Summer Diarrhoea- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Loose stools or diarrhoea is rather a symptom than a disease. It can point out a number of diseases of gastrointestinal origin. In some rare conditions, it can be sign of serious underlying pathology like a carcinoma. Diarrhoea can happen to people of any age or gender irrespective of region or race. It can start as an acute problem or can be recurrent and chronic. In today’s world where people are having toxic diet habits, sedentary lifestyles and less idea about gut microbiota, loose stools are very common. It can happen even due to emotional stress like irritable bowel syndrome and can affect the person’s quality of life.

Human gut is very sensitive as the gut microbiota living in us. Even a small and unfavourable change in diet or environment can disturb the digestion and cause disease. Summer diarrhoea is a disease caused by extremely hot climate changes and the main symptom is frequent & uncontrolled diarrhoea.  Like in any other type of diarrhoea, it is very important to address the underlying cause, but symptomatic management is very important as it can be fatal due to dehydration & electrolyte imbalance in some people.

Signs & Symptoms

• Frequent passage of watery/sticky/loose stools with or without blood mixed with it
• Abdominal cramps or sudden colicky pains
• Vomissements
• Prostration of anus
• Tiredness
• Vertiges
• Anorexia,
• Gas trouble or abdominal discomforts like belching
• Loss of appetite
• Excessive thirst

Causes

• Most common cause is an infection. (virus, bacteria or a parasite)
• Indigestion
• Food allergies or intolerance like lactose intolerance
• Colite ulcéreuse
• Maladie de Crohn
• Irritable bowel disease
• Side effects of antibiotics or some diabetes medications

Physiopathologie

        Diarrhoea results from the disruption in the delicate balance between the absorptive and secretory processes within the bowel. It can be either osmotic or secretory. It is the reversal of the normal net absorptive status of water & electrolyte absorption to secretion. Such a derangement can be the result of either an osmotic force that acts in the lumen to drive water into the gut or the result of an active secretory state induced in the enterocytes. In the former case, diarrhoea is osmolar in nature, as is observed after the ingestion of nonabsorbable sugars such as lactulose or lactose in people with lactose malabsorption. Instead, in the typical active secretory state, enhanced anion secretion (mostly by the crypt cell compartment) is best exemplified by enterotoxin-­induced diarrhoea.

In osmotic diarrhoea, stool output is proportional to the intake of the unabsorbable substrate and is usually not massive; diarrheal stools promptly regress with discontinuation of the offending nutrient, and the stool ion gap is high, exceeding 100 mOsm/kg.

In secretory diarrhoea, the epithelial cells’ ion transport processes are turned into a state of active secretion. The most common cause of acute-onset secretory diarrhoea is a bacterial infection of the gut. Several mechanisms may be at work. After colonization, enteric pathogens may adhere to or invade the epithelium; they may produce enterotoxins (exotoxins that elicit secretion by increasing an intracellular second messenger) or cytotoxins. They may also trigger release of cytokines attracting inflammatory cells, which, in turn, contribute to the acti­vated secretion by inducing the release of agents such as prostaglandins or platelet-activating factor. Features of secretory diarrhoea include a high purg­ing rate, a lack of response to fasting, and a normal stool ion gap (i.e., 100 mOsm/kg or less), indicating that nutrient absorption is intact.

Diagnostic

• Complete blood tests
• Faecal examination
• Urine culture
• Fasting tests
• Hydrogen breath test
• Endoscopy
• Ultrasound
• Colonoscopy
• Sigmoidoscopy

Traitements

Acute-onset diarrhoea is usually self-limited. Management is generally supportive care.

Oral Rehydration therapy (ORT)

In most cases, the best option for treatment of acute-onset diarrhoea is the early use of oral rehydration therapy (ORT). Pharmacological treatment is rarely of any use, and antidiarrheal drugs are often harmful. Vaccines (e.g., rotavirus) can help increase resistance to infection. Antimicrobial and antiparasitic agents may be used to treat diarrhoea caused by specific organisms and/or specific clinical conditions. ORT is the cornerstone of treatment, especially for small intestine infections with a large volume of watery stool output. ORT with a glucose-based oral rehydration syndrome must be viewed as the safest, most physiologic, and most effec­tive way to provide rehydration and maintain hydration in children with acute diarrhoea worldwide so far, as recommended by the WHO. Not all commercial ORT formulas promote optimal absorption of electrolytes, water, and nutrients. The ideal solution has a low osmolarity (210-250) and a sodium content of 50-60 mmol/L. Administer maintenance fluids plus replacement of losses.

Pharmacotherapy

In terms of recommended antimicrobial treatment in the immunocompetent host, enteric bacterial and protozoan pathogens can be grouped as follows:

Agents for whom antimicrobial therapy is always indicated:

The consensus includes only V cholerae, Shigella species, and G lamblia.

Agents for whom antimi­crobial therapy is indicated only in selected circumstances, include the following:

• Infections by enteropathogenic E coli, when running a prolonged course
• Entero-invasive E coli, based on the sero­logic, genetic, and pathogenic similarities with Shigella
• Yersinia infections in subjects with sickle cell disease
• Salmonella infections in very young infants, if febrile or with positive blood culture findings

Such medications include the following:

• Cefixime
• Ceftriaxone
• Cefotaxime
• Erythromycin
• Furazolidone
• Iodoquinol
• Metronidazole
• Paromomycin
• Quinacrine
• Sulfamethoxazole and trimethoprim
• Vancomycin
• Tetracycline
• Nitazoxanide

Probiotics

Recently, some strains of probiotics (defined as live microorganisms that when ingested in adequate doses, provide a benefit to the host) have been found to be effective as an adjunct when treating children with acute diarrhoea. They consistently show a statistically significant benefit and moderate clinical benefit of a few, now well-identified probiotic strains (mostly Lactobacillus GG et Saccharomyces boulardii but also Lactobacillus reuteri) in the treatment of acute watery diarrhoea (primarily rotaviral) in infants and young children in developed countries. Probiotics can also reduce the risk of spreading rotavirus infection by shortening diarrhoea duration and volume of watery stool output and by reducing the faecal shedding of rotavirus.

