Cirrhosis of the liver is the final stage of many chronic liver disorders. It comprises two phases: compensatory and decompensatory. The compensated phase lasts a long time. Major consequences of decompensated cirrhosis include jaundice, variceal bleeding, ascites, and encephalopathy. The most prevalent symptom is ascites. In 10 years, 50% of compensated cirrhosis patients develop ascites. Treatment for ascites necessitates hospitalization, can result in life-threatening complications and necessitates liver replacement. The advent of ascites signals a worsening prognosis and an increase in mortality. Cirrhosis fatalities 15% of people within the first year after diagnosis, and 40% die within the first 60 months. The death rate after ten years is 34–66 percent. Cirrhosis is caused by alcohol intake, viral hepatitis B and C, and metabolic syndrome linked to obesity. Cirrhosis of the liver is responsible for 1,70,000 deaths in Europe each year. The prevalence of liver illnesses is rising, and a significant increase in the burden of liver disease is projected. Liver cirrhosis’s annual healthcare costs in the United States range from $12 billion to $23 billion.
Due to the high prevalence of Hepatitis B and C, fatty liver disease, and possibly increasing tendencies in alcohol consumption, hepatic cirrhosis in India could be significant. Hepatic cirrhosis has a high cost of quality of life, productivity loss, and medical expenses. Treatments are being tested to arrest the progression from compensated to decompensated state. In the case of end-stage liver disease, liver transplantation is the sole option. Liver transplantation is expensive, has a high death rate, and has a limited number of organ donors. Ayurveda treatment for liver cirrhosis is very effective.
Ascites are associated with Jalodara in Ayurveda. Jalodara stage is reached by all Udara disorders (morbid abdominal disorder). The major goals of the Ayurvedic management plan are to improve Jatharagni (metabolism) and stimulate hepatic function. Nitya virechana, teekshna (strong, piercing) medications, kshara (alkali), gomutra (Cow’s urine), fluid restriction, milk, buttermilk, diet, oral medicaments, and rasayana (rejuvenative) drugs are some of the treatments used in Jalodara (C.Chi.13). Preoperative therapies such as snehapana (internal oleation therapy) and swedana (sudation therapy) are not performed in the Nitya virechana procedure. Virechana is performed with a lower level of intensity and more frequently. However, evidence of Ayurveda treatment of liver cirrhosis with ascites is limited.
The case records of a tertiary care Ayurveda teaching hospital known for successful management of liver cirrhosis with ascites were analyzed in this retrospective analysis. The hospital data, treatment algorithms, virechana process details, prescription patterns, dietary concerns, clinical results, and biological assessments were analyzed.
Several factors can cause cirrhosis. Alcoholism, hepatitis B and C, and fatty liver disease are the most prevalent causes of cirrhosis, but various other factors can also cause them. A disorder that has no known cause is referred to as idiopathic.
Cirrhosis is increasingly caused by obesity, either alone or in combination with alcohol, hepatitis C, or both. Cirrhosis affects many patients who have many causes of liver disease. Cirrhosis is not caused by hepatic trauma or other acute or short-term damage to the liver. Cirrhosis is usually caused by years of persistent damage.
Chronic hepatitis C – Hepatitis C is a liver infection conveyed via contact with an infected person’s blood. Cirrhosis can develop due to chronic hepatitis C, which causes inflammation and damage to the liver over time.
Hepatitis B and D (chronic hepatitis B and D) — Hepatitis B is a liver infection transferred through contact with an infected person’s blood, sperm, or other bodily fluids. Hepatitis B, like hepatitis C, produces inflammation and injury in the liver, resulting in cirrhosis.
Autoimmune hepatitis is a kind of hepatitis in which the body’s immune system attacks liver cells, resulting in inflammation, damage, and cirrhosis. Genetic factors, according to researchers, may make some people more susceptible to autoimmune illnesses. Approximately 70% of people with autoimmune hepatitis are women. Inherited diseases – Cystic fibrosis, alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases- affect the liver’s ability to produce and process and store enzymes, proteins, metals, and other substances required for proper body function. These disorders can lead to cirrhosis. Infections, poisons, and drugs – Drug reactions, long-term exposure to harmful chemicals, parasite infections, and repeated bouts of heart failure with liver congestion are all possible causes of cirrhosis.
Bhringaraja is beneficial to children with cirrhosis of the liver. Other ayurvedic drugs that can aid include vasaka, kakamachi, and triphala.
Ayurveda treatment might be used to treat uncomplicated cirrhotic ascites. When pippal is delivered as a rasyana, the results imply that liver damage can be reversed at the cellular level.
In patients with decompensated cirrhosis, complicated Ayurvedic therapies such as nitya virechana, oral drugs, diet, fluid and salt limits improve the clinical profile, liver function, renal function, prothrombin time, and INR parameters, which justifies further research.
Researchers at Oregon State University discovered that a certain omega-3 fatty acid could help prevent liver inflammation and fibrosis, which are prevalent disorders increasing in tandem with the number of overweight Americans.