Acute Liver Failure

Acute liver failure is a sudden, marked deterioration in liver function, resulting from damage to a large proportion of the liver. To be classified as ‘acute’, the symptoms of liver failure must develop over several days to weeks.

Causes

The sudden loss of liver function can result from a pre-existing medical disorder or substance that damages the liver. These can include:

·         Viral infection of the liver;

·         Scarring of the liver (cirrhosis); and

·         Excessive alcohol or drug intake.

Symptoms and diagnosis

A patient suffering acute liver failure will usually present with the following symptoms:

·         Yellowish discolouration of the skin (jaundice);

·         Heavy, uncontrollable bleeding;

·         Fatigue;

·         Buildup of fluid in the abdominal cavity (ascites); and

·         Depressed consciousness and/or coma.

Acute liver failure can usually be diagnosed based on the results of physical examination. Determination of liver function by blood tests will indicate significantly impaired liver function.

Treatment

The most appropriate course of treatment for acute liver failure is dependent on the underlying cause and resulting symptoms. The patient is usually placed on a restricted diet, with particular emphasis on moderating protein and sodium intake. Alcohol is avoided altogether.

If liver failure is progressive, or left unchecked, the condition may be irreversible, and even fatal. In these cases, liver transplantation may be required.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Gotu Kola (Centella Asiatica, Hydrocotyle Asiatica) [1, 2]:

Recommendation: Strongly against (There is insufficient evidence to support claims that Gotu Kola helps to treat liver failure. Gotu Kola is not advised to be taken by those with liver disease or who take medications that affect the liver)

Grade of Evidence: Low level of evidence

Indian Snakeroot (Rauvolfia, Rawolfia Serpentina) [3]:

Recommendation: Strongly against (There is insufficient evidence to support claims that Gotu Kola helps to treat liver failure. Gotu Kola is not advised to be taken by those with liver disease or who take medications that affect the liver)

Grade of Evidence: Low level of evidence

Summary References

1. http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000253

2. http://www.webmd.com/vitamins-supplements/ingredientmono-753-gotu%20kola.aspx?activeingredientid=753&activeingredientname=gotu%20kola

3. http://web.archive.org/web/20130508051132/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/indian-snakeroot