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|title=Annavaha Srotas
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|keywords=Annavaha Srotas, carakasamhitaonline, charak samhita online, Annavaha srotas is origin, Annavahini dhamani, Left lateral part of chest (vama parshwa), vitiation of annavaha srotas, disorders of annavaha srotas, Deglutition reflex,
|description=Prana means vital force, and srotas means channels of transformation and transportation.
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<p style="text-align:justify;">‘Anna’ means food that is consumed. Srotas are the channels for transportation and transformation of various body constituents. Annavaha srotas are the body channels which carry food (anna). They can be correlated to gastrointestinal system. The channels are responsible for not only transportation, but also digestion and absorption of ingested food. This article deals with description of physiological and pathological aspects of annavaha srotasa. </p>
{{Infobox
|title = Contributors
|label1 = Section/Chapter/topic
|data1 = Concepts/[[Srotas]][[Annavaha Srotas]]
|label2 = Authors
|data2 = Bhojani M. K. <sup>1</sup>, <br/>Arun Lal <sup>1</sup>
|label3 = Reviewer
|data3 = Basisht G.<sup>2</sup>
|label3 = Editor
|data3 = Deole Y.S.<sup>3</sup>
|label4 = Affiliations
|data4 = <sup>1</sup> Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India <br/><sup>2</sup> Rheumatologist, Orlando, Florida, U.S.A. <br/><sup>3</sup> Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
|label5 = Correspondence emails
|data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in], [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]
|label6 = Publisher
|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
|label7 = Date of publication:
|data7 = September 27, 2023
|label8 = DOI
|data8 = {{DoiWithLink}}
}}
== Origin and location ==
<p style="text-align:justify;">Annavaha srotas is originated from amashaya (stomach) and annavahini dhamani (channels carrying food) [Su. Sa. Sutra Sthana 9/12]. According to Acharya Charak, the roots are stomach (amashaya) and left lateral part of chest (vamaparshwa) [Cha. Sa. Vimana Sthana 5/7]. Annavahini dhamani plays a significant role in the nourishing function (preenana) of rasa dhatu. It carries the nutrient fluids (ahararasa), constituted by panchamahabhuta, and formed by the action of jatharagni (digestive capacity). Amashaya is the storage site of undigested food for the action of jatharagni. Annavahini dhamani & left lateral part of chest (vama parshwa) is related to the circulation of nutrient fluids (ahararasa). <br/>Amashaya is situated in between the umbilicus and breast [Cha. Sa. Vimana Sthana 2/22]. The upper part of amashaya is the site of kapha and lower part is site of pitta dosha [Cha. Sa. Sutra Sthana 14/9], [Cha. Sa. Sutra Sthana 20/8].</p>
== Annavahini dhamani ==
<p style="text-align:justify;">Annavaha srotas transports four types of food and drinks – eatables (ashita), drinkables (peeta), linctuses (leedha), and chewable (khadita). The consumed food moves down the alimentary canal stimulated by prana vayu [A. Hri. Sutra Sthana 12/5]. Activities including digestive processes in amashaya is under the control of samana vayu, situated near agni and travels throughout koshtha. It helps in the digestion process (pachana) and separation of nutrient part (sara) and wastes (kitta) [A. Hri. Sutra Sthana 12/8]. After the action of kayagni and pachaka pitta, absorption and assimilation of the nutrient fluid (ahararasa) occurs at annavahini dhamani. </p>
== Left lateral part of chest (vama parshwa) ==
<p style="text-align:justify;">Annavaha srotas is mainly concerned with the transportation and digestion of food materials. All major activities take place in stomach (amashaya), which is in the upper abdomen, on the left side of the body. Many of the disorders related to the deformities of annavaha srotas show pain and distension of the area. It might be because of that, the Acharya Charak includes left flank (vama parshwa) as one of the roots of annavaha srotas. <br/>Amashaya is considered root because of its storage function from diagnostic and clinical point of view. Vama parshwa is root from a clinical view point and annavahini dhamani is root in conduction and circulatory point of view.