Ascites is the accumulation of free fluid in the peritoneal cavity.
It may be due to heart failure, cirrhosis of liver or malignancy.
Clinical features-
The main feature is the distention of the abdomen. The umbilicus becomes everted, scrotal oedema, hernia, are the associated features.
Causes of ascites.
1-Malignantdiseases.
2-Cardiac failure.
3-Liver cirrhosis.
4-Infection like tuberculosis, inflammation in the peritoneum.
5-Nephrotic syndrome.
6-Hyperthyroidism.
7-Renal dialysis.
8-Lymphatic obstruction.
9-Pancreatitis.
Appearance of ascitic fluid.
a) Clear or light green in cirrhosis
b) Bloody fluid in malignancy.
c) Cloudy in infection.
d) Milky white in lymphatic obstruction
Grading of ascites
Grade 1
Mild and visible by ultrasound only
Grade 2
Bulging of both flanks and shifting dullness on percussion.
Grade 3
Abdomen distended with the fluid thrill on auscultation.
Investigation
Ultrasonography is the best choice.
Tapping the fluid (paracentesis) is useful for analysis the fluid.
Depending upon the concentration of protein the fluid may be exudates or transudate.
In cirrhosis of liver, it is transudate.
Treatment
General measures
The aim is to relieve the discomfort.
Reduce the sodium and fluid intake.
If there is too much discomfort tapping of the fluid is necessary.
Homeopathic treatment
Since the disease is a very complicated one, and the causes behind the ascites are severe the remedy and potency selection should be considerably cautious.
The medicine is better tried in the tincture form or in low potency. The discomfort should be relieved first in severe cases. For that, homeopathic remedies like Apis, Ars alb, Apocyanum is effective. Once the acute symptoms are over constitutional drugs are chosen after considering the mental and physical totality of the patient and with given importance to the underlying disease symptoms. The cause to the formation of ascites should be given importance. Because common symptoms in the disease should be avoided while selecting the deep acting homeopathic remedies.Anyway homeopathic is effectivein the treatment of ascites. Medicine can be tried even after paracentesis, so that further formation can be prevented. Even so, the treatment is a prolonged process.
