Grahani Roga: A Critical Review of Nidana Panchaka and Samprapti Vighatana with Correlation to Irritable Bowel Syndrome and Malabsorption Syndromes

Grahani (the functional/anatomical site situated between Amashaya and Pakvashaya that retains ingested food until digestion is complete) is considered so clinically significant in Ayurveda that Acharya Charaka devoted an entire independent chapter — Grahani Chikitsa Adhyaya (Chikitsa Sthana, Chapter 15) — to its disorder, Grahani Roga. This review applies Nidana Panchaka, Ayurveda's five-fold diagnostic framework (Nidana, Purvarupa, Rupa, Samprapti and Upashaya–Anupashaya), specifically to Grahani Roga, presents the original Charaka Samhita shlokas from the Grahani Chikitsa chapter itself that embody this framework, and elaborates the Samprapti (pathogenesis) of Grahani Roga stage-by-stage to identify points of Samprapti Vighatana (interruption of the pathogenic chain) relevant to diagnosis and treatment planning. The pathogenesis centres on Agnimandya (diminished digestive fire), which leads to Ama formation; this Ama afflicts the Grahani, impairing its capacity to retain food for the normal duration of digestion and producing the hallmark presentation of alternating loose and hard stools, undigested or mucus-laden faecal matter, abdominal distension, and progressive loss of strength and complexion. Four Doshika types — Vataja, Pittaja, Kaphaja and Sannipataja Grahani — are described, each with a distinct Nidana and Rupa. This review systematically correlates these four types with the Rome IV diagnostic subtypes of Irritable Bowel Syndrome (IBS-D, IBS-C, IBS-M and IBS-U) and with the clinical presentation of malabsorption syndrome, highlighting the shared functional (non-structural), chronic, and multifactorial nature of both the classical and contemporary constructs. Grahani Roga is proposed as an early, physiologically framed Ayurvedic parallel to modern functional bowel disease, and its Nidana Panchaka-based diagnostic model — which uniquely incorporates a therapeutic diagnostic dimension — is suggested as a useful complementary tool alongside Rome-criteria-based diagnosis in integrative gastroenterology practice.