By Dr. Rita Khanna

Frequency of passing stool is known as diarrhea. Normally, ten litres of fluids reach the intestines from the food, drinking water, and from internal secretions of the stomach, liver, pancreas, and intestines, each day. However, when it is not re-absorbed, or if there is excessive secretion of fluid into the intestinal lumen (The lumen is the cavity where digested food passes through and from where nutrients are absorbed), the enlarged volume of fluid causes increased motility (Motility is a biological term which refers to the ability to move spontaneously and actively) of the intestinal wall and the unabsorbed material is passed out as watery, loose stool. There are two types of diarrhea- acute and chronic. Acute is a short term illness. Chronic is a long term symptom, lasting for weeks, months, or years, and may worsen or improve with changing seasonal conditions.

Symptoms

Food poisoning, overeating, simple indigestion, irritable colon syndrome (Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine), dysentery, colitis, and even cancer of the bowels.

Causes

1. Infections, toxins, poisons, and drugs

2. Psychogenic stress (mental or emotional stress) is also an important factor; it may be developed into an irritable bowel syndrome (IBS) later on in life.

Causes Of Chronic Diarrhea Can Be Classified As:

1. Gastric disturbances

2. Neoplasm (tumor; any new and abnormal growth)

3. Hepatobiliary disorders (diseases affect the liver plus the gallbladder, bile ducts or bile)

4. Pancreatic disorders

5. Small intestinal disturbances

6. Colonic disturbances

7. Rectal disease

8. Metabolic disorders (A metabolic disorder is a medical condition characterized by problems converting food to energy).

9. Drug-induced diseases

10. Post operative causes

Clinical Signs & Symptoms

Frequent loose motions, abdominal cramps and pains, mild to severe fever, vomiting, excessive thirst, and cramps in the legs are the most common symptoms in causing mild to severely acute diarrhea. In chronic diarrhea, along with frequent loose motions, other important associated findings may include:

• Weight loss

• Malabsorption (Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal (GI) tract)

• Arthritis

• Skin manifestations

• Fistula and sinus formation (Fistula and sinus formation may result from subcutaneous or submucosal abscesses from infected anal glands)

• Severe abdominal pain

• Nocturnal diarrhea (Diarrhea that occurs chiefly at night)

Along with clinical assessment of signs and symptoms, laboratory examination of fresh stool for blood, pus, amebae (A single-celled (protozoan) organism that constantly changes shape), and bacteria, such as staphylococci, salmonella, and claustridia, is usually indicated.

Management of Diarrhea

1. Restriction of solid food for 24 to 48 hours.

2. Bed rest.

3. Consumption of enough boiled water to replace lost fluids. In severe cases, parenteral fluid replacement (intravenous glucose or saline) may be instituted where there is a threat of dehydration, especially in children.

4. Application of heat to the abdomen.

5. Medicines can suppress intestinal motility (Intestinal motility disorders apply to abnormal intestinal contractions) and remove infection.

A mild bout of diarrhea is usually short lived and self-limiting. It may come at a time when we have eaten unwisely or in excess, or when digestion and thermo-regulation have been temporarily disturbed. It represents an attempt by the body to restore good health. It is wrong to suppress such a bout of simple diarrhea, with medicines which block the natural purifying reaction of the body. The best treatment is to simply rest, fast for one or two meals, and drink boiled water. As symptoms diminish, food can be recommenced, beginning with liquid broth or light khichari. Usually, this is enough to correct the situation.

However, if the diarrhea continues or worsens, or high fever, vomiting or dehydration supervene, it is an indication that a more severe acute infectious process is underway – possibly even typhoid or cholera. In this situation, a physician can make the diagnosis and prescribe a suitable antibiotic agent. A proper medical diagnosis is also the first step in the treatment of chronic diarrhea. This usually involves examination and culture of stool specimens in a pathological laboratory. Treatment can then be instituted according to the cause and site of origin of the disease.

Poor Digestive Power

One of the most common causes of chronic diarrhea is poor digestive power. This produces hypoacidity, flatulence, and indigestion, and is often the root cause of the low energy state, which results in dysentery and amebiasis (Amebiasis is an infection of the intestines caused by the parasite Entamoeba histolytica). In the long term, chronic mucus colitis may supervene and where there is major psycho-emotional stress involved, the disorder is known as ulcerative colitis (Ulcerative colitis is a form of inflammatory bowel disease). Yogasanas, Shatkriyas, and relaxation, play an important role in the treatment of colitis – in conjunction with dietary regulation, fasting, conventional chemotherapeutic drugs, and purification of the water supply.

