CIRRHOSIS OF LIVER
Definition: This is a condition of the destruction of the hepatic cell, disruption of hepatic architecture, overgrowth of fibrous tissue, the proliferation of the remaining cells associated with features of progressive hepatocellular failure, portal hypertension and portosystemic shunting arising out of diverse aetiology. Cirrhosis is a condition that results from permanent damage or scarring of the liver. This leads to a blockage of blood flow through the liver and prevents normal metabolic and regulatory processes.
what are the major causes of cirrhosis?
causes of cirrhosis are as follows:
.Chronic alcoholism
.Viral infection caused by chronic viral hepatitis (type B, C and D)
.Metabolic diseases such as alpha-1 antitrypsin deficiency, galactosemia, and glycogen storage disorders.
.Inherited diseases such as Wilson disease and hemochromatosis
.Biliary cirrhosis resulting from diseases such as primary biliary cholangitis (PSC) and primary sclerosing cholangitis(PSC)
.Toxic hepatitis caused by the severe reaction to prescribed drugs or prolonged exposure to environmental toxins.
.Repeated bouts of heart failure with liver congestion.
Nutrition: Dietetic deficiency of lipotropic factors results in accumulation of fat in the liver cells and this ultimately leads to hepatic fibrosis.However, the cause and effect relationship of these factors is still unsettled. Indian childhood cirrhosis is a special type in this category.
Chronic alcoholism: This is an important cause of cirrhosis in a temperate climate. Directly, it is responsible for hepatocellular damage and indirectly hepatic damage is produced by the associated deficiency of lipotropic factors and a high-calorie diet. Mallory bodies or alcoholic-hyaline is very suggestive of alcoholic cirrhosis and micronodular cirrhosis usually develops.
Posthepatitic and postnecrotic cirrhosis: Hepatitis B, Hepatitis c. Hepatitis D may lead to this type of cirrhosis. Almost all cases of chronic active hepatitis lead to cirrhosis.
Metabolic disorder and inherited disorders: Cirrhosis may develop in cases of Haemochromatosis (Bronze diabetes), Kinnier Wilson's disease, Glycogen storage disease(Type iv), a Fibrocystic disease of the pancreas Alpha-antitrypsin deficiency, Fanconi syndrome, Galactosaemia and in various others.
Pathology: After necrosis and disintegration of liver cells the reticulin framework collapses thereby portal and central zones are approximated. Fibrous septae develop in the portal zones and proceed towards lobular parenchyma dissecting them into various sizes. In the meantime, some cells regenerate to form nodules of various sizes giving a macroscopic appearance of a macronodular, micronodular or mixed type of cirrhosis. Gradually portal hypertension develops due to increased intrahepatic vascular resistance. This increased resistance is due to compression of a vessel by fibrous tissue. Ultimately from portal hypertension, oesophagogastric varices, splenomegaly with or without hypersplenism, ascites and spontaneous bacterial peritonitis develop. Apart from portal hypertension, ascites may develop from other causes also like low COT, increased sodium retention by kidney due to hyperaldosteronism, increased sympathetic activity, altered renal hemodynamics, production of hepatic and splanchnic lymph giving rise to lymphorrhea, non-absorption of water and lymph by the peritoneal lymphatics and impaired renal water excretion by high ADH.
What are some early symptoms of cirrhosis?
people in the early stages of cirrhosis have few symptoms. Some symptoms an individual ma notice include:
Loss of appetite, nausea, weight loss, fatigue, weakness, exhaustion.
1.Anoresia, nausea, vomiting, flatulence.
2.Gradual weakness, fatiguability, and weight loss.
3. Gradual swelling of the abdomen and feet.
4.Haematemesis (15%-25%) and melaena from ruptured esophageal varices.
5.Abdominal pain either due to ascites or due to stretching of Glison's capsule due to enlargement of the liver.
6.Bleeding piles.
7.Diarrhea or constipation.
8.Amenorrhoea in females.
9. Loss of libido, sterility, impotence, gynaecomastia.
Signs: Age above 30 years usually.
Facies: Hepatic facies is present, This consists of sunken eyes, prominence of malar bones, icteroid conjunctivae, a muddy complexion of the face and spider angioma. Anaemia is present.
