Natural Ayurvedic Treatment And Management For Liver Cirrhosis
Abstract
Cirrhosis is an advanced stage of liver fibrosis it can be a consequence of different factors like our daily life behaviors, our food intake, our daily habits, and everything connected with our physical health, processed foods, junk foods, obesity, iron and copper overload, no physical activities, substance abuse in some cases like alcoholism everything is affecting our liver health, over 18.3% of deaths globally is because of liver diseases and 2.95% in INDIA. In this article, we will discuss Liver cirrhosis in detail.
Introduction
Liver cirrhosis is also known as hepatic cirrhosis, chronic liver failure, and chronic hepatic failure. In this condition the parenchymal tissues are replaced by scar tissues and nodules resulting in chronic liver diseases, as cirrhosis gets worse, the liver starts to fail. In liver Cirrhosis, the patient is unaware of the condition of the liver as the liver can repair itself so patients don’t have any signs or symptoms until it is damaged more than 50% or 60%, because of this the management of liver cirrhosis gets poor and it can lead to death also.
Causes
There are many causes of liver cirrhosis, the most common causes are as follows
- Alcohol Liver Diseases – In ALD alcohol damages the liver by blocking the metabolism of fats, proteins, and carbohydrates, as when alcohol is digested it forms acetaldehyde. It leads to the accumulation of other toxic products.
- Hepatitis B – Due to hepatitis B virus accelerates cirrhosis as a co-infection
- Hepatitis C – Infection by hepatitis C virus (HCV) causes inflammation of the liver
- Non-Alcoholic Fatty Liver Disease (NAFLD) – Fat builds up in the liver and causes scar tissue. This can be caused due to Diabetes, steroid intake, high cholesterol levels, malnutrition, coronary artery diseases, etc.
- Primary Sclerosing Cholangitis – is a condition in which inflammation and scarring of the bile duct are seen which alters the flow of bile to the intestines. Individuals with PSC can develop inflammatory bowel diseases.
- Autoimmune hepatitis
- Wilson’s diseases
- Hepatotoxic drugs or toxins
Pathophysiology
The liver helps in detoxification, protein synthesis, nutrition storage, platelet production, and bilirubin clearance. When the liver cells are damaged over time due to a bad lifestyle, alcoholism, toxic drug intake, or another etiological factor, the liver cells are progressively damaged and replaced with scar tissue, this process is carried by the activation of hepatic stellate cells. Then scar tissue blocks the blood flow to the portal vein. This develops portal hypertension which decreases the sinusoidal flowfrom the liver to sinusoids in the liver and increases lymph production from where the fluid leaks to the surrounding tissues to the lymph to extracellular space causing ascites. It alters cardiac return and central blood flow which activates the renin-angiotensin system (RSSR) due to which the kidney reabsorbs sodium and water, causing water retention and further ascites RAAS can cause vasoconstriction and injury to the kidney. The spleen becomes congested and enlarged, resulting in retention of platelets.
Symptoms
- Fatigue – Generalized weakness and dehydration
- Weight loss – Sudden weight loss
- Itchy skin – Feel of itching above the waist
- Nausea – Vomiting sensation
- Ascites – Collection of fluid in the abdominal cavity
- Poor appetite, muscle loss, and weakness
- Discoloration of urine – the dark color of urine
Complications
- Portal hypertension – When the scar tissues in the liver hamper the blood flow which causes hypertension in the portal vein which carries blood from Stomach, Intestine, Spleen, Pancreas, and Gallbladder. If it’s not treated on time can lead to ascites, peritonitis
- Varices – Enlarged veins that can lead to internal bleeding in the Intestine, Stomach, and Oesophagus.
- Edema – Swelling in the lower limb, ankles, and feet
- GI bleed – Dark-colour stools and vomiting blood
- Jaundice – Yellowish discoloration of the skin and eyes.
- Muscle cramps and sexual problems can be seen.
- Hepatic Encephalopathy – Due to cirrhosis toxins build up in the brain
Diagnosis
Cirrhosis can be suspected by physical examinations, laboratory findings, and based on the history of the person.
1. Physical Examination
- Yellowish discoloration of the skin and eyes.
