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AYURVEDA CONSIDERS THE digestive system the “master system” of the body. The digestive system is the main port of entry for ingesting the food required to nourish every system in the body. The entire process of digestion including nourishment of tissues as well as available energy depends on the health of the digestive system. It is not only what we eat but the strength and balance of the digestive system and agni that determine whether the entire mind-body system gets nourished.
Ayurveda assesses digestive health by the state of a person’s agni. Imbalances of the digestive fire are considered the main cause of various diseases of the digestive system including those of the esophagus, stomach, small intestine, and colon. Therefore, kindling agni and reestablishing its capacity to digest food properly is the main treatment principle in managing disorders of the digestive system.
Ayurveda always discusses the concept of metabolism in terms of digestion. In Ayurvedic terms, metabolism refers to subtle digestion, when absorbed nutrients in the gut are further transformed into the various tissues, energies, and vitality after gross digestion from ingestion to absorption in the intestinal tract. Since subtle digestion occurs in all of the tissues and organs, it is also called cellular digestion. The nutrients from the gut are transformed into energy and absorbed by the body’s various tissues in the process of metabolism that occurs at a cellular level. Therefore, metabolic disorders are also considered a derangement of the body’s subtle agni, which includes hormones and other factors of cellular metabolism. Correcting this imbalance is Ayurveda’s primary focus.
Impairments of digestive strength and metabolism can affect a child’s growth and development and sometimes lead to lifelong issues such as asthma, cardiovascular disease, and high blood pressure. Ayurveda’s approach to pediatric health management is always to maintain a child’s healthy digestion by sustaining balanced agni. Some of the most common digestive conditions that affect children today are stomachache, indigestion, vomiting, and diarrhea along with the metabolic disorders of obesity and diabetes. Let’s look at the Ayurvedic approach to managing these conditions.
stomachache and Indigestion
Tummy trouble tops the list of common issues for children, but their complaints can sometimes be difficult for parents to interpret because the pain is often nonspecific. In many cases, the location of pain in the abdomen along with the nature of the pain can help identify the issue.
Typically, when your child gets a stomachache after eating, it is usually due to indigestion. Burning sensations in the upper abdomen accompanied by acid reflux and sour belching are signs of hyperacidity and inflammation of the stomach lining, commonly known as gastritis. Lower abdominal pain and spasms followed by diarrhea are typically due to acute or chronic conditions in the colon such as dysentery or IBS and usually subside in a few hours or days depending on the nature of the condition. However, if your child complains about a stomachache that won’t go away or recurrent abdominal pain, it’s important to call your child’s physician for an assessment. Prompt medical care avoids unnecessary complications. Anytime you’re unsure if your child’s symptoms warrant a visit to the doctor, it’s always best to call your pediatrician.
The most common reasons for indigestion and stomachache in children are:
•Overeating
•Eating before the previous meal is completely digested
•Eating foods that are hard to digest like oily and fried foods, cheese, and too many raw salads or vegetables
•Eating uncooked or half-cooked food
•Eating excessively sweet, sour, and salty food
•Sleeping immediately after meals
•Drinking lots of water during a meal
Ayurveda offers many natural and effective home remedies to ease spasms of the gut due to indigestion that may lead to colicky-type abdominal pain and cramps and recommends warm application both internally and externally to relieve pain. First and foremost, be aware that feeding your children cold or uncooked, raw foods anytime they have an upset stomach will increase their pain and discomfort. Prepare freshly cooked meals whenever possible and offer warm, easily digestible foods when your child feels hungry. When the digestive fire or agni runs low—which is often the case with indigestion and stomach pain—it’s time to find some kindling! Think of your child’s agni as a little campfire that has been extinguished or isn’t burning brightly enough to fully cook or digest their food. Ayurveda offers various routines and recipes to rekindle and strengthen agni that you can find in chapter 5. Many of them start in the kitchen!
One of the best ways you can stoke your child’s digestive fire is by using digestion-enhancing spices. A pinch of cumin, ginger, cardamom seed, or fennel seed in a cup of tea or bowl of soup, for example, is very beneficial for increasing agni and alleviating stomach pain and discomfort due to indigestion. Avoid cold, oily, or hard to digest foods that will dampen or extinguish agni until your child feels better and expresses a more regular pattern of hunger—a sure sign their digestive fire is burning brightly once again.
Another way you can use Ayurvedic herbs and spices is to transform certain foods and beverages into a more easily digestible form. Dairy is a great example. The usual practice, especially in the Western world, is to give children a glass of cold milk directly from the refrigerator. You can avoid indigestion and stomachaches and make the milk easier for your child to digest by diluting it first with some water and warming it up on the stove with a pinch of turmeric or ginger powder.