Our Digestive System

The digestive system is made up of the digestive tract—a series of hollow organs joined in a long, twisting tube from the mouth to the anus—and other organs that help the body break down and absorb food. Organs that make up the digestive tract are: the mouth, esophagus, stomach, small intestine, large intestine-also called the colon- rectum and anus. Inside these hollow organs is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food. The digestive tract also contains a layer of smooth muscle that helps break down food and move it along the tract. Two “solid” digestive organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes called ducts. The gallbladder stores the liver’s digestive juices until they are needed in the intestine. Parts of the nervous and circulatory systems also play major roles in the digestive system.

Preventive Measures

Polluted water is the main cause of infective diarrhea. Therefore, water should be purified for drinking purposes. Most Indian villages generally depend on open well water or water from ponds, lakes or small rivers; sometimes, the only source of water is a pit dug in a dry river-bed.

Therefore, the following preventive measures should be taken to avoid infections.

1. Where there is no safe water supply, drinking water should be boiled.

2. Water should be chlorinated and purified with bleaching powder.

3. Open eatables from the shop should be avoided, at least in summers, when diarrhea is more prevalent.

4. Contamination, or infection of water, is commonly due to unsanitary toilet habits. Instead of using open grounds and roadsides, trench latrines should be prepared, and waste covered with a little soil.

5. Hands and feet should be washed well after defecation.

The Role of Yoga

• Many people think that Yoga is not very helpful in cases of acute or chronic diarrhea. Yogasanas and Pranayama are the best means of developing, and maintaining a strong digestive power, and thereby eliminating dysentery and colitis, as well as many skin diseases, menstrual disturbances, and liver problems.

• However, the correct application of Yoga can be very effective, especially in emotional cases, where relaxation techniques, such as Yoga-nidra, help to diminish emotional stimuli from the hypothalamus. This, in turn, reduces the hypermotility of the colon.

• Kunjal and Vyaghra Kriyas are other important practices for increasing digestive fire, and alleviating the troublesome symptoms of indigestion in the upper digestive tract.

• The Yogic Shatkarmas, or physical cleansing techniques, are an important means of improving a weak digestive capacity. The practice of Shankhaprakshalana involves drinking sixteen glasses of warm salt water to wash the entire alimentary canal.

Shankhaprakshalana, as well as cleaning and revitalizing the digestive tract, also has a reflex action on the hypothalamus, influencing the emotional processes and relieving disease stimuli. In the case of chronic amebiasis caused by E. hystolytica (Entamoeba histolytica is an anaerobic parasiticprotozoan, part of the genus Entamoeba), Shankhaprakshalana washes away all of the debris, and thick mucus, attached to the walls of the intestines. As a result, causative organisms lying in the folds of the mucosa are successfully eliminated. Inflammation in the sub-mucosal layer is also relieved, due to fomentation by the warm saline water. The inflammation then subsides, as E. hystolytica, remaining in the sub-mucosa, find their way to the surface of the bowel. If Shankhaprakshalana is then performed again later, all amoebae are eliminated from the colon. Thus, by following this simple procedure, a person can be completely cured of chronic amebiasis.

Recommended Practices

After Shankhaprakshalana has been performed, the following Asanas are recommended on a daily basis:

1. Preparatory Practices Part 1 & 2 (Read my article “Yogic Home Work”)

2. Vajrasana, Pawanmuktasana, Sarvangasana, Halasana, Bhujangasana, Shalabhasana, Paschimottanasana, Shashankasan, Matsyendrasana, Yog mudra, and Shavasana. These major Asanas should only be undertaken after pawanmuktasana Preparatory Practices is perfected.

3. Pranayamas are most useful in restoring depleted digestive capacity; particularly,

Omkar, Sheetali Sheetkari, Bhastrika (The Bellows Breath), Shivananda Pranayama (Full abdominal breathing in Shavasana) 15 to 20 minutes.

4. More advanced practices include:

Nadi- shodhana, with Uddiyana, Moola and Jalandhara Bandhas

5. Nauli Kriya.

For Acidity, Gas, Dyspepsia, Vomiting, Diarrhea, Constipation, Piles, Fissure – the following are a must do:

• Before food, Yoga-mudra, and Pawanmuktasana, for 5 to 10 minutes, (no hernia problem). In case of hernia, then first go for treatment. In that case, operation is the solution.

