Bloating or distention of Abdomen (Admana / Anaha)

Fullness of abdomen / abdominal (Anaha / Admana) distention is found as a symptom in various diseases and Ayurveda refers to it as a separate disease entity. ‘Anaha’ and ‘Admana’ as both are having similar pathophysiology as well as symptom complexes.

Distension of abdomen or feeling of fullness of abdomen is a very common complaint. It disturbs the routine activities and its repeated episodes are more worrisome.

Understanding the difference between the closely resembling entitles

1. Anaha- distention of abdomen with stools and often gas

2. Admana – distention of abdomen with gas

3. Atopa – distention of abdomen followed with gurgling sound

4. Udavarta – distention of abdomen caused due to suppression of natural urges.

What leads to bloating?

When the undigested food particles are accumulated in the stomach / intestines or un-evacuated feces is collected in the large intestine, there will be obstruction of the channels. This leads to Vata Dosha aggravation. Since the large intestine is the seat of Vata Dosha. Whenever there is obstruction to the path, usually the first Dosha to get imbalanced is Vata Dosha, because Vata is the cause for movement. This further obstructs free flow of the faces and flatus through normal routes, leading to abdominal fullness and distention.

Major causes for abdominal distention or bloating

1. Indigestion (Ajeerna Ahara)

2. Taking wholesome and unwholesome foods together (Samashana)

3. Overeating (Atyashana)

4. Incompatible food combinations (Viruddhashana)

Types

Based upon the site of manifestation, there are 2 types –

1. Amaja Anaha

2. Purishaja Anaha

1. Amaja Anaha

This type of abdominal distension is caused by weak digestion strength. Ama here refers to toxins build, produced due to undigested food or non evacuated feces.

Symptoms if you have Amaja Anaha

• Thirst

• Common cold

• Burning of the scalp

• Pain in the abdomen

• Heaviness

• Discomfort in the chest /heart

• Suppressed regurgitation etc.

Specific treatment for Amaja Anaha to improve digestion strength.

1. Upavasa – Fasting

2. Pachana And Deepana – Targeting digestion and absorption of food

3. Vamana – Emesis Panchakarma treatments are followed.

2. Purishaja Anaha

Purisha refers to feces. This type of distension is caused due to constipation.

Symptoms if you have Purishaja Anaha:

• Stiffness

• Pain in the waist and flanks

• Constipation

• Urinary retention

• Unconsciousness

• Fecal vomiting

• Dyspnea

• Laziness

• Indigestion

• Lethargy, etc.

Specific treatment for Purishaja Anaha

1. Focus is given on clearing up the bowels using herbal combinations like : Triphala, Avipthi choornam, Trivrit Lehyam, etc.

2. It is advised to undergo mild purgation (Virechana : Under the guidance of Ayurvedic Physician ) followed by Oleation and sudation/steam.

Other Causative factors

Causes of bloating may be due to

• Swallowing air (this can happen when you chew gum, smoke, or eat too fast)

• Overeating

• Reflux (GERD)

• Weight gain

• Hormonal changes during Menstruation (in some women)

Other causes could include medical conditions, such as:

• Infection

• Inflammation (such as a condition called diverticulitis)

• Irritable bowel syndrome

• Pelvic inflammatory disease (PID)

• Liver disease (abnormal buildup of fluid in your stomach or pelvis)

• Crohn’s disease

• Blockage in your bowel or bladder

• Cancer (ovarian, uterine, colon, pancreatic, or stomach)

• Mental health factors, such as anxiety or depression

• Some medicines

MANAGEMENT

Avoid Unwholesome diet and habit

1. Vata aggravating foods (Like raw underground vegetables, Cauliflower, Cabbage, Broccoli, Brinjal, Radish)

2. Vishtambhi Ahara ( constipating foods : Bakery foods, Dried food items, etc.)

3. Heavy to digest foods (meat, cheese, curds, beans)

4. Common food allergens ( potatoes, eggplant, tomatoes, peppers, okra)

5. Avoid food having cold potency (carbonated drinks, frozen foods and drink)

6. Pungent food like (Chilies, garlic, onions and spices like black pepper, ginger, cayenne, cardamom)

7. Suppression of the natural urges

8. Sleepless nights

Follow Wholesome diet and habits

1. Manda (Rice gruel: Cooked over low flame and only supernatant water is used)

2. Mudga Yusha (Soup of green gram)

3. Buttermilk, lemon or kokum juice will help reduce the incidence of distention of the abdomen significantly.

4. Include Dates, Black Raisins, Alkaline foods, Carom seeds, Coriander, Dill seed, 4. Clove, Camel’s milk and Ginger into your diet.

