Tuesday, March 19, 2013

AYURVEDA FOR INTRAHEPATIC CHOLESTASIS OF PREGNANCY (IPC)


Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but it usually goes away within a few days after delivery.

What causes Cholestasis of pregnancy?

Pregnancy hormones affect gallbladder function, resulting in slowing or stopping the flow of bile. The gallbladder holds bile that is produced in the liver, which is necessary in the breakdown of fats in digestion. When the bile flow is stopped or slowed down, this causes a buildup of bile acids in the liver which can spill into the bloodstream.

What are the symptoms of Cholestasis of pregnancy?
  • Itching, particularly on the hands and feet (often is the only symptom noticed)
  • Dark urine color
  • Light coloring of bowel movements
  • Fatigue or exhaustion
  • Loss of appetite
  • Depression
  • Less common symptoms include:
  • Jaundice (yellow coloring of skin, eyes, and mucous membranes)
  • Upper-Right Quadrant Pain
  • Nausea
 Who is at risk for Cholestasis of pregnancy?
1 to 2 pregnancies in 1000 are affected by cholestasis.
The following women have a higher risk of getting cholestasis during pregnancy:
  • Women carrying multiples
  • Women who have previous liver damage
  • Women whose mother or sisters had Cholestasis
How is Cholestasis of pregnancy diagnosed?
A diagnosis of cholestasis can be made by doing a complete medical history, physical examination, and blood tests that evaluate liver function, bile acids, and bilirubin.

How will the baby be affected if the mother is diagnosed with Cholestasis?
Cholestasis may increase the risks for fetal distress, preterm birth, or stillbirth. A developing baby relies on the mother’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on the baby’s liver. Women with cholestasis should be monitored closely and serious consideration should be given to inducing labor once the baby’s lungs have reached maturity.

Treatment for Cholestasis of pregnancy in Modern medicine:
The treatment goals for cholestasis of pregnancy are to relieve itching. Some treatment options include:
  • Topical anti-itch medications or medication with corticosteroids
  • Medication to decrease the concentration of bile acids such as ursodeoxycholic acid
  • Cold baths and ice water slow down the flow of blood in the body by decreasing its temperature
  • Dexamethasone is a steroid that increases the maturity of the baby’s lungs
  • Vitamin K supplements administered to the mother before delivery and again once the baby is born to prevent intracranial hemorrhaging
  • Dandelion Root and Milk Thistle are natural substances that are beneficial to the liver
  • Bi-weekly non-stress tests which involve fetal heart monitoring and contraction recordings
  • Regular blood tests monitoring both bile serum levels and liver function
Treatment for cholestasis of pregnancy needs to be determined by your physician who will take the following criteria into consideration:
  • Your pregnancy, overall health, and medical history
  • The extent of the disease
  • Your tolerance of specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference
Treatments that should not be used for Cholestasis include:
  • Antihistamines
  • Aveeno and Oatmeal Bath
*There are conflicting views on using the medication Cholestyramine for treatment of cholestasis. In the past, this medication was readily used to treat this condition, but some studies have shown that Cholestyramine may not be as effective as other treatments and potentially has some adverse side effects such as blocking essential vitamins like Vitamin K (a vitamin that is already deficient in women with cholestasis).

Ayurvedic treatments for Cholestasis of pregnancy:
Ayurvedic medicines which can help in Cholestasis of pregnancy are as follows:
  • Arogyavardhini
  • Gomutra haritaki
  • Pathyadi kwath
  • Punarnava mandur
  • Shilajit
  • Guduchi
  • Haritaki
  • Panchatikta ghrita
  • Mahatikta ghrita
  • Bhumyamalaki
  • Navayas loha
  • Punarnavasava
 They help in maintaining the bile levels, thereby reduces all the symptoms.

Diet:
The diet includes drinking at least 8-12 glasses of water a day, drinking warm water with the juice from half a lemon, eating an organic diet, getting plenty of fiber, fruits and vegetables with deep pigments, and avoiding sugar and artificial sweeteners.

Complications
Cholestasis in pregnancy increases the risk of stillbirth, fetal distress and preterm birth. For the mother, there is a risk of postpartum hemorrhage.

Risk Factors 
Although the general risk of cholestasis in pregnancy is low, women who have prior liver damage, have had a sister or mother with cholestasis during pregnancy, and women who are carrying twins have a higher risk of developing this condition.

What are the chances of the mother getting Cholestasis in another pregnancy?
Whether or not a woman will get cholestasis in future pregnancies is debatable. However, some sources claim that women who have had cholestasis of pregnancy have up to a 90% chance of having this repeat in future pregnancies.

(P.S: As every human being is different according to Ayurveda, all have different cures. So, kindly consult us or an Ayurveda doctor before taking any herbal medicines.)

This post is written by Dr.Jaina Patwa who is a Chief Ayurvedic practitioner based at Vile Parle, Mumbai, India. She is available as an online Ayurvedic Consultant on Skype. Skype ID - vishwacare

VishwaCARE offers Ayurvedic treatment globally for all chronic and refractory health problems. Dr.Jaina Patwa uses high quality organic herbal extracts which are easy to take, effective and completely safe for long-term use.

For authentic ayurveda treatments or queries, kindly email us on vishwacare.jaina@gmail.com or contact us on +919833998817