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*The term koshtha is also used to refer to duodenum (grahani), which is the pivot of digestion.[Su.Sa.Nidana Sthana 7/6]<ref name=Susruta/>
*The term koshtha is also used to refer to duodenum (grahani), which is the pivot of digestion.[Su.Sa.Nidana Sthana 7/6]<ref name=Susruta/>
*It is considered as a separate pathological terrain (rogamarga), serving as a stratum for its own unique set of diseases.
*It is considered as a separate pathological terrain (rogamarga), serving as a stratum for its own unique set of diseases.
Fifteen organs have been enunciated as parts of koshtha: umbilicus (nabhi), heart (hridaya), pancreas (kloma), liver (yakrit), spleen (pleeha), kidneys (vrkkau), bladder (vasti), sigmoid colon (purishadhara), stomach (amashaya), cecum (pakvashaya), rectum (uttaraguda), anus (adharaguda), small intestine (kshudrantra), large intestine (sthulantra), and omentum (vapavahana). [Cha.Sa. [[Sharira Sthana]] 7/10]
==Embryology==
Koshtha consists mainly of smooth organs like stomach and intestines that are inherited from mother. [Cha.Sa.[[Sharira Sthana]] 3/6] Tilburg et.al., analyzed 308 irritable bowel syndrome (IBS) patients along with 102 healthy controls and 36 inflammatory bowel disease patients of Caucasian traits for maternal inheritance of IBS. 17.5% of the participants had a probable maternal inheritance and the maternal polymorphism 16519T that is seen associated with multiple other functional disorders. This was significantly associated with the maternally inherited IBS.<ref>van Tilburg MAL, Zaki EA, Venkatesan T, Boles RG. Irritable bowel syndrome may be associated with maternal inheritance and mitochondrial DNA control region sequence variants. Digestive Diseases and Sciences. 2014;59(7):1392–7.</ref> As per Ayurvedic embryology, the precursor of gut is grossly seen in the fetus from the third month [Cha.Sa.[[Sharira Sthana]] 4/11] and attains full maturity by the seventh month. [Su.Sa.Sharira Sthana 3/30]<ref name=Susruta/> The development of gut as per the western embryology starts from third week of intrauterine life and attains near-adult level functioning by 32 weeks.<ref>Bhatia A, Shatanof RA, Bordoni B. Embryology, Gastrointestinal. StatPearls [Internet]. 2021 May 8 [cited 2022 Apr 1]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK537172/</ref>
==Physiology==
Koshtha is the important site for digestion. All the three [[dosha]]s and their subtypes play pivotal role in maintaining the physiology of koshtha. The prana vayu (a type of [[vata]]) propels the timely administered food to the koshtha. The bodhaka [[kapha]] (a type of [[kapha]]) in oral cavity senses the taste of food. The kledaka [[kapha]] moistens the food and subjects it to digestion. Further, pachaka [[pitta]] and samana vayu lead the role in division into essence (saara) and waste (kitta). Samana vayu is important in breaking down the moistened food into small particles for easy digestion by pachaka [[pitta]]. Further, the wastes of food are expelled by apana vayu. The essence is circulated by vyana vayu. Hence, the proper functioning of all three are necessary to maintain the equilibrium in the koshtha. In the transient stages of digestion (avasthapaka) the [[dosha]] are nourished in their respective abodes. [[Kapha]], [[Pitta]], and [[Vata]] in [[amashaya]] (upper gastrointestinal tract with stomach), pachyamanashaya (small intestine) and pakvashaya (large intestine) respectively. These parts of koshtha are primary seats of the corresponding [[dosha]].
Grahani (lower part of stomach and duodenum) and [[agni]] (factors responsible for digestion and metabolism) are the most important structural and functional components of koshtha respectively. Grahani holds undigested food till the completion of digestion. It is the part of koshtha that forms the substratum for [[agni]]. The nature of grahani is crucial in deciding the nature of koshtha. When grahani is unable to retain the food till proper digestion or when [[agni]] is so weak that it is unable to facilitate proper digestion, the result is improperly formed metabolites or [[ama]].
==Types of koshtha==
There are basically three types of koshtha:
1. Hard (krura), predominant with [[vata dosha]] and in [[vata]] [[prakriti]] individuals
2. Soft (mridu), predominant with [[pitta dosha]] and in [[pitta]] [[prakriti]] individuals
3. Medium or intermediate (madhya) predominant with [[kapha dosha]] and in [[kapha]] [[prakriti]] individuals. It is also seen in the individuals with equilibrium state of [[dosha]] in [[prakriti.]]
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