Jaundice is usually absent but may be prominent if there is cholestasis or chronic active hepatitis.
Palmar erythema and spider angioma may be present. These are traditionally attributed to excess oestrogen in the circulating blood. However, their presence and absence may not be correlated with oestradiol level in blood. Spider angioma is best observed in the upper part of the chest especially in the necklace area.
Oedema is present, pitting in type. This is due to low protein level, an excess of aldosterone and antidiuretic hormones in the blood, the pressure of ascitic fluid over inferior vena cava and low glomerular filtration rate. Cutaneous haemorrhages may be present due to hypoprothrombinemia. Fever may be present in 35% of cases due to secondary infection particularly tuberculous peritonitis or due to spontaneous infection of an ascitic sac.
Cyanosis may be present in more than 30% cases due to hypoxaemia.
Alimentary System: Tongue is pale and dry, it may be red due to avitaminosis or glossitis. Abdomen is bloated, flanks are more bulged, umbilicus is everted. Abdominal veins are prominent particularly in the epigastric region and they drain away from the umbilicus. These are the result of collateral circulation. Feel of the abdomen is tense or at times cystic.
Liver may be palpable. Spleen is palpable 6-8 cms(35%-50%), soft to firm in feel. Fluid thrill and shifting dullness are present and indicate ascites.
Other features: Apex beat is displaced upwards due to ascites and there may be a soft systolic murmur over the mitral and pulmonary area. There may be hydrothorax. Gynaecomastia, testicular atrophy, falling of pubic and axillary hairs may also be seen due to lack of detoxification of oestrogen in the liver. Other changes include Dupuytren's contracture, parotid enlargement, clubbing of fingers and toes, white and shiny nails(mirror nails), central cyanosis, retraction of eyelids.
Investigations:
.Identifiable symptoms
.Physical examination
.CAT scan(computerized axial tomography)
.Ultrasound
.Radioisotope liver/spleen scan
.Liver biopsy
Definition: This is a condition of the destruction of the hepatic cell, disruption of hepatic architecture, overgrowth of fibrous tissue, the proliferation of the remaining cells associated with features of progressive hepatocellular failure, portal hypertension and portosystemic shunting arising out of diverse aetiology. Cirrhosis is a condition that results from permanent damage or scarring of the liver. This leads to a blockage of blood flow through the liver and prevents normal metabolic and regulatory processes.
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what are the major causes of cirrhosis?
causes of cirrhosis are as follows:
.Chronic alcoholism
.Viral infection caused by chronic viral hepatitis (type B, C and D)
.Metabolic diseases such as alpha-1 antitrypsin deficiency, galactosemia, and glycogen storage disorders.
.Inherited diseases such as Wilson disease and hemochromatosis
.Biliary cirrhosis resulting from diseases such as primary biliary cholangitis (PSC) and primary sclerosing cholangitis(PSC)
.Toxic hepatitis caused by the severe reaction to prescribed drugs or prolonged exposure to environmental toxins.
.Repeated bouts of heart failure with liver congestion.
Nutrition: Dietetic deficiency of lipotropic factors results in accumulation of fat in the liver cells and this ultimately leads to hepatic fibrosis.However, the cause and effect relationship of these factors is still unsettled. Indian childhood cirrhosis is a special type in this category.
Chronic alcoholism: This is an important cause of cirrhosis in a temperate climate. Directly, it is responsible for hepatocellular damage and indirectly hepatic damage is produced by the associated deficiency of lipotropic factors and a high-calorie diet. Mallory bodies or alcoholic-hyaline is very suggestive of alcoholic cirrhosis and micronodular cirrhosis usually develops.
Posthepatitic and postnecrotic cirrhosis: Hepatitis B, Hepatitis c. Hepatitis D may lead to this type of cirrhosis. Almost all cases of chronic active hepatitis lead to cirrhosis.
Metabolic disorder and inherited disorders: Cirrhosis may develop in cases of Haemochromatosis (Bronze diabetes), Kinnier Wilson's disease, Glycogen storage disease(Type iv), a Fibrocystic disease of the pancreas Alpha-antitrypsin deficiency, Fanconi syndrome, Galactosaemia and in various others.
