Short Bowel Syndrome Through the Lens of Grahani Roga: An Integrative Review of Pathophysiology and Management

Background: Short Bowel Syndrome (SBS) is a complex malabsorptive state resulting from extensive surgical resection of small intestine, usually <200 cm of remaining bowel. It presents with chronic diarrhoea, steatorrhea, dehydration, malnutrition, and dependence on Total Parenteral Nutrition (TPN). Modern management is limited to supportive care and intestinal adaptation with GLP-2 analogues. In Ayurveda, a similar syndrome with altered bowel function, malabsorption and deranged Agni is described as Grahani Roga. Aim: To establish conceptual correlation between SBS and Grahani Roga and to explore Ayurvedic management principles for integrative care of SBS. Materials & Methods: Classical Ayurvedic texts and modern literature were reviewed. Results: SBS shows close resemblance to vataja and sannipataja grahani with mandagni and ama. Symptoms like muhurbaddha muhur drava mala pravritti (intermittent loose and formed stools), atisrushta mala, trishna, daurbalya correlate with SBS. Principles of deepana, pachana, grahi, stambhana and takra prayoga offer potential for enhancing intestinal adaptation. Conclusion: SBS can be understood as a grahani-dushti vikara. An integrative approach centered on agni deepana and grahi chikitsa may help in reducing TPN dependence and improving nutritional status.