi.org/10.1080/14786419.2014.883394
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series; 1934; 51/35.
  • Yang Y, Wang S, Bao YR, Li TJ, Yang GL, Chang X, et al. Anti-ulcer effect and potential mechanism of licoflavone by regulating inflammation mediators and amino acid metabolism. J Ethnopharmacol. 2017; 199:175-182. https://doi.org/10.1016/j.jep.2017.01.053
  • Murugan SK, Bethapudi B, Raghunandhakumar S, Purusothaman D, Nithyanantham M, Mundkinajeddu D, et al. A flavonoid rich standardized extract of Glycyrrhiza glabra protects intestinal epithelial barrier function and regulates the tight-junction proteins expression. BMC Complement Med Ther. 2022; 22(1):38. https://doi.org/10.1186/s12906-021-03500-1
  • Padumadasa C, Dharmadana D, Abeysekera A, et al. In vitro antioxidant, anti-inflammatory and anticancer activities of ethyl acetate soluble proanthocyanidins of the inflorescence of Cocos nucifera L. BMC Complement Altern Med. 2016; 16:345. https://doi.org/10.1186/s12906-016-1335-2
  • Chithra MA, Ijinu TP, Kharkwal H, et al. Phenolic rich Cocos nucifera inflorescence extract ameliorates inflammatory responses in LPS-stimulated RAW264.7 macrophages and toxin-induced murine models. Inflammopharmacol. 2020; 28:1073-89. https://doi.org/10.1007/s10787-019-00620-6
  • Gopalapillai KG (editor). Chikitsamanjari. Part II (Malayalam). Trivandrum: Sree Chitra Ayurveda Series.1934; 5/36.
  • Bhattacharya S, Banerjee D, Bauri AK, Chattopadhyay S, Bandyopadhyay SK. Healing property of the Piper betel phenol, allylpyrocatechol against indomethacin-induced stomach ulceration and mechanism of action. World J Gastroenterol. 2007; 13(27):3705-13. https://doi.org/10.3748/wjg.v13.i27.3705
  • Nayaka NMDMW, Sasadara MMV, Sanjaya DA, Yuda PESK, Dewi NLKAA, Cahyaningsih E, et al. Piper betle (L): Recent review of antibacterial and antifungal properties, safety profiles, and commercial applications. Molecules. 2021; 26(8):2321. https://doi.org/10.3390/molecules26082321
  • Fazal F, Mane PP, Rai MP, Thilakchand KR, Bhat HP, Kamble PS, et al. The phytochemistry, traditional uses and pharmacology of Piper Betel. linn (Betel Leaf): A pan-asiatic medicinal plant. Chin J Integr Med. 2014. https://doi.org/10.1007/s11655-013-1334-1
  • Shine VJ, Latha PG, Shyamal S, Suja SR, Anuja GI, Sini S, et al. Gastric antisecretory and antiulcer activities of Cyclea peltata (Lam.) Hook. f. and Thoms. in rats. J Ethnopharmacol. 2009; 125(2):350-5. https://doi.org/10.1016/j.jep.2009.04.039
  • Singh SG, Nishteswar K, Patel BR, Nariya M. Comparative antipyretic and analgesic activities of Cissampelos pareira Linn. and Cyclea peltata (Lam.) Hook. F. and Thomas. Ayu. 2016; 37(1):62-6. https://doi.org/10.4103/ayu.AYU_208_14
  • Shine VJ, Anuja GI, Suja SR, Raj G, Latha PG. Bioassay guided fractionation of Cyclea peltata using in vitro RAW 264.7 cell culture, antioxidant assays and isolation of bioactive compound tetrandrine. J Ayurveda Integr Med. 2020; 11(3):281-6. https://doi.org/10.1016/j.jaim.2018.05.009
  • Ibrahim B, Sowemimo A, van Rooyen A, Van de Venter M. Antiinflammatory, analgesic and anti-oxidant activities of Cyathula prostrata (Linn.) Blume (Amaranthaceae). J Ethnopharmacol. 2012; 141(1):282-9. https://doi.org/10.1016/j.jep.2012.02.032
  • Labanski A, Langhorst J, Engler H, Elsenbruch S. Stress and the brain-gut axis in functional and chronic-inflammatory gastrointestinal diseases: A transdisciplinary challenge. Psychoneuroendocrinology. 2020; 111:104501. https://doi.org/10.1016/j.psyneuen.2019.104501
  • Sun Y, Li L, Xie R, Wang B, Jiang K, Cao H. Stress triggers flare of inflammatory bowel disease in children and adults. Front Pediatr. 2019; 7:432. https://doi.org/10.3389/fped.2019.00432
  • Feagan BG, Lémann M, Befrits R, Connell W, D’Haens G, Ghosh S, et al. Recommendations for the treatment of Crohn’s disease with tumor necrosis factor antagonists: An expert consensus report. Inflamm Bowel Dis. 2012; 18(1):152-60. https://doi.org/10.1002/ibd.21870
  • Payyappallimana U, Venkatasubramanian P. Exploring ayurvedic knowledge on food and health for providing innovative solutions to contemporary healthcare. Front Public Health. 2016; 4:57. https://doi.org/10.3389/fpubh.2016.00057

Abstract Views: 180

PDF Views: 92




  • Traditional Kerala Ayurvedic Formulations as a Guideline for the Management of Inflammatory Bowel Disease (IBD) – A Review

Abstract Views: 180  |  PDF Views: 92

Authors

K. K. Bindu
Department of Rachana Sareera, Vaidyaratnam P. S. Varier Ayurveda College, Malappuram - 676501, Kerala, India
B. Gopika Menon
Ambady, Kottakkal, Malappuram - 676503, Kerala, India

Abstract


Inflammatory Bowel Disease (IBD) refers to conditions characterized by the presence of idiopathic intestinal inflammation. The main challenge in the management of IBD is the adverse effects associated with the currently available drugs. Also, not all patients respond completely to the conventional treatments of IBD and its efficacy wanes over time. Thus, the use of complementary and alternative medicine is increasing, as a safer alternative. Certain traditional Ayurveda literature of Kerala describe a condition termed ‘jatara vrana’ (ulcer of the gastrointestinal tract), which, along with its associated clinical features, resembles IBD. Due to the similarity in pathology and presenting features, the line of treatment adopted in the management of jatara vrana may be extended to that of IBD. A close observation of the formulations described in the management of jataravrana described in Chikitsamanjari (a regional Ayurvedic literature of Kerala) reveals that in each formulation individual drugs with varying mechanisms of action, including anti-ulcerative (vranaropana), anti-diarrheal (atisaraghna), anti-inflammatory (sophahara), anti-pyretic (jwarahara) or analgesic (vedanahara) activities, have been logically selected and combined. The active components of some of these drugs have been proven to have various effects in IBD pathology. Though these treatment principles have been used traditionally and Ayurvedic management is promising in many experimental models, it is essential to supplement it with well-designed clinical trials to define the exact role of each of these formulations in the prevention or management of IBD

Keywords


Chikitsamanjari, Inflammatory Bowel Disease (IBD), Jataravrana, Kerala Ayurveda Literature.

References





DOI: https://doi.org/10.18311/jnr%2F2023%2F31395