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Fatty Liver (NAFLD) Management At Sri Vaidya

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INTRODUCTION

Fatty liver is the condition in which fat builds up in the liver. Having small amounts of fat in your liver is normal, but too much can become a health problem .Liver is largest gland in the human body, regulating all kinds of the biochemical cycles, to maintain normal health of the body.

Too much fat in your liver can cause liver inflammation, which can damage your liver and create scarring. In severe cases, this scarring can lead to liver failure.

When fatty liver develops in someone who drinks a lot of alcohol, it’s known as alcoholic fatty liver disease (AFLD).

fatty liver

In someone who doesn’t drink a lot of alcohol, it’s known as non-alcoholic fatty liver disease (NAFLD). According to researchers in the World Journal of Gastroenterology, The term Non-alcoholic Fatty Liver Disease (NAFLD) refers to a broad spectrum of disorders characterized by fatty infiltration of the liver, steatosis, steatohepatitis, and cirrhosis. Epidemiological studies suggest prevalence of NAFLD in around 9% to 32% of general population in India with a higher prevalence in those with obesity and diabetes. No established pharmacological treatment is available for NAFLD in conventional medical science. Several empirical treatment strategies such as dietary restriction, physical exercise and weight reduction form the first line of treatment. Ayurveda has immense potential in the management of Non-Communicable Diseases, and NAFLD is one among them. Purpose of the present study was to formulate a practical Ayurvedic protocol for the management of NAFLDNAFLD affects up to of 25-30 % of the people in the United States and Europe.

Clinical Presentation

A 50 yrs old ,male patient came at Vaidya Sri Ayurveda Hospital on 31st March 2021, with the following complaints

  1. Fatty liver (grade 2, NAFLD)
  2. High GGT value 212 U/L
  3. High SGPT values 43 U/L

He was also known case of

  1. Diabetes Mellitus type 2
  2. Hypothyroidism since 22 years.

He was also having history of high creatinine value and got admitted for dialysis. Family history also shows cases of fatty liver and leading to fatal conditions. Clinical examination revealed that he is also having higher fluctuation on sugar levels. Also having heaviness in all over body. Dull pain over right hypochondria. On prakriti vishleshana it shown that, he is having Pitta Pradhan and Kafa anubandhi prakriti.

On Rog Rogi pariksha and Dashavidha pariksha following results disclosed-

  1. NADI – Pittaj and Vataj pradahan with Guruta
  2. AGANI – Madhyam
  3. PRAKRUTI – Pitta pradahan Kfa anubandhi
  4. KOSHTA – Madhyam
  5. BALA – Madhaym
  6. MALA – Sam
  7. MOOTRA – Prabhut
  8. KSHUDHA – Prakrut
  9. JIWA – Sam
  10. SATVA – Madhyam

Treatment Planning for Fatty liver

With above findings, doctors from Vaidya Sri Ayurveda Hospital, planes for following

Panchkarma therapies and Ayurvedic medication, along with some Naturopathic treatments.

Panchkarma

Pacahana

Agnitundi vati was used for pachana.

Most important factor in any panchakarma procedure, for the Doshas to stabilize and regulate disturbed digestive fire.

Snehapan

Mahatiktak ghrut was used for snehapana, for 3 days snehpana was given till the all symtoms of snehpana appear on patient’s body.

Second important step next to pacahana, to prepare body for virechana and to prevent the vat prakopa after virechana.

Virechana

Icchabhedi Ras was used.

Main step, that drains out all doshas, causing toxic effects on body, mainly Pitta dosha and next Kafa dosha.

Sansarg Krama

Followed for three days.

To increase the digestive fire gradually and to digest any remaining dosha after Virechana.

Medicine

Yakrit plihari loh

1-1 tab twice a day

Amrittotar lkasahayam

3-3 tsp twice a day

Dadimashtak churna

3- 3 gms twice a day

Vaishvanar churna

2-2 gms a day

Naturopathy

GH Pack

(Followed for 10 days)

Gastrohepatic pack gives effective reduction in blood glucose level by improving organ.

(liver, pancreas) functions as well as utilizing of the glucose from blood. It stimulates liver for metabolism and pancreas to secrete insulin.

ACCUPRESSURE

The first acupressure point is intestines’ point. This acupressure point might assist in digestion and weight loss, which may make diabetic management a lot simpler.

The second acupressure point is wrist .This point assist in controlling stress in the heart.

The third acupressure point is liver point. It help in cure insomnia, diabetes, stress etc.

