Ayurveda and Gut Health: An Integrative Review of Classical Concepts and Therapeutic Approaches

Background: In Ayurveda, Agni is considered fundamental to digestion, metabolism, nourishment, and the maintenance of health, while impaired digestive function is associated with the formation of Ama, which contributes to the pathogenesis of various disorders. Classical Ayurvedic texts describe the importance of Agni, Ama, and Doṣa in maintaining physiological equilibrium and gastrointestinal health. These concepts provide a traditional framework for understanding digestive function and its relationship with overall well-being. Objectives: To explore the Ayurvedic understanding of gut health through the concepts of Agni, Ama, Deepana-Pachana, Grahi, and Rasayana, with particular emphasis on the therapeutic relevance of selected medicinal plants (Dravyas) and their potential associations with contemporary gastrointestinal science. Methods: Relevant concepts were examined through classical Ayurvedic treatises, including the Charaka Saṃhita, Sushruta Samhita, and Aṣṭhanga Hridaya, alongside contemporary scientific literature retrieved from PubMed and Scopus. The discussion focused on digestive physiology, gut microbiota, intestinal barrier function, short-chain fatty acids, inflammation, and the pharmacological properties of selected medicinal plants. Discussion: Ayurveda emphasizes the maintenance of Samagni for effective digestion and metabolic balance, whereas Mandagni is associated with impaired digestion and the formation of Ama. Deepana and Pachana are important therapeutic approaches directed towards improving digestive function and addressing Ama, while Grahi and Rasayana have distinct roles in traditional gastrointestinal care and health maintenance. Selected Dravyas, including Jiraka, Methika, Pippali, Musta, Bilva, Sunthi, Dadima, Shatavari, Guduchi, and Amalaki, possess traditional digestive indications, with varying degrees of contemporary evidence for their effects on gastrointestinal function, inflammation, and microbial activity. These findings offer opportunities to investigate potential relationships between Ayurvedic principles and modern concepts of intestinal homeostasis, while recognizing that direct equivalence between traditional concepts and biomedical mechanisms remains unestablished. Conclusion: Ayurvedic principles of Agni, Ama, and Deepana-Pachana provide a valuable framework for understanding digestive health and exploring traditional therapeutic approaches. Their systematic evaluation alongside contemporary scientific evidence may support further pharmacological, clinical, and translational research in gastrointestinal health.