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Cirrhosis

Cirrhosis

Description

Cirrhosis is a chronic and irreversible condition in which liver cells are progressively destroyed. As the cells undergo necrosis, the liver attempts to regenerate itself. The necrotic cells are replaced by new ones, but also by extensive connective tissue. Liver structure is altered so much that the flow of lymph and blood through this organ is much less efficient; the liver eventually stops functioning.

Cirrhosis affects twice as many males as females.

The primary treatment is to remove the underlying cause. This can involve eating a well balanced diet and abstinence from ethyl alcohol. Rest, frequent and small meals, and avoiding infection aid recovery.

Causes

There are many causes of cirrhosis but the most common is alcoholism. Other causes are:

Sudden and massive infection
Hepatitis
Malnutrition
Inborn errors in physical or chemical processes
Hemachromatosis
Syphilis
Obstruction of liver bile ducts which may be due to stones, inborn errors, and tumors
Medications such as anticancer drugs and anesthetics
Enema
Heart disorders which obstruct the flow of blood

Signs & Symptoms

There are many signs and symptoms of cirrhosis, some of which are:

Early Symptoms

WeaknessMalaise
AnorexiaWeight loss
Loss of sexual interestAbdominal ache
NauseaDiarrhea
ConstipationIndigestion



Late Symptoms

FeverInflamed tongue
Breathing difficultiesBleeding in esophagus or stomach
VomitingVomiting of blood
Hemorrhage of bleeding tendenciesEnlarged and firm liver
Enlarged spleenJaundice
Diminishing testesLoss of pubic and chest hairs
Irregularities of menstruationGynecomastia
Musty breathMuscle atrophy
Zinc deficiency Vitamin K deficiency
ObtundationComa
Peripheral neuritisAsterixis
Enlarged superficial abdominal veins"Spider veins" on skin of the upper body
Tingling sensation in the skin of the hands and feetRedness of the mound of the palm at the base of the thumb



Mental changes
Slurred speech
Paranoia

Nutritional Supplements

Structure & Function:
        Detoxification &
        Antioxidants


---------------------------------
General Supplements
---------------------------------

AdultChild/Adolescent
Choline 100 - 500 mg n/a
EPO*
Inositol 100 - 500 mg n/a
Lecithin*
Manganese 5 - 10 mg n/a
Quercetin*
Rutin*
Selenium 50 - 300 mcg n/a
Vitamin B-6 25 - 100 mg n/a
Vitamin B-9 400 - 800 mcg n/a
Vitamin B-12 100 - 500 mcg n/a
Vitamin C1,000 - 3,000 mg n/a



* Please refer to the respective topic for specific nutrient amounts.

Notes:

Lecithin (or its derivatives, like phosphatidylserine) are helpful, especially if the condition derives from alcohol abuse.

Antioxidant usage is heavily promoted, ranging from bioflavonoids like Quercetin and Rutin to superior antioxidants like Proanthocyanidins (Pycnogenol™).

One leading product, from the plant kingdom, is milk thistle (Silymarin).

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

Cirrhosis with encephalopathy must be managed with a Low Protein Diet. The encephalopathy indicates that the sick liver is unable to clear toxic amines from the system. Additional dietary protein would cause further liberation of these amines.

Advanced cases of cirrhosis with encephalopathy require that proteins be completely withheld from the diet.

Homeopathic Remedy

1.*Mercurius Vivus                30C
2. Hydrastis canadensis        30C
3. Hepar sulphuris calcareum        30C
4.*Mercurius dulcis                15C

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

----------
Herbs
-----------


Dandelion Root (Taraxacum officinale)
Ginseng
Gotu kola
Milk thistle (silymarin)

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Dandelion Root is considered to be a specific antioxidant for the liver.

Ginseng is reputed to heal internal scarring.

Gotu kola has proven effective against alcohol-induced and idopathic cirrhosis but not chronic hepatitis. (Darnis, 1979)

Currently, a single herb, milk thistle (silymarin) is being used [70 - 210 mg t.i.d.], although it may form part of a combined therapy, including castor oil poultices and homeopathy. Silymarin can improve immune function in patients with cirrhosis. (Deak, 1990)

The German Commisssion E recommends Milk thistle fruit, exclusively, for cirrhosis of the liver.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Darnis, F et al., Use of a titrated extract of Centella asiatica in chronic hepatic disorders. Semin. Hosp. Paris, 1979, 55:1,749-1,750.