<ref name="ref1">Lahange, Sandeep Madhukar, Archana Nivrutti Bhangare, and Vikash Bhatnagar. "Critical review on srotomool of annavaha srotas and its sigificance in clinical practice in present era." (2016).</ref> Anatomically, annavaha srotas can be considered as upper part of gastrointestinal tract from mouth upto the small intestine where digestion and absorption occur.<ref name="ref2">Khobragade, Shyam D., M. Yusuf M. Shareef Sheikh, and Gopal B. Sharma. "Conceptual review of the annavaha srotas with respect to its moolasthana." (2019).</ref> <br/>Vayu, with the help of pitta helps in the formation of body channels. Annavaha srotas is originated from maternal factors (matrija bhava). The essence (sara) of rakta and kapha, acted upon by pitta and vayu form intestines (antra), rectum (guda) and bladder (basti) [Su. Sa. Sharira Sthana 3/31].</p>
== Clinical features of vitiation of annavaha srotas ==
# Disinterest for food (anannabhilasha)
# Indigestion (avipaka)
# Anorexia (arochaka)
# Vomiting (chhardi) [Cha. Sa. Vimana Sthana 5/8]
The clinical features of injury to annavaha srotas are:
# Abdominal distention (adhmana)<ref name="ref3">http://namstp.ayush.gov.in/#/sat</ref>
# Pain (shula)
# Aversion to food (annadwesha)
# Vomiting (chhardi)
# Thirst (pipasa)
# Blindness (andhya)
# Death (maranam) [Su. Sa. Sharira Sthana 9/12]
== Causes of vitiation of annavaha srotas ==
# Intake of food in excess quantity (atimatra bhojana)
# Untimely intake of food (akala bhojana)
# Intake of unwholesome food (ahita bhojana)
# Vitiation of agni (dushti of pavaka) [Cha. Sa. Vimana Sthana 5/12]
<p style="text-align:justify;">For the proper functioning of the digestive process two factors are responsible, food and digestive capacity. Eight considerations are laid down relating to the ordinances about food and drink. They are: nature (prakriti), transmutation (karana), combination (samyoga), measure (rashi), desha (place of origin etc), kala (season and age), upayoga-samstha (conditions of use) and upayoktri (taker himself of food and drink).<ref name="ref4">Narayana A. Diseases of Annavaha Srotas (gastroenterology): historical view point. Bull Indian Inst Hist Med Hyderabad. 2002 Jan-Jun;32(1):15-30. PMID: 15307207.</ref> <br/>In this modern era, improper diet habits and changes in lifestyle cause vitiation. It causes poor digestive capacity (agnimandya) leading to indigestion and various disorders. Hence irrespective of any disorder, agni should be considered first.<ref name="ref5">Biswas SG, Dasar D, Diwedi AK. Review on Annavahasrotodushti with Respect to Arsha Vyadhi. Indian Journal of Forensic Medicine & Toxicology. 2021;15(1):330-4.</ref> </p>
== Management of disorders of annavaha srotas ==
<p style="text-align:justify;">Acharya Charak explains that the treatment of disorders of annavaha srotas should be done along the line of amapradoshaja vikara (diseases caused by the absorption of undigested food that is absorbed by the body, which acts as toxin) [Cha. Sa. Vimana Sthana 5/26]. Restricted nutrition (apatarpana) is the principle of management for this. [Cha. Sa. Vimana Sthana 2/9(13)]. Apatarpana (therapy to decrease excessively increased body components like fats (medo dhatu) etc.) is of three types – langhana (therapeutic fasting, hunger or intentional starving), langhana-pachana, and doshavasechana (shodhana). Langhana is done in mild cases (alpa bala dosha). Langhana-pachana (therapeutic fasting + digestion or promoting digestion) in moderate cases (madhyama bala dosha) and doshavasechana in excessively aggravated dosha (bahu dosha) [Cha. Sa. Vimana Sthana 3/23(43)].</p>
== Manipur chakra (solar plexus) and annavaha srotas ==
<p style="text-align:justify;">Chakra are the energy points or nodes in the subtle body described in Yogic science. Manipur chakra is 3<sup>rd</sup> among six chakras. It is known as solar plexus. According to modern anatomy, these chakra are parts of autonomic nervous system and are formed from the medial division of sympathetic ganglia. Manipur chakra has control on several functions of digestive system. It is even affected by psychosomatic disorders. The manipura chakra delineated in yogic compendia has similar activities as that of coeliac plexus which is autonomic in nature. Practicing measures to stimulate them, especially manipura chakra helps in proper functioning of abdominal organs and thereby helps in preventing and managing diseases related to GIT.<ref name="ref6">Smitha Jha and Sachin Khedikar. Inuence of Manipur Chakra (Coeliac Plexus) on Annavaha Srotas (Gastro Intestinal Tract). J. Res. Trad. Medicine 2016; 2(4): 113-116 http:dx.doi.org/10.21276/jrtm.2016/183</ref></p>
