ABSTRACT

The word end stage liver disease gives a sign of panic to everyone. Nowadays due to increased prevalence of unhygienic lifestyle (over intake of unsaturated fats and beverages), behavioral activities, adulteration in most of the food items, the rate of liver disease has also been raised. The life expectancy of an end stage liver disease patient can be managed very well with the use of herbal medicines. So let’s start discussing about the role Ayurveda plays in managing end stage liver disease .

INTRODUCTION

End stage liver disease means the stage of liver failure or we can say liver cirrhosis, in which the functioning and working of the liver got hampered as liver cells (hepatocytes) lose their ability to work properly.

IMPORTANCE OF LIVER IN OUR BODY

  • Liver is situated in the right hypochondrium region of our stomach. It’s upper surface is in close contact with the right lung.
  • It helps in purifying the blood by removing harmful toxins from it.
  • Gall bladder is present below the inferior surface of the liver; it stores the bile juice that is produced by the liver. It breaks down the fat into fatty acids thus help in digestion and absorption of fat.
  • Plays a major role in synthesis of clotting factors and plasma proteins, releases important haemostatic substances that helps in controlling blood loss from injured blood vessels.

Ayurvedic Correlation of End stage liver Disease

  • In Ayurveda this ailment comes under the “asadhya vyadhi” (non curable ailment).
  • In our ancient text it is already mentioned that:

(charak.sutra 10/7-8)

If a physician has a thorough knowledge of curable and non curable ailments and after that when he precedes the treatment in proper time, he will surely succeed.

But if he try to treat incurable disease even after knowing that it is a non treatable ailment, he will certainly suffers from the loss of arth (wealth), vidya ( his/her study), yash (reputation) in the society. Means it is very important for a doctor to tell his patient that your disease is a non curable one, we cannot treat it completely but we can stop its advancement and manage its further deterioration very well  with herbal medication.

Life Expectancy of End Stage Liver Disease as per Ayurveda

  • In our classical texts it was clearly mentioned that the recovery rate of an individual with any chronic condition depends upon the “SATAV” (mind and psyche). It is of three types:
  • Pravar( superior)- with strong will power.
  • Madhyam( medium)- with medium  strength.
  • Avar( inferior)- with very less determination power.
  • There are two types of psychological appearance of persons in any disease.
  • One who though suffering from a severe disease appears to be suffering from Mild ailment because of the dominance of strong psyche, strength and body called “Guru vyadhit”
  • The other one are those, who in reality suffer from a mild ailment appear to be suffering from a very severe disorder because of the lackness of strong will power, psyche and strength called “Laghu vyadhit”

So a physician can very easily evaluate the life expectancy of a patient by keeping in consideration these two points mentioned thousands of years ago by our ancient acharya.

CAUSES

As per ayurveda liver (yakrit) along with pancreas (pleha) are considered as the main seat of “raktavah srotas” [blood containing channels]

Liver diseases, occurs due to the imbalance in functioning of “raktavah srotas

  • Vidahi annapan( intake of spicy food)
  • Engage yourself in snigdha (soft), ushan (hot) and drav (liquid) diet .
  • Over exposure of sun and fire.

End stage liver disease may result due to following etiological factors:-

  • Excessive alcoholism. 
  • Fatty liver disease.
  • Liver carcinoma.
  • Viral infection such as chronic hepatitis infection.
  • Non alcoholic fatty liver disease.

Symptoms

It means the complaints along with the patient present in front of the physician .They are as follows:-

  • Nausea & vomiting.
  • Bruising (bluish discoloration of skin) over the body.
  • Jaundice (presence of yellow coloration of skin & sclera of eye).
  • Dilated abdominal veins.
  • Edema ( fluid accumulation)
  • Profuse sweating.
  • Low blood pressure.
  • Ascites (fluid in the abdominal cavity).
  • Fatigue.
  • Body ache
  • Drowsiness (lethargic)
  • Indigestion
  • Polydipsia (excessive thirst)
  • Anorexia ( loss of hunger)
  • Clubbing of fingers ( abnormal shape of nail bed)
  • General body weakness.

DIAGNOSIS

  1. Proper history taking of the patient.
  2. Detailed general physical examination of the patient

It Includes:

  • Inspection
  • Palpation
  • Percussion
  • Auscultation.

3. Laboratory findings

  • Complete blood count
  • Ultrasonography.
  • Liver function test- It includes serum bilirubin, SGOT, SGPT etc.
  • Toxicology screening of urine.
  • Prothrombin time becomes prolonged as liver plays a major role in the synthesis of coagulation factors that got hampered in this.
  • Per-cutaneous Liver biopsy.
  • Fine needle aspiration cytology.

According to Ayurveda - The two most common diagnostic techniques are

  • Trividh pariksha (set of 3 examinations)
  • Darshan-(diagnosis is made by visual examination of the symptoms)
  • Sparshan-(physician use tactile examination to evaluate whether skin is cold/ hot.
  • Prashan-(physician ask direct question form the patient means history taking.

Asthavidh pariksha( set of 8 examination procedure)

  • Nadi pariksha- by palpating the pulse rate of the patient.
  • Mutra pariksha- by examining the urine of the patient.
  • Mal pariksha- by stool examination.
  • Jivha pariksha- by examining the tongue whether coated or not.
  • Shabad pariksha- by observing the natural sounds within the body like intestinal sound (peristalsis)
  • Sparsh pariksha- by observing the patient skin texture whether it is cool, wet or dry in psoriasis it is usually dry, rough in texture.
  • Drik pariksha- when physician inspect patient symptoms through his/her eyes. In liver disease patient yellowish discoloration of skin (jaundice) is the prime finding.
  • Akriti pariksha- observing the patient body posture whether lean or obese.

