A CASE STUDY ON VIBANDHA W.S.R. TO CONSTIPATION IN CHILDREN

About Author

Correspondence Address

Balrog Department ,Shri Ayurved Mahavidyalaya, Nagpur
Contact No. : 9325794225, Email : d_mahalle@rediffmail.com

Date of Acceptance : 28 Mar 2025

Date of Publication : 30 Mar 2025

Article ID : SD-IJAY_126

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3106

Abstract

Vibandha is a common condition seen in childhood, which is one of the main reasons for increased parental concerns. It occurs as a result of the obstruction happening to the functioning of Apana Vayu. It is not only an independent disease but also a complication of some diseases and is responsible for both physical and psychological morbidity and poor quality of life. It is defined as infrequent passage of stool with pain and difficulty, or delay in defecation. Management of constipation revolves around correcting the underlying cause, dietary modifications, and behavioral training.

A 12-year-old female patient was admitted to the IPD of Kaumarbhritya , Shri Ayurved College and Hospital Nagpur , with complaints of difficulty in passing motion regularly associated with the passage of hard stools once every 8 to 10 days. Abdominal pain on & off for 3-4 months, bloating, burning sensation in the body, headache, loss of appetite, and general weakness. These complaints have been persisting for the past 5-6 months. This condition can be understood as Vibandha. After a thorough clinical examination and laboratory evaluation, Panchakarma treatment, including Abhyanga, Swedan, and Matra Basti, was started with suitable internal medicines. There was significant improvement in the condition of the patient. Later, she was discharged with medicines and dietary advice to be continued at home.

KEY WORDS:-  Vibandha, Constipation, Basti, Apana vayu.

Introduction

Constipation is a symptom of an underlying disorder seen in approximately 10 to 25% of all patients presenting in a pediatric gastroenterology clinic. A normal bowel pattern is considered a sign of good health . Constipation in children is common, often chronic (persisting for more than 2 weeks), and associated with consequences such as chronic abdominal pain, fecal soiling, voiding dysfunction, psychosocial stress, and behavioral problems resulting in poor quality of life. Constipation is related to vibandha in Ayurveda. The Ayurvedic samhitas do not explicitly and directly describe the illness known as vibandha. In most Annavaha and Purishvaha Srotovikriti, it is seen as a symptom.

Constipation is defined as infrequent defecation, painful defecation, or both; in most cases, stools are too large, too hard, not frequent enough, and/or painful to pass. The North American Society of Gastroenterology, Hepatology, and Nutrition (NASPGHAN) defines constipation as "a delay or difficulty in defecation, present for 2 weeks or more, and sufficient to cause significant distress to the patient."

According to Rome III definition of chronic constipation, symptoms must include at least two of the following for the past two months:

► Two or lewer defecations per week <2/wk

► At least 1 episode of fecal incontinence per week in a toilet-trained child

►History of excessive stool retention or retentive posturing

►History of painful or hard bowel movements

►Presence of large fecal mass in the rectum

►History of large diameter stools that may obstruct

According to Ayurveda, the main causes of constipation include Purishaja Vegadharana (with holding of stool, Children nowadays are spending too much time on devices like smart phones and televisions, which causes them to neglect their daily hygiene routines.), Akal or Asamay purish tyag , a lack of water consumption and a lack of fiber-rich foods, eating fast food, which is typically composed of maize flour eg: eg:pizza, burger, momos etc3 . Metabolic or endocrine abnormality- Hypothyroidism, Hypercalcemia, Hypokalaemia, Diabetic mellitus, Vit. D intoxication also causes constipation.

Ayurveda offers wonderful treatment modalities for vibandha with effective results and minimal to nil side-effect.

Discussion

laxatives, which are generally used in Constipation, become habitual after some duration and only symptomatic relief.

Moreover, these medicines never alter pathogenesis of disease. So, it is a need of hour to search effective, safe & alternative formulations in Ayurveda, which can completely break the pathogenesis of malavshtambh.

As per Ayurveda, Vata Dosha is the main factor involved in this condition. Therefore, the prime treatment recommended by Ancient Acharyas is Snigdha Ahar, Anulomak dravya , Dipak pachak dravya and basti kriya . Apana vata is the primary factor in constipation in children. Externally Abhyanga and Nadi sweda was done for 30 days. Abhyanga being a Bahya Snehana Chikitsa along with Swedana did the Vataharana. Bala  taila was selected for Abhyanga as it is Balya as well as Brumhana by its nature. Since Vata is the main Prakupita dosha here, Basthi chikitsa was planned in order to provide Samyak Anulomana and Matra basthi was administered with Dhanvantar taila for 30 days  and alternate  Anuwasan Basti  with Bala Taila +saidhav +madhu and Niruh with Erandmuladi  kwath +erandmul churnakalka+ Bala Taila +saindhav +madhu given for 30 days .

Medicine with properties of Ushna, Madhur, and Snigdha administered to patient.  Ushana guna 4 act as dilating of Srotas, alimentary canal, increase the secretion of glands which generats spasm on sphincteric muscles and helps feces remove from obstructive path. these drugs improve digestions by stimulating Pitta and corrects metabolic activities inside the body. Madhur guna 5 of drug provide strength to the muscles. Because Prthvi and Jala Mahabhuta predominate in medications with Madhura Rasa, these compounds might be characterized as having an unctuous quality and moistening the body's channels. Snigdha Guna 6 provides the viscosity necessary for easy expulsion as well as softening and lubricating the feces in the alimentary canal.

