Clinical Evaluation of Ayurvedic Management in a Case of Ascites with Splenomegaly and Liver Parenchymal Disease

Abstract

Ascites is a common complication of chronic liver disease and portal hypertension, frequently associated with hepatic parenchymal damage, splenomegaly, and metabolic disturbances. In Ayurveda, the clinical presentation of ascites can be correlated with Jalodara, Yakritodara, and Plihodara described under Udara Roga. This case report describes the clinical outcome of a 65-year-old male patient presenting with abdominal distension, pedal edema, anorexia, generalized weakness, icterus, and ultrasonographic evidence of chronic liver parenchymal disease with splenomegaly, bulky pancreas, and minimal ascites. The patient had a significant history of chronic alcohol consumption and smoking. Ayurvedic management included Pippali Vardhamana Rasayana, Langhana, and Takra Pathya for seven days. Clinical assessment, biochemical investigations, and ultrasonographic findings were evaluated before and after treatment. Marked improvement was observed in abdominal distension, appetite, pedal edema, and general wellbeing. Serum bilirubin reduced from 3.2mg/dL to 1.0mg/dL, while SGPT levels improved from 49U/L to 29U/L. Follow-up ultrasonography demonstrated reduction in ascitic fluid and improvement in hepatic pathology. The therapeutic effect may be attributed to the Deepana, Pachana, Rasayana, and hepatoprotective properties of Pippali (Piper longum Linn.). This case suggests that Ayurvedic interventions may provide supportive benefit in the management of ascites associated with chronic liver disease and splenomegaly.