LIVER & AYURVED

The LIVER (known as YAKRIT in Ayurved) is one of the major organs in the body. Ayurved has recognized this fact as is evident in many classical texts written thousands of years ago. There is ample description of liver diseases in Ayurved, the types of liver ailments, their classification, and their treatments. Some of the terminologies are unique to Ayurved and is beyond the understanding of modern medicine. The principles of Ayurved are hard to comprehend when weighed by modern criteria but results of ayurvedic medicines cannot be denied as they can be verified by modern investigations as well as clinically.

Ayurved has been dealing with Liver diseases with medicines chiefly. The treatments for all liver diseases are mentioned ranging from simple liver diseases to very grave conditions like Cirrhosis. The physiological understanding of liver functions are a bit unique to Ayurved but still not very contradictory to modern science. Of course, modern medicine has simplified the liver to a great extent. Modern investigations can measure every change in the liver & this helps in the diagnosis so much. Ayurved has a vast expertise in liver diseases & it deals with all Liver diseases through medicines. At Amoghsanjeevani we always emphasize on this point since we do really want patients to come to Ayurved & get treated for the worst of liver diseases.

1. Functions of Liver: Let us have a look at the functions of the liver⇒

1. FILTRATION of the blood: Nearly 1500 ml of blood enters the liver sinusoids per minute via the Portal Vein & the Hepatic Artery. The liver cells then act on this blood & perform various functions. This filtered blood is then given back to the systemic circulation.

2. STORAGE of blood: The liver is an expandable organ capable of acting as a valuable blood reservoir in times of excess blood volume & capable of supplying extra blood in times of diminished blood volume.

3. BLOOD CLEANSING function: Blood entering the portal vein always carries intestinal bacteria. KUPFFER cells are special cells in the liver that can cleanse blood very efficiently as it passes through the liver sinuses. Hence not more than 1% of bacteria entering the portal vein succeed in passing through the liver into the systemic circulation

4. METABOLIC functions: The liver can be compared to a large chemical factory. The liver plays an important role in Carbohydrate & Fat metabolism, but its most important role is in Protein metabolism, for e.g. formation of urea for removal of ammonia from the body fluids

5. BLOOD COAGULATION (CLOTTING): The liver forms a large proportion of the blood substances used for the coagulation process, for e.g. fibrinogen, prothrombin etc

6. EXCRETION/ REMOVAL of drugs, hormones etc.: The liver is known for its ability to detoxify or excrete into the bile many Drugs, Copper, Hormones Obviously, liver damage can lead to excess accumulation of one or more of these substances which can cause death in a few days.

7. BILE formation: Liver forms nearly 600 to 1200 ml of bile per day. Bile serves 2 important functions

a. Fat digestion & absorption due to bile acids

b. Bile serves as a means of excretion of several important waste products from the blood, for e.g. bilirubin, excess cholesterol.

8. STORAGE: The liver stores minerals (IRON), vitamins (VIT A, D, B12, FOLATE).

These are the main physiological functions of the liver. In Ayurved, the liver has been described elaborately & its functions are also described in detail. The only difference is that Ayurvedic theory has its own terminology which cant be understood completely by modern physiology.Hence Ayurvedic description is very unique but still, there are quite similarities with modern science. Nonetheless, the differences have no impact on the treatment aspect.

2. Causes of Liver diseases: The liver can become diseased due to many causes, the main are summarized as⇒

a. Alcohol

b. Viruses ( Hepatitis A, B, C)

c. Drugs

d. Poisons

e. Faulty Diet Habits

f. Bacterial infections

g. Cancer

Ayurved has listed some very unique causes of Liver disease. The list includes mainly diet items and wrong ways of living which ultimately affect health. When we study them carefully we can understand that these are the same things that now modern science is accepting slowly. More research is needed in this aspect.

3. Symptoms of Liver Disease: The symptoms of liver disease depend on the exact condition the liver is suffering from. Occasionally the patient may be suffering from a very serious liver disease but may not be having such symptoms, this category of patients are a very RISKY group because they may suddenly DIE leaving the relatives perplexed. Even then there are some symptoms that the common man is generally aware of & consults a doctor

a. JAUNDICE: Patients can usually recognize high grades of jaundice, but even mild jaundice can indicate very serious liver disease.

b. ANOREXIA: Varying degrees of loss of appetite is a usual accompaniment of liver disease.

c. NAUSEA / VOMITING: This is seen in many liver diseases.

d. FEVER: Usually a low-grade fever is seen in most of the liver diseases.

e. ASCITES: This is seen in CIRRHOSIS OF LIVER

f. WEIGHT LOSS: This is a result of anorexia, indigestion, vomiting & poor metabolism.

g. Indigestion, Flatulence, Diarrhoea, Constipation, Anaemia.

h. TIREDNESS: The patient complains of tiredness even though he may be apparently looking well.

i. ALTERED SENSORIUM: This is a very very important sign to note. This usually occurs in HEPATIC ENCEPHALOPATHY (brain dysfunction) & is fatal if not treated immediately.

