Liver is a vital organ in human body with very important metabolic functions like enzyme release, digestion & absorption of fat, conversion of food into energy, energy storage and detoxification & elimination of waste products. It also filters toxic substances out of bloodstream.
Liver disease is a general term that refers to any disease condition affecting the liver. There are many causes and conditions that damage the proper functioning of the liver and all these conditions are collectively known as liver diseases, though some of they are different diseases with specific aetiology & pathology, many of the liver diseases present with similar signs & symptoms. They can damage the liver seriously and affect its functions badly.
Signs & Symptoms
Symptoms may vary according to the disease but there are general ones which give a hint about a damaged liver. They are,
- Jaundice; yellow skin and eyes
- Dark urine
- Pale or discoloured stool
- Swelling in the legs or belly
- Nausea & vomiting
- Loss of appetite
- Fatigue
- Pruritus
- Skin prone to bruising and bleeding
Causes
- Cirrhosis
- Various types of Hepatitis
- Fatty liver disease
- Autoimmune conditions like hepatitis, Primary biliary cirrhosis, Primary sclerosing cholangitis etc.
- Genetic diseases like Haemochromatosis, Wilson’s disease,
- Cancer – hepatocellular carcinoma
Pathophysiology
Pathophysiology is different in each disease. Here are a few of most common ones explained.
Cirrhosis
Cirrhosis is the term used to denote the later stage of almost all the liver problems. In general, liver can regenerate its damaged cells on its own but the process leaves a scar on liver tissue. When the scar tissue becomes too much, the liver functions & capacity to regenerate are badly affected. This condition is known as cirrhosis. It can happen due to many causes like alcohol abuse, cystic fibrosis or syphilis. It is treatable in the very early stages but if not treated properly, liver failure will happen eventually.
Hepatitis
It is a viral infection causing damage to liver. Most of them are contagious, so strict hygiene, vaccination and other preventive steps are needed to stop their occurrence. There are5 types of hepatitis A, B, C, D and E.
Fatty liver disease
Alcoholic and non-alcoholic fatty liver can cause serious damage to liver tissues, leaving scar tissue and eventually lead to cirrhosis if left untreated.
Autoimmune conditions
Autoimmune hepatitis- Body’s immune system attacks body’s own liver cells resulting in inflammation which can lead to cirrhosis and liver failure if left untreated.
Primary biliary cirrhosis- Damage to the bile ducts in liver leads to a collection of unwanted bile. It can lead to cirrhosis and liver failure.
Primary sclerosing cholangitis – It is an inflammatory condition causing damage to bile ducts. Blockage in the bile ducts cause building up of excess bile in liver and eventually cause cirrhosis or liver failure.
Genetic conditions
Hemochromatosis – In this disease, body stores more iron than needed. Usually this excess iron is stored/deposited in internal organs including liver. Such a condition, if not treated on time, can cause serious damage to liver tissue and lead to liver failure eventually.
Wilson’s disease – Elementary copper reaching the body as a part of the diet is supposed to be released into the bile ducts to be eliminated. But in Wilson’s disease, copper is absorbed & deposited into the liver tissue. It can cause serious liver problems and the excess copper will travel in the bloodstream and deposited in other places including eyes &brain.
Cancer
They can be primary, which start in the liver cells or secondary, which start in other cells or organs and spread into liver cells. Most common type of cancer of the liver is Hepatocellular carcinoma.
Diagnosis
Blood tests to check
- Liver function tests
- Total count or Complete blood count
- Lipase levels
- Tests for various Hepatitis infections
Imaging studies
- Abdominal ultrasound
- CT scan
- MRI
- Cholescintigraphy (HIDA scan)
Invasive tests like
Endoscopic retrograde cholangiopancreatography (ERCP)
Liver biopsy
Treatments
Diet and lifestyle management is the best treatment when it comes to liver diseases along with symptomatic treatment. Many conditions are chronic & irreversible but can be managed well with proper treatment.
- Alcohol cessation
- Maintaining body weight/losing extra fat
- Drinking enough water/Avoid dehydration
- Diet including more fibre & protein than bad fat, sugar and salt.
