Fatty liver or fatty liver disease refers to the accumulation of fat cells in the liver. The liver typically contains some amount of fat. The liver tends to convert usual food into protein, fats and sugar. Some fat in your liver is normal. However, in case that it makes up more than five to ten percent of the organ's weight, you may have a fatty liver.

The basic fatty liver is otherwise called steatosis. Over the top fat in the liver can cause the liver to get swollen and lead to liver damage. Fatty liver aggravation can be brought on by excessive alcohol abuse in which case the condition is known as alcoholic steatohepatitis. However, it can also be brought about by obesity and is then known as nonalcoholic steatohepatitis or NASH. As the ailment advances, liver irritation can prompt cirrhosis and liver failure.

Ayurveda is an old Indian medical system that makes use of herbs existing in nature to create homegrown cures using the intrinsic power present as a part of these herbs. Ayurveda uses the intrinsic power of normal herbs to bring results when it comes to curing various ailments. The herbs are natural and are hundred percent safe. They enhance the body s digestive system and help recover from various diseases and

disorders. The herbs enhance the immune system and strengthen the body in a healthy way.

Here are a few methods to treat fatty liver with Ayurveda:

Terminalia (Arjuna): The herbs of Arjuna have been used since ancient times for its radiant properties. It has unique healing effects on the heart as it tones the cardiovascular muscle and in this way protects it as well. It does so by reinforcing the cardiovascular muscles.

Boerhavia Diffusa (Punarnava): Punarnava is a brilliant Ayurvedic herb with diuretic properties and builds the renal blood stream. It has astringent, sharp, mitigating and calming properties.

Phyllanthus Niruri (Bhumi Amla): It is an exceptionally effective herb appropriate for the management of Hepatitis B and different types of Hepatitis. It has been utilised as a soothing agent for the kidney and liver damage. It is fit for taking out poisons and toxins from the body.

Andrographis (Echinacea): Andrographis is well known for its superb effects on the immune system. It boosts the immunity of the body. It has incredible control over the inflammatory responses in the body. Echinacea is found to have antimicrobial properties that function admirably in infective conditions. It gets rid of distinctive types of diseases and infections.

Cinnamomum Zeylanica(Dalchini): It is a typical Indian herb utilised mostly in each Indian kitchen. Its regular use reduces breathlessness and reinforces the heart muscles, vascular framework and acts as an antioxidant. Cinnamon  is also known to control nausea, sickness and diarrhoea.\

Fatty Liver - Effective Ayurvedic Ways to Treat it

The liver is a vital organ in our body because it performs many important functions. This includes filtering harmful substances in our blood, producing bile to facilitate digestion of food, storing energy and nutrients as well as producing hormones and enzymes that the body uses for performing essential functions. However, too much consumption of alcohol can affect the liver, lead to serious consequences related to our health, and also result in an alcohol-related liver disease (ALD). An ALD may, in turn, cause disruption of the digestion process and weaker immune system. It may even increase the risk of developing cancer.

Causes:

As the name suggests, the prime cause behind the development of alcohol-induced liver disease is the consumption of alcohol for a long duration. However, some of the other causes behind the development of alcohol-induced liver disease include the presence of an existing liver disease such as fatty liver or hepatitis, inherited liver disease, or a liver disease induced due to excessive or prolonged consumption of certain drugs.

Alcohol-induced liver diseases (ALD) can be of three types. 

Alcoholic fatty liver disease: Alcoholic fatty liver disease or steatosis occurs due to the deposition of fats in the liver, which is an end result of excessive alcohol consumption.
Alcoholic hepatitis: Too much of alcohol consumption can also lead to liver inflammation, which is called alcoholic hepatitis.
Alcoholic cirrhosis: This alcoholic-liver disease occurs when the liver is scarred due to excessive consumption of alcohol. In this case, the healthy and soft liver tissues are replaced with dead and hard tissues.
Symptoms: Some of the signs and symptoms, mostly related to ALD, are not noticed in the initial stage. It is only after a few years that the symptoms may appear. Some of the common symptoms include abdominal pain, loss of appetite and weight loss, swelling in the abdomen as well as the legs, feet, and ankles, a yellowish appearance of the skin, itchy skin with hair loss, and bleeding and complications such as liver cancer or ascites.

Diagnosing alcohol-related liver disease is based on your history of alcohol consumption. But, there is no single test that can detect this type of disease, so a combination of tests will be suggested by your physician before a specific type of alcoholic liver disease is diagnosed.



Ayurvedic Treatment

Ayurveda is known to be greatly beneficial for the treatment of alcohol-induced liver diseases. The use of natural ingredients like herbs can not only treat the liver disease but also promote the overall well-being of the liver. The treatment will include abstinence from alcohol, as it is very important when it comes to undoing the damage that alcohol has caused to your liver.

There are some home remedies also which are only supportive in case of Alcoholic fatty liver, but if you are suffering from alcoholic hepatitis and ALD related liver cirrhosis you must need proper line of treatment under a well experienced and expert Ayurvedic doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!

Alcohol Related Liver Diseases - Ways Ayurveda Can Help With It!

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!

A liver transplant surgery involves surgically substituting a problematic liver with a healthy liver from a different person. Usually, the healthy liver is taken from a person who has recently passed away. In some cases, a living person may also give away part of the liver. Usually, living donors are members of the family or someone who has a good blood type match. The liver regenerates lost tissues after a surgery; hence, the donor s liver becomes normal within a few weeks of surgery.

