Excess fat cells in the human body can settle under the skin and cause obesity, Additionally, they may even settle in specific organs and liver is one of them. When fat starts accumulating in the liver, a condition known as fatty liver manifests itself.

There are two types of fatty liver disease alcoholic and non-alcoholic. As the name suggests, the former is triggered by excessive alcohol consumption, whereas the latter takes place due to other reasons. While non-alcoholic fatty liver disease interferes with the normal functioning of the liver, alcoholic fatty liver disease has specific symptoms such as jaundice, fever, spider veins, and increase white blood cells (WBCs) count.

In the world of Ayurveda, the liver is a pitta organ, which is absolutely essential for normal digestion and elimination. Therefore, the pitta dosha should always be in balance so that toxins are eliminated by the liver from the body. A liver disease results when the pitta is aggravated, which can be treated with the help of lifestyle and dietary modifications, in addition to Ayurvedic remedies.

The following are some of the Ayurvedic tips and guidelines that can support liver healing and reduce the symptoms of fatty liver:



Avoid fatty and fried foods as these can further aggravate pitta and heating and overstimulating.
Incorporate cool and non-acidic food items such as berries, pears and melons into your diet.
Eat a combination of steamed vegetable and whole grains such as quinoa.
Consume aloe juice in moderate quantities as it is cooling.
Regularly consume a mixture of 2 grams of long pepper powder and 1 teaspoon honey once a day for complete 1 month.
Consume a decoction of giloy (Tinospora cordifolia), 30 ml, mixed with a teaspoon of honey once a day. 7. Drink plenty of water to cool the body down and eliminate toxins.
Consume 10 to 20 ml of bhumi amla juice.
Take 1 to 3 grams of kakuti powder twice a day with water after meals.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Fatty Liver Diseases - 8 Best Ayurvedic Home Remedies to Treat It

Uncontrolled alcohol consumption over a prolonged time can severely affect the liver, giving rise to Alcohol-Induced Liver Disease. The liver plays a significant role in digestion as well as filtering the toxins out of the body. Normally, the liver is capable of regenerating its damaged cells and tissues. However, unlimited alcohol consumption interferes with the functioning of the liver. With time, the ability of the liver to regenerate itself also gets affected (reduces) due to excessive drinking resulting in liver problems and disorders.

The stages of alcohol induced liver disease
Alcohol induced liver disease progresses through three stages, alcoholic fatty liver disease, alcoholic hepatitis, and finally cirrhosis.

Alcoholic fatty liver disease: The fatty liver is an early stage of Alcohol induced liver disease, characterized by excess deposition of fats (~ between 5-10% of the total liver weight) in the liver cells and tissues. People with fatty liver should give up drinking for good (or at least till the condition is improved and reversed). Fatty liver seldom exhibits any characteristic symptoms.
Alcoholic hepatitis: Alcoholic hepatitis mostly affects people who are heavily into drinking. More than often, the condition triggers damage and destruction of the liver. Further, there may be swelling and inflammation of the liver. A person with alcoholic hepatitis may experience
Abdominal pain
Fever
Nausea and vomiting
In some patients, the condition may trigger jaundice (excess build up of blood bilirubin resulting for improper functioning of the liver)
In extreme cases, alcoholic hepatitis may result in fatal consequences
Liver cirrhosis: This is the most severe form of alcohol induced liver disease that can give rise to serious and life threatening health complications. Cirrhosis is often an irreversible condition where there is maximum scarring of the liver cells and tissues. In addition to the symptoms associated with alcoholic hepatitis, a person with cirrhosis may also exhibit the following symptoms.
Esophageal varices: It is a condition characterized by bleeding of the esophageal veins
Ascites: In people with cirrhosis, there may be an excessive fluid accumulation in the stomach.
Portal hypertension: It is a condition when the blood pressure in the liver shoots up.
Cirrhosis may also affect the spleen, resulting in its enlargement. There may be mood swings and behavioral problems. A person with cirrhosis should waste no time and immediately consult a specialist to avoid further aggravation.

Factors contributing to alcohol induced liver disease
The following factors in combination with alcohol can wreak havoc, worsening the condition further:

Malnutrition: In some people, excessive drinking can result in malnutrition (alcohol often results in malabsorption of the essential nutrients). Malnutrition, in turn, can adversely affect the liver.
Obesity: Obesity, one of the common consequences of alcohol consumption, can spell doom for the liver and its normal functioning.
Alcohol: It acts as a poison for people suffering from Acute Hepatitis C (viral hepatitis), further damaging the liver. Some research suggests that women who are into heavy drinking are more likely to suffer from liver problems than their male counterparts.
Genetics: It may be responsible for the inability of the body to processes alcohol effectively, resulting in liver problems.

