What are Chylous Ascites? – How can Ayurveda help?

Abstract

Chylous ascites is a rare condition. Some three decades back, chylous ascites were reported as 1 in 20,000 cases. However, now the incidence of chylous ascites has increased. It is believed to have increased due to increase in the survival rate of patients with cancer and excessive surgical intervention such as laparoscopic surgery and transplantation. In this article, let us have a detailed look at chylous ascites and how ayurveda can help with it.

INTRODUCTION- WHAT IS CHYLOUS ASCITES?

Chylous ascites is a milky appearing peritoneal fluid in the abdominal cavity. This fluid is considered to be rich in triglycerides. It is usually due to the presence of intestinal lymph in the thoracic cavity. Chylous ascites develop when there is a disturbance in the lymphatic system which is most commonly due to traumatic injury. Any sort of benign or malignant obstruction also causes disruption in the lymphatic system and hence chylous ascites.

CAUSES

Some of the most common causes for chylous ascites are

1) TRAUMATIC CAUSES

• Surgical trauma – Vagotomy, nephrotomy, gynecological surgery.
• Non surgical trauma- Radiotherapy

2) ATRAUMATIC CAUSES

• Neoplastic-Lymphoma,carcinomas, sarcomas.
• Cardiac- Constrictive pericarditis, congestive heart failure
• Gastrointestinal- Celiac sprue, Whiplle’s disease, Volvulus.
• Disease- Cirrhosis, yellow nail syndrome, lymphangioma.
• Infections- Tuberculosis, Filariasis, Ascariasis and AIDS.
• Inflammatory- Pancreatitis, SLE, Nephrotic syndrome, Sarcoidosis etc.
• Drugs- Calcium channel blockers, Sirolimus

SYMPTOMS

If the fluid buildup in the body is less, then it may not cause any visible symptoms. If it goes beyond a certain point, the following symptoms appear

• A large rounded belly
• Bulge or swelling in the abdomen
• Loss of appetite
• Lumps in groin
• Swelling in legs
• Trouble breathing
• Vomiting

TREATMENT

Treatment of the underlying cause is one of the most important steps of the treatment of chylous ascites.

• Peritoneovenous shunting
• Transjugular intrahepatic portosystemic shunt
• Abdominal paracentesis
• Angiography
• Surgical treatment ( in postop,congenital and neoplastic causes)
• Medications (such as orlistat, octreotide or etilefrine)
• Dietary therapy

AYURVEDIC PERSPECTIVE AND MANAGEMENT OF CHYLOUS ASCITES

Although chylous ascites is not specifically mentioned in Ayurveda, it does mention ascites in detail. Ascites in Ayurveda are called ‘Jalodara’. The term Jalodara is made up of two words namely Jala and Udara which means water and abdomen respectively. It is considered as Udara rog meaning a disease of the abdomen. Ayurveda believes this disease originates because of the accumulation of waste material in the body which disturbs the dosha balance of the body and eventually slows down the metabolism and Agni (Digestive fire) in the body. This pathology ends up leading to ascites. Ayurveda mentions various forms of Shamana and Shodhana treatment in case of ascites. There are many ayurveda herbs that are known to help in the case of chylous ascites. Some of them are Amla (Embilica officinalis), Gokshur (Tribulus terrestris), punarnava (Boerhavia diffusa) etc. Further in this article let us take a detailed look at the ayurveda herbs that help in chylous ascites.

AYURVEDA HERBS THAT HELP IN CHYLOUS ASCITES

1) PUNARNAVA

Punarnava (Boerhavia diffusa) is mentioned in Ayurveda textbooks as one of the best herbs for kidney disorders. This herb is called hogweed and is a diuretic. This herb helps in removal of excess water from the body and helps in micturition. This herb has madhur Vipaka, balances Vata and Kapha and mainly focuses on rejuvenation properties of the body thus it helps really well in case of ascites.

2) GOKSHURA

Gokshura (Tribulus terrestris) is used to remove kidney stones in ayurveda. It is a natural diuretic and works amazingly well on the genito-urinary system. It not only provides strength to the urinary system but also regenerates them and prevents dialysis in the longer run. This has madhur rasa and Vipaka along with cold potency which is why it has anti-inflammatory properties and helps deal with chylous ascites.

3) TRIPHALA

Triphala, a combination of three ayurveda herbs namely amla (Phyllanthus emblica), Harad(Terminalia chebula), Bahera (Terminalia billerica) is one of the most used ayurveda combinations has a unique ability to provide multiple benefits to the body. A combination of three herbs, it helps in constipation and digestion. Along with this, it helps to detox, replenish and nourish the liver with its qualities. It can be easily consumed in powder form, tablet form or in a decoction form.

