Hello, Given your history of chronic alcohol use and the current presentation of leg swelling (edema) and right upper quadrant pain, this suggests the liver is still recovering from long-term congestion or structural changes, even though you have been sober for 18 months. In Ayurveda, this is viewed as a disturbance of Yakrit (Liver) and Vyan Vayu, leading to Shotha (swelling) due to the accumulation of toxins (Amavisha). Low alkaline phosphatase, while less common than high levels, can sometimes correlate with nutritional deficiencies or specific metabolic shifts during liver regeneration. The goal is to improve liver micro-circulation, reduce water retention, and provide “Medhya” (cooling/healing) effects to the hepatic tissues. Start this meodicne : 1. Punarnavasavam: This is the primary liquid for edema. It acts as a natural diuretic and liver tonic. Dose: 20 ml with equal quantity of lukewarm water, twice daily after food. 2. Heposem Tablet: A specialized formulation for liver protection and correcting functional imbalances. Dose: 1 to 2 tablets twice daily before food. 3. Sahacharadi Thailam (External): To address the leg swelling directly without putting a load on the liver. Application: Gently massage onto legs in an upward direction (towards the heart) to improve lymphatic drainage. Diet: Strictly limit salt intake, as sodium worsens leg swelling. Focus on easy-to-digest foods like mung dal soup and bottle gourd. Clinical Correlation: Since you are a medical professional, ensure you rule out cardiac or renal involvement (check Serum Albumin and Creatinine), as chronic liver issues can sometimes lead to secondary hypoalbuminemia, causing that edema. Monitoring: If the abdominal pain becomes sharp or the swelling increases rapidly, please consider an abdominal ultrasound to check for portal hypertension or fatty changes.
Hello I can understand your concern You have already taken the most important and positive step that is stopping alcohol But now you are having swelling in legs with pain in right upper abdominal pain along with fatigue This has to be carefully evaluated as there may be stress in liver ▪️Important The symptoms mentioned may be due to early liver damage or fluid imbalance Even though your bilirubin is normal We need further test to come to a final diagnosis Please get it done as early as possible -Liver function test -Serum Albumin ( important as you are having swelling) -Ultrasound of abdomen and pelvis -PT INR This all will help us to rule out underlying liver stress ▪️Ayurvedic plan of treatment Phyllantus syrup 10 ml twice daily after food Arogyavardini vati 1 tablet twice daily after food Guduchyadi kwath 10 ml twice daily after food Punarnavasa kwath tablets 2 tabkets twice daily after food This all are liver protective, reduce the swelling and help in reducing overall liver stress Diet and lifestyle Have more of moong dal Lauki Tori In moderate coconut water Keep your legs elevated Avoid Alcohol Oily food Fermented food Red meat Your body is getting adjusted and recovered from long term alcohol intake Please do the required test so that we can come to a confirm diagnosis and help to prevent further liver damage Wishing you a good health😊 Warm Regards Dr Snehal Vidhate