A simple and traditional Ayurvedic practice that uses external application of warmth to relieve colicky abdominal pain in children is to apply warm castor oil on the abdomen. You can heat it to lukewarm either on the stove or simply by rubbing it between your palms using friction. The application should be very light and ideally in a clockwise direction for a minute or so. Ayurveda recommends you press the pause button on all sports, exercise, and strenuous activities and encourage your child to rest until stomach pain fully resolves.
Vomiting and Diarrhea
Vomiting and diarrhea are common childhood conditions that can either signal a problem on their own or be symptoms of other illnesses like inflammatory bowel disorders or appendicitis. While vomiting or emesis is the forceful expulsion of stomach contents from the mouth, diarrhea expresses as frequent watery or loose stools. Vomiting is often associated with nausea, which can be a strange uneasy feeling for children. These conditions can affect your children’s moods and behaviors, and sometimes make them anxious or even cry. Or they may become very quiet and subdued when they feel like they might throw up. Usually, they will want to lie down or go to bed early. Keeping your children company when they are under the weather helps them feel supported and protected and may even help speed up their recovery!
There are many causes of vomiting and diarrhea such as viruses, bacteria, food poisoning, indigestion, hyperacidity, gut inflammations, intestinal parasites, overeating, underlying medical conditions, or eating undercooked food. Ayurveda’s primary consideration for both these conditions whether they occur on their own or together is the gut responding to something that it doesn’t agree with, creating crisis for its normal function.
There can also be mental or emotional causes of vomiting such as stress or seeing something that creates aversions or disgusting feelings in the mind such as a pool of blood or an open wound or exposure to a foul smell, for example. Other disorders that cause vomiting are migraine headaches, motion sickness, imbalances of the inner ear like Ménière’s disease, and behavioral issues like bulimia. The most common reasons for diarrhea in children are stomach infections like gastroenteritis, indigestion, and food intolerances and allergies to ingredients like gluten and dairy.
Vomiting and diarrhea are natural, protective urges your body expresses to expel harmful contents and should never be suppressed—especially in cases of toxicity, indigestion, or food poisoning. The general principles Ayurveda suggests you follow are to allow the body to purge whatever it needs to remove from the system and then support the body to avoid possible complications like dehydration and exhaustion. Cases with no substance to be expelled, such as overstimulation of the gastric or esophageal mucosa or excessive vagal stimulation, can affect nutrition and cause considerable discomfort, which needs to be either managed or treated depending on the root cause.
The most important advice to parents when your child vomits is to stay calm. Vomiting is frightening and exhausting to children, and if they see you worry or panic, they will be much more affected mentally by the episode. Reassuring your child and avoiding dehydration are key at this stage. A lot of parents make the mistake of feeding their child immediately after vomiting, thinking they are probably starving because the last meal is now out of their system. The fact is when you feed your child or encourage them to drink a lot of fluids at this point, it might cause the vomiting to continue. Resuming a normal diet when your child has diarrhea can also prolong the problem. The best practice is to wait to feed your child until the vomiting and diarrhea completely subside and sip fluids that can give your child some immediate energy as well as electrolyte balance. Prolonged bouts of these conditions can lead to dehydration, which can be serious if left untreated. Always watch for these signs of dehydration:
•Dry lips, dry mouth, and sometimes cracked lips
•Dry or wrinkled skin (notably on the abdomen and upper arms or legs)
•Absence of urination for 6–8 hours
•Reduced alertness or inactivity
•Weak, fast pulse
•Excessive sleepiness or disorientation
•Rapid and deep breathing with sunken eyes
Ayurveda identifies many simple kitchen ingredients and spices that can treat nausea, vomiting, and diarrhea in children. Fresh lime juice, cardamom, ginger, black pepper, and cumin can all relieve and soothe nausea and help stop vomiting. Sipping a tea made by boiling water with the skin of pomegranate fruit or a pinch of nutmeg powder with honey may help ease diarrhea. Here are some traditional Ayurvedic home remedies that can help you support your children’s recovery:
•Add a teaspoon of lime juice to a cup of water at room temperature and blend with a teaspoon of unrefined cane sugar and a pinch of salt. Sipping this every few minutes can help soothe nausea, vomiting, and dehydration due to diarrhea.
•Boil a tablespoon of powdered puffed rice in a cup of water, add a teaspoon of unrefined cane sugar, and take 1 teaspoon of this mixture every ten to fifteen minutes to ease nausea and manage dehydration and exhaustion.
•Chewing one or two cardamom seeds can also help ease nausea.
