PRATYATMA LAKSHANA (CHARACTERISTIC FEATURES) OF UDARA
Pratyatma Lakshanas are disease-specific signs that help in the diagnosis of Udara Roga.
Enlargement of abdomen (Udaravriddhi)
Distension without proportionate weight gain
Discomfort and heaviness in the abdomen
Pain in flanks and abdominal region
Loss of appetite (Arochaka)
Constipation or altered bowel habits
Vein engorgement over the abdomen (especially in Jalodara)
Visible movement of fluid (in ascites/Jalodara)
рд╕рд╛рдорд╛рдиреНрдпрдореБрджрд░рдВ рдирд╛рдо рд╡рд░реНрдзрдорд╛рдирдВ рддреБ рдЧрд╛рддреНрд░рддрдГред
рд╡рд┐рд╡рд░реНрдгрддреНрд╡рдВ рдмрд▓рд╣реНрд░рд╛рд╕рдВ рд╢реВрдирддрд╛рдВ рдЪреЛрдкрд▓рдХреНрд╖рдпреЗрддреНрее
тАФ Ashtanga Hridaya, Nidanasthana 11/3
HETU (CAUSES) OF UDARA
Excessive consumption of incompatible, heavy, and untimely food (Viruddha, Guru, Atyanta Bhojana)
Suppression of natural urges (Vegadharana)
Habitual intake of stale or improperly digested food (Ama)
Excessive physical exertion after meals
Chronic liver/spleen disorders
Alcohol abuse
Intestinal parasites (Krimi)
Emotional disturbances causing digestive disorders
рддреИрд╕реНрддреИрд░реНрджреЛрд╖реИрд░реНрдирд╡рд╛рдиреНрдиреИрд╢реНрдЪ рдХреЛрдкрд┐рддреИрдГ рд╕рдореБрдкрд╕реНрдерд┐рддреИрдГред
рдЖрдорд╛рд╢рдпрдВ рдЧреГрд╣реАрддреНрд╡рд╛рде рдХреБрдХреНрд╖рд┐рдВ рдЪреЛрджрд░рдорд╛рд╡рд╣рдиреНрее
тАФ Charaka Samhita, Chikitsa Sthana 13/7
SAMPRAPTI (PATHOGENESIS) OF UDARA
Agnimandya тЖТ Ama Nirmiti тЖТ Dosha Dushti (mainly Vata)
Vata gets aggravated and localized in the abdominal region
Leads to obstruction of channels (Srotorodha) and improper function of Apana Vata
Accumulation of Dosha + Mala + Aama leads to abdominal distension
Depending on Dosha dominance, different types of Udara manifest
рд╡рд╛рддрд╛рджреНрдпрд╛рдГ рдХреЛрдкрд┐рддрд╛ рджреЛрд╖рд╛рдГ рдХреБрдХреНрд╖реМ рд╕рдВрд╕реНрдерд╛рдп рд╕рдиреНрдирд┐рдкрд╛рддрд╛рддреНред
рд╡рд┐рдирд┐рд░реНрдорд┐рдиреНрд╡рдиреНрддрд┐ рд╡рд┐рд╡рд┐рдзрдВ рд╡рд┐рдХрд╛рд░рдВ рддрдВ рд╕рдореБрджреНрдзрд░реЗрджреМрд╖реНрдардореНрее
тАФ Sushruta Samhita, Nidanasthana 7/5
BHEDA (TYPES) OF UDARA
According to Sushruta, there are 8 types:
Vataja Udara
Pittaja Udara
Kaphaja Udara
Sannipataja Udara
Udavarta (reverse movement of Vata)
Baddha Gudodara (intestinal obstruction with retained feces)
Pleehodara (spleen enlargement)
Jalodara (ascites or fluid accumulation)
Chidrodara (perforation or fistulous opening in abdomen - post surgical/traumatic)
рд╖рдбреБрджрд░рд╛рдгрд┐ рд╡рдХреНрд╖реНрдпрд╛рдорд┐ рд╡рд╛рддрдкрд┐рддреНрддрдХрдлрд╛рддреНрдордХрдореНред
рд╕рдВрдирд┐рдкрд╛рддрд╕рдореБрддреНрдердВ рдЪ рдЙрджрд╛рд╡рд░реНрддрдВ рдмрдзреЛрджрд░рдореНрее
рдкреНрд▓реАрд╣реЛрджрд░рдВ рдЪ рдЬрд▓рдВ рдЪ рдЫрд┐рдиреНрдирдВ рдЪрд╛рдкреНрдпрдерд╡рд╛ рдкреБрдирдГрее
тАФ Sushruta Samhita, Nidanasthana 7/3
PURVAROOPA (PRODROMAL SYMPTOMS) OF UDARA
Anorexia
Mild abdominal distension
Feeling of heaviness after meals
Irregular bowel movements
Flatulence
Malaise
SAMANYA LAKSHANA (COMMON SYMPTOMS) OF UDARA
Progressive enlargement of abdomen