Depending upon the condition & disease pathology many types of treatments are advised in liver problems
- Antiviral drugs to treat hepatitis
- Steroids to reduce inflammation of the liver
- Blood pressure medications
- Antibiotics
- Anti-allergic medications for symptomatic relief
- Vitamins and supplements
In very severe and chronic cases, surgery or liver transplant will be needed.
Prognosis
If diagnosed and treated in the early stages, many of the diseases affecting liver are manageable. But it is impossible to reverse/treat and become fatal in the last stage.
Complications
- Portal hypertension
- Splenomegaly
- Internal bleeding & bruises
- Infections due to compromised immunity
- Malnourishment
- Hepatic encephalopathy
- Jaundice
Disease & Ayurveda
The liver is called Yakrit in Ayurveda. It is the seat of Pitta dosha. Any disease affecting the liver is called Yakridvikaara.
Nidana
- Diet which enhances the vitiation of Pitta & Rakta
- Unwholesome diet
- Alcohol intake
- Suppression of natural urges
- Day sleep and keeping awake at night
- Too much hot & spicy food intake
- Toxins
- Poisoning
- Exposure to excess heat
- Burns
- Injury
Purvaaroopa
Not mentioned
Samprapti
Vitiated doshas, mainly Pitta & Kapha causes blockage in the circulation and cause inflammation & swelling in the liver. Impaired functioning of liver leads to deranged metabolism and diseases.
Lakshana
- Loss of appetite
- Anaemia
- Jaundice
- Nausea & vomiting
- Diarrhoea/constipation
- Pale stool
- Dak coloured urine
- Fatigue & weight loss
- Coating of tongue
If there is yakridvruddhi (enlargement of liver) symptoms like jaundice, fever, pain on right side of abdomen & body, Breatlessness, Cough, Constipation, Swelling, excessive thirst etc will be present
Divisions
Not mentioned
Prognosis
Krichrasadhya/Yaapya
Chikithsa
Samana
Aamapachana
Agnideepana
Sodhana
- Sneha-Sweda
- Teekshnavirechana
- Vamana
Commonly Used Medicines
- Patolakaturohinyadi kashayam
- Punarnavadi kashayam
- Avipattikarachoorna
- Chandraprabhavati
- Dasamoolahareetaki
- Punarnava mandooram
- Ayaskriti
- Mandooravatakam
Ayurvedic Supplements to promote liver health
- Drakshadi Kashayam Tablets
- Cytozen Forte Syrup
- Panchagavyam Ghrutham
- Varanadi Kashayam Tablets
- Kumarkalyan Ras (GOLD)
- Arogyavardhini Gutika
- Drakshadi Kwatham Tablets
Brands Available
- AVS Kottakal
- AVP Coimbatore
- SNA Oushadhasala
- Vaidyaratnam oushadhasala
Home Remedies
Once a liver problem is diagnosed, taking no home remedy is effective.
But wholesome diet and healthy daily routine can help improve the functioning of liver.
Diet
- To be avoided
Avoid excess intake of salt and oil as a part of diet.
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha and cause respiratory problems
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Barley, wheat, meat soup of animals living in dry lands, processed with digestive & carminative spices
Green gram, lentils, soups.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
- Quit alcohol/smoking/narcotics.
- Avoid sedentary lifestyle. Be active.
- Better to avoid exposure to excessive sunlight wind rain or dust.
- Maintain a regular food and sleep schedule.
- Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
- Avoid day sleep.
Yoga
Vigorous exercises are not allowed in these conditions.
Only stretching, moderate walking, and mild cardio exercises are advised. Also, specific yogacharya including Ardhamathsyentrasana, Dhanurasana, Gomukhasna and naukasana is recommended. Range of movement and flexibility must be considered while doing every exercise.
Sookshma sandhi vyayama (warming up small joints) is advised.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Ardhamathsyentrasana
Dhanurasana
gomukasana
Naukasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/9052109/
https://pubmed.ncbi.nlm.nih.gov/30871980/
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