Complete clinical and endoscopic remission in severe ulcerative pancolitis following personalized Ayurveda management: A case report.

INTRODUCTION: Ulcerative colitis (UC) is a chronic, idiopathic inflammatory bowel disease (IBD) characterised by relapsing-remitting mucosal inflammation commencing in the rectum and extending proximally towards the intestine. The global incidence of UC is on the rise presenting a complex therapeutic challenge. Conventional management ranging from aminosalicylates and corticosteroids to biologics and surgical management using colectomy is effective but is often limited by secondary non-response, significant adverse events and high costs. This case report explores the clinical and endoscopic improvement in UC using Ayurveda interventions. Complete clinical remission was achieved within three months. Follow-up colonoscopy demonstrated complete mucosal healing (UCEIS 0/8).

CASE PRESENTATION: A 44-year-old male presented with a confirmed diagnosis of pancolitis (Mayo Score 3), characterized by bloody diarrhoea, urgency, tenesmus, abdominal pain, and significant weight loss (10 kg). The patient had comorbidities including Type 2 Diabetes Mellitus, Hypertension, and Hypothyroidism. An Ayurvedic assessment correlated the clinical presentation with Raktatisara (bloody diarrhoea) superimposed on Pittaja Grahani (Malabsorption syndrome). The therapeutic intervention, spanning nine months from October 2024 to July 2025, involved a personalized regimen of Deepana-Pachana (metabolic correction), Raktastambhana (hemostasis), and Rasayana (rejuvenation). Key formulations included Kutajghan Vati, Panchamrit Parpati, Bilwadi Avaleha, and Manasamitra Vati.

OUTCOMES: The patient achieved complete symptomatic remission within three months. A follow-up colonoscopy in June 2025 revealed complete mucosal healing with an Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score of 0/8, improving from a baseline of diffuse ulceration. Haematological and biochemical parameters stayed within normal limits throughout the treatment, evidencing the safety of the herbo-mineral intervention administered.

CONCLUSION: This case demonstrates that personalized and tailored Ayurvedic management may serve as a viable, steroid-sparing, and safe alternative for achieving mucosal healing in severe UC. It underscores the potential of integrative medicine approaches in managing complex autoimmune gastrointestinal disorders.