Fatty liver treatment through Ayurveda

Fatty liver is the fastest growing epidemic in the world now. There is no known drug available to treat. Ayurveda medicines can reverse liver damage and help cure fatty liver in the early stages.

1. LIVER DISEASE Dr. Lima Mathew MD, FAO

2. LIVER DISEASES Liver disease is a general term that refers to any condition affecting your liver. These conditions may develop for different reasons, but they can all damage your liver and affect its function. 4 stages of liver disease: Inflammation Fibrosis Cirrhosis Liver failure

3. NAFLD - TYPES Nonalcoholic fatty liver disease has two types: Simple fatty liver: This is the more common type, which entails presence of fat in the liver without any inflammation or cell damage. It doesn’t normally get worse and turn into a serious condition. Nonalcoholic steatohepatitis or NASH: Afflicting nearly one-fifth of those having NAFLD, NASH signifies inflammation of the liver and is a much more serious condition than a simple fatty liver. The cell damage and inflammation can even lead to scarring of the liver including fibrosis and cirrhosis and even liver cancer.

4. Other risk factors for NAFLD or NASH include: The elderly are more prone. If you have polycystic ovary syndrome. If you have sleep apnea. If you have hypothyroidism. If you have hypopituitarism (underactive pituitary gland). Malnourishment. Sudden weight loss. Exposure to certain toxins or chemicals. Having metabolic syndrome which makes one more prone to diabetes and heart disease.

5. The liver’s job is to break down alcohol. If you drink more than it can process, it can become badly damaged. The effects of alcohol on the liver depend on how much and how long you have been drinking.

6. What are the problems precipitated by ALD? While alcoholic fatty liver disease is preventable and generally gets better once you kick the bottle, it can also cause complex conditions like: Enlarged liver: This might cause pain or discomfort in the right upper side of the tummy, However, it may not show any symptoms at all. Alcoholic hepatitis: This is an inflammatory condition of the liver which may cause nausea and vomiting, fever, tummy ache and jaundice. Alcoholic cirrhosis: This is a serious condition, involving scar tissue buildup in the liver. Besides similar symptoms like hepatitis, cirrhosis can also lead to ascites or massive fluid buildup in the tummy, elevated blood pressure in the liver, bleeding, enlarged spleen, confusion, and even liver failure. Alcoholic hepatitis can over time turn into alcoholic cirrhosis.

7. How ALD damages the liver…..

8. What are the symptoms of alcoholic liver disease? Fatty liver: Often causes no symptoms Build-up of fat inside the liver cells enlarges the liver, causing upper abdominal (belly) discomfort on the right side Tiredness and weakness Weight loss Alcoholic hepatitis: Pain over the liver Fever Weakness Nausea and vomiting Appetite loss Yellowing of the skin and eyes (jaundice Alcoholic cirrhosis: Portal hypertension (increased resistance to blood flow through the liver) Enlarged spleen Poor nutrition Bleeding in the intestines Ascites (fluid build-up in the belly) Kidney failure Confusion Liver cancer The effects of alcohol on the liver depend on how much and how long you have been drinking alcohol. These are the most common symptoms and signs:

9. What are the complications of alcoholic liver disease? About 30% of people with alcoholic liver disease have hepatitis C virus. Others have hepatitis B virus. People with alcoholic liver disease are also at greater risk for liver cancer. About 50% have gallstones. Those with cirrhosis often develop kidney problems, intestinal bleeding, fluid in the belly, confusion, liver cancer, and severe infections.

10. Treatment - NAFLD Lifestyle modifications. If you are overweight or have obesity, losing weight by making healthy food choices, limiting portion sizes, and being physically active can improve NAFLD—either NAFL or NASH. Losing at least 3% to 5% of your body weight can reduce fat in the liver. Use dietary supplements like Vitamins. Comorbidities like Insulin resistance, Type II DM, Dyslipidemia has to be treated. No medicines have been approved to treat NAFLD—either NAFL or NASH.

11. TREATMENT - ALD The most important part of treatment is to completely stop drinking alcohol. Sometimes diet changes are advised, too. Vitamin - E supplements. The liver is often able to repair some of the damage caused by alcohol so that you can live a normal life. In some cases, liver transplant may be considered. But you must complete a rehab program and go through alcohol detox before this is even an option.