Deak, G et al., Immunomodulator effect of silymarin therapy in chronic alcoholic liver disease. Orv. Hetil. 1990, 131:1,291-1,292, 1,295-1,296.

Ferenci, P. et al., Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J. Hepat. 1989, 9:105.



Aromatherapy - Essential Oils

Garlic Essence,Ginger Essence.


Related Health Conditions

AlcoholismAnorexia
BleedingCancer
ComaConstipation
DiarrheaHeart disorders
HemorrhageHepatitis
IcterusIndigestion
InfectionMalnutrition
MenstruationParanoia
SyphilisTumors
Vomiting



Abstracts

References

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Bories-P.N. & Campillo-B.: One-month regular oral nutrition in alcoholic cirrhotic patients. Changes of nutritional status, hepatic function and serum lipid pattern. Br-J-Nutr. 1994 Dec; 72(6): 937-46.

Cabr? E & Gassull MA: Nutritional support in liver disease. Eur J Gastroenterol Hepatol, 1995 Jun, 7:6, 528-32.

Cabr? E & Gassull MA: Polyunsaturated fatty acid deficiency in liver diseases: pathophysiological and clinical significance. Nutrition, 1996 Jul-Aug, 12:7-8, 542-8.

Caregaro L et al., Malnutrition in alcoholic and virus-related cirrhosis. Am J Clin Nutr, 1996 Apr, 63:4, 602-9.

Caregaro L et al., Nutritional and prognostic significance of insulin-like growth factor 1 in patients with liver cirrhosis [see comments]. Nutrition, 1997 Mar, 13:3, 185-90.

Chandra S & Mehendale HM: Nutritional modulation of the final outcome of hepatotoxic injury by energy substrates: an hypothesis for the mechanism. Med Hypotheses, 1996 Mar, 46:3, 261-8.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide, William Morrow and Company Inc., Pub. 594 pp.

Chicago Dietetic Assoc & the South Suburban Dietetic Assoc of Cook & Will Counties. 1981. Manual of Clinical Dietetics. Saunders Co., Philadephia.

Conn, H.O. 1983. Nutritional management of advanced liver disease. In Nutritional Support of the Seriously Ill Patient. R.W. Winters and H.L. Greene, eds. Academic Press, New York.

Corrao G et al., Exploring the role of diet in modifying the effect of known disease determinants: application to risk factors of liver cirrhosis. Am J Epidemiol, 1995 Dec 1, 142:11, 1136-46.

de la Maza MP et al., Effects of long-term vitamin E supplementation in alcoholic cirrhotics. J Am Coll Nutr, 1995 Apr, 14:2, 192-6.

de-la-Rubia-MA et al: [The assessment of the nutritional status of patients in the terminal stage of liver disease who are candidates for orthotopic liver transplantation]. Nutr-Hosp. 1994 May-Jun; 9(3): 163-9.

Eagles, J.A. & M.N. Randall. 1980. Handbook of Normal and Therapeutic Nutrition. Raven Press, New York. 323 pp.

Feinman, L. & Lieber, C.S. Nutrition and Liver Disease, Hospital Medicine, April 1990;150-166.

Frezza, M. et al: Oral S-Adenosylmethionine in The Symptomatic Treatment of Intrahepatic Cholestasis: A Double-Blind Placebo Controlled Study. Gastroenterology, 1990;99:211-215.

Goldbaum, J.S. Vitamin C in the Use of Megascorbate Therapy in General Medicine. Austalas Nurses Journal, 11 1982.

Guler-AH et al: Effect of copper on liver and bone metabolism in malnutrition. Turk-J-Pediatr. 1994 Jul-Sep; 36(3): 205-13.

Hamilton, H.K. ed. 1982. Professional Guide To Diseases Intermed Communications Inc. Pub, Springfield, Massachusetts. 1323 pp.

Hegsted, M.D. 1976. Present Knowlege In Nutrition. 4th ed. The Nutrition Foundation Pub., Washington D.C. 605 pp.

Heinerman, John, Ph.D.. 1982. Herbal Dynamics. Root of Life, Inc.: Publ.

Hikino, H. Antihepatotoxic constituents of Chinese drugs. Chin Pharm Bull 20 (1985): 415-417.

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Kirschmann, J.D. 1990. Nutrition Almanac: Nutrition Search. McGrew-Hill: New York.

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Linder, M.C. Other Trace Elements and the Liver. Semin. Liver Disease, 4 1984.

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Muller-MJ et al: Metabolism of energy-yielding substrates in patients with liver cirrhosis. Clin-Investig. 1994 Aug; 72(8): 568-79.

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