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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH  
Importance of Understanding Constipation (Malavashtambh) In view of  
Panchabhautik Siddhanta  
Dr.Anuradha Babanrao Sangle 1 , Dr.Archana A. Kulkarni 2  
1 Second Year PG Scholar, Department of Rognidan, BSDT’s Ayurved Mahavidyalaya, Wagholi, Pune.  
2 HOD, Department of Rognidan, BSDT’s Ayurved Mahavidyalaya, Wagholi, Pune.2  
Corresponding Author: Dr.Anuradha Sangle  
E-Mail : anusangle3236@gmail.com  
Article Info: Article Received on : 20/02/2026  
Article Reviewed on: 05/03/2026  
Article Published on : 15/04/2026  
Cite this article as: - Sangle, A., & Kulkarni, A. (2026). Importance of Understanding Constipation (Malavashtambh) In view of  
Panchabhautik Siddhanta. International Journal of Diagnostics And Research, 3(3), 88–94.  
https://doi.org/10.5281/zenodo.19597611  
Abstract  
According to Ayurveda, healthy human body represents an equilibrium state among Dosha, Dhatu, Agni and Mala  
accompanied with a pleasant Atma, Indriya and Mana. An imbalanced state of all or any of these is considered as  
pathological condition. The significance of Mala is equivalent to that Dosha, Dhatu and Agni. In Ayurveda, the human  
body and the universe are composed of five elements -Earth, Water, Fire, Air, and Space collectively known as the  
Panchamahabhutas. Constipation is defined as the incomplete and infrequent evacuation of hard stools. In Ayurveda, it  
can be correlated with Malavashtambha due to similarities in causes and symptoms. Classical Ayurvedic texts do not  
recognize Malavashtambha as a standalone disease; rather, it is seen as a symptom of various diseases or may appear  
as a single complaint. The causative factors of Malavashtambha can be analyzed based on Dosha predominance and  
their inherent qualities, such as Laghu, Ruksha, and Kharatva, which also help to determine the involvement of  
predominant Mahabhuta in pathogenesis. This review paper aims to explore the Hetu, Samprapti and Chikitsa of  
Malavashtambha through the framework of Panchabhautik Siddhanta. Understanding this concept is essential for  
effective disease prevention, diagnosis, prognosis, and treatment.  
Key words- Constipation, Goksheer, Malavashtambh, Panchmahabhuta.  
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These are typically expelled through Bahirmukha  
Introduction :  
Srotas (natural body channels and openings). One  
Swasthya of an individual depends entirely upon  
the balanced state of Dosha, Dhatu, Agni, Mala  
accompanied with pleasant Atma, Indriya and  
Mana.[1] The significance of Mala is equivalent to  
Dosha, Dhatu and Agni, this highlights the  
importance of Mala and physical activities  
associated with them. In Ayurveda, the process of  
digestion is termed as Avasthapak, which is  
classified into three stages based on dominant ‘Ras’  
formed during each stage i.e. Madhura Avasthapak,  
Amla Avasthapak, Katu Avasthapak. The ingested  
food undergoes transformation through successive  
stages of Avasthapak and in the end stage i.e. Katu  
Avasthapak pind Swaroop Purish mala is formed,  
which is Katuras Pradhan (pungent) due to  
dominance of Vayu Mahabhuta [2]. After digestion,  
food is divided into two components: the Sara-  
bhaga (nutritive essence) and the Kitta-bhaga  
(waste material). The Sara-bhaga, also referred as  
Ahara-rasa which is responsible for nourishing the  
tissue and sustaining body, while the Kitta-bhag  
collectively includes waste products such as Mala.  
According to Ayurveda Malas are beneficial for  
maintaining metabolic processes when they are in  
equilibrium state. For instance Malaroop pitta  
contributes in process of digestion, however when  
mala accumulate excessively they must be  
eliminated from the body to prevent onset of  
pathological conditions.[3] These waste products are  
broadly classified into two type:1) Aahar Mala–  
waste products formed during the digestion of food  
i.e. Purisha (feces), Mutra (urine), 2) Dhatu Mala–  
waste products generated during tissue metabolism  
such as Sweda (sweat), excreta in ear, nose etc.  
