Brief Answer:
Evaluation and Management

Detailed Answer:
Dear,

Thanks for contacting Ayurveda with your health concern.

Going through your case & medical history following points are worth mentioning

1. Since there is/was history of mumps, kidney stones, alcohol intake thus make sure to check regularly with your physician regarding pancreatitis.

PS -
. mumps/alcohol are risk factors for pancreatitis since complication of both is/are inflammation of pancreas.
. since you developed kidney stone, make sure to undergo an Ultrasound to know about the gall bladder for gall stones.

2. Although there is no direct relation between alcohol and joint pains but heavy alcohol consumption results in increased formation of uric acid in the body, resulting in pain and inflammation.

PS. pain in right upper quadrant area can be attributed to alcohol abuse.

3. Binge drinking is more dangerous than regular drinking since it suddenly overload the liver with excess alcohol due to which proper metabolism and detoxification is not achieved and resulting in your present symptoms.

4. Since LFT [liver function test] came normal twice it is worth mentioning that because liver has tremendous power of regeneration thus it is still working and metabolizing good.

5. Since alcohol slows down bowel movement [peristalsis] thus involved in constipation.

PS. due to dehydration there is loss of fluids/electrolytes resulting in dry/hard stools.

6. Long term use of alcohol is associated with water retention [puffy and swollen eyes]

7. Regarding your Questionnaire:

1. Do let me know about the Dose of alcohol which you consumed regularly in 4 years which will evaluate your present condition and further guide for management and treatment of point 3.

2. DIETARY AND LIFESTYLE CHANGES

1. There is a limit to how much one can exercise everyday. An average (non athlete) person cannot run or exercise vigorously for more than 30 minutes i.e., you cannot burn more than 300 calories through EXERCISE everyday! So it is important to control the tongue, along with whatever exercise you do:
½ hour of walking burn 130 calories
½ hour of jogging/running burn 300-350 calories
½ hour of swimming burn 250 calories
½ hour of cycling burn 150 calories
½ hour of aerobic exercise burn 250 calories
½ hour of light exercise like writing/driving burn 50 calories
i.e. if you don’t exercise you consume about 2000-2500 calories per day. To this you Add any of the above exercise protocol to consume more calories, and keep your calorie consumption below 2000 per day and you will be losing weight.

2. Tips on Eating: Starvation is not the right way to loose weight. Take the right type of diet and eat heartily:

AVOID:
.sedentary lifestyle, day time sleeping after meals, newly harvested rice, curd, butter, alcohol, ghee, cheese, cream, chocolates, cakes, pastries, ice-creams
. oils should be reduced to minimum, avoid deep fried foods like puries, bhujees, potato chips.
.avoid potatoes, sweet potatoes, beets, yam, nuts, fruits with sweet pulp like XXXXXXX chickoos, bananas and grapes.
. avoid processed and tinned foods, opt for fresh foods.
. drinking cold water after exercise.
. Eliminate all cold food and drink, you should eat nothing that is refrigerator cold.

WHAT TO EAT:
.start the meal with large bowl of thin soup, followed by good volume of salads prepared with green vegetables (cabbage, cauliflower, lettuce, cucumber, sprouted pulses). This will prevent you from taking extra servings of the meals. Drink plenty of water and diluted buttermilk.
.Avoid rice, take roti or phulka, without oil or ghee. The bhaji servings should be prepared from green leafy vegetables, onions, cauliflower’s, lady’s finger, radish, turnips, mushrooms, sprouted pulses. Oil may be substituted by gravy of tomato, onion, garlic, and ginger, in the curry or bhaji for taste.
. For morning and evening snacks, take recommended fruits, vegetables and low fat (skimmed) milk, black tea without sugar has negligible calories.
. Carbohydrates: fat requires carbohydrates to burn, so take them in moderation like grains.

2. DEVELOP HEALTHY EATING HABITS:
. Do not eat only 2 large meals a day. It leads to overeating due to hunger. Take snacks in between. It is advisable to eat a good breakfast and light lunch and dinner.
. Keep a quiet and pleasant atmosphere in the dining hall. Watching TV while eating, talking, arguments, angry discussions all lead to overeating.
. Eat slowly, chewing each bite thoroughly gives a feeling of satiation.
. do not be tempted to finish up the leftovers.
. use nonstick cooking ware for cooking.

