To all Ayurveda fans...A must read,by Dr Cyriac Abby Philips,Gastroenterologist @Cochin.
English/മലയാളം താഴെ
Can someone who has never touched a single drop of alcohol all his life develop severe alcoholic liver disease?
മദ്യപാനി അല്ലാത്ത ഒരുവനിൽ മദ്യംമൂലo കരൾവീക്കം: ഇങ്ങനെ സംഭവിക്കാമോ?
I met a 40-year-old man in the O.P.D for evaluation of severe jaundice. His bilirubin levels were in excess of 12 mg/dl and his liver enzymes were more than 5 to 8 times the upper limit of normal. His liver tests were very classical of alcohol use, but the man denied taking a single drop of alcohol all his life. He was a pineapple farmer, worked hard for his family, did not abuse any substances and led a healthy life. He was fit and without a shred of fat on him. So we went through the same protocol that we do for all patients who present with acute severe jaundice. Every common cause we looked at was negative - all the viruses, autoimmune hepatitis; use of over the counter medications, herbal medications, pain killers, antibiotics - he denied all of that - it was the first time he was ever falling sick. So we started looking at rare causes - such as herpes viruses, cytomegalovirus, parvo virus, dengue, typhoid fever and rare cancers - all the blood tests came back negative. His jaundice was increasing day by day and so we had to resort to a test most patients are worried for, but as physicians we really want to perform because it gives us that final clue - or at times - the final answer to a liver disease - the liver biopsy. The man, tired of his ongoing mysterious illness, agreed to a liver biopsy without haste. A liver biopsy is NOT done ONLY to diagnose cancers, but ALSO to identify the cause and understand the severity of liver disease.
The biopsy went smoothly, and the reports came back - my pathologist calls me and says - 'this biopsy is very classical of severe alcoholic hepatitis' - a disease that strikes the liver when alcohol is taken in heavy doses regularly or in binges. So I went back to the patient and told him - see you might lie about the alcohol, but your liver wont! We have proof that you have been drinking too much and in secret - the man almost broke down - he told me the exact same thing he has said time and again before - 'Sir, I have not taken a single drop of alcohol in my entire life'. So I thought, well, it is time to bring the family in. I was in my FBI mode and questioning health and health behaviors in the presence of the family, especially the daughters, brings out the 'teddy bear' in almost all fathers - and then they breakdown and I will have my confession and could finally plan my treatment. But I was stumped there too. Every family member, including his daughter and the son-in-law vouched for this man - he never drank. They were always together, ate together and worked the fields together. But then the wife let something slip by that caught my ears. 'He eats well - and then takes a digestive to reduce the bloating after the meal'. I asked her - what digestive? 'Oh, that is nothing, it has been in use for so many years' - Dashamoolarishtam'. I sat up.
Dashamoolarishtam is an age old Ayurvedic tonic used for improving not only 'digestion', but a multitude of other symptoms and is sometimes the second commonest household item seen inside a Kerala home, the first being the electric mosquito killer bat. It is made up of more than 30 herbal and other ingredients (https://ayurmedinfo.com/2011/06/18/dasamoolarishtam-ingredients-uses-dose-and-side-effects/) and has self generating alcohol in it due to the presence of a flower of the plant called 'Woodfordia fruiticosa' that has the ability (like grapes) to self ferment and generate alcohol. In the modern times, to increase alcohol content (it is what gives the good digestive feeling) and fasten the fermentation process, some practitioners add baking yeast to the product and others, add direct alcohol to it - increasing its potency. This Ayurvedic medicine is so popular in Kerala, that when the Government banned alcohol sales in the State at one point, the population started overdosing on Arishtams to get a high - and some producers of the product intentionally increased alcohol content in their product to boost sales. It was all over the news! (https://www.thenewsminute.com/article/shutters-down-bars-kerala-binge-%E2%80%98alcoholic%E2%80%99-ayurvedic-medicine-get-high-37229)
My patient was consuming around 4 to 5 ounces of this Artishta 4 times a day after every meal (almost 38 grams of alcohol daily; considering alcohol content in the Arishta to be 8 to 10%) that lead to not only well being, but severe alcohol related liver injury in a man who never took alcohol. But that was not all. My pathologist who saw the liver biopsy also reported that one of the findings in the biopsy was not usually seen with alcohol liver injury - a finding called necrosis. So even though the man was started on treatment for severe alcoholic liver injury (and he was improving), I asked him about all of this recent food intake behavior. In the last month, he had been excessively consuming fresh pineapple juice harvested from his own farm. What was so bad about that? An impressive use of pesticides and insecticides - like Fenval, Karate and what not. We then took pineapple samples from his farm and ran them through a strong chemical analyses. We found a host of toxic chemicals such as nickel tetracarbonyl, acetyl pentacarbonyl and carbamic acids in the pineapples tested. Another reason for part of the liver injury seen in our patient - toxic hepatitis due to chemicals. A final diagnosis of Ayurvedic Arishta related severe alcoholic hepatitis and chemical induced toxic hepatitis due to excessive pineapple consumption was made. Traditional medicines and the practice of such are not require for a healthy well being. In the current era, they may actually cause more of problem that solution. You do not need to take 'a digestive' to improve digestion - digestion is something the body and the organ system involved knows how to do! The patient recovered fully from his disease after treatmen…
English/മലയാളം താഴെ
Can someone who has never touched a single drop of alcohol all his life develop severe alcoholic liver disease?