of the primary waste products Purisha, is formed  
after the complete digestion of food. Due to  
Agnimandya improper digestion occurs, leading to  
stagnation of improperly digested food which  
results in frequent or loose stool. In such cases,  
even a small intake of food or drink may stimulate  
bowel movements because the digestive system has  
not properly processed the previous intake. On the  
other hand, when food intake is insufficient, the  
formation of stool may be compromised. In such  
cases, the body may not initiate effective peristaltic  
movement, leading to constipation. Thus, the  
formation and elimination of stool are closely  
linked to the efficiency and balance of the digestive  
process. Malavastambha is a symptom which  
occurs due to Vikruti of Apan Vayu (Pratilom  
[4]  
Viguna of Apan Vayu)  
and Purisavaha Srotasa  
Dushti.[5] If stool is not evacuated easily and at the  
appropriate moment, it begins to accumulate in the  
rectum, resulting in difficulty or incomoplete  
evacuation.  
In  
Ayurveda,  
the  
obstruction,  
restriction, or blockage of the normal process of  
defecation is known as Malavashtambh. Acharya  
Charaka mentioned ‘Malavastambha’ in terms of  
‘Vibandha’ or ‘Bandha. This pathological condition  
give rise to symptoms such as a feeling of Gourava  
(heaviness), Agnimandya (reduced appetite), Aruchi  
(loss of taste sensation), Anutsah (lack of  
enthusiasm), Alasya (laziness), and Daurbalya  
(general weakness). Classical Ayurvedic texts do  
not recognize Malavashtambha as a standalone  
disease; rather, it is seen as a symptom associated  
with various diseases or may present as isolated  
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2. From Samhitas and related articles data is  
complaint.[6] Constipation is defined as the  
incomplete and infrequent evacuation of hard  
stools.[7] Constipation can be correlated with  
Malavstambha as both terminologies have similar  
features like Purish Nigraha (obstruction of stool),  
Pakvashay shool (pain in abdomen), Parikartika  
(pain during defecation) etc. according to ayurveda  
constipation may occur at any age, but it is more  
common among individuals who resist the natural  
urge of defecation. This voluntary suppression of  
urge leads of vitiation of Vaat particularly Apan  
Vayu, which disrupts the normal formation of stool  
and its evacuation. Ayurveda is a science of not  
only how to cure diseases but also how to improve  
our health. Today, Ayurveda has established itself  
as a main alternative medical science. The classical  
Ayurvedic therapy is based on Tridosha Siddhanta.  
Human body and the nature are both created from  
the Panchamahabhutas. These five elements are:  
Prithvi (solid matter), Aap (water), Tej (fire), Vayu  
(air), Akash (space). This paper aims to explore the  
etiological factors, pathogenesis, and therapeutic  
principles of Malavashtambha, integrating these  
with the applied perspectives of the Panchabhautik  
Siddhanta.  
collected  
and  
correlation  
between  
and its  
Malavashtambh,  
constipation  
Panchbhautikatva is analysed by Yukti  
Pramana (Logical reference).  
Review Of Literature :  
Synonyms of Purish Mala – Kitta, Mala, Purisha,  
Shakruta, Shauch, Varchas, Vishta, Varchas.  
Sthan of Purish Mala-  
Acharya Sushrut, explained seven Kala out of which  
Purishdhara Kala is identified as fifth Kala.[8]  
Regarding the origin, position and extent of  
Mulasthana of Purishvaha Srotas there is a slight  
difference in opinon of Acharya Charak and Acharya  
Sushrut.  
1.According to Charaka- Mulasthana of Purishvaha  
Srotas are Pakwashaya and Sthulaguda,[9]. Here  
Pakwashaya is correlated with colon and rectum i.e  
part of large intestine and Sthulaguda is correlated  
with external segment of Guda i.e anal canal.[10]  
Which are primarily responsible for accumulation and  
evacuation of feces.  
2.According  
to  
Sushrut-  
Purishvaha  
Srotas  
Mulasthana are two in number and their Mulasthana  
is Pakwashaya and Guda. Here Pakwashaya is  
considered as the portion of intestine present below  
the umbilicus and Guda refer to rectum and anal  
canal.[11]  
Aim and Objective:  
The aim of this paper is to explore the Hetu,  
Samprapti and Chikitsa of Malavashtambha  
3.According to Ashtang Sangraha-  
through  
the  
framework  
of  
Panchabhautik  
Mulasthana of Purishvaha Srotas are Pakwashaya and  
Sthulantra.[12] Here also as per Indu Tika Pakwashaya  
is considered as the portion of intestine present below  
the umbilicus and Guda refer to rectum and anal  
canal.[13]  
Siddhanta.  