8. Since there is grade 1 fatty liver which means fat accumulation is around the surface of the organ and doesn't interfere with functions of the liver [as suggested by normal liver function tests]

PS. fatty liver due to alcoholism requires permanent abstinence from alcohol to prevent the progression of disease into stage 2 and 3. In the alcoholic fatty liver type, voluntarily abstaining from alcoholic beverages for the entire duration of the person’s existence is sufficient to prevent the progression of this disease.

Please revert back with your concern(s)

Dr. Munish Sood
Consultant & Physician
Naimittika

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Brief Answer:
Alcohol Liver disease.

Detailed Answer:
Dear,

Thanks for reverting back

1. Danger dose of Alcohol

The danger dose of alcohol consumption is > 80g/day for atleast 8 years. A steady daily intake is more dangerous than intermittent drinking [doesn't include binge drinking]. Alcohol related liver damage does not exist if the intake is below 40g/day.

Alcohol equivalents
. Whisky: 30 ml = 10g
. Wine: 100 ml = 10g
. Beer: 250 ml = 10g

PS.
i. 4 years of 250 - 300 ml whisky/day equals 80 - 100g/day equals 3600g/year i.e. 14,400 in 4 years
ii. later from 2012 till September 2014: 80g/week equals 4560 in 1 year 9 months
iii. since last 3 months, on weekends it is 4500 ml beer which means: 180g for 2 days

2. Take: old brown rice, green gram dal and soup, amla murraba,sugar, pomegranate, dates, coconut, old ghee, milk, pickles, bottle gourd, XXXXXXX fasting, sauna bath, good company, music, spend more time with your better half.

Avoid: tobacco in any form, excess heat [physical], corrylium, errhine therapy.

3. Home Remedies.

i. Boil 1 spoon black pepper powder and 5 spoon jaggery in 4 cup water till 2 cups remain. Filter it and drink for 1 month.

ii. mix 3-4 dates in half glass of butter milk every morning.

iii. regular intake of apples helps to get rid of intoxication and reduces thirst for wines or any type of liquor.

4. In ALD [alcoholic Liver disease] I usually prescribe hepato-protective drugs like: कासनी [ kasni]/ कुटकी [kutki]/ निम्ब [nimba]/अमृता [amrita]/ भृंगराज [bhringraj]/भूम्यामलकी [bhuiamlaki] which helps in hepato cellular regeneration, immuno-modulation and anti viral activity which is evident through significant improvement in liver function tests and clinical improvement in patients, thus I will recommend to go for Syrup "EVERLIV" which has a major contributory efffect on hepatocytes protection and regeneration.

PS. Since immediate abstinence or avoiding alcohol at one might result in alcohol withdrawal syndrome [sweating, anxiety, tremors] thus I would ask to go for fermented medicated alcohol, like
. श्रीखंड आसव [shrikhand assav] and/or
. खर्जुरादी मंथ [ kharjooradi manth]

5. going by your alcohol intake which is influencing all the three doshas:
. pain/constipation due to Vaat imbalance
. jaundice/ fatty liver due to Pitta imbalance
. puffiness/weight due to Kapha imbalance

Since your IP Address is not opening even on repeated attempts, thus unable to define your precise location [India or abroad] since there is difference in seasonal variation.

Dr. Munish
Naimittika

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Brief Answer:
Alcohol related pancreatic Damage

Detailed Answer:
Dear
Thanks for reverting back.

1. Since the liver needs only 10% of its cell mass to maintain metabolic functions and because of its unique regeneration capability, initially the patient are asymptomatic and if you abide by the management schedule and said protocol it will take a time period from 6 months to 1 year to fully detoxify the system.

PS. do not start abstaining completely, as withdrawal symptoms [delerium tremens] can manifest compromising your recovery.

2. regular use of alcohol cause enzymes of pancreas to secrete internally rather than going into the small intestine to digest food, instead auto digestion starts where enzymes attack its own organ and thereby causes inflammation, swelling of tissues and blood vessels resulting in acute pancreatitis and if drinking is continued, inflammation becomes permanent i.e. chronic pancreatitis

PS. one should regularly check with
. Serum Lipase/Amylase level
. Serum albumin/Calcium
. Blood sugar
. Serum Bilirubin and alkaline phosphatase [if obstruction is suspected]

3. Regarding Constitutional Information [Vata,Pitta, Kapha] please contact me at the following:
http://doctor.healthcaremagic.com/doctors/dr-munish-sood/62147

Dr. Munish
Naimittika

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