Pronostic

The prognosis of diarrhoea is generally good. The discomforts will be subsided within days.

Complications

• Dehydration
• Electrolyte imbalance
• Kidney failure
• Organ damage
• Malabsorption

Maladies et Ayurveda

Atisaara – Paittika

Nidana

• Excess water intake
• Intake of dry meat & meat of emaciated animal
• Food which is not habitual or suitable to body
• Sesame (dry, grinded and oil removed)
• Sprouts
• Alcool
• Dry food intake
• Excess food intake
• Hémorroïdes
• Faulty routine during ghee intake (as a treatment)
• Intestinal parasites
• Suppression des besoins naturels

Purvaaroopa

• Pricking pain in chest, rectum and abdomen
• Weakness of body
• Constipation
• Distended abdomen
• Indigestion

Samprapti

        Due to the causative factors, Vaata dosha vitiates and brings the water content in the body into the koshtha and expels through anus. With this excess water in koshtha, reduces the Agni (digestive fire), damages the gastrointestinal tract along with faecal matter and causes loose stools. It makes the stool watery and the disease diarrhoea gets manifested especially in people who eat unwholesome diet.

Lakshana

• Vaathika
• Watery, more frequent stools with obstruction
• Defaecation with pain & abnormal sounds
• Dry, frothy/clear or hardened stools
• Resembles over-cooked jaggery
• Sticky stools passed with severe tearing pain
• Dryness of mouth
• Rectal prolapse
• Horripilation
• Groaning

Paittika

• Yellow, black, green like grass,
• With blood
• Foul smelling,
• Excess thirst
• Fainting/giddiness
• Excess sweating
• Sensation de brûlure
• Abdominal pain
• Heat and inflammation of rectum & anus

Kaphaja

• Heavy, sticky, with thread-like structures, white in colour, oily & sticky, faeces with particles of undigested food
• Irregular & interrupted flow containing only a little faecal matter in one vega with mucous &foul smell,
• With flatulence
• Pain
• Excess sleep
• Lazy
• Aversion pour la nourriture
• Horripilation
• Feeling that not completely voided faeces after defaecation

Sannipatajam

All three doshalakshanas are present

Bhayajam and Shokajam

(Resembles Vaata-Pitta akshanas)

 

Very hot and liquified stools

Very light & floating

Divisions

        6 types

• Vaatika
• Paittika
• Kaphaja
• Thridoshaja or sannipaatika
• Bhayajam (due to fear/anxiety)
• Sokajam (due to grief)

        2 types

• Saamam         – with indigestion
• Niraamam      – without indigestion

        2 types

• Saraktam       – with bleeding
• Araktam        – without bleeding

Pronostic

Kricchrasadhya in healthy individuals without any complications & dhatudushti.

Asaadhya in children, old persons and with complications.

Chikithsa

        Ayurveda treatment for atisaara includes fasting as an important method.

Samana

• Langhana        – fasting
• Upekshaa        – Leaving the body to expel out the excess doshas by atisaara
• Aamapachana
• Agnideepana

Sodhana

• Vamana – In atisaara with severe abdominal pain & distension
• Snehavasti
• Kashayavasti-Picchavasti

Commonly used Medicines

• Vilwadi gulika
• Kutajarishtam
• Pippallyasavam
• Dadimashtakachoornam
• Kaidaryadi Tablets

Marques disponibles

• AVS Kottakal
• AVP Coimbatore
• SNA Oushadhasala

Remèdes maison

Taking Oral Rehydration Therapy: Mix one glass of boiled water with one teaspoon of sugar & one pinch of salt. Take it sip by sip for 3-4 hours. This is the simplest method of rehydration which can be done at home.

Moderate fasting on solid foods till feeling better & hungry.

Fenugreek seeds boiled in water for drinking

Carminatives like cumin seeds help correct the indigestion

Buttermilk boiled with turmeric, curry leaves, ginger, etc.

Régime alimentaire

• À éviter

Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.

la malbouffe - elle perturbe la digestion et réduit la biodisponibilité du médicament

carbonated drinks – makes the stomach more acidic and disturbed digestion

aliments réfrigérés et congelés - provoquent une digestion faible et paresseuse en affaiblissant l'agni (feu digestif)

le lait caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies

• A ajouter

Drink only boiled water

Des repas légers et des aliments faciles à digérer

Gramme vert, soupes, babeurre bouilli avec du curcuma, du gingembre et des feuilles de curry.

aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.

Comportement :

Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.

Évitez de soulever des poids lourds et de pratiquer d'autres activités physiques intenses.

Maintenir une alimentation et un sommeil réguliers.

Évitez de vous asseoir continuellement pendant une longue période et évitez de vous accroupir.

postures de Yoga

Complete bedrest is advised for a patient with loose stools. But after regaining normal health, following a daily exercise routine will help the person to improve digestion & health.

Stretching exercises and specific yoga asanas like pavanamuktasana, vajrasana, bhujangasana etc are recommended.

L'exercice régulier contribue à améliorer la biodisponibilité des médicaments et des aliments ingérés et favorise la santé.

Le yoga permet de maintenir l'harmonie à l'intérieur et avec l'environnement.

Pavanamuktasana

Vajrasana

Bhujangasana

Exercises for Low backache

Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.

Articles de recherche

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622957/

 

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