gulma

Gulma is a traditional term in Ayurveda describing an abdominal lump or distension arising from a disturbance in digestive and metabolic processes. The word is Sanskrit in origin, with gulm meaning a lump, mass, or swelling, and Gulma referring to a localized swelling in the abdomen.

Clinical features include abdominal swelling or distension, a sense of heaviness or pressure, intermittent pain, gurgling sounds, and changes in appetite or bowel habit. The lump may be fixed or movable, and its presentation can vary with time and posture. In Ayurvedic interpretation, Gulma is often linked to aggravation of Kapha with involvement of other doshas and the formation of Ama, a digestion-derived toxin.

Etiology and pathophysiology: Gulma is attributed to an imbalance of doshas, primarily Kapha, leading to obstruction of the channels (srotas) and accumulation of Ama in the abdomen. Contributing factors described in classical texts include improper diet, irregular meals, overeating, constipation, sedentary lifestyle, and the intake of incompatible foods. A weakened digestive fire supports toxin buildup, contributing to the development of a palpable mass.

Diagnosis and treatment: Diagnosis relies on patient history and abdominal examination, including assessment of location, size, consistency, and mobility of the lump. Classical classifications distinguish by site (upper, middle, or lower abdomen) and physical character (soft, hard, movable, fixed). Management emphasizes balancing the doshas through diet and lifestyle adjustments, herbal medicines, and, in some cases, purificatory therapies or therapeutic enema. Modern readers are advised to corroborate with contemporary medical assessment.

Modern perspective: Gulma is a traditional concept and not a single modern diagnosis. Some equate it to abdominal tumors, cysts, fibroids, or chronic distension; others view it as functional or obstructive gastrointestinal disorders. The Ayurvedic approach remains guidance from qualified practitioners.