Abstract
CHYLOUS ASCITES occur when chyle collects in the belly. Chyle is a milky fluid which is made in the intestines. It is an uncommon and a rare type of condition arising from obstruction of lymphatic drainage or trauma. It was first reported in 1912. It has an incidence of approximately 1 per 20,000 people. The present ascitic fluid can turn into chylous fluid as a secondary event. It can occur in children, although most are infants and toddlers and adults.
INTRODUCTION
Chylous ascites is defined as the milky appearance that results from leakage of lipid rich lymph into the peritoneal cavity. This usually occurs due to trauma and increased peritoneal lymphatic pressure or rupture of the lymphatics. Presence of the ascitic fluid with high fat (triglyceride), usually more than 200 mg/dL is defined as true chylous ascites.
SYMPTOMS
Chylous ascites are usually asymptomatic, but the following symptoms can be seen.
- Weight gain
- Shortness of breath
- Increased abdominal pressure
- Enlarged lymph nodes
- Malaise
- Anorexia
- Vomiting or Diarrhea
- Abdominal pain due to sudden leakage of chyle into the peritoneum.
- Bulge or swelling
CAUSES
- Injuries due to Trauma or surgery
- Rupture of lymphatics
- Increased peritoneal pressure
- Obstruction
- Malignancy
- Congenital lymphatic malformations
- Systemic infections such as tuberculosis, It can also occur from Cirrhosis, pericarditis etc
- Inflammatory causes such as peritonitis .
- Mediastinal tumors
Diagnosis of chylous ascites
- Paracentesis - sample of the fluid is taken from the belly with the help of the needle and examined under the microscope.
- Ultrasound
- Lymphoscintigraphy
- Magnetic resonance (MR) lymphography
- Blood culture - triglyceride test
- CT ( computed tomography )
MANAGEMENT
As per modern : The management will be in two types : Conservative and Surgical.
CONSERVATIVE -Low fat diet
- IV nutrition
- Removing fluid from the belly ( Paracentesis)
- Placing a drain in the belly to let fluid flow out.
- Transjugular intra hepatic porto systemic shunt (TIPS)
AS PER AYURVEDIC OVERVIEW
Ayurveda is a holistic way of healing which heals on the basis of dosha , dhatu , mala through herbs with different diagnostic tools such as dashavidha pariksha. Ayurved helps in treating the disease from the roots without any harmful reaction to the body .It aims to restore the health of the healthy person and to treat the diseased person.
Chyle Ascites is due to either vata and kapha dosha , vata dosha helps in the movements of the body and maintains the normal functions of the body whereas kapha provides stability to the body. It comes under udara roga as per ayurveda It happens due to accumulation of the toxic fluid into the peritoneal cavity.
Diagnosis
- Darshana ( Direct perception)
- Sparshana (Touch Perception)
- Prashan (Questioning)
Management
- Dietary management
- Lifestyle changes
- Shaman chikitsa (Herbal formulations)
- Shodhana chikitsa (Purificatory measures)
- Shastra chikitsa (surgical or para surgical procedures)
Tips
- Diet -Take warm and liquid food such as soups and stews , Avoid salty, heavy ,oily, spicy food and carbonated drinks. Have fresh vegetables and fruits , a high fibre diet and low sodium diet.
- Lifestyle - Gentle exercise , Meditation and yoga to cope up with stress.
- Shodhana chikita - snehana , swedana, nitya virechana , asthapan and anuvasana basti.
- Shaman chikitsa - Using herbal drugs or formulations to manage the condition such as triphala , guggulu , punarnava , Kalmegh etcc..
HERBAL REMEDIES FOR CHYLOUS ASCITES BY PLANET AYURVEDA
PLANET AYURVEDA is an ayurvedic clinic which provides holistic healing through herbs and diet. They also have a manufacturing unit which is GMP and ISO certified. They provide natural supplements such as herbal oils, tablets, capsules, powders ,syrups etc which are 100% pure and natural. They also provide classical medicines and serve the society for more than 20 years.
Product Lists
- Punarnava capsules
- Shothari mandoor
- Tribulus power
- Indian echinacea
- Yakrit plihantak churna
1. Punarnava capsules
It is one of the patent medicines of the planet ayurveda consisting of punarnava (Boerhavia diffusa) available in capsule form.. Punarnava is a classical ayurvedic herb which is used to reduce inflammation, in liver disorders, increases digestive fire, useful in wounds , abdominal disorders.
DOSAGE: 2 Capsules twice a day after meal with plain water.
2. Shothari mandoor
It is one of the classical as well patent medicines by planet ayurveda available in tablet form . It consists of various herbs such as Triphala(Haritaki, amalaki, vibhitaki), Trikatu(Sunthi, maricha, pippali), madhu(honey) , nirgundi swarasa(vitex negundo), chavya(Piper chaba) , gomutra etc.. It is useful in treating edema, inflammation, in case of injury bleeding.
DOSAGE - 2 tablets twice a day after meal with plain water.
3. Tribulus Power
This is a patent medicine by planet Ayurveda available in capsule form. It is a single herb formulation consisting of gokshura (Tribulus terrestris) .This is useful in balancing all the doshas, relieves from pain and it has anti-inflammatory and diuretic properties
DOSAGE - 1 Capsule twice daily after meal with plain water.
4. Indian echinacea
Indian echinacea is a patent herbal formulation by planet ayurveda available in capsule form which includes indian echinacea (Andrographis paniculata) in sanskrit it is known as kalamegha. It pacifies kapha and pitta dosha and increases immunity.
DOSAGE: 1 capsule twice daily after meal with plain water.
5. Yakrit Plihantak churna
It is one of the planet ayurveda's patent formulation in powder form which includes kalmegh (Andrographis paniculata), bhringraj (eclipta alba) , bhumi amla (Phyllanthus niruri) , sharpunkha(Tephrosia purpurea) etc.. It is useful in liver and spleen disorders. It relieves from disorders like liver cirrhosis, liver damage , infections etc.
DOSAGE: 1 Tablespoon twice daily after meal with plain water.
CONCLUSION
Chylous ascites have a milky appearance , which arises due to above mentioned causes . It results from leakage of lipid rich lymph into the cavity .Chylous ascites have both conservative and surgical management which makes it curable. According to ayurveda it comes under udara rogas which can manifest due to no. of causes and can be treated by different methods such as diet, lifestyle , shodhana and shaman therapies as well as shalya karma( surgery). As this condition can be managed by conservative treatment herbal remedies play a major role. You can find the classical as well as patent medicines for this condition at www.planetayurved.com
