Monday, March 19, 2007 Dumaguing: Aminoleban nurtures and heals sick livers By Dr. Vic Dumaguing To Your Health
THE liver is the single biggest organ in the body. The liver is a virtual factory, with so many varied functions that contribute to the overall normal functioning of the whole body. Only some of its functions are related to digestive in nature.
The nutrients of food are absorbed into the wall of the intestine, which is supplied with many tiny blood vessels, which flow into veins that join larger veins and eventually enter the liver as the portal vein. This vein splits into tiny vessels inside the livers where the incoming blood van be processed in two ways; bacteria and other foreign particles are removed and many nutrients absorbed from the intestines are further broken down so that they can be used by the body. The liver performs the necessary processes at high speed and passes into blood laden with nutrients into the general circulation. For such an enormous task, the liver is adequately supplied with blood; at any given time, the liver has 1.5 liters of the total five liters of blood that each adult has; one liter is in the portal vein while 500 ml is in the hepatic arteries.
Alcoholic liver disease is damage to the liver that results from excessive drinking of alcohol. Women are more vulnerable to liver damage than men. However, the amount of alcohol that causes liver damage varies from one person to the other. Alcohol may cause three types of liver damage: fat accumulation or fatty liver, alcoholic hepatitis and liver cirrhosis.
Cirrhosis is the destruction of normal liver tissue that leaves nonfunctioning scar tissue surrounding areas of functioning liver tissue. Alcoholic abuse is a common cause. Among people aged 45 to 65 years old, cirrhosis is the third most common cause of death, after heart disease and cancer. People with cirrhosis are weak, with poor appetite, feel sick and lose weight. If bile flow is always obstructed, the person has jaundice (yellowish discoloration of eyes and skin), itching and small yellow skin nodules especially around the eyes. Malnutrition commonly results from a poor appetite and the impaired absorption of fats and fat-soluble vitamins.
Malnutrition is associated with increased morbidity (illness) and mortality (death) rates in patients with cirrhosis. These patients have a higher rate of hepatic encephalopathy (coma) infection and variceal bleeding from the esophagus. Intervention in the early stages of malnutrition can improve outcomes. The goal of nutritional therapy is to improve the protein-calorie malnutrition and to correct specific nutrient deficiencies.
How reassuring to know that Aminoleban is here. At the recently concluded annual convention of the Philippine Society of Gastroenterology and induction of the members of the Hepatology Society of the Philippines on March 12-14 at the EDSA Shangrila, different modalities of alleviating the malnourished state of the liver patient were discussed and naturally, the attention gravitated towards Aminoleban, composed of branched-chain amino acid supplementation. It has been proposed that depletion of the branched-chain amino acids might promote the development of hepatic encephalopathy by enhancing or increasing the passage of aromatic amino acids like tryptophan, tyrosine and phenylaline across the blood brain barrier, leading to the formation of false and unwanted neurotransmitters. A 2003 review of 11 randomized trials concluded that indeed, the use of branched-chain amino acids (BCAAs) improved hepatic encephalopathy especially when administered.
A recent multi-centre, randomized study demonstrated that oral supplementation with BCAAs for two years, improved survival, serum albumin concentration and the quality of life in patients with cirrhosis.
Aminoleban comes in two forms, the Parenteral solution for injection, indicated for the treatment of hepatic encephalopathy in patients with acute and chronic liver disease. It is particularly useful and beneficial in patients with hypercatabolic states like surgery, trauma, burns with evidence of negative nitrogen balance.
Aminoleban Oral is an enteral formula containing amino acids (branched-chain), carbohydrates, fats, vitamins, minerals as a dietary supplement especially for patients with liver impairment. The usual dose is 50 grams (one sachet) three times a day. The 50-gram sachet of Aminoleban can be reconstituted with 180 ml of lukewarm water. The 150-gram per day provides 40.5 grams of protein and a total of 630 calories. Occasional nausea and diarrhea may occur.
Thus, if you have liver disease, strictly follow you doctor's advice especially with regard to alcoholic intake. Heed their advice of small frequent five small feedings per day and cap it with a late night snack. And if the need arises, there is always Aminoleban.
