Changes

No visible ''srotas'' is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the ''kala'' and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores14. Thus, in ''udara'', the distension of abdomen is due to the accumulation of the fluids within the space between the ''kala'' and visceral tissues in the abdomen15 [9-11].

No visible ''srotas'' is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the ''kala'' and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores14. Thus, in ''udara'', the distension of abdomen is due to the accumulation of the fluids within the space between the ''kala'' and visceral tissues in the abdomen15 [9-11].

==== Types of udara roga ====

==== Types of ''udara roga'' ====

The clinical condition of peritonitis is comparable to the udara roga in general. Clinically this is categorized into primary or secondary, acute or chronic and localized or diffuse. These are comparable to the doshaja udara that includes vataj, pittaja, kaphaja and sannipataja udara roga. Splenomegaly and hepatomegaly refers to plihodara and yakritodara respectively. Intestinal obstruction is said by the baddhagudodara (enlargement of abdomen due to gastrointestinal obstruction) and chhidrodara (abdominal enlargement due to intestinal perforation) refers to the intestinal perforation. [22]

The clinical condition of peritonitis is comparable to the ''udara roga'' in general. Clinically this is categorized into primary or secondary, acute or chronic and localized or diffuse. These are comparable to the ''doshaja udara'' that includes ''vataja, pittaja, kaphaja'' and ''sannipataja udara roga''. Splenomegaly and hepatomegaly refers to plihodara and ''yakritodara'' respectively. Intestinal obstruction is said by the ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chhidrodara'' (abdominal enlargement due to intestinal perforation) refers to the intestinal perforation. [22]

Peritonitis caused without an apparent source of contamination of peritoneal cavity is regarded as primary peritonitis. The spontaneous peritonitis caused due to hematogenous spread of bacterial infection into the peritoneum causing inflammation. Chronic liver disease is the most common cause of such infection. This can even happen without any underlying disease. 80 % of the patients present with fever. Acute onset of abdominal pain is characteristic and malaise, fatigue, or encephalopathy is the other co morbidity16. The primary peritonitis caused by gram negative bacteria matches with the symptom of vataj udara. Sub acute manifestation with non pyogenic exudation causing ascites points towards the diagnosis of vātodara. Microbiology study of ascitic fluid will reveal pathogens like Escherichia coli and enterococci16 [25].

Peritonitis caused without an apparent source of contamination of peritoneal cavity is regarded as primary peritonitis. The spontaneous peritonitis caused due to hematogenous spread of bacterial infection into the peritoneum causing inflammation. Chronic liver disease is the most common cause of such infection. This can even happen without any underlying disease. 80% of the patients present with fever. Acute onset of abdominal pain is characteristic and malaise, fatigue, or encephalopathy is the other co-morbidity16. The primary peritonitis caused by gram negative bacteria matches with the symptom of ''vataja udara''. Sub acute manifestation with non pyogenic exudation causing ascites points towards the diagnosis of ''vatodara''. Microbiology study of ascitic fluid will reveal pathogens like Escherichia coli and enterococci16 [25].

Image 01: Patient suffering from udara roga

Image 01: Patient suffering from ''udara roga''

Again, based on the etiology udara roga is further segregated into nija (endogenous) and agantuja (exogenous) type. Among the different types of udara roga; the types of udara caused due to erroneous food and habits and mediated through morbidity of dosha and dushya is considered as nija type of udara. Plihodara (enlargement of the spleen) and jalodara (enlargement of abdomen due to collection of fluid) are segregated as nija udara in the list of dushya dominant udara. All the four types of dosha dominant udara fall under the category of nija udara (distension of abdomen due to endogenous causes). Contrary to this the baddhodara (enlargement of abdomen due to gastrointestinal obstruction) and chidrodara (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as agantu udara (distension of abdomen caused due to exogenous causes) 17 [22].

Again, based on the etiology ''udara roga'' is further segregated into ''nija'' (endogenous) and ''agantuja'' (exogenous) type. Among the different types of ''udara roga''; the types of ''udara'' caused due to erroneous food and habits and mediated through morbidity of ''dosha'' and ''dushya'' is considered as ''nija'' type of ''udara''. ''Plihodara'' (enlargement of the spleen) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are segregated as ''nija udara'' in the list of ''dushya'' dominant ''udara''. All the four types of ''dosha'' dominant ''udara'' fall under the category of ''nija udara'' (distension of abdomen due to endogenous causes). Contrary to this the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chidrodara'' (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as ''agantu udara'' (distension of abdomen caused due to exogenous causes) 17 [22].

==== Vātodara ====

==== Vātodara ====