SHOOLA: A CONCEPTUAL REVIEW WITH CONTEMPORARY CORRELATION

Background: Shoola is an important clinical concept described in Ayurvedic classics and is predominantly characterized by severe pain. Although the term is frequently associated with abdominal pain, classical literature describes Shoola at different anatomical sites and in association with different Doshas and pathological processes. Materials and Methods: A conceptual review was conducted based on the classical Ayurvedic references and contemporary correlations. The information was systematically analyzed under the domains of definition, classification, etiological factors, Dosha involvement, Samprapti, Lakshana, Upashaya and Sadhyasadhyata. Discussion: Shoola is described in Ayurvedic classics as severe, sharp or stabbing pain, sometimes compared with the sensation of being pierced by a pointed object. Vata is considered the predominant Dosha in the pathogenesis, with Pitta, Kapha and Ama contributing according to the type. Dietary errors, improper lifestyle, suppression of natural urges, psychological factors and Agnidushti are important etiological factors. The clinical descriptions show similarities with several contemporary conditions including intestinal colic, gastritis, peptic ulcer disease, gastroparesis, pleurisy, angina, urinary obstruction and rectal pain. Conclusion: Assessment based on Dosha, Agni, Ama, anatomical site, relation with digestion, associated symptoms and Upashaya provides a systematic approach to understanding the condition soola. Contemporary correlations may help in interpreting the clinical significance of the classical descriptions.