Author: Dr. Vikram Chauhan

Grahani and Agni (the digestive–fire) are having mutual relationship which has been described as Adhara-Adheya-Sambandha in Ayurvedic system of medicine. Grahani has been mentioned as an Agni Adhishthana (malfunctioning of the digestive-fire) by a majority of the Ayurvedic physicians. Mandagni (low the digestive–fire) is the root cause of Ama (enteric toxins). Ama is the critical factor for the manifestation of the majority of the diseases. Among these diseases, Grahani is the prime- disease of the digestive tract and patients are often seen in clinical practice.

The ‘Small’ Intestine has been mentioned as Grahani in Ayurvedic system of medicine. Literally, grahain menas ‘that holds’. The small intestine is a long organ and consisting of three main layers

1. Mucosal – The innermost layer of the grahani (small intestine) is a complex but dynamic site of identification of six tastes (diet-chemistry). Small intestine contains hairlike structures, known as villi, which pushes the food particles towards the deeper layers.
2. Muscular – The muscular layer pefros action through the process of peristalsis (alternating contracting and relaxation). For this apparent reason, grahani has been classified mostly as mamsa…muscle tissue in Ayurveda.
3. Serosal – The function of the serosal layer is to interface with the general circulation so as to perform the assimilation of micro and macronutrients.

Definition

Grahani defines a diseased condition, in which the integrity and the function of the small intestine (known as grahani in Sanskrit) is compromised. Grahani is the principal seat of agni… the digesrive fire. Normally, grahani holds up the meals, until it is digested and releases it from the site only, after digestion is over. But when the function of grahani is compromised due to weakness in the digestive fire, it releases the ingested material even in undigested conditions.

Cause

In Ayurveda, first part of the small intestine is known as grahani (anatomically known as the duodenum). Most probably, the disease has got name from grahani as it the site of absorption of food. Some Ayurvedic texts have called it as sangrahani. According to Ayurvedic concept, irregular dietary habits and continuous exposure to stress are contributing factors of the disease. Today we call this disorder as malabsorption as a process of absorption is hindered in the small intestine. According to modern medicine, the exact cause of the disease is not known.

Ayurveda Describes Four Different Types of Grahani

1. Vata grahani (Malabsorption caused by vitiation of the biological air) – In vata grahani, constipation is the predominant symptom.
2. Pitta grahani (Malabsorption caused by vitiation of the biological fire) – In pitta grahani, diarrhea is the predominant symptom.
3. Kapha grahani (Malabsorption caused by vitiation of the biological water) – In kapha grahani, dysentery is the predominant symptom.
4. Tridosha grahani – In this case, all the three biological humours are involved.

Other texts have mentioned two varieties of grahani accrual (samgraha grahani) (accrual malabsorption) and an incurable type called ghatiyanthra grahani (tympanitis predominant malabsorption). This has been described as sangrahini.

Signs and Symptoms

The clinical features encountered in malabsorption are

• Abdominal pain
• Anaemia
• Dehydration
• Depression
• Diarrhoea with fatty stools
• Lethargy
• Loss of weight

The worst part of grahani is that in later stages, the human body refuses to absorb carbohydrates and minerals. Here, the disease tends to be chronic.

Remedies

Grahani is considered under eight major diseases. Grahani  is hard to diagnose and difficult to treat.

• Planet Ayurveda’s Agnitundi vati and Digestion Support, an proprietary Ayurvedic medicine, are clinically-tested for improving digestion, detoxfying ama and improving other symptoms associated with grahani.
• Planet Ayurveda’s Kumari Saar in doses of Kumari Saar 3 tbsp should be taken twice daily in the morning and evening, with equal water. Kumari (Aloe vera), the major ingredient in the formulation is effective in grahni caused by vitiation of the the biological fire..pitta.
• Planet Ayurveda’s Chitrkadi vati (One tablet, twice a day with lukewarm water) is very efficacious in promoting appetite and restoring the digestion.
• Half teaspoonful (2.5 gm) of Planet Ayurveda’s Belgiri Powder thrice a day is prescribed with lukewarm water for diarrhoea associated with grahani caused by vitiation of the the biological fire pitta.

Prognosis of Grahani

According to Ayurveda

• Grahani is curable if occurring in children
• Grahani is difficult if occurring in middle age

Grahani is incurable if occurring in older patients

• Samgraha grahani (accrual malabsorption) is difficult to cure.
• Ghatiyanthra grahani (tympanitis predominant malabsorption) is incurable.

Precautions or Diet

Dietary restriction has its own importance in treating malabsorption. Buttermilk is the mainstay of the treatment. Salt, spice and water should be avoided. Sleeping for one hour during the day is beneficial.

Conclusion

Although Grahani is predominately a pitta disease, one must take care for other biological humours vata and kapha. In addition, addressing the mind/body relationship is of prime importance along with health lifestyle and dietary choices.