Purīṣavaha Srotas: A Review with Special Reference to Enteric Nervous System and Gut–Brain Axis

Background: In Ayurveda, Purīṣavaha Srotas are the channels involved in transportation and elimination of faeces, with Pakvāśaya (colon) as its primary anatomical seat (Mūla). Pakvāśaya is established in classical texts as the main site of Vāta Doṣa, the force regulating all neuro-regulatory and motor functions. Modern physiology has simultaneously recognised the Enteric Nervous System (ENS) as the “Second Brain” that works autonomously with the Central Nervous System (CNS) to preserve gastrointestinal homeostasis through the bidirectional Gut–Brain Axis (GBA). Aim: To synthesise the classical perspective on Purīṣavaha Srotas, evaluate functional analogies with the neurophysiology of the ENS and GBA, and explore Vāta-kṣaya/vṛddhi and its role in enteric dysregulation. Methods: A classical review was done by analysing Mūla Sthāna, Kriyā, and Srotoduṣṭi Lakṣaṇa from classical texts such as Bṛhatrayī with commentaries, and through indexed electronic databases for Ayurvedic and modern literature on neuro-gastroenterology, neurotransmitters, and functional gastrointestinal disorders (FGIDs), covering publications from 2000 to 2026. Results & Discussion: The functions of Apāna Vāyu and Samāna Vāyu in the Pakvāśaya are functionally analogous to the intrinsic reflex arcs of the myenteric (Auerbach’s) and the submucosal (Meissner’s) plexuses, respectively. In addition, the Srotoduṣṭi manifestations such as Atipravṛtti (diarrhoea/hypermotility) and Saṅga (constipation/hypomotility) appear conceptually analogous to the pathology of an altered Gut–Brain Axis due to Mānasika Bhāvas (psychological stressors such as Cintā and Bhaya). Conclusion: Correlation of Purīṣavaha Srotas with the ENS gives a measurable neuro-physiological basis to understand Vāta disorders in the gut and provides deeper insights into the holistic management of functional bowel disorders. Keywords: Purīṣavaha Srotas, Pakvāśaya, Enteric Nervous System, Gut–Brain Axis, Vāta Doṣa, Apāna Vāyu, Samāna Vāyu, Visceral Hypersensitivity