In modern day societies of intense stress and work pressure, the average diet mostly comprises of street foods, packaged fast foods and processed foods. Such stress and overexposure to a lot of toxins (present in the processed food, fast foods, and street foods) disable the liver from performing its primary function of cleansing the toxic materials through the skin, the respiratory and the digestive system. Besides, this overexposure to toxins also disrupts bile formation, which hinders the absorption of necessary nutrients, resulting in a severe disruption in health. Also, liver is responsible for the proper functioning of the eyes, the brain, the kidneys and the joints in the body. Thereby, it is necessary to include these 7 foods in your diet which help to detoxify your liver from the excessive toxins and allow it to function properly.

    Avocado: Avocados contain a rich amount of the antioxidant glutathione, which helps the liver to fight against the toxins.
    Garlic: Garlic contains a rich amount of selenium and allicin, which helps to cleanse the liver. A little amount of garlic helps in the activating liver enzymes which in turn helps to eliminate the toxins from the body.
    Green tea: Green tea contains a rich amount of the plant antioxidant known as Catechin, which help the liver to function properly. It also helps to protect the liver from the toxins.
    Beets and Carrots: Beets and carrots contain a rich amount of beta - carotenes and plant flavonoids which help to regulate the overall function of the liver.
    Turmeric: A little amount of turmeric in your daily meal helps in the cleansing the liver by helping the enzymes to get rid of the toxic carcinogens.
    Green Vegetables: Green Vegetables like spinach, bitter gourd and chicory contains a rich amount of detoxifying components, which helps in the neutralization of heavy metals which in turn regulates the cleansing ability of the liver. Green vegetables also help in the simulation of the flow of bile.
    Grape Fruit: Grape fruit contains a rich amount of vitamin C and antioxidants which initiates the cleansing process of the liver. Grape fruit also help in the formation of enzymes that destroys toxins like carcinogens.

Cleanse Your Liver - 7 Natural Foods that Will Help You 

The liver performs over 500 functions and is considered to be one of the most important organs in the human body. The functions liver perform include regulating cholesterol and blood sugar, filtering out blood toxins, storing energy and making hormones and proteins. There are many diseases which liver can catch and most prominent being alcoholic liver disease

When a person consumes alcohol in excess, it leads to building up of fats, inflammation and scarring of the liver   which results in alcoholic liver disease.

The damage that occurs due to this disease in the liver can affect the whole body. Since the liver is generally highly effective in repairing and regenerating itself so the damage takes longer to come into notice. It often becomes distinctive by the time the damage is already irreversible.

This disease usually takes place in people between 40 and 50 years of age. This disease is most commonly seen in men. Certain cases have been seen where people may have inherited the risk for the disease.

Liver disease related to alcohol consumption fits into following 1 of 3 categories:

Fatty liver: This takes place due to acute consumption of alcohol. This state is generally reversible if alcohol isn t consumed.
Alcoholic hepatitis: This is an acute type of alcohol-induced liver injury which takes place when alcohol is consumed excessively over a long period of time. It can lead to liver failure and death as well.
Cirrhosis: Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by over consumptions of alcohol. It can also occur due to other reasons as well.
Some Facts about Alcoholic Liver Disease

It is the main cause of chronic liver disease in Western nations and the third most common cause of liver transplants.
Staying away from alcohol is the only way to the patient s recovery.
Jaundice and tremors are the most common symptoms of this disease.
Medication, lifestyle changes, and surgery are some available treatments.
Early signs of the Disease
The early signs of alcoholic liver disease are not much noticeable and affect many systems in the body.

Pain in the abdomen
Nausea and vomiting
Diarrhea
Decreased appetite
If these signs are left unattended and the patient continues to consume alcohol, it can lead to a faster damage to the liver.