Alcohol Induced Liver Disease - Understanding It In Detail!

The liver can be transplanted either from the living-donor or from the deceased donor. Liver transplant surgery includes the transplantation of a part of the liver from the donor to the donee who has a damaged liver and does not function well. Living-donor liver transplant is more common especially among children as the number of liver donee are more than the available deceased donors of the liver.

Living liver donors are the alternative for the donee waiting for a liver transplant from a deceased person. The remaining liver of the living donor, after the transplant, regenerates itself and reoccurs to its usual capacity and volume within a few months post the surgery. The donated part of the liver to the donee also regenerates and restores to its normal functioning.

Most often, the living-donor of the liver is a close relative or friend. Everyone or anyone cannot donate a liver but only those can who have the matching liver depending on age, organ size, blood type, and other health and medical factors. Both the donor and the donee have to go through a thorough medical examination before the transplant to know the potential outcome and risk involved.

Procedure-
For the transplant, the donor is first operated and the required part of his/her liver is removed. The donee s damaged liver part is then replaced by the healthy liver part of the donor. Both the donor s and the donee s operated liver is then attached with the bile duct and the blood vessels. Both the patients are kept under observation for some days for the medical team to know if they are having any health issue due to the transplant. The operated liver regenerates itself within certain months and starts functioning normally.

Precautions for the Donor-
Although the donor can go back to normal life routine a few months after the transplant there are a number of precautions that should be taken into account to avoid any health issue or liver damage.
  Avoid smoking.
  Avoid consumption of alcohol.
  Eat on time or do not starve or overeat.
  Avoid having heavy meals.
  Avoid heavy exercise or weight lifting or physical work.

Take Away-
Liver transplant is a surgery conducted to remove the damaged or injured liver of the patient with the healthy liver of the donor. The donor of the liver can either be deceased or living depending upon the availability of the donor and the severity of the donee.

Various lab tests and examinations are conducted on the donor and the donee to confirm their match and assess potential complications before the transplant. The donor is usually someone close to the patient or the donee whose liver has been matched depending upon various factors. As the liver regenerates within a few months, the donor can lead a normal life after the transplant.

Know How To Choose A Liver Donor For Liver Transplant! 

The liver is the engine of the human body. It is basically composed of 2 types of cells (a cell is the basic building block of the human body)   hepatocytes (liver cells) and cholangiocytes (bile duct cells). It also has other supporting tissue and their respective cells. The hepatocytes are by far the most numerous cell type, not surprisingly tumours (otherwise called mass or lump.  Tumor  means lump in Latin), of this cell form the majority of abnormal growths in the liver. Abnormal growths can be benign (that is, they do not grow rapidly, spread to other parts of the organ or to other parts of the body) or malignant (grow rapidly, spread to other parts of the organ and to other parts of the body, i.e. cancer). These abnormal growths from liver cells are Focal nodular hyperplasia (FNH), Adenomas (the benign variety) and hepatocellular cancer (otherwise called Hepatoma/HCC, the cancerous type). What we need to recognize is that certain adenomas can turn into HCC, over a period of time. The other type of growths in the liver are those that have originated elsewhere in the body and spread to the liver, for example a growth of the breast spreading to the liver. These are in fact the commonest tumours of the liver. I will discuss these at a later date.

Benign growths of the liver

Common benign growths are Haemangiomas, FNH and Adenoma. Most of these are identified when a scan is performed as investigation for some other problem. Accurate diagnosis of the nature of these lumps is important to determine the type of treatment needed. This can be ascertained by a carefully selected scan like an Ultrasound, CT scan or an MRI. The technology of these scans is continuing to evolve and get better year on year. There are different types of Ultrasound, CT and MRI scans with different applications, based on whether contrast is used or not, the different phases of scanning, the type of MRI scanning sequence etc. Therefore, these scans although commonly available and used very frequently, need to be performed under the supervision of a team involving Liver doctors and radiologist who is well versed in the diagnosis of liver lumps, for accurate diagnosis without the need for unnecessary tests (Box 1).

Haemangiomas are by far the commonest. It is estimated that 5% of the adult population harbor this lump in their livers! They occur in both sexes and at all ages but are commonest between 30 to 50 years in women. Most of them are small, less than 4-5 cms in diameter and are are identified on Ultrasound. MRI and its various applications is the scan of choice for accurate diagnosis. This is crucial as most of them do not need treatment.

Focal Nodular Hyperplasia (FNH) are the second most common liver lumps. They are usually single and small (less than 4 cms) and occur in women between 35   50 years of age. About 2.5-3% of population harbor this lump in their livers. Special MRI techniques using special contrast agents is diagnostic and the findings are quite distinct from haemangiomas. Again treatment is not recommended apart from selected circumstances. Assessment in a dedicated Liver team is recommended for accurate diagnosis and a proper management plan to be formulated.

