An ayurvedic management of alcoholic hepatitis – a case study

Alcoholic hepatitis is a severe inflammatory liver disease caused by heavy, prolonged alcohol consumption and is a frequent precursor of liver cirrhosis and hepatocellular carcinoma. In Ayurveda, such conditions can be managed on the lines of Kamala (Shakhashrita Kamala). A 42-year-old male with a history of chronic alcohol consumption for more than 20 years presented to the Ayurgram clinic, Ravet, Pune, with yellowish discolouration of eyes and urine, loose motions alternating with constipation, adhmana (gaseous distension), bilateral lower limb swelling, loss of appetite and generalized weakness for one month, along with deranged liver function tests. He was managed with Sadyavirechana using Ichhabhedi Ras (Shodhana Chikitsa), followed by Shamana Chikitsa comprising Arogyavardhini Vati, Kamdudha Rasa, Triphala Yog, Erand Bhrasht Haritaki and a Kadha of Triphala, Indrayava and Nimba Twak. Arogyavardhini Vati is widely used in hepatic disorders, Kamdudha Rasa has Deepana and Pachana properties, Triphala has anti-inflammatory activity, Indrayava is known to support liver function, and Erand Bhrasht Haritaki promotes gentle bowel clearance. After one week, the symptoms were markedly reduced and serum total bilirubin fell from 14.30 to 6.26 mg/dL, with serum glutamic pyruvic transaminase decreasing from 107.2 to 53.3 and serum glutamic oxaloacetic transaminase from 196.8 to 94.6. No adverse effects were observed. This case suggests that an integrated Shodhana and Shamana approach may be useful in alcoholic hepatitis; larger controlled studies are needed.