Changes

=== Causes of ''grahani'' disorder ===

=== Causes of ''grahani'' disorder ===

''Abhojana'' (starvation) leads to increase in ''vata'' and in turn ''agnimandya''.(Ca.Vi/ 2/7) Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.

''Abhojana'' (starvation) leads to increase in ''vata'' and in turn ''agnimandya''.[Cha. Sa. [[Vimana Sthana]] 2/7] Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.

''Atibhojana'' (excessive intake) causes provocation of all the ''dosha'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea.  Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or  diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama pitta'' condition leads to ''grahani dosha'' and various other disorders.( Ca. Su 13/76 ) Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad.  

''Atibhojana'' (excessive intake) causes provocation of all the ''dosha'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea.  Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or  diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama pitta'' condition leads to ''grahani dosha'' and various other disorders.[ Cha. Sa. [[Sutra Sthana]] 13/76] Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad.  

Suppression of manifested natural urges may have impact on nervous system resulting in effect  either on enzymatic secretion or on the hormonal secretion.These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''vata'' in rectum and pelvic region) and ''purisha vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.( Ca. Su. 7/ 6,8,12) Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya'').  

Suppression of manifested natural urges may have impact on nervous system resulting in effect  either on enzymatic secretion or on the hormonal secretion.These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''vata'' in rectum and pelvic region) and ''purisha vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.[Cha. Sa. [[Sutra Sthana ]] 7/ 6,8,12] Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya'').  

Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana''  leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in ''agni''.(Ca.Su.22/37) ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body.  

Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana''  leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in ''agni''.[Cha.Sa. [[Sutra Sthana]] 22/37] ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body.  

Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion.  

Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion.