E-ISSN:2456-3110

Review Article

Ashta Udara Roga

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 6 JUNE
Publisherwww.maharshicharaka.in

Descriptive and Comparative Study of Ashta Udara Roga : An Ayurvedic Review

Manish KP1*, Namrata K2
DOI:10.21760/jaims.9.6.45

1* Manish Kumar Paul, Post Graduate Scholar, Dept of Roga Nidana Evum Vikriti Vigyana, Shri Npa Govt Ayurved College, Raipur, Chhattisgarh, India.

2 Namrata Khobragade, Reader, Dept of Roga Nidana Evum Vikriti Vigyana, Shri NPA Govt Ayurved College, Raipur, Chhattisgarh, India.

The meaning of the word Udara is Kukshi or Jathara. It lies in between Nabhi (Umbilicus) and Stana (Breast). Udara Roga denotes Udara Utsedh and Kukshi Aadhman which is generalised distention or enlargement of the abdomen of varied etiology. Udara Roga is a disease which has been described in detail in all our classical textbooks. In Ayurveda, there are eight types of Udara Roga. Kukshi Aadhman (Generalised abdominal distention) is present in all types of Udara Roga. Mandagni is the main cause of Udara Roga. As per the Ayurvedic principle, Agni plays an important role during the disease process. This review may provide many important facts to differentiate Udara Rogas.

Keywords: Udara, Udara Roga, Agni, Aadhman, Agnimandya, Abdomen.

Corresponding Author How to Cite this Article To Browse
Manish Kumar Paul, Post Graduate Scholar, Dept of Roga Nidana Evum Vikriti Vigyana, Shri Npa Govt Ayurved College, Raipur, Chhattisgarh, India.
Email: 		Manish Kumar Paul, Namrata Khobragade, Descriptive and Comparative Study of Ashta Udara Roga : An Ayurvedic Review. J Ayu Int Med Sci. 2024;9(6):283-289.
Available From
https://jaims.in/jaims/article/view/3500

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-04-13 2024-04-22 2024-05-03 2024-05-16 2024-05-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Authors state no conflict of interest. Non Funded. The conducted research is not related to either human or animals use. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

© 2024by Manish KP, Namrata Kand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Manish Kumar Paul et al. Descriptive and Comparative Study of Ashta Udara Roga

Introduction

As per the Ayurvedic principle, Agni plays an important role during the disease process "Rogah Sarve-Api Mande-Agnau Sutaramudarani Tu" (A.H.Ni. 12/1). All types of disease originated from Mandagni especially Udara Roga.[1] Functionally weak Agni that is Mandagni cause improper digestion of ingested food which leads to Udara Roga. Udara Roga denotes the generalised distention or enlargement of the abdomen of varied etiology.[2]

Udara Roga is one among the Ashtamahagada according to Acharya Sushruta (it means the disease is difficult to manage)[3] Swedavaha and Ambuvaha Shrotas are typically involved in the formation of Udara Roga.[4] In our Ayurvedic textbooks the etiology, symptoms, signs and treatment of Udara Roga have been described in detail. Different Acharyas have elaborate Udara Roga at various places in their respective Samhitas.

Aim and Objectives

1. Descriptive study of Ashta Udara Roga
2. Comparative study of Ashta Udara Roga

Materials and Methods

This article is based on a review of Ashta Udara Roga from Ayurvedic Samhitas and texts available in the Library of Govt. Ayurved College, Raipur (C.G.) i.e., Charak Samhita, Sushrut Sanhita, Ashtang Hridya, Ashtang Sangrah, Madhav Nidana, Bhaishajya Ratnavali are reviewed for this article.

Descriptive study of Ashta Udara Roga
A detailed review of Nidanpanchaka of Ashta Udara Roga (Nidana, Purvaroopa, Roopa, Samprapti, Upshaya & Anupshaya)

Nidana (Causes)
Nidana of Udara Roga is classified into two categories viz. Aharaj (dietary factors) Viharaj (Habitual factors)

Aharaj Nidana (dietary factors)[5,6]Viharaj Nidana (Habitual factors)[7,8]
1.  Excessive intake of foods that have Ushna Property (Hot foods like Tea, Coffee, etc.)
2.  Excessive intake of foods that have Vidahi Property (Spicy foods like fast food)
3.  Excessive intake of foods that have Amla Rasa (Sour foods like Chincha, Pickles etc)
4.  Excessive intake of food that having Lavana Rasa (salty foods like Namkeen, mixture, Samudra lavana etc.)
5.  Excessive intake of food that have Ruksha Property (foods having dry property like Yava, Kalay, etc.)
6.  Viruddha foods (incompatible foods like fish with milk)
7.  Atipurana (Excessive consumption of food)
8.  Mithyasansarjana (Improper dietetic regime after Panchkarma therapy)
9.  Atyambupana (excessive intake of water)		1.  Vegavidharana (Suppression of natural urges)
2.  Karmavibhrama (Improper administration of Panchkarma therapy)
3.  Klishtanampratikara (Ignorance of Persistent illness without treatment
4.  Sankshobha (excessive jerking)
5.  A person who emaciated due to diseases like Phiha (Spleen disease), Arsha (Piles), and Grahni Dosha
6.  Obstruction of the passage of stool due to Piles or Hair in ingested food
7.  Paapkarma (Sinful acts)
8.  Antra-Sphutana-Bhednat (Perforation and tearing of intestines)

Purvaroopa (Pre-monitory Signs and Symptoms)[9,10]
1. Kshunnasha (loss of appetite).
2. Atisnigdha-Guru-Annam Pachyate Chirat (delayed digestion of sweet, too unctuous and heavy food).
3. Bhuktam Vidahyate (Burning of the entire food taken with hyperacidity).
4. Sarvam Jirnajirnam Na Vetti Cha (Absence of feeling of digestion or indigestion).
5. Sahate Natisauhityam (intolerance to overeating).
6. Ishacchophashcha Padayo (Slight edema on feet).

7. Shashvadbalakshayo (Continuous deterioration of strength).
8. Alpe-Api-Vyayame Shwasamruchhati (dyspnoea even on slight physical exertion).
9. Vriddhi Purishanichayo (abdominal enlargement, accumulation of faeces).
10. Bastisandhau Rugadhmanam (Pain in pelvic region due to roughness and upward movement of Vayu / tympanitis).
11. Vardhate Patyate-Api (increasing, tearing and expansion of abdomen even on light and little food).
12. Rajijanma Valinasha (appearance of streaks and disappearance of abdominal wrinkles)


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Roopa/Samanya Lakshana (Common Signs and Symptoms)[11,12]
1. Kuksheradhmanam-Atopa (Tympanitis and gurgling sound in abdomen).
2. hobha Padakara (Edema on hands and feet).
3. Mandoagni (Weak Agni).
4. Shlakshna Ganda (Smoothness of cheeks).
5. Karshyam (Emaciation).

Samprapti (Pathogenesis)[13-15]
Due to Aharaj and Viharaj Nidana Sevan Agni gets functionally weak that is Mandagni, which causes improper digestion of ingested food and accumulation of Doshas. Agni Dosha and Mala Vriddhi cause vitiation of Prana Vayu, Jatharagni, and Apana Vayu and obstruct the upward and downward passages. The vitiated Doshas get lodged between Twak (Skin) and Mamsa (Muscle tissue) and cause extensive distention of the abdomen. Thus, the Udara Roga is Produced.

Samprapti Chakra
Nidana Sevan
↓
Agnimandya
↓
Amotpatti
↓
Pran Vayu, Jatharagni, Apan Vayu Dusti
↓
Udakavaha and Ambuvaha Strotasavrodha
↓
Obstruction in upward and downward Passage
↓

Vitiated Doshas get lodged between Twak (Skin) and Mamsa (Muscle tissue)
↓
Kukshi Adhamana (extensive distention of abdomen)
↓
Udara Roga

Samprapti Ghataka
1. Dosha - Vata Pradhana Tridoshaja
2. Dushya - Rasa, Rakta, Mansa, Twacha
3. Agni - Jatharagni, Dhatvagni
4. Agnidusti - Mandagni
5. Ama - Jathragnijanya
6. Shrotas - Svedavaha, Ambuvaha, Rasavaha, Annavaha, Mansavaha, Raktavaha,
7. Shrotodusti - Sanga, Vimargagamana
8. Adhisthana - Udara, (Twak-Mansa)
9. Rogamarga - Abhyantara
10. Swabhava - Chirkari
11. Sadhyasadhyata - Krichhsadhya

Upashaya (Pathya) and Anupshaya (Apathya)[16,17]