•If the nausea, vomiting, and diarrhea are due to indigestion or the previous meal not agreeing with the stomach, mixing a few drops of ginger juice with a teaspoon of lemon juice and taking a few drops every few minutes can settle the stomach.
•Boiling ½ teaspoon of cumin seeds in a cup of water with a pinch of nutmeg, and sip frequently.
•Offer your child ½ teaspoon of equal parts natural raw honey and fresh lemon juice—another effective home remedy!
Obesity
According to Ayurveda, all diseases can be broadly classified into two categories: diseases due to overnutrition or accumulation (santarpanaja roga) and diseases due to depletion and degeneration (apatarpanaja roga). When material and energy inputs to the body exceed its normal outputs, accumulation and weight gain occur. On the contrary, when energy output is greater than energy input, this results in weight loss. In other words, metabolic diseases are either due to anabolic excess or catabolic excess; obesity is the former.
Obesity is a continuing epidemic in the United States and affects one in five children and adolescents. According to the National Center for Health Statistics (NCHS), 19.3 percent of children and adolescents ages two to nineteen are obese, affecting about 14.4 million individuals.[1] This serious, chronic disorder impacts every aspect of a child’s life and also puts tremendous strain on families. Childhood obesity gives children and adolescents a much greater risk for poor health. Obesity is linked to many disorders including type 2 diabetes, heart disease, joint disorders, and cancers.
Body mass index (BMI) is commonly used to assess childhood weight status. It is calculated by dividing a person’s weight in kilograms by the square of their height in meters. For children and adolescents, BMI is ageand gender-specific and varies based on these factors. Because of this, a child’s BMI needs to be identified relative to other children of the same age group and gender. When a child’s BMI is greater than the ninety-fifth percentile, they would be considered obese.
Ayurveda identifies obesity as a kapha-predominant disorder. While there are many potential causes of childhood obesity, these are considered the most common:
•Overeating and having meals too frequently
•Excessive fried, sweet, and fatty foods
•Lack of exercise or sedentary lifestyle
•Excessive sleeping, especially during the daytime
•Hereditary factors
•• Increased stress and emotional disturbances
•Derangement of agni that includes subtle hormonal imbalances
Ayurveda considers obesity a major disease (maha roga), meaning a complex condition that affects multiple body systems and can be difficult to manage. Due to one or more of these causes, the digestive and metabolic fire (agni) can weaken and affect the transformation of food and nutrients to energy for various tissues, causing an accumulation of fat in the body. Since this process slows down the efficient processing of energy, these children often experience a decrease in energy levels and feelings of laziness that in turn make them more sedentary and causes further accumulation.
The key factor that makes obesity such a difficult condition to manage is that it increases hunger. Let’s take a look at how that happens. You probably know that fat is an insulator. The increased development of the body’s layers of fat makes it difficult for heat to dissipate from the inner body. When that heat accumulates inside the body, it expresses as increased hunger. As a child’s hunger increases beyond normal levels, there will be a tendency to eat larger quantities of food more frequently. And here’s where things become even more complicated. The stress mechanism triggered by emotional disturbances works in the opposite way. When your child experiences increased stress and anxiety, it puts the sympathetic nervous system in overdrive. The body perceives this situation as a crisis and initiates the coping or supporting mechanism of hoarding resources to combat the crisis. Unfortunately, fat and sugar are the easiest energy resources for the body to start accumulating. This response develops into obesity or diabetes. These children often find sweet and greasy foods to be comforting while under stress or emotional crisis, further adding to the problem. The increased weight affects a child’s quality of life due to lethargy, exhaustion, breathlessness, an excess load on weight-bearing joints, and social discrimination.
Ayurveda suggests that only a comprehensive approach of management can provide a sustainable outcome. That includes diet, lifestyle practices, activity, breathing techniques, and mind management techniques like counseling. Ayurvedic principles for managing obesity in children focus on a reduction of kapha coupled with streamlining agni. While approaches to weight loss that include drastic crash diets or excessive exercise may provide a sudden drop in body weight, this path will only lead to instant gratification; it will never provide a sustainable outcome and may affect the balanced growth and development of your child. Ayurveda recommends taking a moderate and consistent approach using as many tools as possible. The tools Dr. J finds most effective for supporting and managing obesity in children are:
1.Offer your children balanced and satisfying meals three times a day with varied ingredients like lentils, vegetables, whole grains, proteins, and spices, and reduce sweets, oils, and fatty items. This will help them feel satiated and engage the entire digestive system in a normal and gradual digestive process without a sudden surge of carbohydrates to the system. Regular mealtimes support the body’s natural intelligence to align the digestive and metabolic systems with circadian rhythms to perform optimally and enhance the reutilization of fat in the body.
