Neurological disorders such as Parkinson’s disease, multiple sclerosis, and functional neurological syndromes represent a growing global health burden. Increasing evidence indicates that chronic constipation is not merely a secondary symptom but an early and contributory factor associated with gut–brain axis dysregulation, systemic inflammation, and neuroimmune alterations. The Siddha system of medicine, a traditional medical system practised in India, has long emphasized purgation therapy (Virechanam) as a regulatory intervention for neurological dysfunctions attributed to imbalances in Vatham, the functional principle governing movement and neural activity. This narrative review examines the therapeutic relevance of Siddha-based purgation therapy in the context of contemporary neurogastroenterological and neuroscientific research. By synthesizing evidence from studies on gut dysbiosis, vagal signalling, immune modulation, and neuroinflammation, the review explores conceptual convergences between traditional Siddha principles and modern understandings of the gut–brain axis. Chronic constipation, recognized both as a traditional marker of systemic imbalance and a prodromal feature
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