Pathology: After necrosis and disintegration of liver cells the reticulin framework collapses thereby portal and central zones are approximated. Fibrous septae develop in the portal zones and proceed towards lobular parenchyma dissecting them into various sizes. In the meantime, some cells regenerate to form nodules of various sizes giving a macroscopic appearance of a macronodular, micronodular or mixed type of cirrhosis. Gradually portal hypertension develops due to increased intrahepatic vascular resistance. This increased resistance is due to compression of a vessel by fibrous tissue. Ultimately from portal hypertension, oesophagogastric varices, splenomegaly with or without hypersplenism, ascites and spontaneous bacterial peritonitis develop. Apart from portal hypertension, ascites may develop from other causes also like low COT, increased sodium retention by kidney due to hyperaldosteronism, increased sympathetic activity, altered renal hemodynamics, production of hepatic and splanchnic lymph giving rise to lymphorrhea, non-absorption of water and lymph by the peritoneal lymphatics and impaired renal water excretion by high ADH.
What are some early symptoms of cirrhosis?
people in the early stages of cirrhosis have few symptoms. Some symptoms an individual ma notice include:
Loss of appetite, nausea, weight loss, fatigue, weakness, exhaustion.
1.Anoresia, nausea, vomiting, flatulence.
2.Gradual weakness, fatiguability, and weight loss.
3. Gradual swelling of the abdomen and feet.
4.Haematemesis (15%-25%) and melaena from ruptured esophageal varices.
5.Abdominal pain either due to ascites or due to stretching of Glison's capsule due to enlargement of the liver.
6.Bleeding piles.
7.Diarrhea or constipation.
8.Amenorrhoea in females.
9. Loss of libido, sterility, impotence, gynaecomastia.
Signs: Age above 30 years usually.
Facies: Hepatic facies is present, This consists of sunken eyes, prominence of malar bones, icteroid conjunctivae, a muddy complexion of the face and spider angioma. Anaemia is present.
Jaundice is usually absent but may be prominent if there is cholestasis or chronic active hepatitis.
Palmar erythema and spider angioma may be present. These are traditionally attributed to excess oestrogen in the circulating blood. However, their presence and absence may not be correlated with oestradiol level in blood. Spider angioma is best observed in the upper part of the chest especially in the necklace area.
Oedema is present, pitting in type. This is due to low protein level, an excess of aldosterone and antidiuretic hormones in the blood, the pressure of ascitic fluid over inferior vena cava and low glomerular filtration rate. Cutaneous haemorrhages may be present due to hypoprothrombinemia. Fever may be present in 35% of cases due to secondary infection particularly tuberculous peritonitis or due to spontaneous infection of an ascitic sac.
Cyanosis may be present in more than 30% cases due to hypoxaemia.
Alimentary System: Tongue is pale and dry, it may be red due to avitaminosis or glossitis. Abdomen is bloated, flanks are more bulged, umbilicus is everted. Abdominal veins are prominent particularly in the epigastric region and they drain away from the umbilicus. These are the result of collateral circulation. Feel of the abdomen is tense or at times cystic.
Liver may be palpable. Spleen is palpable 6-8 cms(35%-50%), soft to firm in feel. Fluid thrill and shifting dullness are present and indicate ascites.
Other features: Apex beat is displaced upwards due to ascites and there may be a soft systolic murmur over the mitral and pulmonary area. There may be hydrothorax. Gynaecomastia, testicular atrophy, falling of pubic and axillary hairs may also be seen due to lack of detoxification of oestrogen in the liver. Other changes include Dupuytren's contracture, parotid enlargement, clubbing of fingers and toes, white and shiny nails(mirror nails), central cyanosis, retraction of eyelids.
Investigations:
.Identifiable symptoms
.Physical examination
.CAT scan(computerized axial tomography)
.Ultrasound
.Radioisotope liver/spleen scan
.Liver biopsy
Top Natural Homeopathic Remedies for Cirrhosis of Liver:
Chelidonium:
Chelidonium is the pain in liver under right shoulder blade with jaundice symptoms. The jaundice symptoms include yellow skin, yellow urine and yellow or white-colored stool and yellow-coated tongue. Desire for extremely hot drinks is noted in patients needing Chelidonium.
Arsenic Album: Homeopathic medicine for Liver cirrhosis with fatigue and weight loss.