5. Vyayama (regular exercise)

6. Dugdha (Organic warm Cow’s milk)

7. Jala (Regular intake of warm water)

Lifestyle Practices

1. To start with you need to fix your biological clock and the best way to do so is to fix the timings of your meals and daily practices (workouts, yoga, etc.).

2. Daily application of Ayurvedic Oils or Ghee, before a warm shower, helps regulate circulation, enhances metabolism and detoxification.

3. Excessive fluid intake while having meals, should be avoided. Sip only hot- warm water during the meals., to allow easy passage of meals .

4. Sleep-3-4hours after dinner, not soon after meals as it can disrupt the digestive system.

5. Dinner should be the lightest meal of the day and be done with it before sunset and heavier meal should be Lunch (Subjective to Dosha balance or imbalance).

6. Avoid dehydrating drinks like Caffeinated drinks.

7. Avoid wearing tight clothing, especially around the waist (this can interfere with digestion and movement of digested food)

General Management guidelines

In general, for the treatment of both the types of Anaha, below line of treatment are recommended:

1. Fasting (Pachana) is advisable until Ama is detoxified.

During this time, you can drink warm water (at a temperature of 60 degrees), mung water (Mung bean soup), or consume light and warm vegetable soups.

2. Snehana and Swedana – Oleation with Ayurvedic Oils/Ghee and Sudation with herbal water

Applying various warm Vatahara oils (e.g. Mahanarayana Oil, Saindhavadi Oil, and Sahachara Oil) followed by hot steam helps to pass gas and soften the stomach.

3. Virechana – Purgation (Induced by medicines)

4. Asthapana Basti – Herbal Decoction enema

For adults with severe pain or constipation, it is advisable to perform Asthapana Basti (medicated decoction enema) for immediate results. It will aid defecation and help release gas. In case of excess dryness and wind, your Ayurvedic expert might suggest an enema course (Anuvasan Basti or oil enema) for 7 to 10 days depending on the disease and Dosha condition.

5. Guda Varti – Anal suppositories

In cases of severe constipation, especially in children, inserting suppositories (Gudvarti) in the rectum gives better results. These can be prepared by mixing salt, Trikatu, jiggery, and cow’s urine. Cook the mixture, make a suppository and insert it in the anus – it will aid defecation and help release gas from the colon.

Snigdha Ahara

Role of an unctuous, fresh and wholesome diet

• Food with proportionate use of oil, ghee or water, provides proper texture and taste to food.

• Snigdha food kindles the digestive fire and also eases the process of digestion. Proper digestion ensures effortless and normal movement of Vata and other Doshas, thus maintaining the Tridosha balance.

• Snigdha property of food also pacifies the Rooksha (dry), Laghu(excessive lightness), chala(excessive and abnormal movement) property of deranged Vata.

• It normalizes the functions of Vata Dosha by controlling its movements.

• Unctuousness (Snigdha) of the foods like ghee, oil, buttermilk, butter, natural oil content foods like coconut, coconut milk preparations, nuts, curd, Lentils, Soups, Vegetable Chutneys, Salad dressings, helps rejuvenation of the body at the cellular level and thus nourishes the body.

Easy to do Yoga Asanas that helps relieve bloating

Vajrasana (Advised for 5minutes after meals)

Pawanmuktasana ( Include in your morning yoga Practice)

Balasana ( Include in your morning yoga Practice and also can be done before bed time to enhance better sleep)

Tips to reduce bloating

1. Drink Aloe Vera juice on regular basis (2-3times a week on empty stomach): The enzymes present in Aloe-Vera juice helps in regulating the digestive system of our body.

2. Make your digestive tea:

Carrom seed (Ajwain) and Fennel tea before or between each meal.

Ajwain is one of the most powerful herbs for expelling and preventing excessive air in the system and correcting the flow of Vata. Fennel is one of the essential Ayurvedic spices for treating any digestive issue and strengthening the digestive fire. Drinking this tea between meals will increase the digestive force, reduce air in the system, flush out toxins and prevent symptoms of indigestion such as the gas and bloating.

Directions: Boil 4 cups of water. Add in 1 Tablespoon of fennel seed and 2 tsp of Ajwain seeds. Boil on a low heat until there are only 2 cups remaining. Strain the seeds and drink one cup of the tea between breakfast and lunch and another cup between lunch and dinner.

3. Drink buttermilk after Lunch : Works as the natural source of antibiotics.