The term cirrhosis refers to liver scarring due to various diseases and conditions such as chronic alcoholism and hepatitis. Each time the liver gets injured, it tries to repair itself, resulting in the formation of the scar tissue. With the progression of cirrhosis, a number of tissues generate making the task of liver difficult. Since the liver is an important organ of the body due to its functionalities such as detoxification and nutrient generation, reduced function of liver poses a serious threat to the body.

Symptoms of liver cirrhosis:
Unfortunately, cirrhosis doesn t portray any conspicuous symptoms that can be easily identified until the scarring has reached a level of threat. Some of the common signs and symptoms of this disease include fatigue, nausea, itchy skin, drowsiness, enlarged breasts, testicular atrophy, fluid in the abdomen, bleeding from the mouth, leg swelling, redness in palms etc.

Causes of liver cirrhosis:
There could be an array of reasons for the occurrence of liver cirrhosis. The major causes include an accumulation of fat in the liver, chronic alcoholism and chronic hepatitis. Some of the other reasons include cystic fibrosis, bile duct deformation, Wilson s disease, hemochromatosis, schistosomiasis, continuous consumption of medicines such as methotrexate, a disease involving glycogen storage and Aalagille syndrome.

Complications involved in liver Cirrhosis:

High blood pressure: Cirrhosis results in slow blood movement through the passage of the liver resulting in an increased pressure on the vein that is responsible for carrying blood from the intestine to the liver. This increases the blood pressure in the body.
Swelling of abdomen and legs: Portal hypertension can result in accumulation of fluid in the leg and the abdomen due to the liver s inability to producing an important protein known as the albumin.
Spleen enlargement: Portal hypertension is responsible for changing the shape of the spleen. Decreased count of WBC and the platelets indicate towards portal hypertension and cirrhosis.
Bleeding: Portal hypertension doesn t let the blood flow in its normal path. It directs the blood to flow through smaller veins. The veins, in turn, swell and burst to cause a massive amount of bleeding.
Apart from these some of the other complications involve jaundice, liver cancer, infections, bone diseases and liver failure.

Diagnosis:
Liver cirrhosis doesn t get detected easily. It is often diagnosed with a routine blood test. Some of the lab tests that can help to identify cirrhosis include blood work to check organ function of liver and kidney. Your doctor might suggest other tests such as MRI scan, CT scan or liver biopsy.

Treatment:
Treatment for the underlying cause of liver cirrhosis is done to keep the disease under control. A doctor might treat you for weight loss, alcohol dependency, complications related to hepatitis, portal hypertension and hepatic encephalopathy. For advanced cases where the liver stops functioning, a doctor might suggest a patient go for a liver transplant.

Liver Cirrhosis - What You Must Know About It?

The human body s ability to manage the fats consumed and the way the liver functions to handle this in the overall metabolism setting are dependent on choline. Choline, which is present mostly in the form of Vitamin B12, is available in plenty in most of the foods consumed by people regularly. The issue arises when the body system fails to absorb choline nutrient from the food consumed. There are also cases where the dietary intake does not possess adequate choline in it.

Natural Difficulty in Absorbing Choline
There are certain conditions in which the system finds it difficult to absorb choline though the diet may contain the nutrient. People who have just undergone a by-pass surgery or those who have had a kidney transplant done or if there is already a liver problem like cirrhosis face this issue. There are other reasons also which can lead to choline deficiency, such as the prolonged intake of anti-convulsant drugs and so on.

How to Detect or What are the Symptoms?
Some apparent symptoms can lead the GP to ask for more tests to establish that the person does have choline deficiency. In normal person, even high blood pressure could be caused due to choline deficiency. Then in many cases, a blood test for any other condition might reveal very low levels of VLDL (Very Low-Density Lipoprotein). This substance in the blood is used by the liver to transport fats and naturally, if VLDL is below a certain threshold the person is bound to be suffering from choline deficiency. High level of cholesterol is another symptom. It has to be understood that choline is also essential for the human brain to be functioning at its active best. Deficiency of choline can lead to an early setting in of dementia. Of course, any patient with liver and kidney related condition reaching the doctor will be checked for choline deficiency since these are closely related.

Where to Get Choline from?
The next obvious question is which foods can get you choline easily and you won t suffer from a deficiency. As mentioned there are plenty of food items of daily consumption which have choline in them. The most frequently recommended are the yolk of the egg. Pastured eggs are recommended and though even one egg can give some 115mgms of choline, you can make a couple of eggs a part of your daily breakfast menu. The other suggestion is raw liver as in beef liver which is quite rich in choline. Those who consume only vegetarian foods can always eat a lot of green vegetables like cauliflower, cabbage and also nuts and legumes (soaked) and milk and yoghurt are all good for choline intake.

