Evaluation of the status of Agnibala and Kostha among subtypes of irritable bowel syndrome: An observational study

Abstract

Background: Irritable Bowel Syndrome (IBS) persists as a significant clinical challenge in the 21^st century, being one of the most relevant functional gastrointestinal disorders affecting diverse populations. The global variability in the prevalence of irritable bowel syndrome (IBS) subtypes reflects underlying heterogeneity in gastrointestinal motility, secretion, and digestion, which may be meaningfully interpreted through the Ayurvedic concepts of Agnibala and Kostha. Agni, as a fundamental determinant of digestion and metabolism, and Kostha, representing bowel nature and evacuation patterns, together offer a functional framework for understanding IBS phenotypes. Objective: The objective of this study was to evaluate the status of Agnibala (strength of digestive fire) and Kostha among subtypes of irritable bowel syndrome.  Materials and methods:  It was an observational cross-sectional study in which participants aged between 18 to 60 years of either sex were selected from the Kaya chikitsa OPD, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi. A total of 139 subjects were registered, out of which 59 were male and 80 were female. Results: The present study reported that a predominant proportion of individuals diagnosed with irritable bowel syndrome (IBS-C) exhibited Mandagni (89%) whereas Viṣamagni was most frequently observed among diarrhoea-predominant IBS (IBS-D) subjects (54.4%). Despite differences in Agnibala, both groups predominantly demonstrated Madhyama Koṣṭha was the most commonly observed Koṣṭha type in both groups. Conclusion: The variation in Agnibala was observed in both the subtypes of IBS, as IBS-C exhibited Mandagni, whereas Viṣamagni was reported in IBS-D. However, Madhyama Koṣṭha was observed as the Koṣṭha type in both the groups.