Ascites (Jalodara )
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Introduction

 

Jalodara or ascites is an extremely dangerous problem often leading to death. This problem could be a symptom of cancer, and so it is a very serious condition which needs urgent medical attention. However, all ascites is not due to cancer.

   

Definition of Ascites (Jalodara)

 

Ascites is the condition in which fluid builds up in the peritoneal cavity of the abdomen. Sometimes the fluid buildup is mild and cannot be detected externally. But in extreme cases, the fluid builds up to such a large extent that it causes severe abdominal distention. The condition is quite painful and the person suffering from it finds it extremely inconvenient to even move around.

Also, the condition is socially unappealing. People suffering from ascites have bloated abdomens due to which they find it ungainly to make an appearance in public. In severe cases, finding clothes of the right size also becomes a major issue.

However, that is perhaps the least of the concerns for people suffering from ascites. That is because ascites could be one of the symptoms of several kinds of abdominal cancers. If that is so, then urgent medical attention is required. Even otherwise, fluid buildup in the peritoneum can occur due to several other ailments such as cirrhosis, heart failure, pericarditis, veno-occlusive disease, etc. Hence, any kind of ascites is a serious condition requiring medical attention.

In Sanskrit, ascites is quite aptly named jalodara. This word is made up from two words – jala meaning ‘water’ and udara meaning ‘stomach’.

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Causes of Ascites (Jalodara)

The abdomen consists of several visceral organs. In order to protect these organs, the abdomen is lined with a double-membrane called as the peritoneum. The two layers of the peritoneum are such that one of the layers communicates with the inner abdominal wall and the other layer drapes the visceral organs. In between the two membranes, there is the peritoneal fluid, which is provided for protection of the visceral organs.

In normal conditions, the peritoneal fluid is up to a specific quantity, just enough to provide the necessary protection. But in some cases, the volume of this fluid can increase drastically. This is what leads to ascites.

There are several causes that can lead to ascites, and accordingly ascites is classified into different forms. The following is a list of them:-

Increased Fluid Pressure in the Peritoneum

  • Cirrhosis of the liver
  • Budd-Chiari Syndrome, i.e. Hepatic Vein Occlusion
  • Congestive Heart Failure
  • Constrictive Pericarditis
  • Occlusion of the Inferior Vena Cava

Decreased Colloid Pressure in the Peritoneum

  • Malfunction of protein synthesis in the liver
  • Protein loss accompanying the Nephrotic Syndrome
  • Enteropathy causing protein loss
  • Malnutrition, especially of proteins

Increased Permeability of the Capillaries in the Peritoneum

  • Complications due to Tuberculosis
  • Complications due to Bacterial Infections
  • Cancers of the Peritoneum

Leakage of Fluids into the Peritoneal Cavity

  • Leakage of bile into the peritoneal cavity, i.e. Bile Ascites
  • Leakage of urine into the peritoneal cavity, i.e. Urine Ascites
  • Leakage of chyle into the peritoneal cavity, i.e. Chylous Ascites
  • Leakage of pancreatic juice into the peritoneal cavity, i.e. Pancreatic Ascites

Other Causes

  • Meig’s Syndrome, which is a disease of the ovaries in females
  • Myxedema
  • Chronic Hemodialysis

Ayurveda goes into much detail when discussing the causative factors of ascites. According to Ayurvedic science, the contributing factors for ascites are:-

    • Low digestive fire, i.e. pitta dosha
    • Low production of ama
    • Obstruction in sweat and water carrying systems
    • Vitiation of the Prana and Apana Vata

There are in all eight types of jalodara as described in Ayurveda – those due to vitiation of vata, pitta and kapha, those due to vitiation of the dual doshas and those due to liver and spleen disorders.

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Symptoms of Ascites (Jalodara)

The first and most prominent symptom of ascites is that of abdominal distention. As the fluid accumulates in the peritoneal cavity, the abdomen can reach abnormally large sizes, making life very difficult for the person. The person finds it extremely difficult to walk, stand, sit and even lie down. Apart from that, there is a constant feeling of heaviness in the abdomen, which results into pain in the flanks and limbs.

The symptoms of ascites can be divided into three grades as follows:-

(i) First Grade Symptoms

In this stage, the fluid accumulation is to a very low level. In this condition, the abdomen is not distended and there is no swelling apparent from the outside. At this stage, it is very difficult to even understand that there is abdominal swelling. Only an ultrasound can help detect the abnormal accumulation of the peritoneal fluid.

(ii) Second Grade Symptoms

Here the fluid accumulates to a greater extent. A slight distention is observed from the outside. Hence this case is easier to detect. There are other symptoms felt such as pain in the flanks and a fluidity of the abdomen when touched. There is a shifting dullness when physically examined.