Hepatic adenomas (Hepatocellular adenoma, HCA) are rare lumps and occur in 0.2 to 0.3% of the population, again occurring mostly in young women during their reproductive period. They are again solitary and most usually 3-4 ms in diameter.

There are a couple characteristics which make this lump different from the previous 2, there is a strong relation between hormones the development of HCA and some of these HCA can turn into the malignant Hepatocellular carcinoma (HCC). Therefore, accurate characterization and diagnosis of these HCA is essential. Sometimes biopsy of the lump, molecular and genetic tests maybe necessary to determine if the HCA has a high chance of progressing to HCC. Imaging tests are generally adequate, contrast MRI Liver and its different techniques is accurate in diagnosing HCA and sub-typing it, however CT and contrast-enhanced Ultrasound is sometimes necessary along with MRI.

Generally, a HCA in a male is recommended for surgical resection. While in women, discontinuation of the OCP pill/ any other such hormone is recommended for a period of 6 months, if the HCA does not have any worrying features and size is less than 5 cms. IF HCA is larger than 5 cms and has features suggestive of a high risk for change to HCC, surgery is advised. Again these decisions have to be made as a part of a Multi-disciplinary team (Box 1)

Malignant growths beginning within the Liver

As mentioned earlier, usually malignant growths which are seen in the liver spread to it from elsewhere in the body. Hepatocellular cancer/Hepatoma (HCC) is the commonest malignant tumour beginning within the liver, as apposed to those that spread to the liver from elsewhere. It occurs between 40-70 years of age and occurs commonly in men. It is estimated that 17000 new patients develop this tumour every year in India. The vast majority (> 80%) of these develop in patients who have chronic liver disease (cirrhosis). Importantly the number of HCC cases is increasing year on year as cirrhosis due to fatty liver disease, Hepatitis B (3% of Indian population carry this virus, ie nearly 40 million individuals) and alcohol are continuing to increase in India. Nearly overall it is the 4th or 5th most common cause of cancer and the second most common cause of cancer-related death. This is continuing to increase too. We do not have a national policy in India to screen and diagnose these lumps in the liver at an early stage. Most patients present at a late stage when effective treatment is not possible.

Hepatitis B is a vaccine-preventable disease, there are good drugs to treat it and decrease the risk of cirrhosis and HCC in HBV patients, therefore it is important to test for this virus infection. The fatty liver disease can cause chronic liver damage and HCC, regular exercise and consuming a balanced diet can reduce the risk of fatty liver disease.

The usual mode of detection of these growths is when a scan is done for some other reason. Occasionally patients can develop pain in the abdomen or jaundice which leads to an investigation. The treatment of HCC depends on the extent of tumour, the extent of the chronic liver disease (the stage of cirrhosis) and the overall condition of the patient. These patients are best seen, assessed and treated in a team (Box 1) which specializes in the treatment of Liver disease.

The best treatment for HCC is surgery. However, this is suitable only for certain carefully selected patients. This can take the form of liver resection (where a portion of the liver with tumour is removed) or liver transplantation (where the whole liver is removed and a donated liver (full or partial) is replaced into the patient. Indeed surgical has excellent survival rates; more than 75% of patients survive for more than 5 years after resection or transplantation making treatment for these cancers one of the most satisfactory.

Other treatments which can be combined with surgery in selected patients or can be combined with patients not suitable for surgery are different types of Interventional radiological therapy   chemotherapy or radiotherapy delivered through fine catheters introduced into the blood vessels of the liver (TACE: Transarterial chemotherapy, TARE: Transarterial radiotherapy) and or heat energy delivered to the tumour area by means of carefully placed needles/probes (RFA: radiofrequency ablation, MWA: microwave ablation).

HCC is unique cancer as its treatment should be tailored to the patient, the treatments are varied and range from catheter-based non-invasive treatment to major surgery and transplantation. This necessitates that HCC patients are best managed in a multidisciplinary team which is highly skilled in and specializes in the management of liver diseases.

Box 1: A liver tumour multidisciplinary team   Integrated Liver Care team

The team should be one with expertise in the management of benign liver lesions and should include a Hepatologist, a Hepatobiliary & Transplant surgeon, Diagnostic and Interventional radiologists, Medical oncologist and a Pathologist.

Each member of the team must hold specific and relevant training, expertise and experience relevant to the management of benign liver lesions.

The team should be one with the skills required not only to appropriately manage these patients but also to manage the rare but known complications of diagnostic or therapeutic interventions.

The Increasing Problem Of Liver Tumours In India!

