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<p style="text-align:justify;">4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] </p>
<p style="text-align:justify;">4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] </p>
<p style="text-align:justify;">5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] </p>
<p style="text-align:justify;">6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] </p>
<p style="text-align:justify;"> 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]</p>
<p style="text-align:justify;">8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] </p>
<p style="text-align:justify;">9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] </p>
<p style="text-align:justify;">10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]</p>
<p style="text-align:justify;">11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] </p>
<p style="text-align:justify;"> 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]</p>
<p style="text-align:justify;">13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] </p>
<p style="text-align:justify;">14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] </p>
<p style="text-align:justify;"> 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]</p>
=== Treatment as per different conditions===
*In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]
*In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]
*In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]
*In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140]
*In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]
*Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]
*In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]
*In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]
===Measures alleviating udavarta (udavarta hara)===
*Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]
*Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]
*Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]
*Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]
*Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]
*Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]
===Diet for udavarta===
<p style="text-align:justify;">Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]</p>
===Researches===
#1)<p style="text-align:justify;">A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.</P>
#2)<p style="text-align:justify;"> A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)
Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).</p>
#3)<p style="text-align:justify;"> Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. </p>
===Thesis on udavarta===
<p style="text-align:justify;">In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. </p>