== Annavaha srotas and mental health ==
<p style="text-align:justify;">Defective agni (vaigunya) is one of the important causes for the vitiation of annavaha srotas. Excess intake and unwholesome food, as well as mental conditions like excess desires (kama), anger (krodha), greed (lobha), negligence (moha) etc., cause the formation of ama in body. Worry (chinta), grief (shoka), fear (bhaya), anger (krodha) etc. may also contribute to improper digestion of food [Cha. Sa. Vimana Sthana 2/8-9].<ref name="ref7">Charak Samhita; edited with Vidhyotani hindi commentary by Kashinath Pandeya et all published by Chaukhambha bharti academy, Varanasi; viman sthan 2/8-9 page no.688 (2009)</ref> <br/>According to classical texts and modern literature, various psychological factors play a significant role in the pathology of gastrointestinal diseases. Stressful conditions activate the sympathetic nervous system. This is responsible for alteration in gut motility, permeability, and secretions. A variety of neurotransmitters in stressful situations modify the gut flora, which is ultimately responsible for digestive disorders.<ref name="ref8">Nitin Kumar, Harish Chandra Gupta, Vikash Bhatnagar. Physio-Anatomical Exploration of Role of Mental Health in Annavaha Srotas Disorders. AYUSHDHARA, 2016;3(2):649-651.</ref> <br/>When the Agni (digestive capacity) is weak, a number of unwanted unripe byproducts of digestion and metabolism start forming and accumulating in the body at different levels from the gross to the molecular level, from a local gastrointestinal tract (GIT) level to the systemic level in tissues and cells. Such products are collectively called ama and act as toxic and antigenic materials, giving rise to many antibodies. The presence of ama (including the production of antibodies) renders an ama state (amavastha) in the body, which is characterised by increasing impermeability and sluggishness of the srotas (body channels) resulting in srotodusti (vitiation).<ref name="ref9">Amruthesh S. Dentistry and Ayurveda--III (basics-ama, immunity, ojas, rasas, etiopathogenesis and prevention). Indian J Dent Res. 2007 Jul-Sep;18(3):112-9. doi: 10.4103/0970-9290.33786. PMID: 17687173.</ref> This indigestion is the basic culprit which causes many systemic illnesses. Therefore, first and foremost need is to take care of our stomachof and appetite.<ref name="ref10">Dr. Kalpana Ladvikar. A systematic review on concept of Annavaha Srotas and its clinical aspect. J Ayurveda Integr Med Sci 2019;6:115-118.</ref> </p>
== Functional anatomy of gastrointestinal tract ==
<p style="text-align:justify;">Digestion is defined as the process by which food is broken down into simple chemical substances that can be absorbed and used as nutrients by the body. Most of the substances in the diet cannot be utilized as such. These substances must be broken into smaller particles so that they can be absorbed into blood and distributed to various parts of the body for utilization. Digestive system is responsible for these functions. Digestive process is accomplished by mechanical and enzymatic breakdown of food into simpler chemical compounds. A normal young healthy adult consumes about 1 kg of solid diet and about 1 to 2 litre of liquid diet every day. All these food materials are subjected to digestive process, before being absorbed into blood and distributed to the tissues of the body. Digestive system plays the major role in the digestion and absorption of food substances. <br/>Thus, the functions of the digestive system include:</p>
# Ingestion or consumption of food substances
# Breaking them into small particles
# Transport of small particles to different areas of the digestive tract
# Secretion of necessary enzymes and other substances for digestion
# Digestion of the food particles
# Absorption of the digestive products (nutrients)
# Removal of unwanted substances from the body<ref name="ref11">Sembulingam K, Sembulingam P. Essentials of Medical Physiology. 6th ed. Vol. 1. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2012.</ref>
== Functional organization ==
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== References ==
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