MEld and Model of End Stage Liver Disease and Its Ayurvedic Treatment

Abstract

The model of end stage liver disease is a scoring system for prioritizing patients for liver transplant. There are many kinds of liver disease and conditions that can affect the normal functioning of the liver. All liver diseases are progressive in nature and if not treated on time they can lead to the end stage of liver disease (Scarring of liver tissues which is irreversible). We will discuss how we can determine the severity of disease and survival rate of a person with the help of MELD score.

Introduction

The liver plays an important role such as protein production, blood clotting and glucose and iron metabolism. When there is any kind of injury to liver whether it is by excessive alcohol intake or due to any other cause, liver tries to heal on its own by producing scar tissues. As these progresses there is production of multiple scar tissues which hinders normal functioning of the liver. The liver damage caused by cirrhosis usually is irreversible and it can further worsen the condition, as per modern medicine concept.

Symptoms

Initially there are no sign and symptoms but as disease progresses following symptoms can be seen:

• Yellowing of skin and eyes
• Nausea
• Loss of appetite
• Weight loss
• Pain in right upper quadrant
• Vomiting
• Low sex drive
• Mental confusion
• Itchy skin
• Fluid accumulation in abdomen
• Swelling in legs and face
• Spider like blood vessels
• In women irregular periods
• loss of sex drive, enlarged breast
• Slurred speech and drowsiness
• Changes in stool color

Main causes of ESLD

There are multiple diseases and conditions which can lead to liver cirrhosis:

• Chronic viral hepatitis ( B,C,D)
• Non alcoholic fatty liver disease
• Wilson’s disease
• Cystic fibrosis
• Chronic alcohol abuse
• Biliary hepatitis
• Inherited disorders
• Alagille syndrome
• Autoimmune disease
• Certain medications such as methotrexate or certain antibiotics

Risk factors

There are some risk factors which can aggravate the situation.

• Excessive alcohol intake
• Obesity
• Viral hepatitis

MELD OR MODEL of ESLD (END STAGE LIVER DISEASE)

MELD stands for the model for the end stage of liver disease. MELD score helps to determine whether someone with liver disease needs a liver transplant or not. A MELD score is a number based on laboratory tests which ranges from 6 to 40. It gives you an idea about severity and progression of disease.

MELD score is calculated on basis of results of several lab test including:

• Creatinine Level– Creatinine is a chemical waste product which is produced by muscle metabolism. This test reveals about normal functioning of kidneys.
• Bilirubin Level – Bilirubin is produced by normal breakdown of red blood cells. Elevated bilirubin level indicates liver disease.
• INR (international normalized ratio) – This test gives an idea about production of blood clotting factors which are produced by the liver.
• Serum Sodium Level – sodium blood test reveals normal sodium level in your blood. Abnormal sodium level may indicate kidney and liver disease.

Usually MELD score ranges from 6 to 40 which tell the severity of disease and need of transplant. Higher the MELD score, the urgency of liver transplant is higher.

1. If your score is below 10 it is recalculated once in a year.
2. If it is between 11to 18, it will be recalculated every three months.
3. It will be recalculated once in a month if the score is between 19 to 24.
4. If it’s 25 or more than 25, the score will be recalculated every week.

Ayurvedic Treatment to Manage End stage Liver disease

According to Ayurveda, any kind of disease occurs due to imbalance in three energies of the body (vata, pitta and kapha). Liver diseases occur due to extreme aggravation of pitta dosha in the body. The main site of pitta dosha is liver and aggravation of pitta affects normal functioning of liver. Ayurvedic treatment mainly focuses on avoiding causative factors which are responsible for disequilibrium of three energies. Diet and lifestyle changes are main to prevent etiology and manifestation of disease.

Dietary Changes

• Avoid intake of alcohol, milk products, processed food and frozen food.
• Reduce salt intake. Increase intake of fresh vegetables and fruits like avocado, cauliflower, apples, broccoli, spinach and carrots.
• Cut down the animal protein.

Lifestyle Modifications

Lifestyle modifications help in prevention and delay the progression of liver disease.

• Try to add yoga and meditation in your daily routine.
• Go for running or you can do simple exercises at home to aid weight loss.

Herbal Remedies Offered By Planet Ayurveda

Planet Ayurveda offers an effective herbal combination in the form of Liver Care Pack to manage and prevent liver diseases.

1. Echinacea Capsules
2. Yakrit Plihantak Churna
3. Liver detox Formula
4. Phyllanthus Niruri

1. Echincea Capsules

Echinacea capsules are prepared from pure and standardized extract of Kalmegh (Andrographis paniculata). Kalmegh has hepatoprotective and hepatostumulative properties. It promotes normal functioning of the liver and is very beneficial in treating liver disorders.

Dosage: 2 capsules twice daily with plain water after meals

2. Yakritplihantak Churna

This churan is a combination of multiple herbs like Bhumi amla (Phyllanthus niruri), Kalmegh (Andrographis paniculata), Kaasni (Cichorium intybus), Kutki (Picrorhiza kurroa), Punarnava (Boerhavia diffusa) etc. These herbs in combination work amazingly to improve liver functions. This churna helps to detoxify and rejuvenate liver.

Dosage: Boil 1 teaspoon of powder in 400 ml water. Boil it till it is reduced to 50ml. Strain the mixture and drink the water. Drink it twice daily after meals.

3. Liver Detox Formula

Liver detox formula has extracf of various effective herbs ie Kutki (Picrorhiza kurroa), Makoy (Solanum indicum), Kalmegh (Andrographis paniculata), Haritaki (Terminalia chebula) etc. As the name suggests Liver detox helps in detoxification of the liver and improves its condition to work more efficiently.

Dosage: 2 capsules twice daily with plain water after meals only.

4. Phyllanthus Niruri

The main ingredient of this formulation is phyllanthus niruri (Bhumi amla). It is a widely used herb to improve the condition of the liver. It is rich in antioxidants and it removes toxins from the liver. It also provides strengthening to the liver.

Dosage: 2 capsules twice daily with plain water after meal

Conclusion

It is concluded from the above discussion that End stage liver disease severity can be determined with MELD score. This condition can be managed effectively by using Planet Ayurveda’s Liver Care Pack. As this pack is made of effective herbs which have no side effects as they are chemical free.