Phytotherapy ofliver cirrhosis

By: AbdulRAhman ElHadary

Introduction :Cirrhosis is a complication of many liver diseases that is characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, and the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue.

Causes :Long-term alcoholism Chronic liver infections , As : hepatitis B and particularly hepatitis CLiver injury, exposure to toxic substancesGenetically “ inherited “

Obesity has recently been recognized as a risk factor

Types :Portal or nutritional cirrhosis : related with history of alcoholism.

Biliary cirrhosis : caused by intrahepatic bile-duct diseases Post necrotic cirrhosis : caused by various types of chronic hepatitisPigment cirrhosis (hemochromatosis) : caused by Disorders like the inability to metabolize iron

Symptoms :- Liver enlargement

- The palms of the hands turn red- constipation- diarrhea- dull abdominal pain- anemia- bleeding gums- fever- hallucinations- neuritis- slurred speech- tremors

Complications : - Ascites

-Edema - Spleen enlargement - Menstrual irregularities in women - Sever itching- jaundice - portal hypertension , life threatening - breasts may grow , testicles may shrink in men

Cirrhosis is an irreversible condition.

Treatment goals :- Slow the progression of liver damage- Reduce the risk of further complications.

Silybum marianumParts used : Seed

Habitat and cultivation : Indigenous to Kashmir (India), Southern Europe, Southern Russia, North Africa, and Asia Minor. It was introduced to most areas of Europe, North and South America and Southern Australia

Constituents :three isomeric flavonolignans :- silibinin (silybin)- silychristin- silidianin collectively known as silymarin- other flavonolignans : betaine, apigenin, silybonol- proteins, fixed oil and free fatty acids,

Uses :Its primary activities are of use as antioxidant and hepatoprotective.- Silymarin successfully opposes alcoholic cirrhosiswith its antioxidant and hepatoprotective mechanisms restoring the normal liverbiochemical parameters.- Silymarin also ameliorates cytolysis in active cirrhosis patients.- However use of silymarin is inadvisable in decompensated cirrhosis

Common names :- Blow ball- Lion's tooth

Parts used : Leaves, root.

Habitat and cultivation :While extensively cultivated in france and germany, the dandelion herb also grows wild in most parts of the world and is a garden plant in many countries.

Taraxacum officinale

Constituents :

Leaves :- bitter glycosides- carotenoids- terpenoids- choline , potassium salts, iron and other minerals, vitamins A, B, C, D.Root :- bitter glycosides- tannins - triterpenes- sterols , volatile oil , choline, asparagin, inulin.

Uses :

- A natural diuretic : helps the body release excess water caused by liver dysfunction.

- A detoxification agent : the root of the dandelion remove the waste products accumulated in the liver and the gall bladder enhancing their function

Curcuma longa

PARTS USED :Rhizome.

Habitat and cultivation :Indigenous to south asian countries, especially india ,turmeric is now commercially grown across southern and eastern asian nations

Constituents :

CURCUMIN ,,, The most useful derivative from turmeric.

Cumin which is also found in turmeric with its characteristic yellow

Uses :

Has ability to heal liver disorders and facilitate its functioning

PARTS USED :Root.

Glycyrrhiza glabra

Sweet Wood

Habitat and cultivation :Originally it grew in the wild in many parts of southeastern europe and southwestern asia. But now licorice is extensively cultivated and can be found in many other parts of the world.

- saponins- glycosides (inc. glycyrrhizin),- estrogenic substances, - coumarins - flavonoids- sterols - choline- asparagine - volatile oil.

CONSTITUENTS :

Both Eastern and Western holistic physicians use licorice root to treat liver disease.

Uses :

There is some evidence that some of the chemicals in licorice might be effective .

But the studies involved too few patients to draw firm conclusions.

Side effects and cautions :

Long term and high intake of licorice which contains glycyrrhizin can be quite harmful. It can increase blood pressure and can cause retention of water in the body. So long term use should be avoided or should be done only under strict supervision of competent doctors.

Bupleurum chinense

PARTS USED :Roots.

CONSTITUENTS :

- Bupleurumol- Triterpenoid saponins , saikosides (saikosaponins)- Flavonoids (rutin)

Uses :In the Chinese system of medicine, a physically weakened liver or a poorly functioning liver is believed to be ideally and effectively treatable using the bupleurum herb ,due to the strong anti-inflammatory action possessed by the herb; this property of the bupleurum is believed to be a major contributory factor in its ability to heal liver disorders.

Panax ginseng

Chinese Ginseng

It grows natively inremote forests of Manchuria and North Korea, but has become over-harvested in other parts of Asia. It is cultivated in Korea, China, and Japan for export and use as a medicinal herb.

Habitat and cultivation :

CONSTITUENTS :

- triterpene glycosides, or saponins, commonly referred to as ginsenosides.- amino acids- Alkaloids- Phenols- proteins, polypeptides- vitamins B1 and B2

Uses :Ginseng extracts have been reported to show protective effects on hepatocytes in vitro and liver injury in various animal, and clinical models induced by a wide variety of hepatotoxinsPreliminary research findings indicate that ginseng may encourage the growth of certain types of glandular cells within the liver, thus helping it to heal, but more research is needed to draw conclusions.

Mechanisms of Actions :Antioxidation /The mechanisms which provide ginseng’s hepatoprotective effects are closely attributed to antioxidation properties. Ginseng enhanced the antioxidant defense mechanism and increased self-antioxidant enzyme activitiesAlso acts as anti-inflammatory

- Balanced diet promotes regeneration of healthy liver cells.- Eating five or six small meals throughout the day should prevent the sick or bloated feeling patients with cirrhosis often have after eating.- Alcohol and caffeine should be avoided- Patients who have cirrhosis should weigh themselves every day

A doctor should also be notified if a patient diagnosed with cirrhosis:- sudden gain of five pounds or more- vomits blood- passes black stools- seems confused or unresponsive- shows signs of infection (redness, swelling, tenderness, pain)