Common liver disorders and their homoeopathic management
The liver is the largest organ of the body. It is functionally most complex organ. It has multiple life-saving functions like metabolism both anabolic and catabolic. It is responsible for detoxification and eliminates endogenous as well as exogenous (foreign) substances. It takes part in immune reactions, and in the synthesis of coagulation factors. It has exocrine and endocrine functions. As an endocrine organ, it secretes growth factors, angiotensinogen and angiotensin, thrombopoietin, etc. Its exocrine function involved bile production. The liver is a filter and store of different substances (e.g. glycogen, vitamins). It is the site of serum protein (e.g. albumin, prothrombin, fibrinogen) and enzyme synthesis. Metabolic processes (e.g. bilirubin, hormone, carbohydrate and lipid turnover) and the removal of toxic products are important liver functions.
Viral or bacterial infections of liver or by infestation with parasites have become common. Diseases of the blood or immune system may also interfere with hepatic metabolism and affect liver. Many different types of medication (e.g. acetaminophen, tetracycline, oral contraceptives, chlorpromazine, isoniazid, halothane, androgens) can produce an adverse liver reaction in certain people. Other hepatotoxins (e.g. alcohol, fungal toxins, and anabolic steroids) can cause specific damage to liver cells. Alcohol-induced hepatic injury is a common problem. Toxic hepatitis may be clinically silent or severe enough to lead to the rapid development of hepatic failure. Unhealthy diet may cause liver damage. As a result of these, liver may exhibit symptoms such as jaundice, fatigue, loss of appetite, nausea and vomiting, headache, abdominal pain, dark urine, generalised itching, fever, weight loss, anorexia and depression. Examination findings may include hepatomegaly, abdominal tenderness and liver enzyme abnormalities. The fatty degeneration of the liver is the most common abnormality observed in chronic alcoholics. In patients with underlying cirrhosis, manifestations of portal hypertension may predominate. This article overviews the common liver problems and lists out the commonly used liver remedies with indication.
Jaundice: It is yellowish pigmentation of the skin and mucous membrane, due to increased levels of bilirubin in the blood (hyperbilirubinaemia). It may be due to abnormalities in the formation, transport, metabolism or excretion of bilirubin. It has non-hepatic as well as hepatic causes. All the common liver remedies like Abies canadensis, Berberis vulgaris, Boldo, Carduus benedictus, Carduus marianus, Cassia fistula, Chelidonium majus, Chelone glabra, Chionanthus virginica, Condurango, Fel tauri 3x & 6x, Hydrastis, Hydrocotyle, Iris versicolor, Pichi pichi (Fabiana imbricata) may be useful in jaundice. Physician has to select the a remedy based on individuality.
Hepatitis (due to Hepatitis viruses A, B, C, D & E): Homoeopathy has a wide scope in viral infections and especially in hepatitis. A thorough case taking will be helpful to choose a remedy from commonly used drugs like Andrographis paniculata, Carduus marianus, Chelidonium, Chionanthus virginicus, Hydrastis canadensis, Ipecacuanha, Iris versicolor, Lachesis, Lycopodium, Nux vomica and others.
Alcoholic hepatitis: It is becoming common these days. After heavy drinking, symptoms worsen and tend to vary with the severity and progression of the disease. Sometimes symptoms do not present themselves until the disease is relatively advanced. Common symptoms include abdominal pain and tenderness, ascites, confusion, dry mouth / excessive thirst, fatigue, fever, jaundice, loss of appetite, nausea, weight gain due to ascites, etc. Along with drugs for alcoholism like Quercus robur/glandibus, liver remedies to normalise liver function to be used.
Autoimmune hepatitis: It is inflammation of liver due to immune cells that mistake the liver’s normal cells as harmful invaders. A person with autoimmune hepatitis has autoantibodies circulating in the bloodstream that cause the immune system to attack the liver. The cause is predominantly genetic. However, certain bacteria, viruses, toxins and drugs can trigger an autoimmune response in people who are genetically susceptible to develop an autoimmune disorder. Case to be managed symptomatically.
Nonalcoholic fatty liver disease: Fatty liver, also known as fatty liver disease (FLD), is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e. abnormal retention of lipids within a cell). Some measures like losing weight, regular exercise, improving the diet with fibrous food, avoiding alcohol and fatty substances, controlling cholesterol levels and diabetes are helpful. Drugs like Apocynum, Arsenic Album, Bryonia, Cardus marianus, Chelidonium, Digitalis, Ferrum metallicum, Helleborus Niger, Iris versicolor, Kalium carbonicum, Lycopodium, Natrum carbonicum, Nux Vomica, Phosphorous, Sepia, etc. are commonly used.
Cholelithiasis: It is a medical term for gallstone. Aversion to fatty food, abdominal discomfort, nausea and vomiting after meals may be symptoms of cholelithiasis. Drugs like Aurum muriaticum natronatum 3x & 6x, Berberis vulgaris, Boldo, Chelone glabra, Cholesterinum 3x & 6x, Dioscorea villosa, Fel tauri 3x & 6x and Pichi pichi (Fabiana imbricata) are specific for gallstone.
Bile duct obstruction: It is due to various causes like cysts of the common bile duct, enlarged lymp nodes in the porta hepatis, gallstones, inflammation of the bile ducts, narrowing of the bile ducts from scarring, injury from gallbladder surgery, tumors of the bile ducts or pancreas, tumors that have spread to the biliary system, etc. Scope of homoeopathy in individual case based on causative factor to be established before starting the treatment. Based on this, the choice of remedy & plan of treatment to be drawn.