Yoga And Pranayama

Suryanamaskara, paschimottasana, viprit karni asana anuloma viloma, ujjayi, bharamari pranayama are highly effective. Stress increases the body production of adrenalin which raises the blood sugar level. Reducing stress through yoga and pranayama helps restore regularly , healthy sleeping pattern, sound sleep ease the stress and bring blood sugar level in control, as stress is closely associated with the rise in insulin.

Jala Neti

Jala neti maintain the nasal hygiene by removing the dirt and bacteria trapped along with the mucus in the nostril. It clear the upper body .

Mud Pack

Mud pack on abdomen and eye relaxes the pores of the skin , draws the blood to the surface, relieves inner congestion and eliminates morbid toxins from the body.

Diet

For diabetes we focus on eating lean protein, high-fiber, less processed carbs, fruits and vegetables, low fat dairy and healthy vegetables based fats such as nuts , olive oil etc.

Yoga Nindra

Yoga nindra works predominantly by its ability to decrease the stress response, which in turn control blood glucose level. Posture and mind relaxing may benefit the functions of abdominal organs specially in pancreas.

DISCUSION

Ayurvedic treatment modalities have immense potential in the management of these kind of lifestyle disorders. As per Ayurvedic concepts, Agni, Pitta, Kapha, Vata dosha, Anna vaha Srotasa, Rasa, Rakta, Meda Dhatu & Srotasa , Yakrit are the cornerstones of pathology of Non-Alcoholic Fatty Liver Disease.

A practical treatment protocol including Virechana, Shamanoushadha and Pathyasevana with due importance to particular bodily constitution can help in the proper management of the disease.

By following the all the Pthyas of Virechana and with the potency of the medicines,

Weight loss is the good treatment for fatty liver and there was 4kg wt loss after the completion of the treatment. During the Virechana and Sansrg Karma, patient didn’t take any medication for sugar and still sugar levels were stable.

Also there was huge difference in the before and after evaluation of laboratory tests values which are combined the table.

