Cirrhosis of the liver refers to all forms of liver disease characterised by a significant loss of cells. It is one of the most serious hepatic diseases. The liver gradually contracts in size and becomes hard and leathery.

The liver is one of the most important glandular organs in the body. It is located high up on the right side of the abdomen just under the diaphragm. It is a vast chemical laboratory which performs many important functions. It produces bile, cholesterol, lecithin, blood albumin vital to the removal of tissue wastes prothrombin essential to the clotting of blood and numerous enzymes. It inactivates hormones no longer needed, synthesises many amino acids used in building tissues and breaks proteins into sugar and fat when required for energy. It stores vitamins and minerals. It also destroys harmful substances and detoxifies drugs, poisons, chemicals and toxins from bacterial infections. Liver damage interferes with all of these functions.

In cirrhosis of the liver, although regenerative activity continues, the progressive loss of liver cells exceeds cell replacement. There is also progressive distortion of the vascular system which interferes with the portal blood flow through the liver. The progressive degeneration of liver structure and function may ultimately lead to hepatic failure and death.

Symptoms
In the early stages of the diseases, there may be nothing more than frequent attacks of gas and indigestion, with occasional nausea and vomiting. There may be some abdominal pain and loss of weight. In the advanced stage, the patient develops a low grade fever. He has a foul breath, jaundiced skin and distended veins in the abdomen. Reddish hair like markings, resembling small spiders, may appear on the face, neck, arms and trunk. The abdomen becomes bloated and swollen, the mind gets clouded and there may be considerable bleeding from the stomach.

Causes
Excessive use of alcohol over a long period is the most potent cause of cirrhosis of the liver. It has been estimated that one out of 12 chronic alcoholics in the United States develops cirrhosis. The disease can progress to end-stage of hepatic failure if the person does not abstain from alcohol. Cirrhosis appears to be related to the duration of alcohol intake and the quantity consumed daily. Recent researches indicate that the average duration of alcohol intake to produce cirrhosis is 10 years and the dose is estimated to be in excess of 500 ml of alcohol daily.

Poor nutrition can be another causative factor in the development of cirrhosis and a chronic alcoholic usually suffers from severe malnutrition as he seldom eats. Other causes of cirrhosis are excessive intake of highly seasoned food, habitual taking of quinine for a prolonged period in tropical climate, and drug treatments for syphilis, fever and other diseases. It may also result from a highly toxic condition of the system in general. In fact, anything which continually overburdens the liver cells and leads to their final breakdown can be a contributing cause of cirrhosis.

Treatment
The patient should be kept in bed. He must abstain completely from alcohol in any form. He should undergo an initial liver cleaning programme with a juice fast for seven days. Freshly extracted juices from red beets, lemon, papaya and grapes may be taken during this period. This may be followed by the fruit and milk diet for two to three weeks.

In this regimen, the patient should have three meals a day, each of fresh juicy fruits and milk. The fruits may include apples, pears, grapes, grape fruit, oranges, pineapples and peaches. One liter of milk may be taken on the first day. It should be increased by 250 ml. daily up to two to two and a half liters a day. The milk should be fresh and unboiled, but may be slightly warmed if desired. It should be sipped very slowly.

After the fruit and milk diet, the patient may gradually embark upon a well-balanced diet of three basic food groups, namely

An adequate high quality protein diet is necessary in cirrhosis. The best complete proteins for liver patients are obtained from raw goat's milk, home-made raw cottage cheese, sprouted seeds and grains and raw nuts, especially almonds. Vegetables such as beets, squashes, bitter gourd, egg-plant, tomato, carrot, radishes and papaya are useful in this condition. All fats and oils should be excluded from the diet for several weeks.

The patient should avoid all refined, processed and canned foods, sugar in any form, spices and condiments, strong tea and coffee, fried foods, all preparations cooked in ghee, oil or butter and all meats rich in fat. The use of salt should be restricted. The patient should also avoid all chemical additives in food and poisons in air, water and environment.