മദ്യപാനി അല്ലാത്ത ഒരുവനിൽ മദ്യംമൂലo കരൾവീക്കം: ഇങ്ങനെ സംഭവിക്കാമോ?
I met a 40-year-old man in the O.P.D for evaluation of severe jaundice. His bilirubin levels were in excess of 12 mg/dl and his liver enzymes were more than 5 to 8 times the upper limit of normal. His liver tests were very classical of alcohol use, but the man denied taking a single drop of alcohol all his life. He was a pineapple farmer, worked hard for his family, did not abuse any substances and led a healthy life. He was fit and without a shred of fat on him. So we went through the same protocol that we do for all patients who present with acute severe jaundice. Every common cause we looked at was negative - all the viruses, autoimmune hepatitis; use of over the counter medications, herbal medications, pain killers, antibiotics - he denied all of that - it was the first time he was ever falling sick. So we started looking at rare causes - such as herpes viruses, cytomegalovirus, parvo virus, dengue, typhoid fever and rare cancers - all the blood tests came back negative. His jaundice was increasing day by day and so we had to resort to a test most patients are worried for, but as physicians we really want to perform because it gives us that final clue - or at times - the final answer to a liver disease - the liver biopsy. The man, tired of his ongoing mysterious illness, agreed to a liver biopsy without haste. A liver biopsy is NOT done ONLY to diagnose cancers, but ALSO to identify the cause and understand the severity of liver disease.
The biopsy went smoothly, and the reports came back - my pathologist calls me and says - 'this biopsy is very classical of severe alcoholic hepatitis' - a disease that strikes the liver when alcohol is taken in heavy doses regularly or in binges. So I went back to the patient and told him - see you might lie about the alcohol, but your liver wont! We have proof that you have been drinking too much and in secret - the man almost broke down - he told me the exact same thing he has said time and again before - 'Sir, I have not taken a single drop of alcohol in my entire life'. So I thought, well, it is time to bring the family in. I was in my FBI mode and questioning health and health behaviors in the presence of the family, especially the daughters, brings out the 'teddy bear' in almost all fathers - and then they breakdown and I will have my confession and could finally plan my treatment. But I was stumped there too. Every family member, including his daughter and the son-in-law vouched for this man - he never drank. They were always together, ate together and worked the fields together. But then the wife let something slip by that caught my ears. 'He eats well - and then takes a digestive to reduce the bloating after the meal'. I asked her - what digestive? 'Oh, that is nothing, it has been in use for so many years' - Dashamoolarishtam'. I sat up.
Dashamoolarishtam is an age old Ayurvedic tonic used for improving not only 'digestion', but a multitude of other symptoms and is sometimes the second commonest household item seen inside a Kerala home, the first being the electric mosquito killer bat. It is made up of more than 30 herbal and other ingredients (https://ayurmedinfo.com/2011/06/18/dasamoolarishtam-ingredients-uses-dose-and-side-effects/) and has self generating alcohol in it due to the presence of a flower of the plant called 'Woodfordia fruiticosa' that has the ability (like grapes) to self ferment and generate alcohol. In the modern times, to increase alcohol content (it is what gives the good digestive feeling) and fasten the fermentation process, some practitioners add baking yeast to the product and others, add direct alcohol to it - increasing its potency. This Ayurvedic medicine is so popular in Kerala, that when the Government banned alcohol sales in the State at one point, the population started overdosing on Arishtams to get a high - and some producers of the product intentionally increased alcohol content in their product to boost sales. It was all over the news! (https://www.thenewsminute.com/article/shutters-down-bars-kerala-binge-%E2%80%98alcoholic%E2%80%99-ayurvedic-medicine-get-high-37229)
My patient was consuming around 4 to 5 ounces of this Artishta 4 times a day after every meal (almost 38 grams of alcohol daily; considering alcohol content in the Arishta to be 8 to 10%) that lead to not only well being, but severe alcohol related liver injury in a man who never took alcohol. But that was not all. My pathologist who saw the liver biopsy also reported that one of the findings in the biopsy was not usually seen with alcohol liver injury - a finding called necrosis. So even though the man was started on treatment for severe alcoholic liver injury (and he was improving), I asked him about all of this recent food intake behavior. In the last month, he had been excessively consuming fresh pineapple juice harvested from his own farm. What was so bad about that? An impressive use of pesticides and insecticides - like Fenval, Karate and what not. We then took pineapple samples from his farm and ran them through a strong chemical analyses. We found a host of toxic chemicals such as nickel tetracarbonyl, acetyl pentacarbonyl and carbamic acids in the pineapples tested. Another reason for part of the liver injury seen in our patient - toxic hepatitis due to chemicals. A final diagnosis of Ayurvedic Arishta related severe alcoholic hepatitis and chemical induced toxic hepatitis due to excessive pineapple consumption was made. Traditional medicines and the practice of such are not require for a healthy well being. In the current era, they may actually cause more of problem that solution. You do not need to take 'a digestive' to improve digestion - digestion is something the body and the organ system involved knows how to do! The patient recovered fully from his disease after treatmen…
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