Ayurvedic management of Budd Chiari Syndrome – A case report

Budd-Chiari Syndrome (BCS) is an uncommon liver disorder characterized by obstruction of hepatic venous outflow. BCS is a rare condition affecting one in a million adults. The obstruction may be thrombotic or non-thrombotic anywhere along the venous course from the hepatic venules to the junction of the inferior vena cava to the right atrium. Patient may present with abdominal pain, ascites along with hepatomegaly, jaundice, bleeding in the oesophagus, oedema in the legs, hepatic encephalopathy and liver failure. Treatment for Budd-Chiari syndrome in modern science are dissolving blood clots, improve liver function and treat complication. A 51-year-old female patient presented with complaints of pain in right side of abdomen, loss of appetite, abdominal heaviness, abdominal distension, nausea and swelling at bilateral lower leg for one month. Ultrasonography of the abdomen revealed cirrhosis of the liver, thrombosis of the right, middle, and left hepatic veins, along with features of BCS with gross ascites. She is known case of Budd-Chiari syndrome along with gross ascites. The patient was treated with Deepana (which simulates the digestion) and Pachana (enhancing digestion) Koshthashodhana (mild purgation) followed by Vardhamana pippalirasayana(administration of Pippali in a increasing dose and then tapering the dose) and Shamana chikitsa (pacifying treatment)). Pathya-apathya (wholesome diet and regimen) were advised in line with the management of Jalodara for three months. After three-months treatment there was changes in liver profile (SGPT reduced from 250 to 47, SGOT from 328 to 68, alkaline phosphate 272 to 134mg/dl). The assessment of quality of life using the Chronic Liver Disease Questionnaire (CLDQ) indicated improvement in quality of life. This suggests that Ayurvedic treatment can give symptomatic relief and help to prevent it further complication and also improve the overall quality of life.