• After 6 to 8 weeks of operation, Pawanmuktasana can be done.

• After having food, Vajrasana, 15 to 20 minutes.

• Diet plan, according to the problem.

• Omkar, 5 to 10 minutes

• Sheetali & Sheetkari Pranayama, 10 to 15 times

• Shivananda Pranayama, 15 to 20 minutes

• Meditation, 15 minutes

• Take less medicine because it has side effects.

Dietary Recommendations

1. Avoid all heavy foods, particularly fried foods, which over tax the digestive system.

Avoid uncooked vegetables.

2. Simple boiled vegetables, and khichari, are ideal.

3. Avoid overeating. Take the evening meal around 5 p.m. Try to fix a regular time for meals, and do not take any snack foods in between.

4. If diarrhea is due to indigestion, take one light meal per day, and avoid dairy products. Rice and dahi (yoghurt) are useful when digestion is strong, but when this is not the case, the best preparation is whey.

5. Fasting is the most effective way to alleviate any exacerbation of symptoms.

Other Home Remedies

• An effective remedy, for diarrhea, is the use of buttermilk. It is the residual milk left after the fat has been removed from yogurt by churning. It helps overcome harmful intestinal flora and re-establishes the benign, or friendly, flora. The acid in the buttermilk also fights germs and bacteria.

• It may be taken, and mixed with a pinch of salt, three or four times a day.

• Carrot soup is another effective home remedy for diarrhea. It supplies water to combat dehydration, replenishes sodium, potassium, phosphorus, calcium, sulphur, and magnesium, supplies pectin and coats the intestine to allay inflammation. It checks the growth of harmful intestinal bacteria and prevents vomiting. One pound of carrot may be cooked in five ounces of water until it is soft. The pulp should be strained, and boiled water added, to make a quart. Three-quarter tablespoon of salt may be mixed. This soup should be given in small amounts to the patient every half an hour.

• The pomegranate has proved beneficial in the treatment of diarrhea, on account of its astringent properties. If the patient develops weakness, due to profuse and continuous purging, he should be given repeatedly about 50 ml. of pomegranate juice to drink. This will control the diarrhea.

• Mango seeds are also valuable in diarrhea. The seeds should be collected during the mango season, dried in the shade, and powdered, and kept stored for use as medicine when required. It should be given in doses of about one and a half gram, to two grams, with or without honey.

• Turmeric has proved another effective home remedy for diarrhea. It is a very useful intestinal antiseptic. It is also a gastric stimulant and a tonic. Turmeric rhizome, its juice or dry powder, are all very helpful in curing chronic diarrhea. In the form of dry powder, it may be taken in buttermilk or plain water.

• In case of diarrhea caused by indigestion, dry or fresh ginger is very useful. A piece of dry ginger is powdered, along with a crystal or rock salt. A quarter teaspoonful of this powder should be taken with a small piece of jaggery. It will bring quick relief, as ginger, being carminative, and aids digestion by stimulating the gastrointestinal tract.

• Starchy liquids, such as arrowroot water, barley water, rice gruel, and coconut water are highly beneficial in the treatment of diarrhea. They not only replace the fluid lost, but also bind the stools.

• Other home remedies include: bananas and garlic. Bananas contain pectin and encourage the growth of beneficial bacteria. Garlic is a powerful, effective, and harmless antibiotic. It aids digestion and routs parasites.

• The best water treatments for diarrhoea are the abdominal compress (at 60 o F), renewed every 15 to 20 minutes, and cold hip bath (40 o – 50 o F). If the patient is in pain, abdominal fomentations, for 15 minutes, should be administered every two hours.

AUM SHANTI

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Courtesy: Dr. Rita Khanna’s Yogashaastra Studio.

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Dr. Rita Khanna

Dr. Rita Khanna is a well-known name in the field of Yoga and Naturopathy. She was initiated into this discipline over 25 years ago by world famous Swami Adyatmananda of Sivananda Ashram in Rishikesh (India).

She believes firmly that Yoga is a scientific process, which helps us to lead a healthy and disease-free life. She is also actively involved in practicing alternative medicines like Naturopathy. Over the years, she has been successfully practicing these therapies and providing succour to several chronic and terminally ill patients through Yoga, Diet and Naturopathy. She is also imparting Yoga Teachers Training.

At present, Dr. Rita Khanna is running a Yoga Studio in Secunderabad (Hyderabad, India).