Internally Laghusutashekhar ras , Paripathadi kwath ,Shankh vati ,Hingwashtak churna , Lavabhaskar churna ,Cap mishrak sneh, Cap Murchhit erand tail , Abhayarishta , Panchkolasav + kumariasav , Aragwadh + Panchsakar +Esabgol +Yashtimadhu + Erandmul churna  was administered.

7Hingwashtak churna is a blend of Trikatu (Shunthi, Pippali, and Maricha), Ajmoda /Yavani, Saindhav Lavana, Jeeraka, Krishna Jeeraka and Hingu. Sunthi due to its Katu Rasa and Ushna Veerya property increases the Agni (Digestive fire) thereby relieves Mandagni (Low fire). Sunthi is known to stimulate digestion beneficially.The Sunthi Churna due to its Katu Rasa and Agnidiptikara Karma does the Agnidipana and due to Katu Rasa and Tikshna Guna does the Pachana of Amadosha. Due to Katu Rasa and Laghu, Tikshna Guna it causes Srotoshodhana. 8 Maricha by its Ushna and Katu Vipaka increases Agni; by Tikhna Ushna Guna expels the vitiated Doshas which are in sanchaya avastha (accumulated stage). Pramathi Guna of Maricha helps in Srotoshodhana It is useful for Agnimandya, Ajeerna, Shula and Adhyamana.Pippali increases Agni by its Deepana action .Saindhav Lavana is rock salt, which acts as a catalyst during the digestive process.Shuddha Hingu is one of the well-known herbs for the digestion and relieves the gases produced during the digestive process.Ingredients like Shankha Bhasma, Hingu, Kshara, lavanas, Trikatu, Vatsanabha, Shuddha Parada and Shuddha Gandhaka are found in majority of the Shankha Vati. Ingredients like hing (asafoetida) and Ajwain (carom seeds) enhance Agni (digestive fire) and clear digestive blockages, preventing Ama (toxins) accumulation that can cause constipation. Lavana such as  Black salt and rock salt act as mild laxatives, drawing water into the intestines, softening stools, and promoting peristalsis.The Ushna (hot) nature of Shankh Vati stimulates digestion, balances Vata (which is responsible for dry, hard stools), and promotes intestinal motility.

The Katu Vipaka of Shankh Vati helps in scraping off Ama (toxic undigested material), promoting a clear digestive tract.Ingredients of Paripathadi kwath   like Parpat (Fumaria indica) and Guduchi (Tinospora cordifolia) by its tikta ras help in removing Ama (toxins) and clearing the digestive tract. Kashaya Rasa Herbs like Musta (Cyperus rotundus) absorb excess fluid, regulate bowel function, and support intestinal health. Mishrak sneh capsule contains goghrit, Erand tail, til tail and shyamadi gan dravya. erand tail by its Madhur ras helps in lubrication of intestine , tikta, katu ras stimulate digestion and clear Ama  &  Ushna virya of erand tail helps in Anuloman of Apan vayu. madhur vipak provide gentle laxative effect without irritaion. Erand tail is best Virechan dravya.

Abhayarishta is formulation used in chronic constipation, it helps in Vatanuloman by haritaki, ajawain and shunthi. It helps in stimulation of Agni by Sunthi, Saunf and Ajwain. Dhataki and jaggery aid fermentation, promotes gut friendly bacteria thus provide probiotic effect.

Conclusion

Vibandha can be understood as a Swatantra vyadhi or as an Upadrava of other dis-eases. Treatment of Vibandha is mainly focused on the Anulomona of Apana vata which results in Samyak mala pravrutti. Hence in this case Vibandha is diagnosed as a Swatantra vyadhi and Anulomana and Brumhana chikitsa were adopted internally and externally. Along with Chikitsa, proper dietary plan with fibre rich diet and adequate intake of lukewarm water were also advised.Significant reduction in the complaints was observed after 60 days of treatment. Even after completion of treatment since 6 months completed no any complaints repeated with accompanied of life style change & diet plan.

References

1. A Parthasarathy , IAP textbook of pediatrics chapter 9.7 constipation in children ,6th edition  2016 pg no. 613 .
2. A Parthasarathy , IAP textbook of pediatrics chapter 9.7 constipation in children ,6th edition  2016 pg no. 613.
3.  Charak samhita edited by pt. kashinatha shastri and dr. gorakhanatha chaturvedi sutrasthan chapter 07 reprint edition 2016, chaukhamba bharti academy, page no.454.
4. Therapeutic significance of various rasa and guna of dravya: an ayurveda review dr. Ashwini Gajanan Wahile* 1, Dr. Ashish Kisanlal Chandak2 and Dr. Sandhyarani R. Agarkar.
5. Susruta samhita of maharshi susrut edited by ambika dutta shastri a.m.s. part 2 uttartantra chapter 56 reprint edition 2016, chaukhambha Sanskrit sansthan, page no. 532.  
6. Charak samhita edited by pt. kasinatha shastri and dr. gorakha natha chaturvedi sutrasthan chapter 30 reprint edition 2016, chaukhambha bharti academy, page no. 587.
7. Chemistry and Pharmacology of Ayurvedic medicinal plants Vd.M Sabnis Chaukhambha Amarnath Bharti Prakashan, Varanasi ed.1., 2006; p. no 403.
8.  Dravyaguna Sastram by Vaidya Na. Ha Joshi Sudha Ayurveda Pathyakrama 1960,Pg no.  275.