Natura homeopathic medicine Arsenic Album is of great help for patients with liver cirrhosis who experience fatigue as the main symptom. The patient feels totally exhausted from doing a little labour. He or she goes on losing weight due to debilitating effects of cirrhosis of the liver. Arsenic album os also the homeopathic remedy for patients who experience nausea and vomiting of blood. Along with vomiting, burning in the abdomen is a characteristic feature pointing towards the use of Arsenic album. Vomiting follows drinking and eating. The liver region feels painful.Ascites, or accumulation of fluid in the abdomen, can also be dealt with by homeopathic remedy Arsenic album, thought the general symptoms of fatigue and burning in abdomen should match too.
Cardus Marianus: Cardus Marianus is among the top natural Homeopathic medicines for treating cirrhosis of liver. It covers a wide range of symptoms that can be relieved with its use. The first condition calling for its use is jaundice. The second is a dropsiacl accumulation of water in abdomen.The next field sensitiveness are experienced by most patients needing Cardus Marianus.This Homeopathic medicine is also beneficial for patients who feel fatigued or tired and have bouts of nausea and vomiting due to liver cirrhosis. Abuse of alcoholic drinks is usually among persons needing homeopathic remedy Cardus Marianus.
Lycopodium: Is a natural homeopathic medicine for treating cirrhosis of liver when the liver has atrophied due tp longstanding cirrhosis. The liver region is sensitive. Hepatitis may be predominantly present. Dropsical conditions consequent to liver cirrhosis respond very well to homeopathic remedy Lycopodium. Therefore lycopodium is considered as one of the best remedies for patients of cirrhosis who have a loss of appetite. Eating a small quantity of food brings satisfaction.Auch a patient feels fullness in abdomen from eating a small quantity of food. Bloated feeling in abdomen and gas in abdomen remains a constant feature. Lycopodium can also help provide relief in the general condition of patients who have lost weight, and have become emaciated and thin under the effects of cirrhosis of liver. The patients needing lycopodium may have an increased desire for hot drinks, hot food or sweets.
Phosphorus: Phosphorus is a beneficial natutral homeopathic medicine for treating jaundice in patients with cirrhosis of liver. The symptoms of jaundice are the yellow appearance of skin, and passage of stool of a very offensive nature. Weakness follows the passage of stool. The second sphere where phosphorus is a homeopathic remedy of grat help is vomiting of blood. Phosphorus has an excellent effect in controlling the blood appearing in vomitus. Apart from these symptoms, the desire for cold drinkd,juice and ice creams is usually present in patients needing phosphorus.
Homeopathic remedies for cirrhosis of liver with an accumulation of fluid in abdomen:
Arsenic Album: Homeopathic medicine for Liver cirrhosis with fatigue and weight loss.
Natura homeopathic medicine Arsenic Album is of great help for patients with liver cirrhosis who experience fatigue as the main symptom. The patient feels totally exhausted from doing a little labour. He or she goes on losing weight due to debilitating effects of cirrhosis of the liver. Arsenic album os also the homeopathic remedy for patients who experience nausea and vomiting of blood. Along with vomiting, burning in the abdomen is a characteristic feature pointing towards the use of Arsenic album. Vomiting follows drinking and eating. The liver region feels painful.Ascites, or accumulation of fluid in the abdomen, can also be dealt with by homeopathic remedy Arsenic album, thought the general symptoms of fatigue and burning in abdomen should match too.
Cardus Marianus: Cardus Marianus is among the top natural Homeopathic medicines for treating cirrhosis of liver. It covers a wide range of symptoms that can be relieved with its use. The first condition calling for its use is jaundice. The second is a dropsiacl accumulation of water in abdomen.The next field sensitiveness are experienced by most patients needing Cardus Marianus.This Homeopathic medicine is also beneficial for patients who feel fatigued or tired and have bouts of nausea and vomiting due to liver cirrhosis. Abuse of alcoholic drinks is usually among persons needing homeopathic remedy Cardus Marianus.