12. AYURVEDA approach to fatty liver. Considering the basic concepts of Ayurveda, it may be related to Dhatwagni vikara which may arise from santarpanotha or apatarpanotha nidana. FLDs are caused by an imbalance between Kapha and pitta dosha or elevated Kapha dosha in pitta-dominant regions. Other correlations - Raktavahasrotomoola medavridhi. Pittasthane kaphameda vriddhi, pittasthane dhatwagni dushti, pitta stane medasanchaya. Increased synthesis of fatty acids to liver - Dhatwagni vridhi. Fat from Medasthana to liver - Ashayapakarsha Fibrosis and cirrhosis - Dhatupaka

13. Samprapti The Ranjaka pitta, which turns Apya Rasa Dhatu into Rakta Dhatu, is based in Yakrit. It is also associated to Raktavahi and Mamsavahi Dhamani and is the Mulasthana of Raktavahasrotas. Yakrit is a significant Koshthanga that is closely linked to the Rasa, Rakta, and Mamsa Dhatus and plays a significant part in the Dhatu Parinama. Agnivikruti causes the creation of Apakva Anna Rasa, which causes the vitiation of Kaphadosha and uneven formation and deposit of Medas in Yakrit. Srotorodha is caused by vitiated Kapha and Meda - Vata prakopa. Vata prakopa - Agnidushti, and the cycle continues. Pitta involvement - Inflammation - NASH- 2nd step. Extreme Vata prakopa - fibrosis develops, and the condition may advance to Cirrhosis, ascites, and hepatocellular carcinoma, as well as other metabolic problems.

14. Samprapti ghataka Dosha- Samanavayu, Apanavayu, Pachakapitta, Ranjakapitta, Kledaka kapha, Dushya- Rasa, rakta, medo dhatu. Srotas - Annavaha, Udakavaha, Rasavaha, Raktavaha, Medovaha, and Pureeshavaha.

15. Agnideepana, Rookshana, Srotosodhana, pacification of Kapha, Meda and Vata should be the first line of treatment in the management of Fatty Liver. Here, the treatment principle adopted is almost similar to that of Sthaulya. The probable treatment for Steatohepatitis includes: " ushnam kaphamedoharam vyasaharam rasayanam" Treatment protocol: Dipana-pachana-rukshana Snehapana Vamana, Virechana, Basti Rasayana prayoga When the fatty liver reaches the next stage and the Dhatus get engaged, therapy should focus on the purification of Rasa and Rakta, as well as Yakritshothahara.

16. Shodhana Pachana - Panchakola churna 5 gm twice a day before food. Arogyavardhini vati 250mg twice a day after day (srotoshodhana). Snehana - Mahatiktaka ghrita/Panchatiktaka ghrita 10ml thrice a day before food. Panchatiktaghrita formulation is Medanashana and Lekhana. VIRECHANA - Avipatti, Erandataila, Trivrit Avaleha, Misraka sneha etc. SHAMANA Kashaya - Vasaguduchyadi, Phalatrikadi, Drakshadi, Patola Katurohinyadi Arishta - Sudarshanaarishta, Rohitakarishta, Pippalyasava, Bringarajasava. Churna - Hinguvachadi, Vaiswanara etc.

17. ALD TREATMENT IN AYURVEDA Ayurveda treatment includes nidanaparivarjana, Vyadhipratyanikaaushadhis, hepatoprotectives, Virechana drugs, use of Pathyapathya, dietetics, Rasayana , Nutritives, Pittaharadravyaprayoga, daily walking, changing lifestyle and practice of Yogasanas and Pranayama. Medicines having following properties: Pittahara - Kharjuradimantha , Shadangapaniya, Usheerasava Tiktarasayukta - Bhunimbadikashaya, Mahatiktakakashaya, Guduchyadikashaya Mruduvirechana - Haritakichoorna, Triphalachoorna, Trivrutchoorna. Brimhana & ojaskara - Kooshmandavaleha, Shatavariguda, Balarishtam, Aswagandharishta etc. Rasayana - Arogyavardhini rasa, Shatavariguda, Drakshadi lehya etc.