3. VARUN

This herb is called caper in ayurveda and is another excellent herb for a rare disease like chylous ascites. This herb is an excellent diuretic. It helps in reducing the inflammation and fasten the overall metabolism of the body. It helps in reducing the edema that comes with a rare condition like ascites and reduces the excess fluid accumulated in the body due to ascites

4. AMLA

Amla or Indian gooseberry has antioxidants and helps prevent the body from the attack of free radicals. It is a great source of vitamin C and a huge immune booster. It has a combination of five tastes in Ayurveda and helps prevent bacterial and viral infections. It has cool potency and a sweet post digestive effect which helps in dealing with inflammation in the body. This herb is considered as a Rasayana in Ayurveda and helps in almost all disorders of the body because of its rejuvenative properties.

HERBAL FORMULATIONS FOR CHYLOUS ASCITES BY PLANET AYURVEDA

Planet Ayurveda is an authentic, GMP certified company that produces pure Ayurveda herbs and formulations under the expert supervision of Ayurveda doctors. All the formulations are vegetarian, 100% pure and are mentioned in 5000 year old Ayurveda texts. Some of the formulations by planet ayurveda for Chylous ascites are:-

1. PUNARNAVA CAPSULES

Punarnava Capsules by Planet Ayurveda are prepared by using 500 mg of pure standardized extract of the herb Punarnava (Boerhavia diffusa). Punarnava (Boerhavia diffusa) is mentioned in Ayurveda textbooks as one of the best herbs for kidney disorders. This herb is called hogweed and is a diuretic. This herb helps in removal of excess water from the body and helps in micturition. This herb has madhur Vipaka, balances Vata and Kapha and this formulation mainly focuses on rejuvenation properties of the body.

DOSAGE: 1 capsule twice daily after mealw ith plain wa.

2. INDIAN ECHINACEA

Indian Echinacea capsules are prepared by 500 mg standardized extract of Kalmegh (Andrographis paniculata). This herb has a bitter taste and is known as the king of bitter in ayurveda texts. According to ayurveda, this is yakrit utejak; pittasark and rechak which means these capsules support healthy hepatoprotective activity and sustain good liver health.

DOSAGE: 1 capsule twice daily.

3. YAKRIT PLIHANTAK CHURNA

Yakrit Plihantak Churna by planet ayurveda is a powder formulation prepared with the pure ayurveda herbs such as Kalmegh (Andrographis paniculata), Bhringraj (Eclipta alba), Bhumi Amla(Phyllanthus niruri) and many other hepatoprotective herbs. These herbs have katu (pungent) and Tikta (bitter) ras(taste) and help in balancing out kapha and pitta dosha in the body. All these herbs work in sync and assist in sustaining the health of the hepatic system without any side effects.

DOSAGE: Decoction of 1 tsf of Churna twice daily.

4. SHOTHARI MANDOOR

Shothari mandoor by planet ayurveda is a classical ayurveda preparation mentioned in Bhaishajya Ratnavali, an ancient ayurvedic text book. It contains Mandoor Bhasma (Iron oxide calx) and various other herbs like Nirgundi(Vitex negundo), Amalki (Embilica officinalis), Shunti (Zingiber officinale), Black pepper (Piper nigrum) etc. This formulation is a brilliant source of iron and is very useful in edema, swelling and inflammation. Diuretic action, anti inflammatory action and analgesic action of this formulation makes it a perfect choice for chylous ascites.

DOSAGE: 2 tablets twice daily after mealw ith plain water.

5. TRIBULUS POWER

Tribulus power by Planet Ayurveda is capsule formulation that containspure 500 mg of standardized extract of Gokshura (Tribulus terrestris). This herb is mentioned in classical ayurvedic textbooks and has been used since time immemorial. It is a natural diuretic and works amazingly well on the body. It not only provides strength to the urinary system but also regenerates and rejuvenates the body. This has madhur rasa and Vipaka along with cold potency which is why it has anti-inflammatory properties and is used to increase strength and stamina in the body.

Dosage:1 capsule twice daily after meal with plain water.

CONCLUSION

While modern medicine science does mention various surgical and non surgical ways to treat chylous ascites but Ayurveda has many proven herbs that help in the cases of chylous ascites. These herbs have no side effects and treat the issue from the root cause. Ayurveda is an experience based science which is time tested and has been existent for the past 5000 years. So, it is always beneficial to look out for natural methods and herbs that help deal with diseases from the root cause.