Upashaya (Pathya)Anupshaya (Apathya)
1.  Dugdha, Ghrita, Takra
2.  Raktashali, Yava, Mudga,
3.  Yusha, Yawagu
4.  Jangala Mansarasa
5.  Sidhu, Sura, Madhu
6.  Aasav, Arishta
7.  Snehana
8.  Snehavirechana
9.  Kshira Basti		1.  Aanup and Audak Mamsa (Ex. - Varaah, Harin, Matasya)
2.  Patrashaak
3.  Tilpishta
4.  Vyayama
5.  Diwaswapna
6.  Yaan gaman
7.  Ushna-Vidahi-Lavana-Amla Rasa Pradhan Aahar
8.  Atijalapaan

Comparative study of Ashta Udara Roga (Signs and Symptoms of Ashta Udara Roga)

Characteristic featuresVatodara[18,19]Pittodara[20,21]Kaphodara[22,23]Sannipatodara[24-27]
Type of PainUdara Vipatanam (Tearing/ Bursting Pain in abdomen)
Kukshi Parshva Shula (Colicky pain in illio-lumbar region)
Angamarda,
Parvabheda (Bodyache & Pain in joints)		Dahyate Duyate Dhupyate Ushmayate (Burning sensation associated with faming & heating)Angamarda (Bodyache)
Supti (Numbness)
Gaurava (Heaviness in abdomen)		Dahyate (Burning sensation)
Darunam (Extensive pain)
DiscolorationShyava Arunatvam Cha Nakha Nayan Vadana Tvaka Mutra Varcha (Blackish, dusky red discoloration of nails, eyes, mouth, skin, urine, and stoolHarita, Haridra Nakha Nayan Vadana Tvaka Mutra Varcha (Greenish or Yellowish discoloration of nails, eyes, mouth, skin, urine and stool)Shuklatvam Nakha Nayan Vadana Tvaka Mutra Varcha (Pale or whiteness in nails, eyes, mouth, skin, urine and stool)Varnasch sarve Nakhadishu (different coloured Nails, eyes, face, skin, urine and stool)

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Findings on Abdominal inspectionUdara Tanvasitarajisira (Prominence of thin and dark streaks and veins on abdomen)Neela Pitta Haridra Harita Tamra Rajisiravanddham (Prominence of Blue, yellow, green, or coppery streaks and veins on abdomen)Udara Shuklarajisira (Prominence of pale or white streaks and veins all over the abdomen)Udarampi Nana Varnarajisira (Different coloured lines appeared over abdomen with network of veins)
Findings on Abdominal palpation/ percussionAahat Adhmata Dritishabda Vat Bhavati (Tympanic sound produced on percussion just as on an inflated bladder)
Aniyata Vriddhi Hrasa (Variability of the increase and decrease in size of abdomen)		Svidhyate Klidyate Mridusparsha Kshiprapakam
(Sweating, Moistoning and is soft on palpation and more prone to quick inflammation)		Sthira Kathina Udara (Abdomen is fixed, immovable and hard on palpation)Shighrapakam Sudarunam (Enlargement of abdomen which is quick in maturing/formation of fluid)
Site of SwellingShotha in Kukshi Pani Pada Vrishana (Swelling in belly, hands, feet, and scrotum)Swelling not mentioned in PittodaraPaniPada Mushka Uru Shopha (Swelling in hands, feet, Scrotum, thighs)Shoph (Generalised Swelling)
Other symptoms according to DoshaVata Varcha Mutra Sanga (Obstruction in flatus, stool, and urine)
Adhogurutva (Heaviness in the lower part of abdomen)
Sushka Kasa (Dry cough)
Karshya, (Emaciation)		Katukasyata (Pungent taste in the mouth)
Atisara (Diarrhoea)
Jwara (Fever)
Trishna (Thirst)
Murchha (Fainting)
Bhrama (giddiness)		Arochaka (Anorexia)
Avipaka
(Indigestion)
Utklesha (Nausea)
Kasa (Cough)
Shwas (Dyspnoea)
Nidra (Sleepiness)		Pandu (Anaemia)
Murchha (Fainting)
Bhrama (giddiness)
Trishna (Thirst)
Krisha-Shushyati (Emaciated)