Material and Method:  
1. Literary study is done from Ayurvedic  
Samhitas and various articles related to  
Malavashtambha and Panchamahabhuta.  
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Hetu of Malavashtambh:  
Aharaj Hetu-  
the first major Hetu which occurs due to the  
Prakupit Vata. [14]  
Samprapti of Malavashtambh -  
1. Vishamashan-  
Inappropriate  
food  
Hetu sevana such as intake of Katu-rasatmak,  
Consumption, regardless of the time of day.  
Ruksha  
and  
Shushka  
Ahara,  
along  
with  
2. Lnaghana- Prolonged fasting.  
Vishamashana, excessive exertion, and similar  
Vata-provoking factors leads to Vata Prakopa. As a  
result of vitiated Vata, Agnivaishamya develops,  
which in turn causes the formation of Aama Dosha.  
Continuous consumption of Ruksha Ahara and the  
associated reduction in Shleshma Guna further  
3. Guru Ahara- Excessive intake of heavy food  
to digest, such as milk, butter, cheese, meat,  
dessert etc.  
4. Laghu Ahara - Intake of light and easy to  
digest food, even if there is heavy or excess  
hunger. It includes food such as Mudga, Yava,  
Takra, old rice, green gram etc.  
produces  
Sarvadehika  
Vata  
Prakopa.  
This  
aggravated Vata particularly affects Apana Vayu,  
leading to its Dushti. The presence of Aama Dosha  
causes stagnation of Mala in the Pakvashaya, and  
due to the dominance of Ruksha Guna, the Mala  
becomes dry, hard, and difficult to expel. This  
results in an increase in Purisha Avarodha,  
ultimately culminating in the development of  
Malavashtambha.  
5. Ruksha Ahara - Dry our rough quality diet  
which increases Vaat Dosha, such as Yava,  
Kulith, cereals, millets, popcorn etc.  
6. Picchil Ahara - Mucilaginous, oily or cohesive  
quality food, such as Bhindi, curd etc.  
7. Adhayshana- Consumption of meal, even if  
previously taken meal is not digested  
completely.  
Viharaj Hetu-  
Samanya Lakshana of Malavashtamb -  
Hrulas,  
Amaloudgar,  
Shirshula,  
Udarshula,  
Udardaha,  
Utsaha Hani,  
1. Ratri jagrana- Staying awake at night (not  
sleeping during natural sleeping hours).  
Urovidha,  
Anidra,  
Aalasya, Raga, frequent Malapravriti, Sakashta  
malapravriti, Adhmana Shithil or Grathit mala  
pravriti.  
2. Divaswap- Day time sleeping.  
3. Ativayam- Heavy exercise.  
4. Avyayam- Laziness.  
Chikitsa Sidhhanta-  
5. Atimaithuna- Frequent sexual activities.  
6. Vegvidharana- Suppression of natural urges,  
such as thrust, urine, faeces evacuation.  
7. Manasik Chinta- Mental stress.  
8. Vyagrata- Mental restlessness, distraction, lack  
of self-consciousness.  
Goksheer Guna (Cow’s Milk) -  
Madhura,  
Sheeta,  
Mrudu,  
Snigdha,  
Bahala,  
Shlakshana, Guru, Manda, Prassanna.[15]  
Role of Goksheer: Goksheer is rich in Aap  
Mahabhuta and possesses qualities such as  
Madhura rasa (sweet), Sheeta (cool), Mridu (soft),  
Snigdha (unctuous), Bahala (thick), Shlakshana  
(smooth), Guru (heavy), and Manda (slow) Guna.  
9. Agni Mandya- reduced appetite.  
These  
are  
the  
Hetus  
which  
causes  
Malavashtambha, among which Agni Mandya is  
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As per Charakacharya, “Drava Anna Pana Matra  
Yatha Agni Bala Anurupa” means solid, liquid both  
type of food should be taken according to strength  
of digestive fire.[16]  
comprehending how each Mahabhuta affects  
intestinal physiology. Restoring the elemental  
harmony that controls digestion, absorption,  
motility, and evacuation is the goal of a  
Panchabhutik Chikitsa rather than just treating  
symptoms alone.  
