What is Ascites? How it can be Treated in Ayurveda?

In Ayurveda, Ascites (Jalodara) is considered a subtype of Udara Roga (Abdominal Disorders) and is primarily caused by an imbalance of Vata and Kapha Dosha along with Agni Dushti (Digestive Fire Impairment). The main causes include:
• Liver disorders (cirrhosis, hepatitis)
• Kidney dysfunction
• Heart diseases
• Obstruction in channels (Srotorodha) leading to fluid accumulation
• Ama (Toxins) accumulation in the abdomen
• Excessive alcohol consumption

Ayurveda focuses on eliminating the root cause by balancing Doshas, improving digestion, and detoxifying the body through herbal medicines, Panchakarma therapies, and dietary regulations.

Types of Ascites in Modern Science

Modern medicine classifies Ascites based on its causative factors and severity:
1. Transudative Ascites: Caused by increased pressure in the portal vein due to liver cirrhosis, heart failure, or kidney disease.
2. Exudative Ascites: Due to infection, inflammation, or malignancies (e.g., tuberculosis, cancer, pancreatitis).
3. Malignant Ascites: Caused by cancerous tumors (e.g., ovarian, liver, or pancreatic cancer).
4. Chylous Ascites: Due to lymphatic obstruction, leading to a milky fluid accumulation.
5. Hemorrhagic Ascites: Caused by ruptured blood vessels or trauma, leading to blood in the peritoneal cavity.

Difference Between Ayurvedic and Modern Management of Ascites

Aspect Ayurveda Modern Medicine
Approach Focuses on root cause healing, balancing Doshas, and detoxifying the liver and kidneys. Treats symptoms using diuretics, paracentesis (fluid removal), and liver transplant in severe cases.
Treatment Focus Strengthens digestive fire (Agni), eliminates toxins, and corrects metabolism. Focuses on fluid removal and symptomatic relief but may not address the root cause.
Use of Chemicals Uses natural herbs, Panchakarma therapies, and diet-based management. Involves synthetic drugs, diuretics, and invasive procedures.
Long-Term Benefits Prevents recurrence by correcting metabolic imbalances and improving digestion. Provides temporary relief; fluid accumulation often recurs.

Common Ayurvedic Protocol for Healing Ascites from Root Cause

1. Panchakarma (Detoxification Therapies)

• Virechana (Purgation Therapy): Removes excess Pitta toxins from the liver.
• Basti (Medicated Enema): Corrects Vata imbalance and improves kidney function.
• Raktamokshana (Bloodletting): In cases of liver-related Ascites, this helps purify the blood.
• Jalaukavacharana (Leech Therapy): Helps in reducing swelling and improving blood circulation.

2. Herbal Treatment (Shamana Chikitsa)

• Punarnava (Boerhavia diffusa): Acts as a natural diuretic, reducing fluid retention.
• Gokshura (Tribulus terrestris): Supports kidney function and reduces swelling.
• Kutki (Picrorhiza kurroa): Improves liver function and digestion.
• Triphala: Detoxifies the digestive tract and prevents Ama accumulation.
• Guduchi (Tinospora cordifolia): Enhances immunity and liver detoxification.
• Sharpunkha (Tephrosia purpurea): Beneficial for cirrhosis-induced Ascites.

3. Diet and Lifestyle (Aahara-Vihara)

• Avoid:
• Salty, spicy, fried, and processed foods.
• Alcohol and excessive protein intake.
• Heavy-to-digest foods like dairy, non-vegetarian meals, and legumes.
• Recommended:
• Light, warm, and easily digestible foods (Moong dal, lauki, barley, buttermilk).
• Coconut water, lemon water, and herbal teas to maintain electrolyte balance.
• Small frequent meals to avoid overloading the digestive system.

4. External Ayurvedic Remedies (Lepa and Herbal Poultices)

• Castor Oil Pack: Applied over the abdomen to reduce fluid accumulation.
• Turmeric and Neem Paste: Helps prevent infection and inflammation.
• Warm Medicated Oil Massage (Abhyanga): Improves lymphatic drainage and circulation.

Conclusion

Ayurveda provides a holistic and long-term approach to treating Ascites by addressing the root cause rather than just removing fluid. With herbal medicines, detoxification therapies, dietary modifications, and lifestyle changes, it strengthens liver, kidney, and digestive function, preventing recurrence and complications.