AN AYURVEDIC DIAGNOSTIC APPROACH IN PAKWASHAYAGATA VATA WITH BIOCHEMICAL AND CLINICAL IMPROVEMENT-A CASE STUDY

Abstract

Background: Pakwashayagata vata is a clinical entity characterized by the predominance of aggravated vata localized in the pakwashaya, presenting with symptoms such as malavrodha, anannabhilaṣha, kaṭishula and bhramprachiti. Accurate ayurvedic diagnosis based on dosha, dushya, and sthana forms the cornerstone of successful management. Objective biochemical parameters may complement clinical assessment in documenting therapeutic outcomes. Case Presentation: A 55-year-old male presented with complaints of constipation malavrodha (constipation), atopa (abdominal distension and flatulence), anannabhilaṣa (loss of appetite), bhramaprachiti (giddiness), and kaṭishula (low back pain) for two months. He was a known case of arsha for one year. Baseline serum vitamin B12 level was <50 pg/mL, with no history of vitamin B12 supplementation or any concurrent conventional treatment. Based on clinical features and Ayurvedic examination, the condition was diagnosed as pakwashayagata vata. Intervention: The patient was initially managed with chandraprabha vaṭi, Patha, dhamasa, Ananta, shatavari churna combination, arshoghna vaṭi, and aragvadha kapila. This was followed by kala basti incorporating shampakadi niruha basti for 15 days. Subsequently, Snigdha virechana with abhayadi modaka, aragvadha kola phaṇṭa and eranda taila was performed after sukumarak ghrita snehapana, followed by appropriate saṃsarjana krama and continuation of internal medications. Results: The patient demonstrated progressive improvement in bowel habits, appetite, giddiness, low back pain, and overall well-being. Serum vitamin B12 levels increased from <50 pg/mL at baseline to 80 pg/mL after two months and 131 pg/mL at final follow-up. No adverse events were observed during treatment. Conclusion: This case highlights the significance of ayurvedic diagnostic reasoning in identifying pakwashayagata vata and selecting stage-wise panchakarma-based management. Marked clinical improvement accompanied by progressive biochemical improvement suggests that objective laboratory parameters may serve as supportive evidence while evaluating ayurvedic interventions. Further systematic clinical studies are warranted to validate these observations.