Role of Snigdha Virechana with Chinchalavan Taila in the Management of Malavastambha: A Case Report

Background: Malavastambha (Constipation) is defined as the infrequent and difficult passage of stool. The main features of Constipation are infrequent or hard stool, abdominal pain, bloating, and feeling of unsatisfactory bowel evacuation. Contemporary laxatives, which are generally used in Constipation, become habitual after some duration and only symptomatic relief. Moreover, these medicines never alter the pathogenesis of the disease. So, it is a need of hour to search effective, safe & alternative formulations in Ayurveda, which can completely break the pathogenesis of Constipation. As per Ayurveda, Vata Dosha is the main factor involved in this condition. Therefore, the prime treatment principle recommended by Ancient Acharyas is to pacify Vata by using Vatahara herbs medicated with Snigdha Dravya, Amla, and Lavana Varga. The Chincha Lavana Taila is one such combination that possesses the above principle & so; it can be effective in Malavastambha. Aim: This case study is primarily carried out to study the role of oral administration of Chincha Lavana Taila in Malavashtambha Objectives: To evaluate the efficacy of oral consumption of Chincha Lavana Taila in Malavastambha. Case Report Sawarkar and Sawarkar; JPRI, 33(33B): 132-139, 2021; Article no.JPRI.70543 133 Methods: A single case study. A 50 years old male patient approached Panchakarma O.P.D. with Malavsthambha for one year; he was advised to intake 15ml Chincha Lavana Taila orally at bedtime lukewarm water for consecutive 15 days. Observation and Results: The patient got 100% relief in his all chief & associated complaints and had regular and satisfactory bowel habits after 15 days. Conclusion: Chincha Lavana Taila is one of the best effective oral medicine for Constipation.


INTRODUCTION
Constipation is defined as infrequent, difficult & unsatisfactory passage of stool with abnormal consistency. It is the more common disease of the gastrointestinal system. Its prevalence is increasing day by day due to faulty lifestyle & bad dietary habits [1]. It gives rise to multiple metabolic disorders in the future if it remains for a long time. It also disturbs the quality of life due to lethargy induced due to unsatisfactory bowel habits, which chief complaint in this clinical condition. Moreover, the chronic nature of this disease also disturbs the body's nutrition, leading to multiple degenerative diseases.
Due to frequent or excessive use of various modalities for Constipation in contemporary science, patients become highly dependent on them or suffer from multiple side effects [2]. In some cases, it also becomes ineffective to correct the pathology. On the other hand, these treatment options are also contraindicated in some patients due to other co-morbidity [3]. All these scenarios demand to seek alternative or traditional formulation based on fundamentals in Ayurveda.

According
to Ayurveda's perspective, Constipation can be correlated with "Malavastambha "or "Vibandha" Vitiation of Vata is the main culprit in both above entities.  [4]. Though the broad utility of Chincha Lavan Taila in many gastrointestinal diseases, including Constipation, its' simple but cost-effective method of preparation, easy availability of its raw drugs, it is neither yet included in standard databases of Ayurvedic Pharmacopoeia of India and Ayurvedic Formulary of India [5] nor any its preparative and analytical studies are conducted to set its standards.

Aim
Overview of all the above facts, this case study is planned to evaluate the efficacy & safety of the oral administration of Chincha Lavana Taila for the management of Constipation.

MATERIALS AND METHODS
It is a single case study whose demographic details of the patients are given in Table 1.

Chief Complaints
Chief complaints of the patient with their duration & severity are tabulated in Table 2.

History of Present Illness
A 50-year-old patient was symptomless before one year, gradually emerging symptoms like hard stool and irregular bowel habit, etc. He had taken a laxative (Syp. Duphulac) for consecutive 15 days but didn't get satisfactory relief. Therefore, he approached Panchakarma O.P.D., Mahatma Gandhi Ayurveda Hospital & research center, Salod, Wardha, Maharshtra.

History of the Patient
Specific History of the patient is given in Table 3.

GENERAL EXAMINATION (CLINICAL FINDINGS)
On examination, though the patient's general condition was moderate, the patient was afebrile, conscious, but irritated.

INVESTIGATIONS
Findings of his all routine blood investigations such as Complete Blood Count, Blood Sugar Level(fasting &postprandial ), and Routine and Microscopic Urine Examination were found within normal limits.

PATHOPHYSIOLOGY OF THE DISEASE
Pathophysiology of the disease that occurred in this patient with Samprapti Ghatak Figs. 1 & 2, respectively.

RESULTS AND OBSERVATIONS
The Result & observations of the case are displayed in table no. 5

. After completion of total
Ayurvedic therapy, the patient was significantly improved. The patient was feeling a fresh and relaxed mind. He has a sound sleep now. The patient was enjoying his day-to-day life very well.   [8,9,10,11,12]. According to these modern's perspectives, tamarind acts as an irritant laxative that may be helpful to detach the hard stool from the intestinal mucosa due to its irritant properties, irritates the colon's lining resulting in an increased urgency to pass bowel materials. It also improves liver function & digestion due to anti-oxidant & hepatoprotective properties of the high content of ascorbic acid & B-carotene. It acts as a good laxative due to high amounts of malic, tartaric, and potassium acid. It increases the Intestinal small transit due to tartaric acid, malic acid, and citric acid extracts [8]. It also eliminates worms due to chronic Constipation by anthelmintic property of tannins present in it [9]. It also relieves abdominal pain in chronic Constipation by its antispasmodic action by blocking calcium channels due to malic acid [11,12].

CONCLUSION
This case study reveals that Chincha Lavana Taila effectively corrects the pathology of Constipation without causing any undue or adverse effects. The oral administration of Chincha Lavana Taila is found to be costeffective, safe, and easy to prescribe at O.P.D. Level also. For more scientific validation, the study has to be conducted with a large sample size in different populations with specific markers in the future. Preparative and analytical studies are also expected & highly appreciable to establish standards for Chincha Lavan Taila to improve its Pharmaco-kinetic and Pharmaco-dynamic action by using different edible oils.

DISCLAIMER
The products used for this research are commonly and predominantly use products in our area of research and country. There is absolutely no conflict of interest between the authors and producers of the products because we do not intend to use these products as an avenue for any litigation but for the advancement of knowledge. Also, the research was not funded by the producing company rather it was funded by personal efforts of the authors.

CONSENT
It is not applicable.

ETHICAL APPROVAL
It is not applicable.