This is not an all-inclusive list.Liver diseases can present in many forms & your doctor is the best person to judge what exact disease you are suffering from.

4. Types of liver disease: Liver diseases can be broadly classified into two categories

a. Acute parenchymal liver disease (ACUTE HEPATITIS): Here there is sudden widespread liver damage in which variable number of hepatocytes (liver cells) undergo necrosis. The main causes are

1.HEPATITIS VIRUSES

2.DRUGS

3.POISONS

b. Chronic parenchymal liver disease: Many acute liver diseases can lead to chronic liver diseases. They are of two types.

1. CHRONIC HEPATITIS

2. CIRRHOSIS

They are closely related because some forms of CHRONIC HEPATITIS can & do progress to CIRRHOSIS (end-stage liver disease).

Ayurved has its own classification of liver diseases. The classification is far more complex & difficult to comprehend from the modern point of view & should be left over for the ayurvedic expert to diagnose. The aetiology is very different as well as the terminology. Only an ayurvedic expert can truly understand the concepts & analyze them in the light of modern investigations. We shall now see in detail the above-mentioned liver diseases⇒

1. Viral Hepatitis: Though it can be caused by a variety of viruses, 90% of all cases are caused by five main agents namely HEPATITIS A, B, C, D & E. Of these hepatitis B & C are the most important ones which cause most of the deaths. Usually, in most cases, viral hepatitis resolves in a few weeks of time, but Fulminant Hepatic Failure is the most serious complication which can prove fatal. Other complications are Chronic Hepatitis, Cirrhosis & Hepatocellular Carcinoma.

2. Drug-Induced Hepatitis: Liver is the main organ in which drugs are metabolized. Any liver disease may alter the capacity of the liver to metabolize drugs & hence unexpected toxicity may occur when patients with liver disease are given drugs even in normal doses. This mainly applies to modern drugs since many are known to be hepatotoxic. Apart from acute liver damage, drugs can cause Chronic Hepatitis as well as Cirrhosis. This point has to be remembered since many patients are taking lifetime modern medicines for some or other illness. Hence modern doctors have to frequently check such patients for any evidence of liver damage. Also, Neoplastic changes (CANCER) can be caused by oral contraceptives, hormones(androgens, estrogens) etc., when taken for long periods. On the contrary, most Ayurvedic medicines are so SAFE in nature that they can be taken for very long periods without the fear of causing such harm.

3. Poison Induced Hepatitis: ALCOHOL is the most common poison known to the liver that is totally preventable. Alcohol is a direct toxin to the liver. It causes Alcoholic Hepatitis & eventually leads to cirrhosis. Excessive intake of alcohol usually is the cause, but some patients who drink in moderate amounts are known to get it since every person’s liver has a different capacity to tolerate it. Other poisons are carbon tetrachloride, vinyl chloride etc.

4. Chronic Hepatitis: This is caused by the following main reasons

a. Infection: Hepatitis B & C viruses are the main infectious agents that can cause CLD (CHRONIC LIVER DISEASE). Hepatitis A virus doesn’t cause CLD

b. Alcohol: This is the most common cause for CLD & Cirrhosis.

c. Drugs: Many patients on long-term drug therapy face the risk of developing CLD. It must be noted that ayurvedic drugs do not usually cause CLD, even when taken for very long periods, of course, provided they are taken under the supervision of an Ayurvedic Expert.

d. Biliary tract obstruction: In this, there is an obstruction in the biliary tract at any level. This can cause CLD & even CIRRHOSIS.

e. Chronic Active Hepatitis: There are many causative factors that can cause it. It is interesting to note that though modern medicine has identified some of these factors, for e.g. Hepatitis B, many other factors are not exactly known. Also, many mechanisms by which it is caused have been postulated, but still many are of unknown origin & poorly understood.

f. Liver Congestion: This can lead to CLD when the congestion stays for a long time.

g. Metabolic diseases: Excess liver deposition of IRON (Haemochromatosis) & COPPER (Wilsons Disease), are important examples of metabolic diseases causing CLD.

h. Malnutrition: This is not directly responsible for causing cirrhosis, but can cause it as is seen in some patients after undergoing SURGERY for OBESITY.

i. Unknown Cause: In as many as 30% of cases of cirrhosis, no cause can be found & they are labeled as Cryptogenic Cirrhosis. Ayurved has got an explanation for such cases.

Modern medicine has classified CHRONIC HEPATITIS into two types:

1. Chronic Persistent Hepatitis: This is a comparatively mild condition. The patient complains of fatigue, poor appetite, fatty food intolerance & upper gastric discomfort. But, some patients do progress to Chronic Active Hepatitis (the more serious form) or even Cirrhosis. Ayurved has warned about this condition as they all are some type of POORVAROOPA (the symptoms that develop before the development of actual disease).

2. Chronic Active Hepatitis: This is the serious form of the disease. The underlying liver damage is more serious & progressive. Most patients develop cirrhosis. The mortality rate is up to 50 % in 5 years if no treatment is given.