(iii) Third Grade Symptoms

This is the worst scenario of ascites. Here the abdominal distention is quite easily observed. The abdomen can reach very large sizes and make locomotion very difficult for the person. The ascites fluid exerts pressure on the diaphragm which leads to respiratory complications, such as shortness of breath and gasping. A fluid trill or fluid wave test can confirm the presence of fluid accumulation in the abdominal cavity.

On dosha principles, the following are the symptoms of the different types of ascites:-

Vata dosha Type

  • Indigestion
  • Gas in the abdomen
  • Edema in the feet
  • Abdominal pain
  • Sudden increase or decrease in the size of the abdominal edema

Pitta dosha Type

  • Diarrhea
  • Fever
  • Thirst
  • Profuse sweating
  • Accumulation of fluids in the abdomen

Kapha dosha Type

  • Heaviness in the body
  • White patches of edema on the feet and abdomen
  • Loss of appetite
  • Enlargement of liver and spleen
  • Varicose veins in the abdominal wall

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Complications of Ascites (Jalodara)

Ascites itself is a symptom of several serious problems. The presence of ascites may indicate heart failure, pericarditis, hepatitis and even cancers. Hence it is very necessary to seek a medical diagnosis and arrive at the root of the issue.

The following are some of the complications that are caused by ascites itself (without taking into account the disease that has caused ascites):-

Abnormal fluid retention in the kidneys which will lead to kidney failure

Activation of the sympathetic nervous system, which can affect the sensory faculties of the person

Problems in excretion due to increased production of renin

In extreme cases, there may be impairment of the renal blood vessel leading to the hepato-renal syndrome

Spontaneous bacterial peritonitis can occur

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Transmission of Ascites (Jalodara)

Ascites is not an infectious or contagious condition. Hence it cannot be transmitted from one person to another.

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People who are at Risk of Ascites (Jalodara)

The following people are very high risk of ascites:-

  • People who consume excessive alcohol are at very high risk of developing cirrhosis, which may cause ascites. In such people, the beer belly is actually a slang term for ascites.
  • People who drink water excessively may develop ascites.
  • Lack of exercise is also linked with ascites.
  • People leading a sedentary lifestyle and sleeping in the daytime can suffer from ascites later in their lives.

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Prevention and Basic Care during Ascites (Jalodara)

Ascites can be kept at bay by taking care of certain factors.

  • Avoid drinking. Alcoholism is singly responsible for 83% of ascites-related problems in the world.
  • Lead an active lifestyle. Exercising helps the abdominal muscles to build up. This prevents the accumulation of fluids in the peritoneal cavity.
  • Avoid sleeping in the daytime. Keep regular timetables for going to bed and rising up in the morning.
  • Do not consume water excessively, if you feel you have mild ascites

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Diet for People with Ascites (Jalodara)

There are several helpful and harmful foods for people who are suffering from jalodara. The following is a list of foods that must be taken and must be avoided:-

Foods that are helpful for ascites:

  • Butter milk and milk of the camel
  • Horse gram soup
  • Diet of old (aged) rice
  • Salads containing dry radish as the prime component
  • Spices such as garlic and asafetida
  • Honey

Foods that are harmful for ascites:

  • Diet of excessive starchy components, such as rice, wheat, etc
  • Salt

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Ayurvedic Treatment of Ascites (Jalodara)

Jalodara is a condition that has been studied by Ayurvedic experts for over centuries. The detailed research into the condition and its various complications has resulted in the discovery of the curative properties of several herbs for ascites. The following is a list of some of the most effective herbs in ascites and its effects on the human body. The mode of consuming them is also described in brief.

Ayurvedic Name of the Herb

Biological Name of the Herb

Common English Name of the Herb

Action on the Human Body

Arjuna

Terminalia arjuna

White Murdah

Arjuna possesses diuretic properties. Hence it is effective in the removal of excess fluids from the body.

Heenga

Ferula foetida

Asafetida

Asafetida is one of the most potent medicines in the treatment of ascites. It is dissolved in hot water and used for fomenting on the abdomen to achieve results.

Himsra

Capparis spinosa

The Caper Bush

Himsra is an important ingredient of Ayurvedic preparations for the treatment of cirrhosis of the liver. It must be consumed as per the dosages mentioned on the product label.

Kakamachi

Solanum nigrum

Black Nightshade

The black nightshade is also an important ingredient in Ayurvedic preparations for the treatment of ascites caused due to the cirrhosis of the liver. The black nightshade is known for its diuretic properties.

Kateli

Solanum xanthocarpum

Kantakari

Kantakari is an effective herb used in the treatment of ascites and dropsy. It helps in the expulsion of all fluids in the body of the person.

