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Introduction

Nurturing today’s children is essential for a bright future, as they symbolise tomorrows potential. The physical well-being of young children has direct effect on their overall development. Understanding Vibandha/ Constipation i.e., obstruction of stool will help in understanding the overall health of child. The disease known as vibandha is not specifically and directly described in the Ayurvedic samhitas. It is considered a symptom in the majority of Annavaha and Purishvaha srotovikriti. Vibandha is vyapad of Vamana and Virechana. Vibandh, a side effect of sansodhan (Vamana or Virechana) in Ajirna, is a symptom of parikartika (fissure in ano). It is a consequence of both an apatarpanjanya roga (diseases brought on by nutritional inadequacies) and acute hemostasis in Raktarsha (bleeding piles). In Ayurveda word vibandh derived “vi” and “bandha” which means binding of stool.[1] Vibandha causes due to suppression of the defecation urge for a long time or excess absorption by vata & pitta mala gets hard and is difficult to  defecate. Purishvaha strotas is transport channel of mala & can be correlate with parts of large intestines, these organs are mainly concerned with absorption, lubrication & Storage, and excretion of mala. Any anatomical defect inside these organ leads to disturbances in bowel habits which are similar to that of purishvaha strotas dushti lakshanas. Primary derangement in this disease is at the level of Apan vayu,[9] which causes dryness in lower alimentary tract leading to slow peristalsis which ultimately causes dryness of faeces and constipation. Regular defecation is one of the indicators of good health. The normal defecation pattern of children might change according to age & dietary habits. Constipation is gastrointestinal disease defined as infrequent defecation, painful defecation or both.[10] Initial painful defecation leads to voluntary withholding which is a further way for prolong statis of faecal matter, thus a viscous cycle is initiated & with more pain on defecation & constipation occurs. These leads to distress in child further causing recurrent discomfort in  abdomen reduce in appetite. Also exhibits changes in behaviour such as mood swings & lack of interest in studies or difficulty in concentrating. Functional constipation can be caused by situational psychological, developmental and dietary issues. According to Ayurveda, the main causes of constipation  include Purishaja Vegadharana (with holding of stool,Children nowadays are spending too much time on devices like smartphones and televisions, which causes them to neglect their daily hygiene routines.), Akal or ashamay purish tyag, a lack of water consumption and a lack of fiber-rich foods, eating fast food, which is typically composed of maize flour eg: eg:-pizza, burger, momos etc.[2] The micro or macro anatomical structures known as strotas are responsible for the movement of dosha, dhatu, and mala from one area of the body to another. Purishvaha strotas is concerned with transportation of mala. Moolsthana of purishavaha strotas according to Acharya Charaka is Pakvashaya & Sthula Guda[3] & according to Acharya Sushruta it is Pakvashaya & Guda[4]. Pakvashaya is considered as koshthang by Acharya Charak & aashaya by acharya Sushruta. Guda according to acharya Sushruta is a terminal part of sthulantra. Purishvaha strotas gets vitiated in emaciated persons by suppression off defecation  urge, eating without hunger or by consuming large quantity of food. In modem anatomy, Purishvaha strotas can be correlate with different parts of large  intestines. The sign & symptoms of strotas dushti are Atipravrutti (Increase flow), Sanga (obstructction of flow), Grathitantrata, Sashabda Sashula malapravrutti etc. According to Ayurveda Constipation is a clinical condition in which there is a predominance of vata dosha along with impairment of pachaka pitta & kledaka kapha.[5]

AIM

1. To review the disease Vibandh (Constipation) in children.
2. To review the behavioral causes and neurological involvement of constipation through modern science.

1. To review the management of Vibandh (constipation) through Matra Basti.

Objectives

1. To study the disease Vibandh (Constipation) in children.
2. To study the management of Vibandh (constipation) through Matra Basti

       in children.

METHODOLOGY

The foundation of this research is an examination of Ayurvedic literature. Resources have been gathered regarding the relationship between Vibandha and Matra Basti constipation. Charak Samhita, Susruta Samhita, other important Ayurvedic texts, modern text books, articles and generals were studied in this review.

Discussion

In recent years, there has been an unprecedented increase of incidences of gastrointestinal anomalies, due to changes in life style, diet habits, behavioral pattern etc., which very much disturb the normal physiology of digestion. Vibandha is a disease of Annavaha Srotasa, any disturbance of Agni due to irregular diet and behavioral pattern as well  as the involvement of mental stress and strain, leads to the disease Vibandha. Basti administered through Guda (Rectal Route) reaches the Pakvashaya which is considered as the main site of Vata Dosha. After that it normalizes Apana Vayu leading to Vatanulomana and improves physiological functioning of Vata. The ailment itself is treated when the Vata is calmed, as it is a primary cause of the illness. One variety of Sneha Basti is Matra Basti.[11] Since basti attempts to achieve Purna Purish shodhana in the Purishavaha strotas and Vataanulomana, it can be regarded as the best therapeutic option and emergency therapy for children who arrive with chronic constipation accompanied by abdominal pain and distension. In Vibandha, targeting Vata shamana  and Anulomana Matra basti can be adopted. According to Charak Samhita, it is Balya, Srushtapureesha (cleans bowel) Brihana & Vatarogahar (cures Vata diseases).[12] Sometimes, aggregated vata provokes the aggravation of pitta & kaph Vataanulomana tail or ghrita can be practice with main intension of koshth snehana,vata anulomana, & relieving purish rukshata. Sneha Basti includes six Pala of Sneha, Anuvasana Basti contains three Pala of Sneha, and Matra Basti contains one and a half Pala of Sneha, according to Chakrapani's description of Matra Basti. From above references it can be said that the dose of Matra Basti is 1½ Pala of Sneha i.e.  approximately 60 ml. The normal time of Pratyagamana Kala of Sneha Basti is 3 Yama i.e. 9 hours.[6] In addition to promoting the regular operation of the rectum and associated vessels, medicated basti promptly reduces the retention of urine, feces, and flatus.

Mode of Action: Sneha, also known as Matra basti tail, is completely antagonistic to vata quality. Sneha facilitates smooth evacuation and lubricates the intestines (Pakvashaya). Children who are constipated should take medicine that has Ushna, Madhur, and Snigdha qualities.[7]

Conclusion

It has become very clear that Auishadhi siddha Matra basti in Vibandh is very useful and effective. The main cause of developing vibandh (constipation) is Agnimandya, Adhaman (Pratilom Vayu). Auishdhi siddha matra basti act on all causes for Samprapti Bhanga &  itself not developing any complication like Adhaman. Matra Basti helps to maintain the equilibrium of Vata dosha responsible majorly for vibandh (constipation).