Cirrohosis 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 lethargy.
The frequency of cirrhosis of liver is quite high among Indian children. The highest incidence occurs in late infancy and upto three years of age. Almost 75 per cent cases fall in the age group one to three years.
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 vast chemical laboratory which performs many important functions. It produces bile, cholesterol, lecithin, blood albumin, prothrombin, and numerous enzymes. The liver stores vitamins and minerals. It also destroys harmful substances and detoxifies drugs, poisons, chemicals and toxins from bacerial infections.
Cirrhosis of the liver in children is characterised by fever, bleeding tendency and haemmorrhagic episodes, jaundice, oedema of limbs and haemmorrhoids. In the early stages of the disease, the child’s body often feels warm, though the temperature may not go beyond 99 o F. Recurrent moderate to high temperatures are common.
Some children do not relish normal diet, hitherto enjoyed by them, and instead crave for abnormal stuffs like mud, chalk and coal. Other children possess good appetite, but soon complain of fullness in stomach. Abdominal distention and stomach upsets are quite common in early cirrhosis. Some children get constipation alone or alternating with diarrhoea. The child does not feel normal.
He usually becomes irritable, gets upset very easily and is miserable and indifferent. The liver is enlarged and becomes firm.
In the advanced stage, the spleen is enlarged and firm and the pulse becomes rapid. The child loses weight, runs irregular temperature. He becomes more irritable and indifferent. The child becomes anaemic presumably due to lack of proper digestion and absorption and bleeding from the haemmorrhoids. There may be oedema of limbs and formation of ascites which is preceeded or followed by jaundice. The liver shrinks and the patient shows tremors of fingrs and extremities. He may eventually go into heptic coma and may get convulsions.
Poor nutrition can be the main causative factor in the development of cirrhosis in children. Other causes of cirrhosis are excessive intake of highly seasoned food, infections, toxins, metabolic deposits, habitual taking of quinine for a prolonged period in tropical climate and drug treatment for fever and other diseases.
It may also result from a highly toxic conditoin of the system in general. In fact, anything which continually overburdens the liver cells and leads to their final breakdown can be a contributing causes of cirrhosis in children.
The liver cells have amazing regenerative power and all possible steps are necessary to enhance and stimulate this power through natural methods. Infantile cirrhosis can be prevented by maintaining adequate nutrittious diet for the mother during pregnancy period.
Proper diet and vitamin B complex are considered essential for regenerating liver cells.
In the early stages of cirrhosis, a diet rich in high quality protein is necessary. The best proteins for liver patients are obtained from goat’s milk, homemade cottage cheese, sprouted seeds and grains and raw nuts, especially almonds. Vegetables such as beets, squashes, bitter gourd, egg-plant, tomato, carrot, radish and papaya are also useful in this condition.
Fats should be restricted as their excessive intake may mar the patient’s appetite and lead to gastro-intestinal disturbances.
In the later stage, the high protein intake should be curtailed because of possible protein intoxication. Here, the diet should be rich in carbohydrates and intake of protein should be kept to the minimum to prevent protein deciciency.
The child-patient should avoid all refined, processed and canned foods, spices and condiments, 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.
The morning dry friction bath should form a regular daily feature of the treatment. Fresh air and sunbaths are also beneficial and the child-patient should spend as much time outdoors as possible.