Choline is an essential nutrient in the human body and is critical to the growth and development of cognitive functions and its deficiency can lead to many serious conditions, including liver impairment and brain disorders. There are plenty of foods rich in choline and should be consumed regularly.


Choline Deficiency - Signs You Are Suffering From It + Sources Of Choline!! 

Pregnancy is a time when your body undergoes a plethora of changes, both emotionally and physically. In such a situation, an acute liver failure only triggers further complications, threatening to affect both the mother and the fetus. The ambit of liver diseases range from mild complications to those that can be life threatening. Acute liver failure or ALF, as it is commonly known as in medical parlance is a condition which is caused when then there is a sudden impairment of the ability of the blood to clot. In spite of the erratic nature of the ailment and its ability to affect anybody with a complete disregard of the individual, s pre-existing history of liver problems, there are certain causes that are said to propel it. Some of them are-

Eclampsia with liver infraction: This is an extremely rare condition. Generally, eclampsia refers to the occurrence of convulsions in pregnant women, mostly in those who suffer from high blood pressure. Those women who suffer from eclampsia along with liver infraction are more susceptible to have a liver failure.
Hepatic rupture: Much like eclampsia, hepatic rupture is also caused in women who have high blood pressure. This heightens the risk of an impending liver failure in pregnant women.
Fatty liver: Sometimes excess of fat develops in the liver deterring its functioning. This is not only detrimental to your health but also poses a great danger in triggering a liver failure.
In spite of these, there have been multiple treatments which have developed to manage and curb it. Some of them are-

Remedial measure for coagulation: The inability of blood to clot blood is known as coagulation which is extremely fatal and one of the primary causes that leads to liver failure. Therefore timely and potent intervention of medicine is important to prevent that and in turn diminish the possibility of liver failure.
Volume replacement: Volume replacement refers to the condition where fluids are resuscitated or replenished into the body, those that were lost but at the same time are mandatory for the proper functioning of the body.

Acute Liver Failure in Pregnancy

Liver transplant in the only curative option available for patient who develop cirrhosis of liver due to any cause ( Chronic Hepatitis B , Chronic Hepatitis C, Alcoholic Cirrhosis, NASH etc). Once patient has been diagnosed with cirrhosis it can not be reversed with any non-surgical treatment . Over a period of time patient may develop worsening in liver function resulting in complications of cirrhosis (bloody vomitus, black stools, jaundice , altered sensorium, renal dysfunction, abdominal swelling etc) labeled as  decompensated cirrhosis . These patients require Liver transplant at the earliest and should be reffered to a liver transplant centre immediately. Ideally all patient diagnosed with cirrhosis should be under the follow-up of a gastroenterologist/Hepatologist. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient. 

Before the Liver transplant 

All recipient and Living donor go thorough evaluation before the transplant process that includes blood investigations, Imaging studies, Cardiac and pulmonary fitness tests, multidisciplinary consultation before the clearance for liver transplant is achieved. The healthcare provider will explain the entire procedure. The healthcare provider is also supposed to answer all your questions. You would be needed to sign a consent form that allows the doctor to do the surgery. Eating food is not allowed at least 8 hours before the surgery. If you cannot stay relaxed before the surgery, a sedative will be given. 

After the Liver Tranplsant 
The recipient surgery lasts for anywhere between 12-16 hrs and donor surgery for 8-12 hrs. After the surgical procedure is complete, you will be taken to the intensive care unit (ICU)and will be closely watched for several days. 

Immediately After the Surgery 
You will most likely have a tube in your throat. This is so that you can breathe with the help of a machine (a ventilator) until you can breathe on your own. The ventilator tube will be removed on next morning when all parameters are found to be satisfactory. All parameters are monitored by round the clock critical care doctors and staff for a few days. The recipient has to stay in the hospital for three weeks and the donor is discharged in one week. 

Blood samples will be collected on a regular basis to check the functioning of the new liver. Antibiotics will be infused via IV channels to prevent you from infections. The area where the operation was done should always be kept clean after you have reached home. Any stitches or surgical sutures will be removed at a follow-up visit.

Complications that may arise 
Blocked blood vessels to the new liver, bleeding, an infection, leakage of bile or blocked bile ducts, or the new liver not working for a short time right after surgery are a few complications that may arise. Not to aggravate the condition, in the case of a complication, it is imperative to visit your doctor.

Liver Transplant - What To Expect Before & After The Procedure?

