TO EVALUATE THE COMBINED EFFICACY OF AYURVED AND MODERN MANAGEMENT IN MANAGEMENT UDAR ROGA AND IMPROVE HEPATO RENAL FUNCTION - A CASE STUDY

Jalodara (Ascites) Udara Roga denotes the generalized distension or enlargement of abdomen of varied aetiology. It is one among the Ashtamahagada. From the origin of the illness it is difficult to manage. Agni dosha and mala vriddhi causes vitiation of Prana, Agni and Apana and obstruction of the upward and downward channels of circulation. The vitiated doshas get lodged between skin and muscle tissue and causes extensive distension of the abdomen resulting in Udara roga. The cardinal features are Kukshi adhmana (enlargement of abdomen), Karapada shopha (oedema in the limbs), Mandagni/ Atyanta Nastagni, Krushagatra(emaciation Extreme impairment of agni (digestion and metabolism) is the basic pathology of udara roga in general, which is regarded as one among the mahagada (major illness). It is classified into eight types Vatodara (Accumulation of flatus), Pittodara (Hepatic causes), Kaphodara (Renal causes), Sannipatodara (exudative causes), Plihodara (splenomegaly), kshatodara/chhidrodara (abdominal enlargement due to intestinal perforation), baddhagudodara (enlargement of abdomen due to gastrointestinal obstruction) and jalodara/udakodara (ascites). Yakritodara (hepatomegaly) is also a distinct type of udara roga but incorporated in the plihodara since the aetiology and treatment of these two conditions are similar. The disease closely resembles Ascites, which is pathological accumulation of fluid within the peritoneal cavity. The mortality increases from complications such as spontaneous bacterial peritonitis and hepato-renal syndrome. Mortality ranges from 15% in one year to 44% in 5 years. Treatment in contemporary science for Ascites include trans jugular intra hepatic portosystemic Shunt, Diuretics etc which only provide provisional relief with time dependent recurrence but fluid gets collected in peritoneal cavity repeatedly. In such case, Ayurvedic treatment gives relief without any sideffect.