Exploring the Gut-Brain Axis in Alcohol Use Disorders - Ayurvedic Insights and Therapeutic Strategies

Background: Ayurveda recognises a profound intrinsic link between the digestive system and the brain, conceptualised through Agni (digestive fire), Ama (toxins), and the Pittadhara-Majjadhara Kala (physiological pathways). In modern science, this connection is identified as the gut-brain axis. Alcohol Use Disorder, correlated with Madatyaya, significantly disrupts this axis, leading to both systemic physiological damage and mental health deterioration. Aim: This article aims to explore the Ayurvedic perspective on the Gut-Brain Axis in the context of AUD and investigate how alcohol consumption impacts core principles such as Agni, Kalas, and Ojas. Methods: This systematic review was conducted in accordance with PRISMA guidelines, integrating evidence from contemporary scientific research and classical Ayurvedic literature. A comprehensive search of PubMed, Scopus, Google Scholar, and the AYUSH Research Portal was performed up to April 2023 using predefined keywords. Studies published within the last two decades, including clinical trials, systematic reviews, and meta-analyses, were included. Results: Chronic alcohol consumption disrupts the Gut–Brain Axis primarily through vitiation of Pittadhara Kala, leading to impaired Agni, Ama accumulation, and gut dysbiosis. This disturbance extends to Majjadhara Kala, resulting in neuroinflammation, cognitive impairment, and psychological dysfunction. These findings establish a clear Ayurvedic correlate of Gut–Brain Axis disruption, highlighting the interdependence of gastrointestinal and neurological pathways. Accordingly, a multidimensional therapeutic approach is advocated, including Nidana Parivarjana (avoidance of causative factors), Panchakarma (detoxification), Sattvavajaya (psychotherapy), and Achara Rasayana (behavioural therapy). Conclusion: Integrating Ayurvedic tenets with modern psychiatry offers a holistic model for treating AUD. Targeting the gut–brain axis through diet, herbal therapy, yoga, and meditation supports comprehensive physical and mental recovery. Major Findings: Alcohol-induced disruption of the Pittadhara–Majjadhara Kala axis reflects gut–brain axis dysfunction, effectively managed through integrative Ayurvedic therapies.