Lycopodium: Is a natural homeopathic medicine for treating cirrhosis of liver when the liver has atrophied due tp longstanding cirrhosis. The liver region is sensitive. Hepatitis may be predominantly present. Dropsical conditions consequent to liver cirrhosis respond very well to homeopathic remedy Lycopodium. Therefore lycopodium is considered as one of the best remedies for patients of cirrhosis who have a loss of appetite. Eating a small quantity of food brings satisfaction.Auch a patient feels fullness in abdomen from eating a small quantity of food. Bloated feeling in abdomen and gas in abdomen remains a constant feature. Lycopodium can also help provide relief in the general condition of patients who have lost weight, and have become emaciated and thin under the effects of cirrhosis of liver. The patients needing lycopodium may have an increased desire for hot drinks, hot food or sweets.
Phosphorus: Phosphorus is a beneficial natutral homeopathic medicine for treating jaundice in patients with cirrhosis of liver. The symptoms of jaundice are the yellow appearance of skin, and passage of stool of a very offensive nature. Weakness follows the passage of stool. The second sphere where phosphorus is a homeopathic remedy of grat help is vomiting of blood. Phosphorus has an excellent effect in controlling the blood appearing in vomitus. Apart from these symptoms, the desire for cold drinkd,juice and ice creams is usually present in patients needing phosphorus.
Homeopathic remedies for cirrhosis of liver with an accumulation of fluid in abdomen:
Ascites or the accumulation of fluid is a common complication of liver cirrhosis.To deal with ascites, natural homeopathic medicines Apocynum Cannabinum, Quassia and cardus marianus are effective remedies.The features that help in selecting the best homeopathic medicine for the patients out of these three are the characteristic symptoms of each individual.
For selecting apocynum cannbinum, the symptoms to be considered are bloated abdomen with a weak and slow pulse. Other leading symptoms include an incresaed thirst for water. Difficulty in breathing and pressure in the chest may also appear. Intolerance to food and water with immediate ejection in form of vomiting also experienced by patients of liver cirrhosis who can benefit by homeopathic medicine Apocynum Cannabinum. Homeopathic remedy quassia is the ideal choice when ascites is accompanied by pain in liver and acidity.
Cardus Marianus: Is the best homeopathic remedy for persons who have jaundice or bleeding accompanies ascites.
Chelidonium,phosphorus and Cardus Marianus:All these three are significant natural homeopathic medicine for dealing with jaundice in patients with liver cirrhos.The sumptoms that help in picking homeopathic remedy chelidonium is the pain in liver under right shoulder blade with jaundice symptoms. The jaundice symptoms include yellow skin, yellow urine and yellow or white-colored stool and yellow-coated tongue. Desire for extremely hot drinks is noted in patients needing chelidonium. Homeopapathic medicine phosphorus is of great help when the stool of very offinsive nature is passed, along with appearance of a yellow skin. In contrast to chelidonium, patients needing phosphorus have a desire for cold drinks.In contrast to chelidonium, patients needing phosphorus have a desire for cold drinks.Cardus marianus offers the natrual homeopathic treatment when jaundice with bright yellow stool, liver pain and fluid retention in abdomen is experienced by a patients of liver cirrhosis.
Phosphorus and Crotalus Horridus: Homeopathic medicines for blood vomiting in cirrhosis Liver: The vomiting of blood is a result of varices in the oesophagus.Phosphorus is the natural homeopathic remedy when the vomitus contains bright red blood.Desire for cold drinks may be present. When the blood is dark coloured like blackish or coffee color-like, homeopathic medicine crotalus horridus offers the ideal mode of treatment.
Homeopathic medicines for Alcoholic Cirrhosis of Liver: Alcohol abuse remains the most important cause of liver cirrhosis.Homeopathy has various effective natural medicines to deal with cirrhosis of liver as a result of alcoholic abuse. Nux vomica, cardus marianus, arsenic album, and fluoric acid are very effective homeopathic remedies for liver problems.The ideal natural homeopathic remedy is selected after proper case taking of the patient and is based on the based on the characteristic individual symptoms.
Homeopathic medicines for Alcoholic Cirrhosis of Liver: Alcohol abuse remains the most important cause of liver cirrhosis.Homeopathy has various effective natural medicines to deal with cirrhosis of liver as a result of alcoholic abuse. Nux vomica, cardus marianus, arsenic album, and fluoric acid are very effective homeopathic remedies for liver problems.The ideal natural homeopathic remedy is selected after proper case taking of the patient and is based on the based on the characteristic individual symptoms.
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