Liver is one of the most important organs of the living beings, which performs various functions to keep the body healthy and fit. In some people, the liver will be malfunctioning due to several reasons. So, in these technology days, it is possible for the transplanting it from a healthy person to the patient. Though it is possible but, this transplantation will not be successful for all which can be due to individual health conditions and the stage of liver failure. In order to determine whether a patient can go for the liver transplant or not there are several tests to consider.

Steps to undergo liver transplantation
Liver transplantation is not as simple as it is said, but there are several steps to consider before one thinks of this surgery. Some of the primary steps involved in the process of liver transplantation are:

The first step is to visit the doctor and discuss about liver transplantation.
Then as per the suggestion of the doctor visit the referred liver transplant centre.
The patient is provided with the required information regarding liver transplant.
In this course of time patient will meet several members of the transplant team.
Next medical history of the patient is viewed and recommends some tests to determine the requirement of transplantation.
Then the results of the tests say about the patient condition.
After that, a donor is found out who can be either a living donor or deceased one.
Once the donor is found, transplant centre asks the patient to be prepared for the transplantation.
Process of determining liver transplantation
Determining the requirement of liver transplantation is the most important step which is evaluated by the specialists only. These specialists will be from various fields to know whether it is highly essential or not. This evaluation will be based upon the medical history of the patient, in some of the cases interviewing or discussions with the patient and huge number of tests. All these will be conducted by a professional liver transplant team at the liver transplantation centre only. This team includes:

Liver specialists are also known as Heptalogist
Transplant coordinator
Transplant surgeons
Psychiatrist
Financial coordinator
Social worker
Insurance manager
Anesthesiologist
Dietitian
Chemical dependency specialist
Tests to evaluate the need of Liver Transplantation
Patients are required to present all their previous health records which include X-rays, liver biopsy slides along with the medications during the pre-evaluation of liver transplantation. The common tests that are performed to evaluate the necessity of liver transplantation include following:

Computed tomography for generation of liver pictures
Doppler ultrasound for checking blood vessels from and to the liver is in open condition.
Echocardiogram for the evaluation of heart condition.
Pulmonary function to determine the condition of lungs in respiration process.
Blood test to check the type of blood, clotting ability along with the biochemical status of the blood.
In some patients, AIDS along with Hepatitis are also included.
All the above tests along with the exams help in diagnosing if a patient needs liver transplantation depending upon the condition.

How To Evaluate If Liver Transplant Is Required By A Patient?

Fatty liver or steatosis refers to the condition in which excess fat gets accumulated in the liver causing the liver to dysfunction. Some percentage of fat in the liver is normal but if it gets beyond the figure of 5 to 10 percent, then it is surely a cause of concern. Such a condition warrants treatment and if fatty liver is not treated on time, it can lead to liver cirrhosis or cancer. Therefore, the signs and symptoms of fatty liver should be taken seriously.

Some of the common symptoms of fatty liver include pain in the abdomen, loss of weight, swelling in the foot, jaundice, and inflammation of the liver. Anyone who suffers from these symptoms is likely to suffer from fatty liver. But the good news is that it can be treated. There are medicines in Ayurveda, homeopathy, and allopathy for fatty liver and if one talks about Ayurveda, it treats fatty liver with a holistic approach.

1. Fatty liver and Pitta Imbalance: Ayurveda works on the principles of managing vata, pitta, and kapha   the three physical energies present in the human body. It believes that when there is any imbalance in these energies, dosha (disease) affects the body. According to Ayurveda, pitta is related to the metabolic system of the human body, which governs ingestion, digestion, and excretion. The liver, being a part of the metabolic system, is further related to pitta and this is why, when the pitta gets aggravated, the liver becomes diseased and starts to dysfunction. Ayurveda says that pitta imbalance is responsible for fatty liver. In fact, the liver is known as pitta in Ayurveda. It says that when toxins begin to build up in the liver, the liver has to work extra and this causes inflammation, ultimately leading to liver problems. So, Ayurveda tries to correct this imbalance through herbal medicines and detoxification treatment procedures.



2. Ayurveda dos and don ts: Ayurveda is a holistic science and therefore, it does not focus on suppressing the symptoms, similar to what allopathy does. It is also free from side effects and gives a permanent relief. But the patient undergoing Ayurvedic treatment has to be mindful of their lifestyle and eating habits. In case of fatty liver, Ayurveda prohibits alcohol, smoking, and spicy and oily food. So, the patient should avoid these foods. These food items should not be taken by the patient during the treatment duration. Otherwise, the effect of the medicines will get nullified. Anyone who goes for Ayurvedic treatment should remember that diet and lifestyle is a part of the treatment process and both go hand in hand.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Ayurveda for Fatty Liver - Must Know Information!

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