- Skin rashes and itching above the waist
- Swelling and tenderness in the abdominal region
- Edema in the lower limb
- Outstretched hands for tremors
2. Laboratory Findings
- AlanineAminotransferase (ALT)
- Aspartate Aminotransferase (AST)
- Alkaline Phosphatase
- Higher levels of Bilirubin
- Complete blood count (CBC) – For Anemia
- Viral marker for Hepatitis C and Hepatitis B
- Antinuclear Antibody (ANA)
- Antinuclear Antibody (ANA)
- Anti-mitochondrial antibody (AMA)
- Thrombocytopenia – sepsis, lack of folate
- Platelet sequestering in the spleen decreases
- Thrombopoietin and prothrombin time
- Leukopenia and neutropenia – due to Spleenomegaly
- CRP( C-Reactive protein)
- Procalcitonin.
3. Imaging Test
- Fibro Scan – Shows the stiffness of the liver and level of liver scarring.
- Ultrasound(abdomen and pelvis) – May show a small shrunken liver
- In advanced diseases, liver surface nodulation can be seen.
- An enlarged spleen may also be seen, portal hypertension.
- CT abdomen and MRI – Can help find the fibrosis stage for excellent evaluations. Imagining of bile ducts such as ERCP (Endoscopic Retrograde cholangiopancreatography) and MRCP (Magnetic Resonance cholangiopancreatography), Splenomegaly
Management
The management of liver cirrhosis in allopathy can be done only as per the symptoms. Some Lifestyle modifications can be done as follows
- Hepatotoxic drugs should be avoided strictly
- Lifestyle changes should be made avoiding processed food and more oily food
- Exercise daily and Avoid alcohol
Ayurvedic Aspect
In Ayurveda, there is no direct explanation of Liver cirrhosis as such. However, according to the condition and symptoms seen in Liver cirrhosis, it can be related to the severe stage of Yakrddlyaudara (Inflamed liver) explained under Udara Roga (enlargement of the abdomen). The main causes of Yakrddlyaudara (Inflammation of the Liver) are due to Sthoulya (Obese) Indigestion, toxic food intake (processed food or oil used multiple times for frying), Kamala (Jaundice), Madyapana (Alcoholism) and due to toxins produced due to Ama (Indigestion). Here different Doshas get vitiated and affect the specific Dhatu leading to disease manifestations and symptoms can also be seen.
Etiology And Pathogenesis
All the factors like Manda Agni (Low digestive fire), Dushita Mala (Corrupted garlands), Purish (stools), Mutra (Urine) Sweda (sweat), and Ama (Indigestion), and factors like agni manda (Low digestive fire) and intake of Dushita Ahaar (toxic food) due to these factors there is Anaha (Abdominal distention), Udavarta (Upward movement of Vayu in the abdomen) due to the predominance of vayu (Vata), Unconsciousness thirst and fever because of the predominance of Pitta and heaviness, anorexia, as well as hardness because of the predominance of Kapha. Similarly, these vitiated Dosha will do Rakta Dhatu Dushti and inflame the Liver and spleen. When the left side of the Spleen inflames it causes Liver inflammation too and the patient feels severe pain, due to this weight loss can be seen, which leads to PanduRoga (Anemia). Signs and symptoms of Yakrddalyudara (Hepatomegaly) are – weakness, indigestion, retention of stool and urine, excessive thirst, malaise, vomiting, fainting, mild fever, immobility of wind in the stomach, loss of digestion, distention of alimentary tract, discoloration of the abdomen, appearance of network of veins having Blue, Green or Yellow color. In Yakrddalyudara pain will be at the right side of the stomach. If this is not treated initially, it can lead to Jalodara (Ascitis) which is a collection of water substances in the abdominal region, on palpitation, the physician feels as if the abdomen is a leather bag filled with water.
Treatment of Yakrddalyudaraas Per Charaka Samhita
In Yakrddalyudara there is a predominance of Vayu (air), burning sensation, thirst, fever because of vitiated Pitta and hardness, heaviness, anorexia due to Kapha and vitiated Rakta dosha symptoms are seen. Treatment is according to dosha dominance, or the patient’s Bala (Strength). Oleation (Snehana), fomentation (Swedana), Purgation (Virechan), Enema prepared of medicated decoction (Niruha Basti), Enema prepared of medicated oils (Anuvasana) given through the anorectal region. The patient should be given – Shatpala Ghrita, Abhaya mixed with jaggery, Kshara (Alkaline solutions) as Saindhava Lavana (Rock salt), cow urine, Jaggery, and amla (Phyllanthus emblica) can be used in enema having action in GIT (Gastrointestinal) cleaning reduction of toxic accumulations in colon, balance Pitta which is associated with inflammation and support Liver functions through its diuretics and digestive stimulation properties, and Arista preparations also.