2.Create moderate and consistent daily activities and engage your children in outdoor games based on their interests. Simple and consistent activities every day will provide more sustainable results than excessive exercise two or three times a week.
3.Specific pranayama techniques or breathing practices with activating breaths like Kapalabhati or the Breath of Fire can be very helpful when performed regularly for a few minutes. Children should not engage in breathing practices immediately after meals. It is ideal to wait an hour after eating.
4.Children who have a tendency for emotional eating need to be supported to manage their stress and emotional issues through active interventions by parents that create opportunities to have positive conversations and facilitate practices like meditation and journaling.
5.There are many Ayurvedic natural herbs and formulations that can support obesity by enhancing digestion and metabolism and streamlining the metabolic and energy hormones, which can be incorporated into a treatment protocol based on the guidance of an Ayurvedic physician.
A healthy diet, regular physical activity, and positive lifestyle practices can help children achieve and maintain a healthy weight starting at an early age that continues throughout their lives.
Diabetes
Diabetes comes under a group of diseases called prameha in Ayurvedic medicine. The literal translation of the word prameha is “passing large amounts of urine.” There are twenty types of prameha: ten kapha-predominant, six related to pitta, and four associated with vata aggravation.
Excessive urination and turbidity (cloudiness) are the common features of all stages of prameha, considered a heterogeneous group of diseases with a common symptom of increased production of urine with sweetness and altered viscosity. The involvement of all the doshas along with diabetes’s strong connection to vital organs like the pancreas (kloma) and urinary system (vasti) makes it a serious illness with a prolonged nature and various complications.
Both type 1 and type 2 diabetes can initiate at any age. Children are more prone to type 1. In this case, the pancreas doesn’t produce sufficient insulin so that the body is unable to utilize sugars including glucose, causing an increase of sugar levels in the blood. Type 2 diabetes used to be considered strictly “adult onset” diabetes as children weren’t as prone to it, but the drastic increase in childhood obesity has led to more children being diagnosed with type 2 diabetes these days. The most common reasons type 2 diabetes presents in children are being overweight, hereditary reasons, having a mother who had diabetes during pregnancy, or diseases that affect insulin production. Improper diet and lifestyle contribute to this condition.
According to Ayurvedic principles, the disease processes of diabetes and obesity have many similarities, and children with obesity are prone to diabetes and vice versa. The various reasons mentioned above cause weakened agni, which in turn affects the body’s efficiency in processing food and absorbing nutrients into tissues, energy, and vitality. The unutilized food and nutrients accumulate in the body, causing further stagnation and weakness, and the sustained presence of increased sugar levels in the blood affects the consistency of the body fluids, causing increased drainage through the kidneys or excessive urination (polyuria) and excessive thirst (polydipsia). These fluid imbalances and metabolic irregularities then begin to affect vital organs leading to further diabetic complications including vision problems (diabetic retinopathy) and degeneration of nerves (diabetic neuropathy).
Ayurvedic management of prameha is not just about reducing blood sugar. Ayurveda’s focus is to correct the root cause: enhancing agni, removing stagnation (ama), and correcting system irregularities. A carefully planned healing protocol with a balanced diet, regular activities, streamlined lifestyle practices, and traditional Ayurvedic herbs and formulations are all brought to bear.
Certain food ingredients and spices are considered very beneficial for managing diabetes. Bitter melon has been proven to have positive effects in controlling diabetes but, because of the palatability issue, requires preparing simple dishes for children rather than consuming the juice or soup of bitter melon directly. Ayurveda considers the combination of Indian gooseberry powder and turmeric powder the best home remedy (agrya oushadha) for prameha. A common practice is to drink half a cup of warm water with ½ teaspoon of Indian gooseberry powder and ¼ teaspoon of turmeric powder a day. Common spices like fenugreek seed, black cumin, Indian curry leaves, and turmeric powder are all suggested for children with diabetes. Daily physical activities, kapha-reducing breathing techniques, eating according to a set schedule, staying clear of simple carbohydrates, and avoiding daytime sleep as well as staying up too late are some specific guidelines for all individuals with diabetes.
There are many other disorders that can affect the digestive and metabolic systems. The Ayurvedic system of medicine focuses on correcting the body system regardless of symptoms or the name of a specific condition or disorder. You can understand the management principles of all possible disorders in a single system the same way. Since digestion and metabolism or agni are Ayurveda’s main consideration for prevention as well as healing all diseases, learning about imbalances of the digestive and metabolic system can help you understand and create protocols for other system disorders as well.