Ayurvedic Management of Pittodara Associated with Jirna Atisara (Ulcerative Colitis)

Ulcerative Colitis (UC) is a chronic inflammatory bowel disease characterized by continuous mucosal inflammation, ulceration and rectal bleeding. From an Ayurvedic perspective, the present case was correlated with Pittodara, a form of Udara Roga associated with aggravated Pitta, Agni Dushti, Ama formation, Srotodushti and Dhatu Kshaya. A 42-year-old female presented with 20–25 episodes/day of mucoid watery stools with occasional bleeding, abdominal heaviness, distension, weakness and progressive weight loss. Colonoscopy showed ulcerative pancolitis with continuous inflammation throughout the colon, and biopsy confirmed chronic moderately active ulcerative colitis. The patient received Shamana Chikitsa with Kutaj Ghanavati, Sanshamani Vati, Sudarshan Ghanavati and Dadimadi Ghrita, along with Tikta Skandha Kshira Basti for 40 days. The treatment was planned on principles of Deepana, Ama Pachana, Stambhana, Srotoshodhana, Vrana Ropana and Brimhana. Bowel frequency decreased to 2–3 episodes/day, with complete resolution of mucous discharge and rectal bleeding, improvement in appetite and strength, and weight gain. Follow-up colonoscopy demonstrated marked mucosal healing and near-complete endoscopic remission, with Mayo score improving from 3 to 1 and UCEIS from 6–8 to 2. No treatment-related adverse events were reported. This single case suggests that Samprapti Vighatana-based Ayurvedic approach may have potential as a complementary management strategy in chronic active ulcerative pancolitis; however, larger controlled studies are required.