- Powder 1 part of each Pippali (Piper longum), Nagara (Zingiber Officinale), Danti (Baliospermum Montanum), and Vidanga (Embelia Ribes) with hot water.
- Equal quantity of Vidanga (Embeluia Ribes), Chitraka (Plumbago zeylanica), Sunthi (Zingiber Officinale), ghee (Clarified butter), Rock salt, and Vacha (Acorus calamus Linn) by making Bhasama by puta paka procedure, adjunct with milk cures Gulma (abdominal mass or tumor) and Plihodara (splenomegaly).
Herbal Remedies For Liver Cirrhosis By Planet Ayurveda
Planet Ayurveda is a leading global brand, whose aim is to spread ayurveda all over the globe and to raise awareness regarding the value of ayurveda and its efficacy in chronic diseases. Its products are 100% natural, with the least side effects and excellent results, the products of ayurveda are concerned with classical texts of ayurveda and with no preservatives. Some medications having very good results in liver cirrhosis are
- Yakrit Plihantak Churna
- Phyllanthus Niruri
- Echinacea Capsules
- Liver Detox Capsules
PRODUCT DESCRIPTION
1. Yakrit Plihantak Churna
It is a Product of Planet Ayurveda which is in the form of powder. This is formulated with different drugs such as Bhoomi amla (Phyllanthus niruri), Bhringraj (Eclipta prostrata), Kasni (Cichorium intybus), and Katuki (Picrorhiza Kurrooa). These drugs have similar properties, such as hepatoprotective, antiviral, antibacterial, antioxidant, hypolipidemic, anti-inflammatory etc and they were traditionally used to manage jaundice, inflammation, and does blood purification
Dosage: 1 tsp twice daily with plain water after meals.
2. Phyllanthus Niruri
This is also a product of Planet Ayurveda prepared using standardised extract of Bhumi amla (Phyllanthus niruri) and comes in the form of capsules. This product has hepatoprotective, antiviral, properties which helps in managing liver functioning and alleviates jaundice and inflammation etc.
Dosage: 1 to 2 capsules twice daily with plain water after meals.
3. Indian Echinace
Indian Echinacea capsules by Planet Ayurveda come in capsule form and prepared using standardised extract of Kalmegh (Andrographis paniculata). This formulation helps in scrapping of the dead tissue from the liver due to its lekhana (Scrapping) property and protects the Liver from free radicals. It slows the serum lipid and prevents the accumulation of fat in the liver cells.
Dosage: 1 to 2 capsules daily two times a day with plain water after meals
4. Liver Detox Formula
It is a product of Planet Ayurveda in the form of capsules and formulated with different herbs Katuki (Picrorhiza kurroa), Punarnava (Boerhavia), Haritaki (Terminalia Chebula), Makoy (Solanum Nigrum) etc. These all drugs have some very good qualities for Liver detoxification, hepatoprotective, antimicrobial and cardioprotective etc.
Dosages: 1 or 2 capsules twice daily with plain water after meals.
Conclusion
Liver Cirrhosis is a condition in which the cells of the Liver get damaged and replaced by scar cells, which obstructs the portal vein and leads to portal hypertension. There is no specific cure for liver cirrhosis in modern medicine but symptomatic treatment or transplant. According to ayurveda Liver Cirrhosis is correlated with Yakrddalyudara explained in Uddararoga (enlargement of the abdomen). The etiology and pathology of Yakrddaludara are mentioned in Ayurvedic textbooks and management and proper diet and lifestyle are explained. In the management of Yakrddalyudara, several formulations are advised for detoxification, anti-inflammatory antioxidant properties, etc. Research shows amazing healing results in herbal treatment and natural ways to treat diseases with no side effects.
Dr. Vikram Chauhan
