The use of milk thistle in hepatitis

Abstract

Hepatitis is an increasing health problem across the world. It involves the inflammation of the liver, and is most commonly caused by a viral infection. Hepatitis can either be asymptomatic or can involve a variety of symptoms, including jaundice, fatigue, anorexia, nausea and vomiting (Smith and Watson, 2005). Acute infection is almost always self-limiting and, in most cases, the best practice involves doing nothing (World Gastroenterology Organisation, 2007). However, infection can lead to chronic liver disease that may develop into serious liver damage. The different types of hepatitis virus are summarised in Box 1. Medical management of hepatitis involves regular monitoring, abstinence from alcohol and, in some cases, intake of antiviral drug medication (Fried et al, 2012). Therapy can be expensive and have adverse side effects and poor efficacy in some patients. Consequently, complementary and alternative medicines(CAM), such as herbal remedies, have become increasingly popular among patients suffering from hepatitis. Patients might view the management of symptoms with herbal remedies as a potentially attractive alternative to conventional medical approaches, primarily because of the popular perception that ‘natural’ products are safer and have a lower risk of causing side effects. Milk thistle (<i>Silybum marianum</i>) is one such herbal remedy that has been used for many centuries to treat the symptoms associated with hepatitis. In this CAM skills-in-practice article, the role of milk thistle in the management of hepatitis is explored. Specific attention is paid to the effectiveness and safety of this nonconventional treatment option.