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| CASE REPORT |
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| Year : 2019 | Volume
: 7
| Issue : 3 | Page : 185-188 |
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Management of jalodar (ascites) through treatment principles of ayurveda: A case report
Mukul P Singh, Vaishali Kuchewar
Department of Kayachikitsa, Mahatma Gandhi Ayurved College, Hospital and Research Centre, Salod (H), Wardha, Maharashtra, India
| Date of Submission | 26-Nov-2019 |
| Date of Decision | 13-Dec-2019 |
| Date of Acceptance | 19-Dec-2019 |
| Date of Web Publication | 12-Feb-2020 |
Correspondence Address:
Dr. Mukul P Singh
Department of Kayachikitsa, MGAC, Salod(H), Wardha, Maharashtra
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JISM.JISM_53_19
Introduction: Ascites is an abnormal accumulation of fluid in peritoneal cavity. It has numerous etiological factors, but the most common cause is cirrhosis of liver. It can be correlated with Jalodar, which is one of the types of Udarroga (disease of abdomen). It is described in Charaka, Sushruta, and Ashtanghridaya. Case Report: This is a case of ascites having fullness of abdomen, bilateral pedal edema, loss of appetite, and generalized weakness. The patient was chronic alcoholic and had no history of hypertension or diabetes. He was treated on the basis of treatment principles of Jalodar described in Charaksamhita, such as Nityavirechan daily purgation by using Ayurveda medicines, Strotoshodhan (cleaning of microchannels), and some hepatoprotective medicines. Observation and Result: Patient had complete relief from all complaints such as pedal edema, abdominal distension, and lack of appetite. Conclusion: The positive results of this study motivate to conduct further studies to establish treatment protocol of ascites. Keywords: Ascites, hepatoprotective, Jalodar, Nityavirechan, Strotoshodhan
How to cite this article:
Singh MP, Kuchewar V. Management of jalodar (ascites) through treatment principles of ayurveda: A case report. J Indian Sys Medicine 2019;7:185-8 |
How to cite this URL:
Singh MP, Kuchewar V. Management of jalodar (ascites) through treatment principles of ayurveda: A case report. J Indian Sys Medicine [serial online] 2019 [cited 2023 Mar 21];7:185-8. Available from: https://www.joinsysmed.com/text.asp?2019/7/3/185/278140 |
| Introduction | |  |
Ascites is an abnormal accumulation of fluid in peritoneal cavity.[1] The most common cause of ascites is liver cirrhosis and other causes are cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein.[2] Mild ascites is difficult to diagnose. In moderate-to-severe ascites, patient may complain of abdominal heaviness and shortness of breath due to mechanical pressure on the diaphragm. It can usually be diagnosed with abdominal ultrasound. According to Ayurveda, ascites can be correlated with Jalodar, which is one of the types of Udarroga (disease of abdomen). It is well described in Charaka, Sushruta, and Ashtanghridaya.[3],[4],[5]
In Ayurveda literature, many herbs are described to improve the function of liver. Various studies are also conducted to explore the action of herbs on liver.
Here we present a case of ascites in which patient got complete relief within a short duration of treatment.
| Case Presentation | | |
A 35-year-old male patient was brought to outpatient department of Kayachikitsa (registration no. 1908100007) on August10, 2019, with the following complaints:
- Swelling over both legs and fullness of abdomen since 3 months.
- Loss of appetite and generalized weakness since 1 month.
- Low-grade fever since 15 days.
Past History
The patient was non-hypertensive and nondiabetic. In personal history, he was a labor by profession and alcoholic since 10–15 years. He had taken modern medicinal treatment from general practitioner in his village. It included hematinic and diuretic medicines. He got some relief in pedal edema, but other complaints remained same. He quit alcohol since 1 month.
The clinical findings of the studied case are depicted in [Table 1]:
Therapeutic intervention: The patient was treated per the treatment principle of Jalodar described in Charaksamhita [Table 2].
Diagnostic assessment: Complete blood count (CBC), liver function test (LFT), urine examination, and ultrasonography (USG) were carried out to confirm the diagnosis [Table 3][Table 4][Table 5][Table 6]., , ,
Pathyapathya: The patient was advised to reduce water intake and take only cow milk mixed with Trikatuchurna (10g in 1L milk) as a diet for 24h.
