Ayurvedic constitutions and digestion

Ayurveda places great importance on proper digestion and effective elimination. Our appetite and digestive capacity

Ayurveda attaches great importance to proper digestion and effective elimination. Our appetite, digestive capacity, and the regularity and consistency of stools provide fundamental indications about the general state of health.

Ayurvedic texts such as the Charaka Samhita, one of the oldest and most authoritative treatises of Ayurveda, written between 400 and 200 BC, have long recognized the link between digestive health and the onset of diseases.

Today, modern science confirms this view, highlighting how imbalances in the gut microbiome are linked to numerous chronic diseases, including inflammatory bowel diseases, asthma, behavioral disorders, diabetes, cardiovascular diseases, and autoimmune conditions. (1)

Digestion and Pathogenesis

In Ayurveda, digestive imbalance is considered the main cause of most diseases, except those caused by external factors.

Ancient classical texts identify the Udbhava Sthana (site of origin) in the pathogenesis (Samprapti) of various pathologies, often locating the origin in the stomach (Amashaya) or the large intestine (Pakvashaya).

These Sanskrit terms precisely describe the role of the digestive organs through their meaning:

• Amashaya: "ashaya", dwelling or seat of ama (raw and undigested food material), referring to the stomach.
• Pakvashaya: "ashaya", dwelling of paakva (cooked and digested food material), referring to the large intestine.

Ayurveda introduces two fundamental concepts to understand the digestive process and bowel movements: Agni (digestive capacity) and Kostha (bowel patterns).

The nature of an individual's Agni and Kostha is influenced by the predominant Dosha of their constitution (Prakriti), but can also be altered by any imbalances of the Doshas acquired through diet and lifestyle.

Agni (digestive capacity)

Agni, which literally means "digestive fire," represents the individual's digestive capacity.

In Ayurveda, four types of Agni are distinguished, each describing a different level of efficiency in digestion.

Vishama Agni (irregular digestion)

• Caused by the dry and light qualities of Vata.

• Digestion is unpredictable and irregular.

• Symptoms include variable appetite (sometimes hunger, other times not), bloating, and flatulence.

Tikshna Agni (intense digestion)

• Caused by the hot and penetrating qualities of Pitta.

• Digestion is rapid and intense, and food is metabolized very quickly.

• Symptoms include thirst, excessive hunger, hypoglycemia, and acid reflux.

Manda Agni (slow digestion)

• Caused by the slow and moist qualities of Kapha.

• Digestion is slow and ineffective, and even small amounts of food can be indigestible.

• Symptoms include poor appetite, lethargy, and a feeling of abdominal heaviness. Sama Agni (balanced digestion)

• Result of a balance between the Doshas.

• Associated with good appetite, balanced metabolism, regular digestion, and a feeling of energy and vitality.

Kostha (bowel function)

Kostha is the concept that describes the bowel habits of each individual, including the frequency and consistency of evacuations.

Types of intestine and symptoms

• Krura Kostha (hard intestine)

o Predominance of Vata, which brings dryness in elimination.

o Stools are dry and hard, with difficulty or effort in expulsion.

o Elimination is irregular and does not occur daily.

• Mrdu Kostha (soft intestine)

o Predominance of Pitta, which generates heat and moisture in elimination.

o Stools are soft, semi-solid or liquid, easy or quick to expel. o Elimination occurs several times a day.

• Madhyama Kostha (moderate intestine)

o Predominance of Kapha, which brings heaviness and moisture.

o Stools are well formed(2), neither too dry nor too soft, and are expelled with moderate ease.

o Elimination is regular and daily.

When the Doshas are in balance, a moderate intestine, or Madhyama Kostha, is obtained, which represents the ideal condition and does not favor the development of diseases.

The Bristol Stool Chart

The Ayurvedic approach to bowel habits (Kostha) aligns perfectly with the Bristol Stool Chart, a clinical assessment tool introduced in 1997, which classifies seven different types of stool.

Below is a chart highlighting the correspondences between the Bristol Stool Chart and the Ayurvedic concepts of Kostha and Agni

Digestive Imbalances and Their Impact on Other Diseases

Digestive imbalances arise from an imbalance in the Doshas.

A person with a predominantly Vata constitution naturally tends toward irregular digestion (Vishama Agni) and constipation (Krura Koshtha).

However, in situations of stress or excessive consumption of spicy foods (which generate an excess of Pitta), this same person could develop very intense digestion (Tikshna Agni) or episodes of diarrhea (Mrdu Koshtha).

These imbalances, in the long term, can have repercussions throughout the body, contributing to the onset of various diseases.

Colitis and Skin Problems

In Western medicine, there is a relationship between ulcerative colitis, characterized by inflammation and ulcerations in the colon, and inflammatory skin diseases such as hives, rashes, and psoriasis.

In Ayurveda, this link can be explained through an excess of Pitta (associated with the fire element and therefore with inflammation) in the digestive tract, which can manifest as Pitta-type skin symptoms.

Parkinson's Disease and Constipation

It is known that patients with Parkinson's disease often suffer from constipation.

An important 2001 study highlighted that chronic constipation can be a risk factor for parkinsonism: participants with bowel movements less frequent than once a day had a 2.7 times higher likelihood of developing Parkinson's in old age.(3)

With more regular elimination (2 or more times a day), the risk decreased. In Ayurveda, Parkinson's is known as Kampavata: Kampa indicates tremors and Vata reflects a Vata imbalance, associated with irregular digestion (Vishama Agni) and constipation (Krura Koshtha).

Is there a perfect bowel movement?

While the Bristol Stool Chart indicates that a normal bowel habit can vary from one to three days between evacuations, Ayurveda insists on the importance of having a complete and daily bowel movement.

Even just skipping a day or not having a complete elimination is considered a sign of constipation.

Optimal elimination is the result of Sama Agni (balanced digestion), which leads to Madhyama Kostha (moderate elimination).

Its characteristics include:

• well-formed, cylindrical-shaped stools,

• that float in water,

• light brown in color,

• with a mild odor,

and not sticky (do not adhere to the toilet, leaving the anal area clean) (4)

According to Ayurvedic wisdom, everything we consume should help support the balance of our digestive system.

Imbalances in the digestive system are considered the primary cause of Dosha imbalances in the body, and balancing digestion helps improve overall health.

For this reason, Ayurveda uses an integrated approach of dietary modifications based on qualities and tastes, herbal remedies, and self-care practices.

By knowing your digestive type or imbalance, you can make more conscious food choices to support digestive balance and promote overall well-being.

1 Durack, J. & Lynch, S. (2019): “The gut microbiome: relationships with disease and therapeutic opportunities.” The Journal of experimental medicine vol. 216,1: 20-40. doi: 10.1084

2 Murthy, KRS (2003): Ashtanga Hrdayam by Vagbhata, reprint, volume 1, Sutrasthana 1: Varanasi: Chowkhamba Press.

4 Lad, Vasant (2006): Textbook of Ayurveda, Volume 2: A complete guide to clinical assessment. Albuquerque: The Ayurvedic Press.

References to doshas and energy belong to the Ayurvedic tradition. This content is for information and wellbeing and does not replace professional medical advice.