Toxic hepatitis: It is inflammation of the liver due to medication or exposure to toxic (poisonous) chemicals. First the exposure to toxic substances is to be withdrawn if possible. Drugs for detoxification like Andrographis paniculata, Arsenicum album, Azadirachta indica, Carduus marianus, Chelidonium, Daphne indica, Hydrocotyle, Natrum sulphuricum, Nux vomica, Quercus robur and others are useful.
Cirrhosis: Though it is an irreversible pathology of liver, symptoms are well managed and quality of life can be improved. Common liver drugs like Andrographis paniculata, Carduus marianus, Chelidonium and other will be helpful based on symptom similarity.
Commonly used drugs in liver disorders
Chelidonium majus is a liver remedy, covering many of the direct reflex symptoms of diseased conditions of the organ. It is indicated in jaundice, enlarged liver, gall colic, distension and sluggish bowels due to hepatic disease or bilious complications.
Andrographis paniculata is indicated for liver disease in children, prolonged fever, general debility, enlarged liver and jaundice. It is a tonic and anthelmintic, and is useful in the treatment of dysentery and dyspepsia.
Carduus marianus acts on liver, vascular and portal system, in particular. It is used for liver problems due to abuse of alcoholic beverages, enlargement of liver causing fullness and soreness, hyperaemia of liver, jaundice and initial stages of cirrhosis. Irritability and apathy, lack of appetite, nausea, vomiting, profuse diarrhoea and constipation, haemorrhagic piles, and itching at night are covered.
Hydrastis canadensis has a marked action on the liver. It acts on torpid and tender liver, jaundice, dull dragging pain in the right groin, gall stones, constipation, tumour state when pain is prominent. Also useful in cirrhosis of liver.
Iris versicolor: Increases the flow of bile. It is used for sick headaches due to sluggish liver. It is used for pancreas, intestinal glands, and gastro-intestinal mucous membranes where liver affection is marked. In herbal medicine, it is considered as detoxifier and laxative.
Aurum muriaticum natronatum finds its place in the management of fatty degeneration of the liver, hepatic cirrhosis and ascites. It acts on some metabolic dysfunctions of nervous origin, depression and mental derangement, arteriosclerosis and hypertension.
Berberis vulgaris: It has marked action on the liver, promoting the flow of bile. Acts on gallbladder, improving bile flow, reducing pain of gallbladder stones, amoebicide and anti-dysenteric.
Boldo: It is indicated for atony of bladder, cholecystitis, biliary calculus, loss of appetite with bitter taste, constipation, congested or sluggish liver, burning weight in liver. Painful hepatic diseases and disturbed liver function after malaria are also covered by this medicine.
Carduus benedictus: The action of the drug is to stimulate the secretion of stomach, intestine and gall bladder. It has been used for minor digestive complaints and related intermittent fevers. Homoeopathically the indications are sensation of contraction in many parts, and sluggish liver. It is also used in cases of diarrhoea, digestive headaches. Has reported properties similar to antibiotics.
Pichi pichi (Fabiana imbricata): It is also indicated in cases of liver affections and gallstones. It has also tonic and chologogue properties, used in the treatment of jaundice, dyspepsia and to increase the secretion of bile. Useful in cholelithiasis and liver affections.
Abies canadensis: Canine hunger with torpid liver. Gnawing, hungry, faint feeling at the epigastrium. Great appetite, craving for meat, pickles, radishes, turnips, artichokes, coarse food. Tendency to eat far beyond capacity for digestion. Burning and distention of stomach and abdomen with palpitation.
Acidum citricum is used in haemorrhages, oedema and all forms of dropsy. It regulates the bile flow and some forms of acid-base imbalance.
Acidum hydrofluoricum is a remedy which covers digestive dysfunctions of the old or prematurely old due to chronic diseases. It is indicated for abdominal discomfort, enlarged liver, liver deterioration due to alcohol, flatulence, eructation, itching and distended blood vessels.
Cassia fistula: It is indicated in liver diseases and as laxative. There are reports of its useful results in enteric fevers with sluggish liver. Reported to be possessing antiinflammatory and analgesic action.
Chelone glabra: It is a remedy for liver affection with pain or soreness of the left lobe of the liver and extending downwards. It is also used for soreness of external parts, as if skin were off. Phyto-therapy recommends for gallbladder stone and problems of bile flow. Has mild laxative action, relieves nausea, vomiting, intestinal colic. Antidepressant.
Chionanthus virginica: It is a prominent remedy for liver, gallbladder, jaundice and used for gallbladder pain. Improves appetite and digestion. Is mild laxative.
Condurango: It stimulates the digestive functions, anorexia nervosa, nervous indigestion, and thus improves the general health. Modifies secretions of liver and digestive glands. Research reports cover stimulant for liver and pancreas.
Fel tauri: It liquefies the bile and acts as a purgative and chologogue. It increases the duodenal secretion, emulsifies fats and increases the peristaltic action of the intestines. It is useful in jaundice due to obstruction, biliary calculi and disordered digestion. This agent in a one grain dose before each meal and retiring increases the functional activity of the hepatic cells as well as supplying bile to the intestinal tract. It is also employed as an intestinal antiseptic.
Hydrocotyle: It is an excellent remedy in jaundice. It is an aperient and tonic. In herbal medicine, it is considered as anti-ageing plant.
Ipecacuanha acts on persistent nausea and vomiting, cutting pain around the naval, tenesmus and liver sore.
Podophyllum peltatum is indicated for distended abdomen, feeling of heat and emptiness, sensation of weakness or sinking, painful liver region, jaundice, portal engorgement, gastro-enteritis-like symptoms.
Quassia is considered as a gastric organ tonic. Quassia is indicated for pain above the liver and spleen, pressure and sharp pain in the liver, and cirrhosis of liver with ascites. It acts on dyspepsia, acidity, heartburn, gastralgia and regurgitation of food.