Follow-up and Outcome
The patient was admitted for 8 days. He was on aforementioned medication and Pathya. He followed all the instructions except milk diet. He was having a feeling nausea with only milk, so he was taking Jowar roti with milk in the afternoon and night. During his hospital stay, abdominal girth was measured every day (morning at 9 am). There was improvement in abdominal girth and pedal edema with 8 days of treatment [Table 7]. Due to Erand Taila (oil extracted from Ricinus communis), his bowel frequency was increased (four to five times a day). His appetite started improving after 8 days of treatment. He was treated for 2 months with complete relief in all complaints.
| Discussion | | |
In Ayurveda, excessive use of Ushna, Tikshna Ahara, and Madyapana (consumption of spicy diet and alcohol) is described as etiological factors of Udarroga.[6],[3] These factors were found in the patient. Therefore, he was advised to quit these because Nidanparivarjan (avoiding causative factors of disease) has prime importance in treatment. Nityavirechan (purgation and diuretic), Strotoshodhan (cleansing of microchannel), and use of hepatoprotective drugs are the mainstay of treatment of Jalodar.[3]
For Nityavirechan, Erand Taila was advised because the patient had Mrudukoshtha (easy evacuation of bowel).[7]
Gomutra Arka (cow urine extract)) and Punarnavadi Kwath were used for its Strotoshodhan, Agnideepak (appetizer), Mrudukoshtha (diuretic), and Shothashamak (anti-inflammatory) properties. It removes Strotosanga (obstruction of microchannels) and helps in Sampraptivighatana (reverse pathophysiology).[8],[9] In one study, aqueous extract of Boerhavia diffusa produced a notable diuretic effect.[10]Sarpagandhaghanvati was used because of its antihypertensive property. Its active principle, reserpine has depressant action on central and peripheral nervous system by binding to catecholamine storage vesicles present in the nerve cell.[11]Samshamanivati helped to decrease the body temperature because of its Jwarshamak (antipyretic) property.[12]
Poly Herbal formulation was given to improve the function of the liver. It contains mainly Kalmeg (Andrographis paniculata), Bhumyamlaki (Phyllanthus urinaria), Punarnava (B. diffusa), Kumari (Aloe vera Tourn), Amlaki (Emblica officinalis), Guduchi (Tinospora cordifolia), and Daruharidra (Cedrus deodara). These all medicines have hepatoprotective properties.[13]
Guduchi (T. cordifolia) was used in large quantity because of its antioxidant property.[14] Antioxidants are found to be helpful in protecting the liver.[15]
Udarpattabandhan (wrapping of abdomen) with Arkapatra was performed to prevent further accumulation of fluid.
With 12 days of treatment, patient’s appetite was improved, body temperature was normalized, and abdominal girth was reduced. In the later period, Punarnavamandoor was given because it is indicated in Panduroga and Shoth.[16]Gandharvaharitaki was used to prevent further accumulation of abdominal fluid because of its Amapachan (digestive), Vatanulomana (to normalize the direction of Apanavayu), Mruduvirechan (mild purgation), and Strotoshodhan properties.[17]
| Conclusion | | |
This patient had complete relief from all complaints such as pedal edema, abdominal distension, and lack of appetite within a short duration of treatment with no adverse reaction. Therefore, this case study motivates to conduct further studies to establish treatment protocol of ascites.
Financial Support and Sponsorship
Nil.
Conflicts of Interest
There are no conflicts of interest.
| References | | |
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| 12. | Vaidyanash S, editor. In: Ayurved Sarsangraha. Nagpur, India: Ayurved Bhavan; 2017. p. 430. |
| 13. | Giby A. A review on hepato-protective herbs used in Ayurveda. Global J Res Med Plants Indigen Med 2014;3:303-11. |
| 14. | Kuchewar V, Borkar M, Nisargandha MA. Evaluation of antioxidant potential of Rasayana drugs in healthy human volunteers. Ayu 2014;35:46-9. [ PUBMED] [Full text] |
| 15. | Casas-Grajales S, Muriel P. Antioxidants in liver health. World J Gastrointest Pharmacol Ther 2015;6:59-72. |
| 16. | Shukla V, editor. Chikitsasthan. In: Charaksamhita. Vol 2. Varanasi, India: Choukhamba Sanskrit Publication; 2017. p. 407. |
| 17. | Chunekar KC, editor. HaritakyadiVarga. In: Bhavprakashnighantu of Bhavmishra. Varanasi, India: Chaukhamba Bharati Academy; 2015. p. 5. Reprint . |
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]
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