Constipation or obstruction of feces
Weakness and fatigue
Poor digestion
Emaciation of limbs
Loss of appetite
Visible veins over abdomen
Pain in abdomen or flanks
SADHYA-ASADHYATA (PROGNOSIS) OF UDARA
Sadhya (Curable):
Vataja, Pittaja, and Kaphaja Udara in early stage
Udavarta when treated early
Udara with no evident organic complications
Krichrasadhya or Yapya:
Baddha Gudodara
Pleehodara
Asadhya (Incurable):
Jalodara with severe fluid accumulation
Chidrodara with fistula, multiple organ failure
рд╕рдореБрддреНрдкрддреНрддреМ рдЪ рдпрд╛ рдЪрд┐рдХрд┐рддреНрд╕рд╛ рд╕реБрд▓рднрд╛ рд╕рд╛рдкрд┐ рд╕рд┐рдзреНрдпрддрд┐ред
рдирд╛рддреНрдпрдиреНрддрджреБрд╖реНрдЯреЗ рд╕реНрдиреЗрд╣рд┐рддрд╛, рдордиреНрджреЗ рд╡рд╛ рдпрджрд┐ рдмреБрджреНрдзрд┐рдорд╛рдиреНрее
тАФ Ashtanga Hridaya, Nidanasthana 11/34
AVASTHA BHEDA (STAGES) OF UDARA
Ama Avastha тАУ Initial stage with indigestion, Ama production
Pachyamanavastha тАУ Attempt of the body to digest the Ama, mild fever, discomfort
Pakva Avastha тАУ Manifested symptoms of Udara with doshic features
Dushta Avastha тАУ Chronic condition with complications and poor prognosis
DIFFERENTIATION OF DOSHAJA UDARA
Vataja Udara
Tense and hard abdomen
Pricking pain
Constipation
Sound in abdomen
Blackish discoloration
Pittaja Udara
Burning sensation
Yellow discoloration
Increased thirst and hunger
Loose stools with foul smell
Irritability
Kaphaja Udara
Soft, pale and cold abdomen
Loss of appetite
Heaviness and stiffness
Nausea, excessive salivation
Lethargy
Sannipataja Udara
Mixed features of all Doshas
Worst prognosis
VISHISHTA LAKSHANA OF SPECIFIC TYPES OF UDARA
BADDHA GUDODARA
Obstruction of rectum due to fecal impaction or tumor
Retention of feces and flatus
Pain and heaviness in lower abdomen
Sometimes results in visible abdominal mass
Straining during defecation
PLEEHODARA
Enlargement of spleen
Pain in left hypochondrium
Abdominal distension with shifting dullness
Loss of appetite, anemia
Recurrent infections
Resembles splenomegaly in modern pathology
JALODARA
Excessive accumulation of fluid in peritoneal cavity
Fluctuation test positive
Prominent abdominal veins
Shiny and tense skin
Difficulty in breathing
Resembles ascites (often due to liver cirrhosis, TB, malignancy)
CHIDRODARA
Abdominal perforation due to trauma/surgery
Leakage of bowel contents externally through sinus or fistula
Foul-smelling discharge
Signs of infection or peritonitis
Requires surgical management
MODERN CORRELATION (MODERN PATHOLOGY PERSPECTIVE)
Hepatosplenomegaly тАУ Common in chronic liver disease, malaria, kala-azar
Ascites (Jalodara) тАУ Seen in cirrhosis, congestive heart failure, nephrotic syndrome
Tubercular Abdomen тАУ Mimics Chidrodara with peritoneal TB
Colonic obstruction (Baddha Gudodara) тАУ Due to fecaloma, carcinoma, volvulus
Splenomegaly (Pleehodara) тАУ Due to portal hypertension, hemolytic anemia
Constipation with fecal impaction (Udavarta) тАУ Due to diet, neurogenic causes
Diagnosis тАУ USG abdomen, CT scan, Ascitic fluid analysis, LFT, CBC, FNAC for masses