According to Vaghbhatta, “Prasthaḥ pana-matra”  
i.e maximum quantity of liquid food is 1 Prastha ≈  
768ml  
(approximately).[17]  
In  
daily practice,  
Role of Goksheer: Goksheer is rich in Aap  
Mahabhuta and possesses Madhura, Sheeta, Mridu,  
Snigdha, Bahala, Shlakshana, Guru, and Manda  
qualities. Night-time consumption of Goksheer  
helps in soft evacuation (Mriduvirechana), which  
breaks the pathogenesis of Malavashtambha by  
increasing fluid content, reducing stool hardness,  
and balancing aggravated Vata and Prithvi  
Mahabhuta.  
consuming the full dose of milk at one time may  
not be feasible. Therefore, taking half to one glass  
of lukewarm milk, i.e., approximately 120–250 ml,  
is recommended.  
Discussion:  
The Aharaj and Viharaj causes of constipation are  
primarily associated with Vata-provoking factors  
such as: late-night awakening, consumption of  
light, dry, and rough food, excessive physical  
exertion and frequent sexual activity. These factors  
result in dryness and roughness of stool, leading to  
Ingestion of lukewarm cow milk may lead to  
stimulation of oral thermal and taste receptors,  
which activates the brainstem and enhances vagal  
efferent output. This vagal stimulation subsequently  
activates the enteric nervous system. The presence  
of milk components such as proteins, fats, and  
lactose is detected in the gastrointestinal tract,  
triggering the release of gastrointestinal hormones  
including gastrin, cholecystokinin (CCK), and  
difficult  
and  
incomplete  
evacuation.  
Such  
symptoms clearly indicate the predominance of the  
Vayu Mahabhuta. Additionally, low fluid intake  
results in stool hardness, pointing towards the  
deficiency of the Aap Mahabhuta. According to  
classical texts, hardness is characteristic feature of  
motilin.  
contraction of gastrointestinal smooth muscle,  
resulting in increased peristaltic activity.  
These  
hormonal  
responses  
promote  
Prithvi  
Mahabhuta,  
one  
of  
the  
signs  
in  
Malavashtambha is hardness of stool, making it  
evident the involvement of these elements in diet of  
patients. Thus, derangement of Vayu, Aap, and  
Prithvi Mahabhutas play a key role in the  
manifestation of Malavashtambha.  
Simultaneously, milk-induced stimulation leads to  
5- hydroxytryptamine (5-HT) release, which further  
activates enteric nervous system reflexes and  
enhances colonic motility, thereby facilitating  
bowel movement.  
According to Panchabhautik Chikitsa analysis,  
constipation is a symptom caused by elemental  
In Panchabhautik Chikitsa, the selection of  
Ayurvedic medicines is not limited to traditional  
parameters such as Rasa, Guna, Virya, and Vipaka.  
imbalance,  
decreased  
specifically  
increased  
Vayu  
and  
and  
Aap. more  
A
sophisticated  
customized treatment model can be created by  
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Instead,  
it  
also  
emphasizes  
evaluating  
the  
2. Dr.Bramhanand Tripathi, Charak Samhita -  
2, Chikitsa sthana 15/11, Chaukhambha  
Surabharti Prakashan, Varanasi.  
proportion and dominance of the ingredient. So,  
water, lactose, proteins are one of the key  
ingredients of cow’s milk, its effect also shows  
increased motility of the intestine.  
3. Dr.Bramhanand  
Tripathi,  
Sharangdhar  
Samhita, Chaukhamba Surbharti Prakashan,  
Varanasi, Purvakhand, Panchamadhya, 42.  
Conclusion:  
Malavashtambha, when analyzed through the lens  
of Panchabhautik Chikitsa, is understood to arise  
4. Vd.Vijay  
S.Kale,  
Charak  
Samhita  
Sanskrit  
primarily  
aggravation of Vayu Mahabhuta and deficiency of  
Aap Mahabhuta, along with contributory  
from  
imbalances  
specifically  
the  
Sutrasthan.Chaukhmba  
Pratishthan.Reprint- 2022.Chapter no.7/12,  
Page no.128.  
involvement of Prithvi Mahabhuta. Vata-provoking  
dietary and lifestyle habits result in dryness,  
roughness, and hardness of stools, ultimately  
leading to difficult and incomplete evacuation.  
