Ayurveda Management of Jalodara (ascites secondary to alcoholic liver disease)- A Case Report

Abstract

Background: Alcoholic liver disease (ALD) with ascites is chronic progressive condition with ascites means accumulation of excess fluid in body cavities. Similarly, Ayurveda describes jalodara, a type of udara. Abnormal agni (digestive fire) leads to the accumulation of mala (doshas and kleda). Case Presentation: A 38-year-old male patient having history of regular alcohol consumption past ten years approached PK OPD. Patient came with the complaints of abdominal pain along with distension and reddish skin discoloration at the lateral side of abdomen, thighs and buttocks.  He also complained of swelling in his bilateral lower limbs, yellowish discoloration of the eyes and urine, and decreased appetite. On examination, tridosha vikriti with pitta dominance affecting agni, with impaired rasa, rakta, mamsa dhatus, rasa, rakta, sweda, and udakavaha srotos (channels), sangha (obstruction) and vimarga gamana shrotodushti, yakrut as seat and udara as site of expression. Intervention: The management included abstention from alcohol, improved digestion by bhoonimbadi kadha, cleansing channels and reducing excess abnormal moisture by thirteen days of nitya virechana (daily purgation) using avipattikara churna, katuki churna and nimbu swarasa and hepatoprotective medicine Arogya vardhini vati, Punarnava mandura. Lastly diet restriction with green gram soup maintained for twenty-three days. Outcome:  A Significant reduction was observed in abdominal girth from 96cm to 82cm and complete resolution of pedal oedema, and clinical symptoms. Also, the raised value of liver function test reduced significantly especially total bilirubin 9.3 to 3.8 after 23 days of treatment with one follow-up. Conclusion: The present case demonstrates that Pachana, Nityavirechana, herbomineral rasayanas and proper dietary regulations for 23 days significantly managed jalodara secondary to alcoholic liver disease effectively with no adverse event. Highlighting the feasibility, safety and reproducibility of classical jalodara treatment in ascites due to chronic liver disease proving its role as supportive and integrative approach.