Characteristic featurePlihodar[28,29]Baddhagudodara[30,31]Chhidrodara[32,33]Jalodara[34-37]
Type and site of painKoshthavatashula (Abdominal pain with fullness of abdomen) Parvabheda Angamarda (Tearing pain in joints/ Bodyache)Shiro Hrida Nabhi Guda Shula (Pain in head, chest, umbilicus, and anus) Daaha (Burning pain Varchomutrasanga (Obstruction of stool and urine)Nistudyate Ativa Vidahyate (Cramping and Burning type of pain in abdomen)Udara Shoola (Abdominal pain) Rujanvitam (Pricking type of pain)
Findings on Abdominal inspectionUdara Aruna Varna Vivarna (Abdominal wall becomes dusky red in colour or pigmentation) Neel Harit Haridra Raji Udbhavati (Bluish greenish yellowish streaks/veins over abdomen)Nabhyopari Gopuchhawat (Cylindrical protrusion above umbilicus) Arunam Neel Rajisira (Prominence of dark red and blue streaks and veins)Adhonabhi Prayoabhivardhman (The protrusion mainly below the umbilicus) Salohita Neel Pita Pichhil Kunapgandhi Varcha (Patient passes stool with blood, blueish/yellowish coloured, sticky and foul smelling)Samparivritta Nabhi (Everted umbilicus) Brishonnatam (Abdominal distention) Mahatsnigdha (Smooth and shiny abdomen)
Findings on Abdominal palpation/ purcussionKathina-Ashthilevado Pliha (Stony hard spleen on palpation)Sthiram Udaram (Fixed and immobile abdomen)Udakodaram Bhavati (On palpation abdomen feels like jalodara)Udakapurna-Driti Sankshobh-Sansparsha (On palpation fluctuation like / fluid thril)
Other symptoms Mridu Jwara (Mild fever) Chhardi (Vomitting) Pipasa (Thirst) Aasyavairasy (Tastelessness) Arochaka (Anorexia) Avipaka (Indigestion Agninasha (Weak agni) Tamahpravesh (Dizziness) Murchha (Fainting) Karshya, (Emaciation) Daurbalya (Weakness) Kasa (Cough) Shwas (Dyspnoea) Varchomutragrah (Obstruction in stool and urine)Jwar (Fever) Chhardi (Vomitting) Trishna (Thirst) Mukha Talu Shosha (Dryness of mouth & palate) Arochaka (Anorexia) Avipaka (Indigestion) Urusaad (weakness in thigh) Adhamana (Tympanitis) Kshvathu (Sneezing) Daurbalya (Weakness) Kasa (Cough) Shwas (Dyspnoea)Prameha (Polyuria) Trishna (Thirst) Arochaka (Anorexia) Avipaka (Indigestion) Kasa (Cough) Shwas (Dyspnoea) Hikka (Hiccough) Daurbalya (Weakness)Gudastrav (Watery discharge from anus)
Aruchi
(Anorexia) Annakanksha (Anorexia) Pipasa (Thirst) Kasa (Cough) Shwas (Dyspnoea) Daurbalya (Weakness)

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Discussion

Udara Roga is a group of diseases that mainly occur due to Mandagni caused by Mala Vriddhi and Agni dushti, accumulation of Mala in Udara because of altered function of Agni. Agnidusti is an essential decisive factor in the Pathogenesis of Udara Roga. Ayurvedic Treatments for Udara Roga include Agnideepan, Snehan, Virechan, Anuvasan Basti, Kshira Basti and use of Various types of Kshira. Nitya Virechan is the first line of treatment for Udara Roga.

Conclusion

In our Ayurveda, different Acharyas have mentioned the Nidana, Samprapti, Purvaroopa, Roopa, Upashaya, and Chikitsa in their respective Samhitas. But the differentiation and comparison with Physical Examination are not mentioned separately, there are many differentiation points including signs and synonyms mentioned in Roopa, by which we can differentiate and examine the patient of Ashta Udara Roga. Also, Nidana (etiological factors) are responsible for disease manifestation. Avoidance of such factors can help to prevent disease prevalence. For prevention and later on treatment purposes we should first diagnose the cause and then treat the patient. It shows the importance of Nidana.

References

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24 Kashinath Shastri, Charak Samhita, Vol. 2, Chaukhamba Bharti Academy, Varanasi, 2012, p.-386

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34. Kashinath Shastri, Charak Samhita, Vol. 2, Chaukhamba Bharti Academy, Varanasi, 2012, p.-390

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37. Priyavrata Sharma Vol. 2, Chaukhamba Orientalia, Varanasi, 2005, p.-208, 209


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