Therefore, management must aim not only to  
5. Dr.Bramhanand Tripathi, Charak Samhita -  
1,  
Viman  
sthana  
5/8,  
Chaukhambha  
Surabharti Prakashan, Varanasi. p. 698.  
relieve  
symptoms  
but  
to  
restore  
elemental  
6. Vd. Yashwant G Joshi.Kaychikitsa. Pune  
Sahitya Vitrana.Pune.Reprint-April 2014.  
Chapter no.55, Page no 461.  
equilibrium of gastrointestinal physiology.  
In this context, Goksheer serves as an effective  
therapeutic agent because of its Aap-dominant  
nature and qualities like Snigdha, Mridu, Bahala,  
and Shlakshana, which collectively enhance  
fluidity, soften stools, and pacify aggravated Vata.  
Its night-time administration assists in promoting  
Mriduvirechana, thereby breaking the pathogenesis  
of constipation by increasing moisture content and  
reducing stool hardness. Thus, restoring the balance  
of Vayu, Aap, and Prithvi Mahabhutas forms the  
cornerstone of therapy in Malavashtambha.  
7. Nicholas A Boon, Nicki R Colledge, Brian  
R Walker, Churchill Livingstone Elesvier,  
Davidson’s principles and practice of  
medicine. 20thedition.page no. 873.  
8. e-sushruta Samhita, Sushruta Sharirsthan  
4/16, chapter no.4,  
9. Vd.Vijay  
S.  
kale,  
Charak  
Samhita  
Sanskrit  
References:  
Vimansthan.  
Chaukhamba  
1. Ambikadutta Shastri, Sushruta Samhita,  
Chaukhamba Sanskrit Sansthan Varanasi,  
Eleventh, 1997; 1: 64.  
Pratishtahan. Reprint-2022. Chapter no. 5/8,  
Page no.588.  
10. Charaka. Charaka Samhita (with Ayurveda  
Copyright @ : - Dr.Anuradha Sangle Inter. J.Digno. and Research IJDRMSID0116 |ISSN :2584-2757  
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Dipika commentary of Chakrapani). Editor  
Yadavji Trikamji. Varanasi Chaukhambha  
Declaration :  
Conflict of Interest : None  
Sanskrit Sansthan; 2014. Vimanasthana 5/7.  
11. Sushruta S. Sharira Sthana 4/12 (with  
Dalhana and Gayadas Commentary). 5th  
ed. Varanasi: Chowkhambha Orientalia;  
1992. p. 357  
ISSN: 2584-2757  
DOI : https://doi.org/10.5281/zenodo.19597611  
Dr.Anuradha Sangle Inter. J.Digno. and Research  
This work is licensed under Creative  
Commons Attribution 4.0 License  
12. e-Ashtang Sangraha, Sharirsthan 6/43.  
Submission Link : http://www.ijdrindia.com  
13. Ashtanga Sangraha. Indu Tika. Sharma SP,  
Benefits of Publishing with us  
Fast peer review process  
editor.  
Varanasi:Chaukhambha  
Sanskrit  
Series Office; 2008. Sharirasthana 5/25.  
Global archiving of the articles  
Unrestricted open online access  
Author retains copyright  
14. Vd.Vijay  
S.Kale,  
Charak  
Samhita  
Sanskrit  
Unique DOI for all articles  
Chikitsasthan.  
Chaukhmba  
Pratishthan.Reprint-2022.Chapter no.15/42-  
44.  
https://ijdrindia.com  
15. Vd.Vijay  
S.Kale,  
Charak  
Samhita  
Sanskrit  
Sutrasthan.Chaukhmba  
Pratishthan.Reprint- 2022.Chapter no.27,  
Page no.413.  
16. Vd.Vijay  
S.Kale,  
Charak  
Samhita  
Sanskrit  
Sutrasthan.Chaukhmba  
Pratishthan.Reprint- 2022.Chapter no.5/8-  
12.  
17. Ashtanga Hridaya. Sutrasthana 8/46. In:  
Paradkar H, editor. Ashtanga Hridaya of  
Vagbhata  
with  
Sarvangasundara  
Chaukhambha  
Commentary.  
Varanasi:  
Sanskrit Sansthan; 2016. p. 122–124.  
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