5. CIRRHOSIS: This is the end stage of liver failure.Ayurved has got marvelous treatment for Cirrhosis & here we are talking about an end-stage liver disease.Cirrhosis is described very well in Ayurvedic texts.In our GURU SHISHYA PARAMPARA, there are so many marvelous medicines for this disease that we confidently deal in the worst of cases.Modern medicine has developed the technique of Liver transplant but Ayurved deals with Cirrhosis only via medicines.

6. Steps to prevent liver disease:

Ayurved has always emphasized on the Prevention of diseases. Ayurved states that “The renouncement of reasons that cause a disease is the first step in staying free from that disease”. This phrase is timeless. The only requirements are being health conscious, being knowledgeable about the steps to maintain health & having the determination to act on those steps.As we have seen that the Liver is a complex organ performing many functions it can be understood that there are many CORRECTABLE factors that are under our control so that the Liver doesn’t get diseased.

a. STAY AWAY FROM ALCOHOL: Even illiterates know that alcohol is bad for the liver. Alcohol is at the top of the list when we compare toxins for the Liver (in terms of usage). Alcohol causes several Liver diseases in which cirrhosis is the worst & last. Depending on the intake, frequency, gender, type of alcohol, age etc. the liver is going to get damaged sooner or later. Alcohol consumption is a personal choice matter. Hence please make it an informed choice. This means that

1. How much Alcohol
2. What type of Alcohol
3. Age & Alcohol
4. Gender & Alcohol etc.

Get some basic information regarding these. The problem with alcohol is a person doesn’t know when a casual drink turns into addiction. Alcohol has very detrimental effects on not only liver but also Pancreas, Brain, Heart, Reproductive System (Infertility, Sexual Dysfunction) etc. In fact, Alcohol has bad effects on every system of the body. Countless families would be saved if Alcoholics be able to quit alcohol. Hence the best way is to stay away from all types of alcohol always.

b. Proper Diet: This is the most important to be followed daily recommendation in Ayurved for preventing Liver disease. The diet should be NATURAL in nature i.e it should be free of artificial flavours, chemicals etc. For this eat a diet full of nutrients, derived from fresh fruits, vegetables, low fats, moderate proteins, easily digestible items. Stay away from market sweets, sugar, junk fast foods. The aim is to keep an optimum weight. There are different dietary recommendations for different liver diseases. Hence contact your Doctor for the exact dietary recommendations.

c. Weight control: Obesity is a risk factor for liver disease. Fat accumulates in the liver causing Non-Alcoholic Liver disease. Hence strive hard to maintain an optimum weight.

d. Exercise: Exercise has very positive results in preventing most diseases. This helps in maintaining an optimum weight, physical fitness & strength. This does help in keeping our immune system strong so that our body fights with infections. Exercise improves our organ functioning in many ways. This goes a long way in preventing many liver diseases.

e. Avoid self-medication: Many people have a habit of taking some or the other pill for trivial complaints. This can cause considerable liver damage & has proved even fatal in many patients. Most of the medicinal drugs are metabolized by the liver. Hence such self-medication can prove very very hazardous. Please always consult your Doctor for your health complaints. This can save your life & prevent emergency situations.

7. Ayurvedic Treatment of Liver Diseases:

Ayurved has excellent, marvelous medicinal treatment for all Liver diseases. This applies to simple Liver conditions like jaundice but most notably in Liver Cirrhosis (which is the end stage of Liver failure).Modern medicine has developed the technique of Liver Transplant for such cases but Ayurved deals with all such critical Liver diseases via medicines only. We can say that liver transplant has its role in the treatment of liver diseases, especially in an emergency situation.Mostly liver transplant is done in all such liver conditions where the liver is supposed to be damaged extensively & irreversibly? (end-stage liver disease). Ayurved comes into role here. Since patients do tend to visit modern doctors first & come to Ayurved only when they are told that liver transplant is the only solution in modern medicine, then they come to Ayurved if they don’t want to undergo liver transplant. Ayurved is a boon for all such patients who do not want liver transplant (for any reason) or where liver transplant itself is very risky (due to valid medical reasons) & the successful outcome is not very reliable.Also, the cost of Liver transplant is so huge that a common man cant afford.Even if he somehow manages to arrange for the money, he has to remember that this is not a onetime expense.Why? Because Liver transplant Patients have to always remain in constant medical supervision lifelong. And last but not the least the LIVER HAS TO BE AVAILABLE at the right time for transplant to take place.Taking into considerations all these difficulties, it would be always worthwhile to consider first Ayurvedic treatments for Liver Diseases.Simply speaking Ayurved believes in reviving the damaged Liver. The liver can be revived to function up to a really great extent on its own by Ayurvedic medicines.This sounds too simple but that’s the greatness of Ayurved. Consult an Ayurvedic Expert for more details. You can always contact us for the same. At Amoghsanjeevani we really suggest all such patients to come to Ayurved for all such difficult cases no matter what modern medicine has said. We believe Ayurved has a solution for you.