Cirrhosis

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Latest Edit: Hector 2014-2-18 (EDT)

Cirrhosis refers to a chronic disease of the liver, characterized by fibrosis (thickening and scarring of connective tissue). Cirrhosis leads to portal hypertension and insufficiency of the liver. Most cases develop due to excessive alcohol consumption leading to liver disease or chronic viral infection. Since liver cirrhosis is a precancerous condition, all patients have an increased risk of developing hepatocellular carcinoma.[1] Many cases are asymptomatic and often undiagnosed. Approximately 30-40% of cases are discovered at autopsy.[2]

Contents

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With cirrhosis, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to Cirrhosis.

Lifestyle

  • Long-term alcohol use damages the liver and predisposes to liver disease and cirrhosis.[3]
  • Drinking coffee might actually be protective against the development of cirrhosis.[4]

Environmental

  • Infection with Hepatitis B, Hepatitis C virus, or Schistosoma japonicum can trigger development of liver cirrhosis.[5]

External

Medical Interventions

  • Prescription Medications
  • Some prescription medications can increase the risk of developing cirrhosis such as Methotrexate, Isoniazid, Methyldopa

Genetics

  • Having a hereditary liver condition such as, hemochromatosis increases risk of developing cirrhosis
  • Sex
  • Women have a higher susceptibility to alcohol-induced liver diseases including cirrhosis.[7]

Common Questions

  • Do you ever experience abdominal pain?
  • Can you point to where the pain is felt?
  • How much alcohol do you consume?
  • What medications are you currently taken or have you taken in the past?
  • Have you ever been diagnosed with Hepatitis B or C
  • Do you ever feel itchy?
  • Do you have a history of an autoimmune condition?
  • Ever been diagnosed with inflammatory bowel disease?
  • Do you have a family history of liver disease?
  • Hemochromatosis, Wilson disease, α1-antitrypsin deficiency?

Diagnostic Testing

  • Liver biopsy is the gold standard for diagnosis
  • Diagnosis is based on 3 criteria: diffuse disease, fibrosis, and abnormal nodules.[2]
  • However Cirrhosis is often diagnosed clinically with an appropriate history and findings that suggest end-stage liver disease.

Related Symptoms and Conditions

The risk or occurrence of cirrhosis is associated with the presence of the following conditions:

  • Ascites
  • Hepatic encephalopathy
  • Variceal bleeding
  • Hepatorenal syndrome
  • Portal hypertension
  • Hypoalbuminemia
  • Thrombocytopenia
  • Nonalcoholic fatty liver disease (NAFLD)
  • nonalcoholic steatohepatitis (NASH)
  • Diabetes Mellitus
  • Of those with Liver Cirrhosis, approximately 30% also have Diabetes Mellitus.[8]
  • Disorders of the drainage system of the liver (the biliary system), such as primary biliary cirrhosis and primary sclerosing cholangitis
  • Obstruction of the biliary system can lead to the development of cirrhosis
  • Autoimmune liver conditions
  • Metabolic disorders of iron and copper (hemochromatosis and Wilson's disease)

Characteristics

Common Symptoms

Many patients may be asymptomatic, some common symptoms which may occur include:[9]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Cirrhosis is typically a chronic disease. From a conventional medical perspective, cirrhosis is considered to be an irreversible process. In some cases, disease progression can be halted by abstaining from alcohol, eliminating viral infections or addressing any other underlying causal factors.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Stop consuming alcohol and/or recreational drugs.
  • Practice safe sex to minimize risk of viral transmission.

Lifestyle

Lifestyle recommendations include:

  • Consume 1.0 - 1.8 g/kg body weight/day of protein, especially plant protein.[10]
  • Ensure you drink adequate water.

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies. Therapy may be different depending on the origin of the cirrhosis.

Naturopathic Therapies for Cirrhosis include:

  • Homeopathics may prove helpful in the treatment of cirrhosis.

References

  1. Schuppan D, Afdhal NH (2008 Mar) Liver cirrhosis Lancet; Vol371(9615):838-51 PMID: 18328931.
  2. 2.0 2.1 Anand BS (1999 Aug) Cirrhosis of liver West J Med; Vol171(2):110-5 PMID: 10510657.
  3. Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, Roerecke M (Jul 2010) Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev;29(4):437-45. PMID: 20636661.
  4. Muriel P, Arauz J (Jul 2010) Coffee and liver diseases Fitoterapia;81(5):297-305. PMID: 19825397.
  5. Williams EJ, Iredale JP (1998 Apr) Liver cirrhosis Postgrad Med J; Vol74(870):193-202 PMID: 9683971.
  6. Smyk DS, Rigopoulou EI, Muratori L, Burroughs AK, Bogdanos DP (Jan-Feb 2012) Smoking as a risk factor for autoimmune liver disease: what we can learn from primary biliary cirrhosis. Ann Hepatol;11(1):7-14. PMID: 22166556.
  7. Corrao G, Aricò S, Zambon A, Torchio P, Di Orio F (Nov 1997) Female sex and the risk of liver cirrhosis. Collaborative Groups for the Study of Liver Diseases in Italy. Scand J Gastroenterol;32(11):1174-80. PMID: 9399401.
  8. Garcia-Compean D, Jaquez-Quintana JO, Gonzalez-Gonzalez JA, Maldonado-Garza H (2009 Jan) Liver cirrhosis and diabetes: risk factors, pathophysiology, clinical implications and management World J Gastroenterol; Vol15(3):280-8 PMID: 19140227.
  9. Kumar R, Abbas A, DeLancey A, Malone E (2010) Robbins and Cotran Pathologic Basis of Disease. Eighth Edition. Saunders Elsevier.
  10. 10.0 10.1 Gaby AR (2011) Nutritional Medicine. Fritz Perlberg Publishing.
  11. Hoffman D (2003) Medical Herbalism: The Science Principles and Practices Of Herbal Medicine. Healing Arts Press.
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