Managing hyperbilirubinemia of alcoholic liver cirrhosis by ayurveda medication: a case report

Abstract

Background: Hyperbilirubinemia in Alcoholic Cirrhosis of Liver leads to end stage Liver failure. It is also recognised as a biomarker of short term mortality. due to alcohol induced intrahepatic cholestasis. Many discarded and frustrated liver patients from modern medicine have been approaching Ayurveda hospital as a last resort. Ayurveda attenuates liver injury, inflammation and intrahepatic cholestasis Case Presentation: A 32-year-old rickshaw driver came to OPD with yellow discoloration, dark urine, nausea, anorexia, mild pedal oedema, mild abdominal distention since one year. He had been inking alcohol regularly for five years. The laboratory findings were significant for a total bilirubin of 37.2 mg/dl with direct bilirubin of 32.8 mg/dl, AST of 243 IU/L, ALT of 182 IU/L, platelets of 58K, and albumin of 2.7 gm/dl, GGT of 146mg/dl, haemoglobin of 9.8 mg/dl and the rest of the laboratory findings were within the normal limits. His HCV and HbsAg was negative. Abdominal sonogram showed cirrhosis of liver with portal hypertension and Median liver stiffness was 55.8 Kpa in Fibroscan. The patient was treated with Deepana, Pachana in the initial stage then Virechana. Siddha Makaradwaja was administered to give strength to the patients. Bilirubin gradually trended down to 5.69 mg/dl and has a decreasing trend of all liver enzymes after 15 days. Intensity of alcohol cravings is reduced in this case. The timeline for treatment will be discussed during the presentation. The patient had normalised after three months and his hemoglobin, BMI increased. The patient is leading a normal life now. Conclusions: Craving for alcohol is reduced in this case and may be due to the practice of Pranayama and Dhyana. Ayurveda medication is safe and effective in Hyperbilirubinemia due to Alcoholic Cirrhosis of Liver. More studies on this topic are recommended.