By Dr Rakesh Ayureshmi, Ayureshmi Ayurveda Wellness Centre, Kollam, Kerala, India A Hidden Aggravator We Keep Missing What if the stiffness, swelling, and relentless pain of Amavata were not driven only by joint pathology—but by what the gut fails to eliminate every day? This is a bold but clinically relevant claim. In both classical Ayurveda and modern medicine, the gut–joint axis is now recognized as a decisive factor in inflammatory arthritis. Constipation, often dismissed