WHOLISTIC APPROACH Liver Disorders

1. WHOLISTIC APPROACH Liver Disorders Dr. Ajay K Sachdev MS,PhD HEAD-GI Surgery & GI Oncology

2. WHOLISTIC APPROACH Liver Disorders – How do we treat? • Friendly, caring, convenient environment for patients • Adopt international approach The key to the Centre’s successful interdisciplinary approach is “dedication to a common goal. The professionals at the Centre agree with the philosophy and the vision.”

3. WHOLISTIC APPROACH- Liver Disorders Magnitude and nature of Liver Disorders • Liver disease is a third leading disease – related cause of death in USA • NASH / NAFLD • Alcoholism • Hepatitis-B • Hepatitis-C • Others Meeting multiple objectives within one Centre

4. WHOLISTIC APPROACH– A Journey • Looking at a patient’s symptoms from a much broader perspective. • Incorporating & combining conventional medicine with some of the more wholistic approaches to fill in the missing gaps. • Providing information, explanations & solutions that help provide the desired outcome of better health & well being. • Patient individuality is our prime concern – what helps one person may not suit another with the same condition. • Therapy should be directed at getting people to know themselves – empowering people to help themselves. We, the practitioners, only act as catalysts in this process.

5. WHOLISTIC APPROACH– A Journey –Contd.. • Look & assess a person as a whole being from many perspectives, to capture all levels of influence including mechanical, biochemical & emotional. • This self empowering journey requires full participation & motivation on your part, and close supervision & guidance on our part. • Throughout the journey it is necessary to identify and peel off layers of priority to get to the root of the underlying problem. • Finally, we aim to help you reach a point of self maintenance as you experience a greater awareness and improved health. • Several contributory factors co-exit at any given moment towards any given disease.

6. WHOLISTIC APPROACH– A Journey –Contd.. The following factors that hinder the healing process which need to be considered • Food & water • Lifestyle / Physical activity • Nutrient imbalances / junk foods • Hormone imbalances • Energetic imbalances • Structural imbalances • Toxic pathogens • Toxic metals • Addictions – Alcoholism • Unresolved emotional issues

7. WHOLISTIC APPROACH– A Journey –Contd.. • Step one overall assessment of a person from the medical perspective, outcome of routine tests and investigations • Step two (using Bio-Meridian)- Toxic load, most stressed organ i.e. Liver and efforts to repair and heal/support the Liver • Step three (using Functional Biochemistry)- Looks for nutrient deficiencies, energy, hormone and Liver pathways ensuring that they are working optimally as well as testing for & cleaning any pathogen over proliferation (virus, alcohol etc.)

8. WHOLISTIC APPROACH PEOPLE DON’T EAT NUTRITION, PEOPLE EAT FOOD • What is difference between a dietician and an nutritionist? • When should physician / clinician refer the patient to a Gastroenterologist? • Obesity – relation with food, hormones, physical activity, alcohol  NASH / NAFLD • Dietician / Nutritionist – Helps in shaping healthy food preferences

9. WHOLISTIC APPROACH PEOPLE DON’T EAT NUTRITION, PEOPLE EAT FOOD – Contd… Fatty liver affects more than 50% peoples over 50 years of age • AIIMS study – Elite Public Schools in South Delhi – • 1800 children studied of which nearly 60% had Grade-II to Grade-IIINASH • How can school encourage physical activity and healthier eating to avoid NASH? • Gastroenterologist’s helps/talk productively to parents about their child’s weight and the seriousness/consequences of NASH • A lot of tactics to describe and create an atmosphere of thoughtfulness about food. • What do you think are the critical pillars of any intervention in childhood obesity?

10. WHOLISTIC APPROACH Food for Living “If more of us valued food and cheer and song above hoarded gold, it would be a merrier world” • Food is man’s most basic requirements, but its relationship to health is less well understood • How many of us pause to consider, as we quaff another Burger, Pizza and French fries, washed down with an extra large Cola, how our body’s own, infinitely more complex engine is running? • Also to examine in depth the growing public health threat posed by obesity  NASH  Cirrhosis • Increasing role of SYNBIOTICS – probiotics + prebiotics

11. WHOLISTIC APPROACH Hepcats – The Liver Wellness Group Email: hepcats_dublin@hotmail.com • To promote liver wellness, to share experience and knowledge about Hepatitis B/C and to improve the quality of life • Self Help and Support Welfare Issues-Insurance, Hep B/C as a notifiable disease, Complementary therapies, Sexual issues Lifestyle issues, blood to blood contact by various means • Education and Awareness Talks from our experts Newsletter / Posters • Drop in at our Centre Helpline Extension and visit the ARTEMIS website

