Grahani Roga is a disorder of the digestive system described in Ayurveda, occurring due to impairment of Agni. Among its types, Vataja Grahani is characterized by predominance of Vata Dosha involving Samana and Apana Vata, leading to irregular bowel habits, abdominal pain, distension, and painful defecation. These clinical features closely resemble Irritable Bowel Syndrome, a functional gastrointestinal disorder recognized in modern medicine. Conventional management provides symptomatic relief with frequent recurrence, necessitating exploration of holistic approaches. The present randomized controlled clinical study was conducted to evaluate the efficacy of Virechana Karma followed by Shamana Chikitsa in the management of Vataja Grahani vis-à-vis Irritable Bowel Syndrome and to compare it with Shamana Chikitsa alone. Subjects fulfilling diagnostic criteria were randomly allocated into two groups. Group A received Virechana Karma followed by Shamana Chikitsa with Dadimastaka Churna along with Takra, while Group B received only Shamana Chikitsa. Clinical assessment was carried out using subjective parameters related to bowel habits, abdominal pain, distension, and associated symptoms. Both groups showed statistically significant improvement; however, Group A demonstrated superior and sustained improvement. The study concludes that Virechana Karma followed by Shamana Chikitsa is effective and safe in the management of Vataja Grahani vis-à-vis Irritable Bowel Syndrome.