In Cirrhosis of lever, tissues of liver are gradually damaged which results in disruption in flow of blood in liver cells and hence the patient experiences several problems. It can be described as chronic liver disease which is characterized by abnormal function or dysfunction of liver.
Let’s have a detailed discussion on this with Ayurvedic expert, Dr. Parmeshwar Arora
Q. Be it any liver disease, it brings a lot of sufferings for the patients. So, what is Cirrhosis of Liver?
Cirrhosis of Liver is a process in which we observe diffused fibrosis in liver. Fibrosis is a term for hardening. Eco texture of liver or composition of liver in general, is very elastic. Due to any reason, if liver gradually becomes fibrosed or undergoes the process of fibrosis, or gradually becomes hard then this condition is termed as Cirrhosis of Liver. We can also say that the elastic tissues of liver get converted into plastic tissues and liver starts to look nodular or develops many nodes. When these nodes are small, we call it micro-nodular, and when they are large we call it macro-nodular. So, the condition of liver when it loses its normal elasticity, its tissues become fibrous or its texture becomes plastic, is called as Cirrhosis of Liver.
Q. What could be the Causes of Cirrhosis of Liver? Why does a person become a victim of Cirrhosis of Liver?
When we talk about causes of Cirrhosis of Liver, then there are different types of viral infections mainly hepatitis B Virus…..almost 50% of the times, Cirrhosis of Liver is caused by hepatitis B virus. Following this, hepatitis C virus is the major cause. Also, alcoholic liver diseases are very common cause in the people who often consume large amount of alcohol. Apart from this, any toxin which damages liver cells or causes excessive necrosis….I would like to tell you here that liver is such a structure which highly capable of regenerating itself. In case of acute viral hepatitis in the form of jaundice, there occurs, a sort of destruction of liver cells but if proper treatment and proper rest has been taken, the liver recovers completely. There has been a process of necrosis but cells get restituted and regenerated and the normal size, shape and texture of liver is again achieved. But in a case where someone is consuming alcohol and there is necrosis of hepatocytes (death of hepatocytes) due to this reason and still he continues to consume alcohol, then in that case, regeneration of liver does not happen. The reconstitution of cells which should happen, does not take place and there is continuous necrosis of cells. Necrosis of cells, gives rise to many chemical procedures in the liver and gradually the process of fibrosis begins, which converts the eco texture of liver into hard and globular and there it is, Cirrhosis of Liver. Thus we conclude here that hepatitis B virus, hepatitis C virus and alcohol are the three major causes of Cirrhosis of Liver.
Q. Liver is known as a digestive organ so as I guess, a patient of Cirrhosis of Liver would have to face a lot of related problems. Please tell us about what could be the associated problems resulting out of Cirrhosis of Liver in a patient?
There is one more secret here – Liver is such an organ in our body which would not let any symptom surface even if only 10% of it is functional. This is the reason that, in half of the patients of Cirrhosis of Liver, there are almost no symptoms in initial stages. One-third of the patients of Cirrhosis of Liver remain asymptomatic even after they have developed the disease. But as the disease grows and our liver starts shrinking then it is signaled in the form of problem of portal hypertension. When the pressure is exerted on portal venous system, the venous pressure gets increased. The portal venous pressure which is generally 7 mm of mercury but as the Cirrhosis of Liver progresses, it goes above 10 mm of mercury. If portal venous pressure of 10 mm persists in a patient, we say that now portar hypertension has occurred. At this stage, the patient shows symptoms like oesophageal varices in which dilation of veins in food pipe occurs and sometimes the veins even rupture and as a result patient may bleed from mouth. Similarly the veins in anus i.e. rectal veins, also dilate because of increased pressure in the portal venous system – so these kind of symptoms are observed. Due to obstructive pathology, a patient may develop ascites, which refers to the accumulation of fluid in the peritoneal cavity or accumulation of plasma in the stomach. Thus, while Cirrhosis of Liver is asymptomatic initially, its symptoms in later stages are uncontrollable. Symptoms, as I have already mentioned, include bleeding from mouth, oesophageal varices, rupture of rectal varices, bleeding through stool, ascites or accumulation of water in stomach. Similarly spider angioma anywhere on the body, like on face or chest, which appears as a central red spot(a pinpoint arteriole) and reddish extensions which radiate outwards like a spider’s web( venous dilations), is also a symptom of Cirrhosis of Liver. Also, if you observe the palms of patients, the thenars and hypothenars will appear extraordinarily red (we term it as palmar erythema). So, there are certain signs which help us to identify a patient of Cirrhosis of Liver on the basis of symptoms. Afterwards, we take the help of labs and radiology to confirm or rule out the disease and if confirmed, to investigate its causes and the stage to which it has progressed.
Q. When a person has fever and he consults a doctor, generally now-a-days doctors don’t ignore even small symptoms. For example, if a person has acute stomachache or digestive disorder, he is often advised to undergo a liver test. You just told us that since Cirrhosis of Liver is initially asymptomatic, it generally goes unnoticed till it has progressed dangerously, but if somebody undergoes a liver test, can the beginning of Cirrhosis of Liver, be indicated?
When we refer the term -Cirrhosis of Liver, it is actually quite advanced stage wherein liver has already undergone quite a lot of damage. If we talk about LFT(Liver function test), we may observe increased level of liver enzymes like SGOT, SGPT, alkaline phosphatase, GGTP , which could be a primary indication but Cirrhosis of Liver is a structural disorder, rather than functional one. Thus I would say, ultrasonography would be more useful than LFT, if you want to catch it early. See, liver enzymes can be altered in case of simple jaundice, or initial stages of hepatitis B or hepatitis C. So, if you want to get yourself tested against Cirrhosis of Liver, you can undergo ultrasonography and then a further fibro-scan, in case ultrasonography reports altered liver. CT scan gives a further clear picture of the condition. Fibro-scan indicates that how much elasticity has been lost, and which to stage the disease has progressed. So I would say, a regular ultra-scan can help a person to catch the Cirrhosis of Liver in an initial stage.
Q. Does Ayurveda have a solution for this disease, so far?
In the beginning of the discussion, I told you about various reasons which can cause Cirrhosis of Liver. I would say it very clearly to those who consume alcohol that if you consume of 80gms of ethanol everyday, then if we talk about Indian community, after 15-20 years, 50-70% of you can become a victim of Cirrhosis of Liver and 20% of you, can have hepatoma of liver. So if you consume ethanol, it doesn’t make a difference whether you take wine or whiskey or beer, as long as it has ethanol . If you consume 30 gm of whiskey or 300 gms of bear, they are all the same. So if you withdraw even when 50-70% of your liver is damaged, trust me, your liver will recover completely and you would never require a liver transplant. I would repeat that withdrawal of alcohol give very good results. Now if the cause is viral infection as in hepatitis, in allopathic science there is no proven antiviral. There are intervirone therapy, thymosene therapy and lemovodine therapy but their safety as well as their efficacy is quite doubtful. So, I would suggest that you use the proven Ayurvedic herbal remedies, hepato protective drugs and make effort to boost up your immunity. By using these, I am sure the patients of hepatitis and cirrhosis will get good results.