Liver, one of the most hardworking organs in your body sits snugly in the upper right part of your abdomen, beneath the diaphragm. This organ is a multi-tasker and it works tirelessly all day. Your body needs the energy to carry out all its tasks. You may have a vague idea that the food you eat plies your body with strength. But where does this energy come from? How is it produced? Your liver has a hand in it. Have we piqued your curiosity? Do you want to know how it acts as your body s power source? Read on!

Utilization of carbohydrates
Carbohydrates are a macro-nutrient that are vital for energy production. They are present in foods such as wheat, rice, potatoes, apples, bananas etc. But in the form you consume them, carbohydrates will not energize you. So your body converts them into glucose and stores them in your liver as glycogen. Glucose gives you energy. When your body senses your energy levels are dropping, the liver releases some glycogen that immediately perks you up.

Breaking down proteins
Your liver also breaks down protein by deaminating them to initiate the Krebs/Citric Acid Cycle. It is your liver that starts changing the amino acids so that proteins can enter the Citric Acid Cycle in which they will be converted into the kind of energy that is usable.

Metabolism of fats
Do you know how your liver plays a part in metabolism? It does its bit in the breakdown of fats with the help of bile. And when fats are broken down, you get energy.

Greater liver efficiency with Ayurveda
The ancient Indian medicinal science Ayurveda deals extensively with the liver. Ayurveda can tell you what you can do to ensure that your liver stays healthy and strong. And if you have developed any liver-related disease, such as Hepatitis A, Hepatitis B, Hepatitis C, Liver Cirrhosis or Autoimmune Hepatitis, then Ayurveda can deal with these illnesses. So if you have been diagnosed with any liver illness please take suggestion from an Ayurvedic liver specialist who will have answers to all your liver problems.
Your liver is your source of energy. That is why you have to take excellent care of your liver so that it does not give out on you.
Though there are ways in Ayurveda to treat Liver Diseases and keep liver healthy, it is always advisable to consult an ayurvedic liver specialist before opting for any medicine or remedy.

Your Liver Is Your Power Engine - Learn More!

Having some fat in your liver is legit. But, if you have too much of fat say more than 5%-10% of the organ's weight then you are at risk of getting fatty liver disease. At the onset, you can do one important thing to help your liver stop drinking. It causes fatty liver disease.

There are two main types of fatty liver disease

Alcoholic liver disease or ALD
Non-alcoholic fatty liver disease or NAFLD
If you are a woman who is pregnant, you can also get fatty liver disease.
Alcoholic Liver Disease (ALD)

You can get ALD from drinking lots of alcohol. ALD can also present itself after a short period of heavy drinking.
Genetics has a role to play in ALD. Genes can make you hit the bottle and increase your chances of becoming an alcoholic.
Genes can also impact the way your body breaks down the alcohol you drink.
Other root causes of ALD are:

Hep C doesn't cause ALD. it is one of the causes of fatty liver. 
Hep B is also a cause of fatty liver. There are certain medications which may be helpful from person to person besides lifestyle management.
Excess iron in your body
Obesity
Non-alcoholic Fatty Liver Disease (NAFLD)
The cause of NAFLD is not clear, but we know that it tends to run in families.
NAFLD is also more common in the middle-aged and the obese or, those who have high cholesterol and diabetes.

Other risk factors are:

Certain medicines
Viral hepatitis
Auto-immune or inherited liver disease
Gaining weight fast
Malnutrition
Acute Fatty Liver during Pregnancy
Fat can build up in your liver when you're pregnant, causing this kind of fatty liver disease.
It s a serious condition as it can be risky for both you and your baby. It can cause liver or kidney failure in you and your child, both.
Causes are unknown. But, hormones may play a role.
Symptoms of fatty liver disease
This disease can sometimes cause no symptoms for long. But, the things to look out for are-

Feeling tired all the time
Loss of appetite or weight
General weakness
Nausea
Confusion and trouble concentrating
Your liver can become larger
Pain in the centre or right upper part of your belly
In ALD, your symptoms get worse after bouts of heavy drinking. Fatty liver disease is diagnosed during routine exams when your doctor notices your enlarged liver. Ultrasound, blood tests to check for certain enzymes and biopsy of the liver are performed to confirm it.

Treatment

There is no specific treatment for the fatty liver disease.
You can manage it by managing your diabetes and giving up drinking. If you have ALD and you don t quit, you get complications like alcoholic hepatitis or cirrhosis.
Even if you have a non-alcoholic fatty liver disease, alcohol cessation helps.
Losing weight if you are overweight also helps to manage this disease and having a good balanced diet with exercise also shows benefits.

Fatty Liver Disease - Signs You Are Suffering From It!

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