12. WHOLISTIC APPROACH Government – Health Ministry Role? Online Poll Results on Alcoholism Do you think putting health warnings on Alcohols labels will… • Help reduce Alcohol misuse • Only have a limited effect • Not have any real effect • Unsure • Online Poll Results : 1 – 5%, 2 – 60%, 3 – 30%, 4 – 5%

13. WHOLISTIC APPROACH Alcoholism - Detoxification • Antioxidants may prevent Alcohol-induced Liver disease • Transcendental meditation is helpful in Alcohol addiction • Detoxifying the Liver with milk thistle, Vitamin C, selenium, beta carotene, vitamin E, and N-acetyl-cysteine (NAC) which are powerful antioxidants. • Amino acid SAM-E, Cruciferous vegetables – broccoli, cauliflower, sprouts, cabbage, vegetable juice, Vitamin B, riboflavin, niacin also detoxify Liver • Coffee Enema is helpful in Liver detoxification (Alkaloids in Caffeine stimulate the production of an enzymes “glutathione-S-transferase” an enzyme that facilitates detoxification pathways ) • Coffee Enema is safe even in sensitive patients to caffeine since enema remains in sigmoid colon.

14. WHOLISTIC APPROACH Native Remedies Wholistic Approach helpful in Alcoholism, Hep-B, Hep-C Role of Liver Doctor • To improve functioning of the Liver and promote health. • To prevent problems associated with a sluggish Liver (e.g. depressed immune systems, constant fatigue, obesity, sluggish digestive systems, allergies, respiratory ailments, unhealthy skin, irritability and many other health problems). • To help treat Liver disease and prevent further damage to the Liver , in diseases like viral hepatitis, cirrhosis, fatty liver, hemochromatosis, Alpha-1 antitrypsin deficiency and Wilson’s disease. • To protect the healthy Liver from damage caused by medications and alcohol. • To improve gall bladder functioning, reduce inflammation and help dissipate gallstones. • To neutralize toxins with Liver-friendly antioxidants, vitamin and mineral supplement.

15. WHOLISTIC APPROACH Native Remedies Wholistic Approach helpful in Alcoholism, Hep-B, Hep-C Role of Liver Doctor – Contd… • Avoid Alcohol completely if you have any Liver problems. • Quit smoking. • Exercise regularly and drink plenty of water (preferably purified or still mineral water). • Be very careful of using any prescription or over-the-counter medications. Liver disease can make you very susceptible to the adverse effects of medications. Even seemingly safe medications like paracetamol can be extremely toxic and damaging to the liver. • Avoid eating raw shellfish. These can harbor bacteria that cause severe infections in people with liver disease.

16. WHOLISTIC APPROACH Combined Approach to the use of Nutraceuticals, Western medicine, and Herbal medicine in the treatment of Liver disease

17. WHOLISTIC APPROACH Combined Approach to the use of Nutraceuticals, Western medicine, and Herbal medicine in the treatment of Liver disease – Contd… • Homeopathy • Traditional Chinese Medicine • Acupuncture • Western Herbal Medicine • Therapeutic Touch • Distant Healing (Reiki, Pranic, Healing, Nogier Pulse) • Applied Kinesiology • Nutraceutical and Functional Medicine • Transcendental Meditation

18. WHOLISTIC APPROACH ORGANOTHERAPY - Live Protein therapy • Hepatocyte Growth Factor (HGF) – Proteins and HGF found in liquid liver extract • Liver extract (HGF) – accelerates hepatic function • Colon cleansing is important to decrease the load of endotoxins in the circulation • Organotherapy is by no means a new concept, science behind this mechanism of action is beginning to become clearer • Thomas Bayne, DC • (Email: tom_bayne@mindspring.com) has used Natcell Thymus and Natcell Liver in the management of liver disorder.

19. WHOLISTIC APPROACH Hepatic Detoxification Phase-I Involves cytochrome P450  A “super family” of isoenzymes convert fat-soluble to water-soluble molecules Phase-II Conjugation reactions  Conjugation involving acetylation, glucuronidation, sulfation, glutathione conjugation and amino acid conjugation Nutritional intervention employed to support and balance Phase-I and Phase-II Detoxification

20. WHOLISTIC APPROACH Hepatic Detoxification - Involves • Fasting – limited nutrient intake allows for detoxification / healing • Limited use of hard to digest foods • Quality, moderate protein diets • Low fat diets • Limiting synthetic chemicals, preservatives • High quality readily digestible proteins • Herbs – Milk Thistle – Animal Apawthecary • Nutraceuticals – N-Acetyle-L-Cysteine, Coenzyme Q10, • Antioxidants (Vit. A, C, E, Selenium), Quercetin, Alpha Lipoic • Acid, L-Glutamine, L-Methionine •  • Metagenics (combination products)

21. WHOLISTIC APPROACH Feeling Liverish Thanking You...