What is the samprapti (pathogenesis) of grahani roga as described?

• A. A chronic joint disease unrelated to digestion
• B. A person with recent diarrhea continues a dosha-provoking lifestyle/diet, increasing dosha and disturbing agni; affected grahani expels partially digested and partially undigested food, with foul-smelling feces and sometimes alternating constipation/diarrhea with abdominal pain
• C. Excess sugar intake causing metabolic disturbances
• D. Blockage of the bile ducts

Answer: (B)

The main idea being tested is how grahani roga develops from a disturbance of the digestive fire (jatharagni) driven by dosha imbalance after a diarrheal episode. In this pattern, the recent diarrhea triggers a provocation of the doshas, and if the person continues a lifestyle or diet that aggravates them, the doshas become aggravated and disturb the jatharagni. When the digestive fire is unsettled, the small intestine’s grahani cannot complete proper digestion, so food is only partially digested and partially undigested as it moves through the gut.

This leads to stools that contain undigested matter and often have a foul odor, reflecting the impaired transformation of food. The same agni disturbance produces irregular bowel habits, with episodes of constipation alternating with diarrhea, accompanied by abdominal pain. The situation is a functional imbalance of digestive fire precipitated by dosha vitiation after a diarrheal insult, rather than a structural disease of the joints, a sugar-metabolism issue, or a bile duct blockage.