Diagnosis:
The diagnosis of cirrhosis is usually based on the presence of a risk factor for cirrhosis, such as alcohol use or obesity, and is confirmed by physical examination, blood tests, and imaging. The steps in making the diagnosis of cirrhosis will include medical analysis of the following:
During a physical examination the health care provider may find:
- An enlarged liver or spleen
- Excess breast tissue
- Expanded (distended) abdomen, as a result of too much fluid
- Reddened palms
- Red spider-like blood vessels on the skin
- Small testicles
- Widened (dilated) veins in the abdomen wall
- Yellow eyes or skin (jaundice)
The following Blood Tests can reveal liver problems:
- Aminotransferases – AST and ALT are moderately elevated, with AST > ALT. However, normal aminotransferases do not preclude cirrhosis.
- Alkaline phosphatase – usually slightly elevated.
- Gamma-glutamyl transferase – correlates with AP levels. Typically much higher in chronic liver disease from alcohol.
- Bilirubin – may elevate as cirrhosis progresses.
- Albumin – levels fall as the synthetic function of the liver declines with worsening cirrhosis since albumin is exclusively synthesized in the liver
- Prothrombin time – increases since the liver synthesizes clotting factors.
- Globulins – increased due to shunting of bacterial antigens away from the liver to lymphoid tissue.
- Serum sodium – hyponatremia due to inability to excrete free water resulting from high levels of ADH and aldosterone.
- Thrombocytopenia – due to both congestive splenomegaly as well as decreased thrombopoietin from the liver. However, this rarely results in platelet count < 50,000/mL.
- Leukopenia and neutropenia – due to splenomegaly with splenic margination.
- Coagulation defects – the liver produces most of the coagulation factors and thus coagulopathy correlates with worsening liver disease.
The following tests may be used to evaluate the liver:
- Ultrasound of the abdomen
- CT scan or MRI (MRCP) scan
- Laparoscope
- Endoscopy to check for abnormal veins in the oesophagus or stomach
- Radioisotope liver/spleen scan
- A liver biopsy confirms cirrhosis. Some patients will be screened for liver cancer.
Ayurveda Management
The liver is called Yakrit in Ayurveda. Pitta is the predominant humour of the liver. Most liver disorders are aggravated by conditions of Pitta. Excessive bile production or a blockage in the flow of bile usually indicates high pitta, which in turn affects the Agni or enzyme activities responsible for absorption, digestion and metabolism.
Kumbha Kamala is the classical description if cirrhosis of the liver in Ayurveda.
“|| Kaalantarath khareebhutah kruchrasyaat khumba Kamala ||”
It is a neglected or untreated stage of jaundice or hepatitis, when becomes chronic, produces dry or roughness to the Liver (kharathva or rookshatva). It can become incurable if not attended immediately.
At Bhagwati Ayurveda, we are providing highly effective treatment for Liver Cirrhosis. Our treatment involves Shodana chikitsa (detoxification through Panchakarma procedures), Shamana chikitsa (Palliative researched Ayurvedic medicines) and Kayakalpa (rejuvenation). Our treatment is useful in improving the liver heath and preventing further damage.
Diet restrictions, lifestyle modifications and de-addiction are also the essential factors practised for the best possible results.