Liver Fibrosis

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

Turmeric [1, 16, 17, 18, 19, 20, 21]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that turmeric can help in the treatment of liver disease. More research is needed.)

Grade of Evidence: very low quality of evidence

Licorice (Glcyrhiz Gaba) [1, 12, 13, 14, 15]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Licorice has been shown to have potentially harmful side effects in people with high blood pressure, liver or kidney diseases)

Recommendation: No recommendation (There is insufficient evidence to support claims that licorice helps treat some symptoms of liver fibrosis. More research is needed)

Grade of Evidence: very low quality of evidence

Indian Snakeroot (Rauvolfia, Rawolfia Serpentina) [1, 10, 11]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that Indian Snakeroot helps to treat liver fibrosis in any way)

Grade of Evidence: very low quality of evidence

Gotu Kola (Centella Asiatica, Hydrocotyle Asiatica)[1, 4, 5, 6, 7, 8, 9]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Gotu Kola helps in the treatment of liver fibrosis in any way. More research is needed.)

Grade of Evidence: low quality of evidence

Celandine (Ukrain, Chelidonium Majus) [1, 2, 3]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: weakly against (There is insufficient evidence that Celandine helps to cure or treat liver fibrosis. In addition, the plant is mildly poisonous to humans. It may cause hepatitis as well as symptoms of pain, nausea, thirst, and fever.)

Grade of Evidence: very low quality of evidence

Neural Therapy:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recomendation (there is insufficient evidence to show that Neural Therapy helps in treating liver fibrosis in any way)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://abchomeopathy.com/r.php/Chel

3.http://www.naturalstandard.com/index-abstract.asp?create-abstract=/monographs/herbssupplements/greatercelandine.asp

4. Winston, D., Maimes, S., Adaptogens: Herbs For Strength, Stamina, and Stress Relief, 2007, pp. 226-7

5. "A Double-Blind, Placebo-Controlled Study on the Effects of Gotu Kola (Centella asiatica) on Acoustic Startle Response in Healthy Subjects". Journal of Clinical Psychopharmacology. 20(6):680-684, December 2000. Bradwejn, Jacques MD, FRCPC *; Zhou, Yueping MD, PhD ++; Koszycki, Diana PhD *; Shlik, Jakov MD, PhD

6.  B. M. Hausen (1993) "Centella asiatica (Indian pennywort), an effective therapeutic but a weak sensitizer." Contact Dermatitis 29 (4), 175–179 doi:10.1111/j.1600-0536.1993.tb03532.x

7. Cataldo, A., Gasbarro, V., et al., "Effectiveness of the Combination of Alpha Tocopherol, Rutin, Melilotus, and Centella asiatica in The Treatment of Patients With Chronic Venous Insufficiency", Minerva Cardioangiology, 2001, Apr; 49(2):159-63

8. http://en.wikipedia.org/wiki/Gotu_kola#Medicinal_effects

9. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/gotu-kola

10. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/indian-snakeroot

11. http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/seven/000092149.htm

12. Winston, David; Steven Maimes (2007). Adaptogens: Herbs for Strength, Stamina, and Stress Relief. Healing Arts Press.

13. http://www.ncbi.nlm.nih.gov/pubmed/15190039

14. http://nccam.nih.gov/health/licoriceroot/

15. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-licorice.html

16. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/turmeric

17. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-turmeric.html

18. http://nccam.nih.gov/health/turmeric/index.htm

19. http://news.bbc.co.uk/2/hi/health/1668932.stm

20. http://www.mirror.co.uk/news/top-stories/2009/10/28/curry-kills-cancer-cells-and-other-health-benefits-of-the-nations-favourite-dish-115875-21779950/

21. http://clinicaltrials.gov/ct2/results?term=turmeric

22. Garcia-Tsao G, Lim JK; Members of Veterans Affairs Hepatitis C Resource Center Program. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am J Gastroenterol. 2009;104:1802-1829.

23. Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.

24. Mehta G, Rothstein KD. Health maintenance issues in cirrhosis. Med Clin North Am. 2009;93:901-915.

25. http://www.ncbi.nlm.nih.gov/pubmed/15690074

26. http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Fibrosis.pdf

27. http://www.meddean.luc.edu/lumen/MedEd/orfpath/fibrosis.htm

28. http://www.medical.siemens.com/webapp/wcs/stores/servlet/PSGenericDisplay~q_catalogId~e_-111~a_langId~e_-111~a_pageId~e_103856~a_storeId~e_10001.htm

29. http://www.merck.com/mmpe/sec03/ch026/ch026b.html

30. http://www.puristat.com/livercleansing/fibrosis.aspx

31. http://encyclopedia.farlex.com/Liver+fibrosis

32. http://informahealthcare.com/doi/abs/10.1080/003655299750026272

33. http://www.nlm.nih.gov/medlineplus/ency/article/000255.htm