 BeforeAfter
Serum creatinine1.32 mg/dl1.20 md/dl
SGPT43 u/l25 u/l
Gamma GT212 u/l52 u/l
HDL35.4 mg/dl30 mg/dl
Triglyceride238 mg/dl155 mg/dl
LDL47.6 mg/dl31 mg/dl
Weight81.4 kg77.2 kg
NADI (PULSE)
Nadi is one of the significant diagnostic tools in Ayurveda. Many vaidyas can diagnose only by examining the pulse of the patient. Index, middle, and ring fingers are placed over the root of the thumb to assess the rate, rhythm, speed, and quality of the Nadi. In Ayurveda, the movement of the pulse is compared to the movements of different animals. Vata pulse is compared to the motion of a leech or snake. Pitta pulse resembles the movement of a sparrow, crow, or frog. Kapha pulse is like that of a swan or pigeon.
MALA (STOOL)
Amount, colour, smell, and consistency of the stool are some of the parameters to assess the doshik predominance. Vata aggravated conditions cause stool to become dry, hard, and blackish in colour. Pitta dominance causes loose or liquid, greenish or yellowish in colour and foul-smelling stools. Kapha in excess causes stool to become bulky, slimy, or with mucus and excess in amount.
MOOTRA (URINE)
Early morning sample of urine is usually taken for mootra pariksha. The first stream of urine after waking up is avoided. Vata aggravated urine is less in amount, has a yellow hint to it, and dries quickly. Pitta aggravated urine is reddish to dark yellowish and produces burning. Kapha dominance causes watery, very white urine. Rakta vitiated urine is presented with blood and is hot.
SHABDA (VOICE)
When Doshas are in a normal state, voice is natural. Vitiated Doshas cause changes in shabda. Vata aggravation causes a hoarse and rough voice. Pitta dominance causes a broken and cracking voice. Kapha aggravation causes the voice to become deep and heavy
SPARSHA (TOUCH)
Hot, cold, smooth, rough, dry, moist skin, oedema, fever, etc. are examined by touch. In Vataj disorders, the skin is dry and rough to touch. In Pittaj disorders, the skin is hot and sweaty. Kaphaj disorders, the skin is moist.
DRIKA (EYE)
Eyes may reflect the health of a patient. Vata aggravation causes eyes to become sunken, dry and squinted. Pitta domination causes redness, burning sensation, and photophobia. Kapha aggravation causes moist, white, watery, lusterless, and heavy eyes.
AAKRITI (BUILD)
Hot, cold, smooth, rough, dry, moist skin, oedema, fever, etc. are examined by touch. In Vataj disorders, the skin is dry and rough to touch. In Pittaj disorders, the skin is hot and sweaty. Kaphaj disorders, the skin is moist.
LAB AND DIAGNOSIS
Along with the ancient Ayurvedic diagnostic tools, we at Sri Vaidya also provide facilities for laboratory tests like blood tests, urine tests, imaging, etc. Laboratory reports and imaging helps the doctor keep track of the health status and prognosis. Moreover, evidence in the form of lab tests is the demand of patients these days.
Ayurvedic Medicine
It is a potent method to prevent and cure a disease, and is usually used in combination with therapies. We have our own pharmacy where you can avail all the prescribed Ayurvedic medicines, from herbs to oils to pills and syrups, and many more. We procure medicines from places and companies known for their expertise and quality. Depending on your condition/disease, our Vaids will prescribe the medicine accordingly
Panchakarma Therapies
Widely known for their role in mind/body purification and detoxification process, panchakarma therapies are highly individualized therapies prescribed to a patient based on their needs keeping in mind their lifestyle, doshic imbalance, body constitution, immune status and, of course, symptoms. Detoxification apart, the therapies help manage and cure a number of chronic conditions and neurological, auto-immune, musculoskeletal, psychiatric, dermatological, and many other diseases.
Purva Karma (pre-procedure), Pradhan Karma (main part), and Paschyat Karma (post-procedure), are the three stages of Panchkarma procedure. In Purva Karma stage, the accumulated toxins are loosened by stimulating the muscles and tissues. Pradhan Karma stage consists of five steps of purification such as Vaman, Virechana, Nasya, Basti, and Rakta Moksha. The final stage Paschyat Karma comprises the restoration and rejuvenation of body muscles and tissues and is achieved through the intake of strengthening herbs. You will experience all this once you pay us a visit.
Dietary Counselling
Food constitutes a large portion of Ayurveda’s focus area because of its importance to our wellbeing as well as the negative impact it may have on our health when not taken as per our body’s needs. Our doctors will help you with the modification of your eating habits so that you take the right food in the right quantity and stay away from nutrition-related diseases.
Naturopathy
It looks beyond the symptoms of an illness and tends to heal its root causes using natural remedies. Naturopaths follow a principle that says the human body is made of five elements which include space (akash), air (vayu), fire (agni), water (jal), and earth (prithvi). Any imbalance in these elements gives rise to diseases. While examining you, our doctors will seek detailed answers from you about your lifestyle and health history and prescribe you natural therapies to restore the normal state of your body.
Purva Karma (pre-procedure), Pradhan Karma (main part), and Paschyat Karma (post-procedure), are the three stages of Panchkarma procedure. In Purva Karma stage, the accumulated toxins are loosened by stimulating the muscles and tissues. Pradhan Karma stage consists of five steps of purification such as Vaman, Virechana, Nasya, Basti, and Rakta Moksha. The final stage Paschyat Karma comprises the restoration and rejuvenation of body muscles and tissues and is achieved through the intake of strengthening herbs. You will experience all this once you pay us a visit.
Yoga
Yoga is an important part of our treatment, given its importance in strengthening the body and calming the mind. There are several asanas (poses) in Yoga and each of them is packed with wellness benefits for human body and brain.Our expert Yoga trainers will help you with a set of physical and mental exercises that suits you the most. But even before you visit our hospital, we would like to tell you some of the benefits that come with practicing yoga. It will improve your strength, balance, flexibility and heart health, help you with back pain relief and manage stress, etc.
Acupressure
Human bodies are complex and a problem in one part may affect the other, too. Acupressure is a non-invasive procedure that involves the application of pressure using fingertips on certain points of the body. It helps manage the symptoms of many illnesses like muscle tension and pain, menstrual cramps, insomnia, headache, etc.Only after proper evaluation by our doctors will you be recommended acupressure.
Purva Karma (pre-procedure), Pradhan Karma (main part), and Paschyat Karma (post-procedure), are the three stages of Panchkarma procedure. In Purva Karma stage, the accumulated toxins are loosened by stimulating the muscles and tissues. Pradhan Karma stage consists of five steps of purification such as Vaman, Virechana, Nasya, Basti, and Rakta Moksha. The final stage Paschyat Karma comprises the restoration and rejuvenation of body muscles and tissues and is achieved through the intake of strengthening herbs. You will experience all this once you pay us a visit.
Meditation
Meditation opens doors to calmness, relaxation, and peace of mind. It involves exploring your inner self through a continuous flow of thoughts, and takes you to a world where there is no chaos or conflict.Meditation, however, is not limited to the mind only. It influences the areas in our brain that are linked to metabolism and heart rate. And there is scientific evidence that shows that. Based on your needs, especially the ones which can be managed with meditation, our expert vaids will decide accordingly. So, worry not. Come and rejuvenate yourself, internally as well as externally, mentally as well as physically. There is no greater feeling than being healthy, because health defines everything in our lives.
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