Kutki

Picrorrhiza kurroa

Picrorrhiza

Picrorrhiza herb is mixed with honey and taken thrice daily. This is an effective method of relieving the peritoneum of excess fluid. Its effects are more prominent in ascites caused due to the cirrhosis of the liver.

Punarnava

Boerhaavia diffusa

Hog Weed

Punarnava is better than most of the diuretics available in the market for the treatment of ascites. It is a wonderful herb for the treatment of ascites caused due to cirrhosis and chronic peritonitis. For treatment, the fresh herb is taken in boiled form, or the liquid extract of the dried herb is taken in small doses. Punarnava is also useful in the same manner for the treatment of dropsy.

The herbs mentioned above have been expertly mixed into preparations. These preparations contain just the right proportions of herbs so as not to produce major side effects. The following are some herbs that are effective in the treatment of ascites:-

Type of Preparation

Name of Preparation

Asava/Arishta

Kumari Asava, Rohitaka Arishta, Parapatakadya Arishta, Punarnava Asava

Bhasma/Kashaya

Dashamoola Panchakola Kashaya, Punarnava Kvatha, Loha Bhasma, Vajra Bhasma

Choorna

Yogaraja Choorna, Punarnavastak Choorna, Sooryakshara

Ghrita

Shatapaala Ghrita, Mahapancha Gavya Ghrita

Lehya

Kalyana Guda, Guda Pippali, Bhallatakra Rasayana, Dashamoola Haritaki

Rasa

Jalodararirasa, Ichchabhedi Rasa, Lakshmi Vilasa Rasa

Vati

Jalodarari Vati, Arogya Vardhini Vati, Gokshuradi Vati, Shivagutika Vati

It must be borne in mind that while taking any Ayurvedic preparation, the doctor must be consulted first. Most of the herbs do not have any side-effects (and are indeed a regular part of the diet), but some people may be allergic to certain herbs and may show adverse reactions.

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Comments

based on your treatment preparations,i started a t/t of pt. suffering frm ascites n i got marvelous results,so i wanna show my regards to u,as just now i've started my practice after completion of my course.so thanks a lot
#1 - dr.kamayani tiwari - 04/22/2008 - 04:54
its also possible to encounter ascites due to complications of a VentriculoPeritoneal Shunt, as i have recently discovered within myself.

thank you, i had no idea what ascites were until i found this site.
#2 - jade - 12/06/2008 - 16:41
Thanks for the above informtion. But I am a Ghanaian and where can I get the Purnanava drugs to buy please!
#3 - Bernice Logan - 01/14/2011 - 09:27
Please tell me how I can get the herbal preparations for ascites, acne, and depression/anxiety? I live in Tel Aviv, Israel. My mail is simchasmail@gmail.com. Thank you.
#4 - Julie - 07/29/2011 - 02:59
PLEASE PLEASE, SOMEONE TELL ME WHERE TO PURCHASE THESE " EXPERTLY MIXED INTO PREPERATIONS" FOR MY HEP-C CERROSIS ASCITIES PROBLEMS i CURRENTLY SUFFER FROM. PLEASE CONTACT ME AT homegrown711@live.com

Thanks and God Bless,
Tim
#5 - tim matthews - 12/09/2011 - 15:22
I am very impressed with details provided in this page and am sure now that aurveda is only solution to my problem. I tried allopathy for 2 years where stint was placed in hepatic vein unneccesarly. Done 100s of test but all are negative. Even AIIMS raise their hand said its root cause is known so cant treat it. Homopaty is also not helping from last 3 months. Please guide me to some good ayurved doc near delhi, I dont want to waste more time with this desease. My ID is-heart_thehurt@yahoo.com. please-100 help me out. if any ayurved doc is reading please guide.PLEASEEEEEEEEEEEEEEEEEEE...
#6 - Pankaj bhardwaj - 05/30/2012 - 06:47
dear friends my self i am dr vijay negalur md phd practicing ayurveda since 5 years i treated such cases throu ayurvead if want more information plz send mail
drvijaynegalur@gmail.com
#7 - dr vijay - 06/17/2012 - 23:58
Most of the things you mention as treatment are very new and strange name, for they are not in english.
#8 - grace - 08/15/2012 - 11:03
Sir, Kindly let me know who is a good doctor nearby or in Bangalore to treat Ascities. also let me know where is this Punarnava is available. I shall be thankful if you give this information.
#9 - Ravi K. Girimaji - 11/18/2012 - 09:26
My mum is seriously ill.she has ascites.please i am from ghana and want to know where i can get these herbs.my mum is suffering please help me.
#10 - Gina annan - 10/12/2013 - 16:30
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