Therapeutic Potential of Unani Regimen in Ulcerative Colitis: A Case Report

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon and a major form of inflammatory bowel disease (IBD), characterized by continuous mucosal inflammation resulting in bloody diarrhea, abdominal pain, and urgency. Although its exact etiology remains unclear, it is believed to arise from a complex interaction of genetic susceptibility, immune dysregulation, environmental factors, and alterations in gut microbiota. Conventional therapies, including 5-aminosalicylates, corticosteroids, immunosuppressants, and biologics, are effective in inducing and maintaining remission; however, variable efficacy and concerns regarding long-term adverse effects have led to increasing interest in complementary therapeutic approaches. In Unani medicine, UC is not recognized as a distinct disease entity but is described under conditions such as Sahej (intestinal erosion), Zoosantariya (bloody diarrhea), and Ishaal (diarrhea), which closely resemble its clinical manifestations. Sahej, characterized by intestinal mucosal damage, closely resembles the pathology of UC. According to Unani principles, the condition results from an imbalance of humors, particularly Safra and Balgham-e-Shore, leading to inflammation and mucosal injury. This case report describes a 42-year-old male with hypothyroidism and chronic UC who presented with frequent bloody mucoid stools, abdominal burning, weakness, and weight loss, with inadequate response to conventional treatment. Based on an Unani assessment indicating Safravi Mizaj, the patient was treated with Ilaj bil Ghiza, Ilaj bil Dawa, and lifestyle modifications guided by Asbab-e-Sitta Zarooriya for three months. Significant clinical improvement was observed within 3–4 weeks, including reduced symptoms, improved functional status, and improved Mayo score and IBDQ outcomes, without adverse effects.