MANAGEMENT

  • Conditions like end stage liver disease is usually a non recoverable ailment. 
  • In general the only treatment modality available for liver failure is hepatic transplant. Hepatic transplant is a complex operative procedure. Firstly we need to find the right donor for this and it also has many other related complications such as a great chance of getting inflammatory process (sepsis)

As per Ayurveda the main line of treatment in "raktavah srotas" dushti

  1. Virechan (purgation): this is a very effective procedure to release out the elevated pita dosha from the body through the anal route.
  2. Langhan/Upvaas (fasting) - In this patient is ask advised to do fasting or to eat light food article, to provide rest to the digestive system for elevating the ‘mandagni’ (decreased digestive fire). As mandagni is considered as the – root cause of all the ailment in ayurveda .
  3. Rakta mokshan( bloodletting) -It helps in purifying the blood by removing harmful toxins from it.

Planet Ayurveda , a leading herbal manufacturing unit serving people worldwide with herbal and authentic science of healing ( ayurveda ) also has various herbal formulations that will help you in managing the deterioration of end stage liver disease.

(a).LIVER CARE PACK

1. PHYLLANTHUS NIRURI

It posses sheeta virya ( cold potency) best suited for lowering the vitiated pitta dosha, also is a hepatoprotective & hypotensive (reduces blood pressure) herb, thus aid in maintaining the  normal liver functions so proves very effective in liver failure.

INGREDIENT

Bhumi amla ( Phyllanthus niruri )

DOSAGE: 1-2 capsules twice daily with plain water after meals.

2. LIVER DETOX FORMULA

Above mentioned herbs are natural supplement works as hepatoprotective agents (good for liver), help in lowering the blood pressure, so prove as best medication in liver disease.

INGREDIENTS

  • Katuki ( Picrorrhiza kurrao
  • Kalmegh ( Andrographis paniculata)
  • Kasni ( Cichorium intybus ) etc.

DOSAGE: 1- 2 capsules two times a day with plain water after meals.

3. INDIAN ECHINACEA

Help in maintaining the immune system and supporting overall health it will provide strength to the patient body in end stage liver disease.

INGREDIENT: kalmegha/ bhunimab ( andrographis paniculata )

DOSAGE: 1-2 capsules twice daily with lukewarm water after meals.

4. YAKRITPLIHANTAK CHURNA

All these herbs works as herbal analgesics (relives pain), appetizer (enhance hunger) & hypotensive (lower blood pressure) thus help in managing further growth of hepatic failure.

INGREDIENTS

Is an herbal powder formulation containing herbs like

  • Bhumi Amla ( Phyllanthus niruri ),
  • Bhringraj ( Eclipta Alba )
  • Kutaki (Picorrhiza kurrora )
  • Kalmegh ( Andrographis panniculata) etc.

DOSAGE: You can boil the Churna 1 teaspoonful in 400 ml water. Until it remains 50 ml in quantity. Strain it and drink the lukewarm water and leave the residue. Do it twice daily. Make fresh every time.

Along with the above mentioned pack we also have a single herbal formulation that also shows great result in limiting the disease progression in liver failure.

(1). Liver detox formula

All the herbs present in this herbal formulation are “pittaghan” (maintains a level of vitiated pitta dosha), also very effective in chronic conditions like end stage liver disease because of the hepato-protective action.

INGREDIENTS

  • Katuki ( Picrorrhiza kurrao
  • Kalmegh ( Andrographis paniculata)
  • Kasni ( Cichorium intybus ) etc.

DOSAGE: 1- 2 capsules two times a day with plain water after meals.

2). Liver power

Herbs present in it work collectively in raising the hemoglobin concentration along with properties like antispasmodic(relieves pain), appetizer( increases hunger) and provides power(strength) to the liver so make a good choice for patient of end stage liver disease.

Ingredients

  • Bhumi Amla ( Phyllanthus niruri )
  • Kalmegh ( Andrographis panniculata )
  • Kutki ( Picrorhiza kurrora )
  • Punarnava ( Boerrhavia diffusa )

Dosage: 1-2 capsules twice daily with lukewarm water after meal.

CONCLUSION

Thus coming to an end we can conclude that Ayurvedic herbs shows very good results in managing end stage liver disease. Life expectancy of a patient with such ailment depends upon the level of disease has progressed and on the immunity power of the patient. With herbal medicines we can surely manage this very well. If you are opting for herbal treatment, consider planet ayurveda as your prime priority. Our expert doctor Vikram Chauhan has a great experience in managing such ailments. you can visit us at our clinic in Mohali, Punjab or can send your queries on our official email id- herbalremedies@yahoo.com

Author's Bio: 

Dr. Vikram Chauhan (MD-Ayurveda) is an expert Ayurvedic Doctor based in Chandigarh, India, and doing his practice in Mohali, India. He is spreading the knowledge of Ayurveda - Ancient healing treatment, not only in India but also abroad. He is the CEO and Founder of Planet Ayurveda Products, Planet Ayurveda Clinic, and Krishna Herbal Company. For more info visit our website: www.planetayurveda.com