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===Anulomana===

===Anulomana===

This includes expulsion of waste products/feces (mala) after its complete digestion (paka) of ama (incompletely digested wastes and toxins) and detachment from their abodes. [Sha.Sa.Purva khanda.4/4]<ref name=Shargadara/> The medicine kindles the digestion and metabolic process (agni) first and further increases the liquidity (drava[[guna]]) and mobility (sara[[guna]]) of waste products for smooth passage through rectum. [Adhamalla on Sha.Sa.Purva khanda 4/4]<ref name=Shargadara/> Anulomana medicines are predominant of [[aap]] and [[prithvi]] [[mahabhuta]]<ref name=KulkarniM>Kulkarni M, Sherekar D. Understanding the applied aspects of Sharandharokta virechan karma- A review. PIJAR. 2017 [cited 2020 Sep 06] . Available from: http://pijar.org/archives.html</ref>  which results in unobstructed downward movement of the waste materials. Along with the digestion of waste products, it also improves the digestion process by [[dosha]].<ref name=KulkarniM/>Anulomana can have an effect on samanavata (type of vata responsible for digestion) and its site of action may be the gastro intestinal tract.<ref name=KulkarniM/>

This includes expulsion of waste products/feces (mala) after its complete digestion (paka) of ama (incompletely digested wastes and toxins) and detachment from their abodes. [Sha.Sa.Purva khanda.4/4]<ref name=Shargadara/> The medicine kindles the digestion and metabolic process (agni) first and further increases the liquidity (drava[[guna]]) and mobility (sara[[guna]]) of waste products for smooth passage through rectum. [Adhamalla on Sha.Sa.Purva khanda 4/4]<ref name=Shargadara/> Anulomana medicines are predominant of [[aap]] and [[prithvi]] [[mahabhuta]]<ref name=KulkarniM>Kulkarni M, Sherekar D. Understanding the applied aspects of Sharandharokta virechan karma- A review. PIJAR. 2017 [cited 2020 Sep 06] . Available from: http://pijar.org/archives.html</ref>  which results in unobstructed downward movement of the waste materials. Along with the digestion of waste products, it also improves the digestion process by [[dosha]].<ref name=KulkarniM/>Anulomana can have an effect on samanavata (type of [[vata]] responsible for digestion) and its site of action may be the gastro intestinal tract.<ref name=KulkarniM/>

This can be compared to carminative laxatives. Carminative laxatives due to the presence of volatile oils stimulate the digestive system and regulates gut contractions. It may also increase the water retention in intestinal lumen.<ref name=NimmyVS>Nimmy V S, Praveen Kumar K S. A Conceptual Appraisal of Virechana Karma. AYUSHDHARA, 2018;5(2):1664-1668.</ref> In a study conducted on 15 participants, anulomana procedure took approximately 258 minutes to complete. Most number of participants did not pass [[kapha]] in their final bout of purgation. In 73.46% of participants the consistency of stool as per bristol stool scale lies in category 7  (watery, no solid pieces, entirely liquid).<ref name=NithinPS/>

This can be compared to carminative laxatives. Carminative laxatives due to the presence of volatile oils stimulate the digestive system and regulates gut contractions. It may also increase the water retention in intestinal lumen.<ref name=NimmyVS>Nimmy V S, Praveen Kumar K S. A Conceptual Appraisal of Virechana Karma. AYUSHDHARA, 2018;5(2):1664-1668.</ref> In a study conducted on 15 participants, anulomana procedure took approximately 258 minutes to complete. Most number of participants did not pass [[kapha]] in their final bout of purgation. In 73.46% of participants the consistency of stool as per bristol stool scale lies in category 7  (watery, no solid pieces, entirely liquid).<ref name=NithinPS/>