You may require a liver transplant if your liver does not function optimally, owing to the below mentioned conditions:

    Cirrhosis: This is a chronic disease of the liver wherein, scar tissues replace healthy tissues in the liver, thus, not allowing the liver to function optimally.
    Metabolic disease: Disorders that modify the activity of the chemicals in the body
    Acute hepatic necrosis: This is a disorder that causes the healthy tissues in the liver to die
    Autoimmune disorders or liver cancer: Autoimmune disorders can cause healthy tissues in the liver to die as the immune system in the body starts attacking healthy tissues. Formation of malignant tumors in the liver can impair liver functioning.

Procedure
You have to undergo certain procedures before the surgery is conducted; a general health exam, imaging tests, blood tests and a psychological exam are conducted before the surgery. Based on the functioning of the liver and some other factors, your suitability for the transplant will be determined.
The procedure begins with general anesthesia, following which an incision is made in the abdomen. The liver is then removed and replaced with a healthy one. Once the procedure is completed, the surgeon closes the incision with stitches.

Aftercare
Once the procedure is done with, you are kept in the intensive care unit for a few days. The doctor will monitor your progress and put you on medications. After the recovery, you will have to undergo check-ups at regular intervals. You may also have to take medications such as immunosuppressant to prevent your immune system from attacking the liver.

Liver Transplant Surgery - How Best To Care for it Post Surgery?

Just like the name suggests, Non-Alcoholic Fatty Liver Disease (NAFLD) is a set of diseases that can affect the liver due to excess accumulation of fat. One common disease that arises from this condition is known as nonalcoholic steatohepatitis. This can lead to cirrhosis as well. NAFLD is very common in the Western Countries affecting close to 100 million people annually. Although it can occur in any age group, the most affected age group being the one between 40-50 million. With this condition, the risk of getting other diseases such as cardiovascular problems and type 2 diabetes increases considerably.

Symptoms: Non-alcoholic fatty liver shows symptoms such as fatigue, enlarged liver, and pain, discomfort in the upper abdomen. Some other symptoms that have been witnessed in patients suffering from NAFLD include the development of breasts in men, swelling of the abdomen, red palms, jaundice, swelling of the blood vessels etc.

Causes: Experts have not been able to identify the exact causes of NAFLD. However, it is pretty evident that this condition only arises when the liver fails to produce bile which is responsible for digesting the fat cells. The fat in turn deposits in the liver cells resulting in NAFLD. Some of the possible causes include the following:

The resistance of insulin
Type 2 diabetes
High level of triglyceride in the blood
Obesity
Risk Factors: There is a wide array of risk factors that can pose a threat of NAFLD. Some of them include metabolic syndrome, high cholesterol, hypothyroidism, type 2 diabetes, hypopituitarism, obesity, polycystic ovary syndrome etc.

Complications: The major complications of NAFLD is liver cirrhosis. This is a condition that results in scarring of the liver cells resulting in fibrosis. Some other complications include fluid accumulation in the liver, liver cancer, swelling of the vein etc.

Diet: A mediterranean diet is a perfect diet suited for patients suffering from NAFLD. It includes nuts, fish, vegetables, grains, fruits and olive oil. Fat should be eliminated from the diet by a significant bit. It is important to add the right kind of fat in the diet. Omega-3 fatty acid available in flaxseed oil, leafy vegetables, and nuts fits the bill. Studies have shown that vitamin D and E helps a great deal in fighting liver diseases. Some other food items that should be included in the diet are green-tea, red grapes, Brazil nuts, raw garlic, wolfberry etc.

Treatment: Once the disease is diagnosed, a doctor s first endeavour is to ensure that the patient loses weight through a combination of diet and exercise. Vaccination against hepatitis A and B is the next step that a doctor would ideally suggest. For patients who are suffering from cirrhosis, a liver transplant is the only viable option to increase mortality.

What Are The Reasons Behind Non-Alcoholic Fatty Liver Disease?

Tummy tuck also known as an abdominoplasty, a tummy tuck surgery is a form of cosmetic surgery, which is used to remove excess fat and skin from the abdomen as well as tighten the muscles in your abdominal regions. Similar to 'mommy makeovers' (a procedure applicable after pregnancy, which helps women restore their figure). 


Tummy tuck surgery is used to help patients treat that loose and sagging skin who have experienced excessive weight loss within a relatively short period of time. Although, it is usually done for cosmetic reasons, it does provide a large number of medical benefits, such as:


1. Reduction in stress urinary incontinence: Stress Urinary Incontinence is a bladder control problem that is characterized by involuntary urination because of exercises or normal bodily functions such as sneezing or coughing which might put pressure on the bladder. In some women, (SUI) can develop after a vaginal birth. The condition does not generally require a surgery. However, research has shown that in severe cases, abdominoplasty is helpful in patients who do not have a caesarean section. A slight bladder obstruction is made during the procedure using soft tissue which reduces the incontinence.


2. Better posture and improved abdominal tone: Strong muscles tend to become weak after multiple pregnancies and extreme weight loss. In these cases, diet and exercise are not enough. Abdominoplasty surgically removes excess fat and skin thereby, tightening weak muscles and flattening the abdomen. It is noticed that after the surgery, the patients develop an improved posture due to the tightened muscles supporting the spine. This helps in relieving a variety of back pains.


3. Correction of ventral hernia: Ventral Hernia is the bulging out of tissues through a defect, opening or past incisions within the wall muscles of the abdomen. In such a case, the surgeon may opt for Abdominoplasty to support the abdominal wall and prevent recurrences.


Medical Benefits of Tummy Tuck Surgery 

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