Chylous ascites is a condition in which there is drainage of peritoneal fluid into the abdominal cavity. This fluid is rich in triglycerides having a milky appearance. This condition may lead to nutritional deficiencies and suppress the immune system. Chylous ascites have a high mortality rate up to 40-70% depending on the underlying cause. The risk factor which can lead to chylous ascites can be alcohol intake, heart failure, salt and water imbalance, no physical activity, etc. Based on fluid accumulation and water level the reason for ascites can be high serum albumin gradient. In mild ascites, sometimes no symptoms appear, only there is accumulation of fluid and in severe ascites, heavy stiff abdomen and dilated veins on abdomen. In this article we will know about chylous ascites cause, symptoms and diagnosis; management according to our ancient classical texts.
Chylous ascites is a very rare form of ascites which is due to leakage of lipid rich lymph into the peritoneal cavity (gastroenterological condition). There is accumulation of fluid from thoracic and interstitial lymph. The main reason behind chylous ascites is any injury or trauma to lymphatic or increased pressure in lymphatics. Chylous ascites leads to malnutrition, dehydration, electrolyte imbalance. The function of lymph vessels is to carry lymph fluid to veins then it returns to blood circulation and maintains immunity. Liver secretes a particular amount of fluid but when excess fluid is released it leads to accumulation in the abdominal cavity. This disease is not that common these days. The main reason behind ascites is heart failure and liver cirrhosis/ liver dysfunction. There is extravasation of chyle, a milky fluid rich in triglycerides due to obstruction of the lymphatic system.
The main reason behind chylous ascites is disturbance in lymphatic flow. Other causes behind chylous ascites are as following
- Injury/ trauma
- Congenital or acquired
- Benign or malignant cause
- Portal system pressure
- Systemic illness like tuberculosis
- Increased venous pressure (heart failure, pulmonary hypertension, etc.)
The sign and symptoms of chylous ascites are as following
- Weight gain
- Increased abdominal pressure/ distended
- Enlarged lymph nodes
- Anorexia, malaise
- Fever with night sweats
- Abdominal pain
- Difficulty in eating
- Swelling bilateral legs
The diagnostic methods for chylous ascites are as following
- According to Ayurveda darshan, prashan, sparshan done ( medical history and clinical examination)
- Routine blood investigation (CBC)
- Triglyceride level in ascites fluid
- Abdominal paracentesis
- Lipoprotein electrophoresis
- Cytology and peritoneal biopsy
- CT of abdomen
- X-ray and MRI
The treatment of chylous ascites depends on its underlying cause. The basic line of treatment for chylous ascites are as following
- Diet- low fat, rich in protein
- Lymph angiography
- Surgical treatment
- For preventive measures
- Drink Minimum Water
- Avoid Alcohol
- Avoid Salts
- Avoid Excessive Starch
Ayurvedic Point of View Regarding Chylous Ascites
According to Ayurveda, chylous ascites is a type of ascites which can be correlated with “jalodar”, a type of udar roga (abdominal disorder). Jalodar is a form of two words “jal” + “udar” = jalodar means accumulation of fluid in the abdominal cavity. This condition is tridoshaj (vata, pitta and kapha) but there is predominance of kapha dosha and water (jaal). In classics, jalodar is considered more complicated than other eight udar rogas. The reason behind ascites in Ayurveda is intake of excess amounts of fluid which destroys digestive fire.
Other Causes Are
- Improper diet
- Not following post panchakarma norms
- After oleation imbalance food/ excess water
Clinical Features According to Ayurveda
- Aruchi (anorexia)
- Pipasa (thirst)
- Gudstrav (anal discharge)
- Udar shool ( abdominal pain)
- Swash kash ( breathlessness, cough)
- On palpation feeling like water inside abdomen
Management in Ayurveda
- Shastra karma ( surgical intervention)
- Upwas (fasting)
- Give ghee and medicated oil with saindhav (salt)
- Use of kshara medicines ( like cow’s urine)
- Have milk in diet
Diet Recommended in Classics for One Year
- For six months only milk and meat ( jangham mams)
- For Next three months milk mixed with half water, citrus fruits and meat in diet
- For the last three months, healthy and light food.
Herbal Remedies for Chylous Ascites by Planet Ayurveda
Planet Ayurveda is a large manufacturing unit of herbal medicines which prepare medicines as mentioned in classical Ayurveda texts. Planet Ayurveda is a GMP and ISO certified company. All the products prepared are free from chemicals, any artificial preservatives, color, yeast or starch, etc. The best combination of herbal remedies for chylous ascites provided by planet Ayurveda are as follows
- Punarnava Capsules
- Shothari Mandoor
- Tribulus Power
- Indian Echinacea
- Yakrit Plihantak Churna
1. Punarnava Capsules
These are standardized capsule formulations prepared from extract of punarnava (Boerhavia diffusa). These capsules balance kapha and vata dosha in our body. It has anti-inflammatory properties and reduces oedema. They act as diuretics, regulate kidney function, reduce urinary retention and regulate the digestive system. It helps in digesting fat and absorbing excess fluid from our body.
Dosage- Two capsules twice daily with plain water after meals.
2. Shothari Mandoor
The shothari mandoor is a tablet formulation prepared from the extract of mandoor bhasma (calx of iron), haritaki (Terminalia chebula), bibhitaki (Terminalia Billerica) and amalaki (Emblica officinalis). These tablets help in reducing any type of oedema, swelling or inflammation. It balances vitiated vata and pitta dosha; it is also a good source of iron. These tablets particularly can be used in anasarca and improves digestion.
Dosage- Two tablets twice daily with plain water after meals.
3. Tribulus Power
Tribulus power is a capsule formulation prepared from extract of gokshura (Tribulus terrestris). These capsules balance all three doshas. It helps to treat oedema, obesity and renal problems. These are used in various disorders like kidney disease, urinary tract diseases and it has antioxidant properties.
Dosage- One capsule twice daily with plain water after meals.
4. Indian Echinacea
It is standardized capsule preparation prepared from extract of Indian Echinacea/ kalmegh (Andrographis paniculata). It has antioxidant, anti-inflammatory properties. These capsules help in maintaining bile amount and property. It helps in maintaining all liver disorders and balances vitiated kapha and pitta dosha.
Dosage- One capsule twice daily with plain water after meals.
5. Yakrit Plihantak Churna-
It is standardized powder formulation prepared from extract of bhumi amla (Phyllanthus niruri), bhringraj (Eclipta alba), kaasni (Cichorium intybus), kalmegh (Andrographis paniculata), Sharpunkha (Tephrosia purpurea), etc. This powder is very useful in liver and spleen functioning. It helps in the liver to remove deposited toxins and repair damaged liver cells. It helps in maintaining jaundice, damaged cells, liver damage and fatty liver.
Dosage- One tablespoon twice daily with plain water after meals.
Contact Planet Ayurveda Support Team to provide you the costing / ordering and delivery information at – firstname.lastname@example.org or Call at 0172-521-4030 (India), +91-172-521-4030 (Outside India) or Whatsapp at (+91) 9915-593-604
Ascites is accumulation of fluid in the abdomen and when this fluid contains lymphatic and fatty fluid is known as the condition chylous ascites. Initial conditions have mild symptoms which can be easily managed by medications mentioned above. All the information about ascites will be helpful and you can consult doctors for any severity in condition.