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

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