Alcoholic Liver Disease

Author: Dr. Veena

Alcoholic Liver Disease: An Overview

Alcohol consumption is associated with social, psychological, and physical problems and constitutes harmful use. Alcohol misuse is evident in a patient’s history, even though the patient may minimize their intake of alcohol. Chronic alcohol misuse can lead to medical consequences, including hepatic fatty changes, cirrhosis of the liver, and liver cancer. Other harmful effects also occur on the respiratory, reproductive, musculoskeletal, skin, and gastrointestinal systems. However, this article will specifically discuss alcoholic liver disease.

The most common cause of chronic liver disease is excessive alcohol intake. Not every person who drinks heavily will develop liver disease. In the U.K., mortality from alcoholic liver disease is rising, with over 3,000 deaths per year.

Ref: Davidson’s Principles and Practice of Medicine.

Risk Factors for Alcoholic Liver Disease:

Drinking Pattern: Liver damage mostly occurs in continuous drinkers rather than binge drinkers.
Gender: Women have higher blood ethanol levels than men after drinking due to lower body mass, making women more susceptible to alcoholic liver disease.
Genetics: It occurs more frequently in monozygotic twins than in dizygotic twins.
Nutrition: Animals given a choline-deficient diet are more likely to develop alcoholic liver disease.
Diet: A deficiency of vitamins A and E can worsen alcohol-induced liver damage as it prevents the regeneration of hepatocytes.

Clinical Features:

In alcoholic liver disease, the liver becomes enlarged, even in the presence of cirrhosis.

Types of Alcoholic Liver Disease:

Fatty Liver Disease: Also known as steatosis, it involves fatty degeneration of the liver. It is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells. It has a good prognosis and usually disappears if the patient abstains from alcohol.
Alcoholic Hepatitis: This condition involves jaundice and liver enlargement, with complications such as portal hypertension. Alcoholic hepatitis is characterized by the inflammation of hepatocytes. Patients with acute alcoholic hepatitis often deteriorate during the first 1–3 weeks in the hospital. Even if the patient abstains, it may take up to 6 months for jaundice to resolve. The 3- and 5-year survival rates for patients who abstain from alcohol are 70%. In contrast, those who continue to drink have 3- and 5-year survival rates of 60% and 34%, respectively. Ref: Davidson’s Principles and Practice of Medicine.
Alcoholic Cirrhosis: Alcohol-induced cirrhosis can lead to serious complications such as ascites and hepatocellular carcinoma. Palmar erythema is more common in alcoholic cirrhosis than in cirrhosis due to other causes.

Management:

Cessation of alcohol consumption and cigarette smoking is the most important treatment. Without abstinence from alcohol, the situation will worsen, and other therapies will be of limited value. In the case of cirrhosis, abstinence is essential to prevent the progression of liver disease and death. Those with severe liver disease must maintain lifelong abstinence. General health and life expectancy can improve if the patient stops drinking alcohol.

Before taking herbal medicines, please consult your doctor first.

Herbs Useful for Treating Liver Diseases:

Kutki (Picrorrhiza kurroa, E: Picrorhiza)
Trikatu
Punarnava (Boerhaavia diffusa, E: Spreading hogweed)
Kalmegh (Andrographis paniculata, E: Kalmegh)
Bhringraj (Eclipta alba)
Bhumiamalaki (Phyllanthus urinaria)
Yashtimadhuk (Glycyrrhiza glabra, E: Liquorice)
Guduchi (Tinospora cordifolia)
Daruharidra (Berberis aristata, E: Indian Barberry)
Kakamachi (Solanum nigrum, E: Black nightshade)
Sharpunkha (Tephrosia purpurea, E: Wild indigo, Purple tephrosia)
Yellow Dock

Milk Thistle (Silybum marianum): The U.S. Agency for Health Care Research and Quality has found that milk thistle has the best effects in the early stage of cirrhosis. Flavonoids like silymarin present in this herb help protect against liver damage caused by toxins and drugs. Its anti-inflammatory and antioxidant effects may aid in repairing liver damage.

Kalmegh (Andrographis paniculata): Treats cirrhosis of the liver.

Ref: Agarwal, A. (1999), Therapeutic efficacy of AV/LTP/15 in hepatic dysfunction in dogs, Indian Vet. Med. J., Vol. 23 (3), pp. 245-247.

Punarnava (Boerhavia diffusa): Treats cirrhosis of the liver.

Ref: De, S.; Ravishankar, B. & Bhavsar, G.C. (1993), Plants with hepatoprotective activity - A review, Indian Drugs. Vol. 30 (8), pp. 355-363.

Ginseng: Helps the growth of certain glandular cells in the liver, aiding in healing. However, more studies and clinical research are required.

Green Tea: Useful in treating cirrhosis of the liver as it contains vitamin K.

Turmeric (Curcuma longa): Helps eliminate toxins from the body, preventing liver damage.

Licorice Root (Glycyrrhiza glabra): Can treat liver diseases, but patients with high blood pressure should avoid it.

Nutrition:

Good nutrition is very important.

Natural Home Remedies:

Extract juice from crushed onion and fresh lemon juice. Take this on an empty stomach in the morning.
Extract juice from crushed papaya seeds and add double the quantity of lemon juice. Mix thoroughly and drink this twice daily.
Add one-fourth teaspoon of cumin powder to buttermilk, along with a pinch of salt. Drink this buttermilk twice daily.
Add a pinch of salt to one glass of lemon juice. Mix well and drink this twice daily.
Extract juice from spinach and carrot, mix thoroughly, and drink this twice daily.

(For the quantity of the ingredients for the aforementioned home remedies, contact the author.)

Take light and easily digestible, highly nutritious food. Fresh fruits and vegetables are recommended.

Eggplant (Solanum melongena): Some authors state that this plant is rich in potassium, phosphorus, and magnesium. It stimulates bile flow, helps lower increased cholesterol levels, and is also useful in treating obesity.

In cases of fatty liver, there is already a problem breaking down fats in the liver, which is why fat accumulates. Avoid foods high in saturated fats. Vitamin E and C are highly beneficial for patients with fatty liver disease.

Ref: A study published in the Turkish Journal of Gastroenterology in Sept. 2005.

Fresh lemon juice is advisable. Vitamin A in beta carotene helps detoxify the liver. An excess amount of vitamins and minerals may cause health problems, so take them with a doctor's consultation and source them from foods alone.

Avoid:

Raw seafood
Large amounts of protein at one time
Non-steroidal anti-inflammatory drugs and aspirin
Alcohol intake
Smoking
Herbal supplements containing valerian root or kava kava
Meat, white rice, white flour, processed food, etc.

Granthokta Preparation:

Arogyavardhini
Kumari Asav

Though I have mentioned the quantity of ingredients in some natural home remedies, it is advisable to take the quantity and natural home remedies with the consultation of an Ayurvedic physician or doctor.