Abstract
Background: Ulcerative colitis is a chronic inflammatory bowel disease characterised by recurrent episodes of bloody diarrhoea, abdominal pain, weight loss, and inflammation of the intestinal mucosa. In Ayurveda, its clinical presentation can be correlated with Pittaja Grahani (Ulcerative colitis) and, in chronic stages, with Raktatisara, primarily resulting from Mandagni (weakened digestive fire), Ama formation, and aggravation of Pitta Doṣha (body humor producing heat). Objective: To evaluate the efficacy of Ayurveda management in a diagnosed case of ulcerative colitis. Case details: A 53-year-old male from Supedi, Gujarat, presented with complaints of alternating loose and hard stools, rectal bleeding for 8 months, intermittent abdominal pain, bloating, occasional fever, and Mukhapaka (mouth ulcer) following intake of spicy food. Colonoscopy with biopsy confirmed severe ulcerative procto-sigmoiditis (Baron Grade 4), showing mucosal oedema, erythema, ulceration, exudation, and granularity. Laboratory investigations revealed normal haematological, renal, and blood glucose parameters, while stool examination was positive for occult blood. Based on clinical features and Ayurveda assessment (Muhur Badhdham Muhur Dravam Mala Pravriti), the condition was diagnosed as Pittaja Grahani with features of Raktatisara (bloody diarrhoea). The patient was treated with Śhodhana Chikitsa (detoxification therapy) in the form of Madhusarpis Basti (medicated enema), followed by Śhamana Chikitsa (Conservative management). Internal medications included Patoladi Churna, Rasa Parpati, Arogyavardhini Vati, Kamdudha Vati, Haritaki Churna, and Mahatiktaka Ghrita (ghee-based medicine) administered for two months. Dietary and lifestyle modifications were advised, including restriction of Amla (sour), Katu (pungent taste), and Lavana (salt) intake Results: Significant clinical improvement was observed after one month of treatment. Rectal bleeding gradually reduced and completely subsided. Bowel habits normalised with reduction in alternation between loose and hard stools. Associated symptoms such as abdominal pain, bloating, and fever were markedly reduced.Conclusion: The therapeutic outcome suggests that Ayurveda management focusing on Agni Dīpana (improve appetite and digestion), Āma Pachana (digestion of undigested metabolic byproduct), Pitta Shamana (control of acid secretion), Grahi (anti diarrhoeal) action, and mucosal healing is effective in managing ulcerative colitis which contributed to clinical improvement and enhanced intestinal absorption.

Key words: Grahani, Ulcerative Collitis, Madhusarpis Basti, Agni