Effect of Eranda (Ricinus Communis L.) Taila (Oil) in The Management of Purishaja Udavarta (Chronic Constipation): A Prospective, Open-Label, Single-Arm Pilot Study

Abstract

Background: In today’s era the prevalence of the diseases and symptoms related to digestive system are increased due to unhealthy eating practice and sedentary life style. The physiological and morphological disturbance of digestive system exhibits impact on health, productivity, mental health and gut-brain axis. There is laboratory limitation in concern with diagnostic tools of the functional gastrointestinal disorders. The Purishaja Udavarta (chronic constipation) is the diseases conditions concerned with Purishavaha srotas (Large intestine and Rectum). The Vyadhi- viniscya (diagnostic conditions) of Purishaja Udavarta (chronic constipation) is based on Lakshanas (Cardinal symptoms). The treatment of Purishaja Udavarta with Eranda (Ricinus communis L.) beeja taila (seed oil) mentioned in the Ayurveda. Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire is frequently used in clinical trials of constipation.

In current study, Lakshanas (Cardinal symptoms) of Purishaja udavarta and PAC-SYM questionnaire used for the assessment effect of Eranda taila in management of the Purishaja udavarta.

Materials and Methods: A Prospective, Open-Label, Single-Arm Pilot Study Thirty patients with cardinal symptoms of Purishaja udavarta were enrolled. Patients received oral administration of 2.5 ml of castor oil with 50 ml lukewarm water before food at night for 21 days. Outcomes were six cardinal symptoms and 12-item PAC-SYM questionnaire.

Results: Thirty patients completed the trial. The composite PAC-SYM score showed a statistically significant reduction from 17.70 ± 7.54 to 4.93 ± 2.15 (mean difference: 12.77; 95% CI): [10.42,15.11] , <0.001, r=1.10) with an item reduction of 1.06 exceeding the MCID threshold (≥ 0.50). Purisha sanga improved by a 90.0% reduction from 4.00 ± 0.00 to 0.40 ± 0.50 (p <0.001, r=1.10), with full resolution in 86.7% of cases. Subscale reductions were significant across Stool (77.2%), Abdominal (67.1%), and Rectal (66.9%) domains (p <0.001). The total Ayurvedic symptom score dropped from 11.07 ± 3.16 to 2.80 ± 1.83 (74.7% reduction p < 0.001).

Conclusion: The findings of the study demonstrated the effect of Eranda taila in managing Purishaja udavarta on the basis of relief in the lakshanas of Purishaja udavarta and reduction in score of the PAC-SYM.