The symptoms of this disease become noticeable usually during the later stage of liver disease. The symptoms of this disease include:

Jaundice
Edema or swelling of the lower limbs
A build-up of fluid in the abdomen, known as ascites
Fever and shivering
Extremely itchy skin
Clubbing of fingernails
Loss of weight
General weakness
Blood in vomit and stools
Bleeding and bruising more easily
More sensitive reactions to alcohol and drugs
In most patients with the alcoholic liver disease, the illness is not severe. You may not require hospitalization immediately as long you take necessary precaution like stopping the consumption of alcohol, take good nutrition and follow the advice of the doctor. However, in more severe cases, the doctor may be able to suggest the best line of treatment.

Alcoholic Liver Disease - Know The Symptoms!

Liver disorders are very common. Gastroenterologists trained in liver diseases are known as Hepatologists.Symptoms of liver disease include jaundice, vomitting of blood(Hemetemesis), bleeding in the motions(also known as Melena or hematochezia),altered sensorium known as Hepatic encephalopathy(HE), Renal failure also known as Hepatorenal syndrome(HRS), Breathlessness (due to Hepatopulmonary syndrome and portopulmonary hypertension).

Let s understand the liver disease point by point: 

1. Hepatitis B: Hepatitis B is a virus which is usually acquired in four ways. Unprotected sexual intercourse with the infected partner, from infected to the child, infected needles, infected blood. It takes many years for the hepatitis B virus to cause liver damage. Once the liver is damaged it is called Cirrhosis or chronic liver disease. When liver is more then 80 percent damage, it causes blood vomiting also known as hematemesis, Ascites(water in the stomach), Jaundice, HE, HRS etc. Treatment depends on virus count which is calculated by HBV DNA PCR and other lab parameters. Once the treatment starts monitoring of viral count is done to document the effectiveness of the treatment. All the family members and sexual partners must get HbsAg screening done to detect early silent infection. All those who test negative, Hepatitis vaccination should be done, by three injections which provide them with 100% protection against the HBV infection.

2. Hepatitis C: Hepatitis C is a virus which is acquired by injection drug abuse and infected needles and blood. Transmission by unprotected sexual intercourse is possible but chances are very low. Hepatitis C virus damages the liver slowly and takes years before clinical symptoms of liver failure appear. Once the liver is damaged it is called Cirrhosis or chronic liver disease. When the liver is more than 80 percent damage, it causes blood vomiting also known as hematemesis, Ascites(water in the stomach), Jaundice, HE, HRS etc. All hepatitis C virus infected patients must be treated irrespective of virus count. Baseline virus count by HCV RNA  is done to measure the effectiveness of the treatment. HCV Genotype is done for patients with cirrhosis. Vaccination is not available for hepatitis C but newer medicines(Direct acting antivirals DAA) for Hepatitis C can cure it with more than 95% certainty.

3. Acute viral Hepatitis: Sudden infection in the liver can be due to multiple causes but commonly is due to Hepatitis A and Hepatitis E, which are caused due to eating or drinking contaminated food and water. Rarely Hepatitis B and Hepatitis C can cause Acute hepatitis including Acute liver failure. Acute hepatitis presents with Jaundice, loss of appetite, generalised fatigue, vomiting and abdominal pain.  Patients are usually treated on an outpatient basis but if they have severe vomiting, abdominal pain or altered sensorium, they are admitted for inpatient care and monitoring. Drugs or complementary and alternative medicines (CAM) such as herbal or bodybuilding protein supplements which contain steroids and heavy metals can cause acute hepatitis.

4. Liver transplant: Removing the damaged liver and to put a new liver in the patients is called Liver transplant. Liver transplant is major surgery and costs around 20 to 30 Lacs. Indications of liver transplant are an acute liver failure due to hepatitis viruses such as hepatitis A, Hepatitis B, Hepatitis C and Hepatitis E, decompensated cirrhosis due to any cause including chronic hepatitis B and C, Drug-induced liver failure such antitubercular drugs(ATT). The donor for liver transplant is either a close relative (Living donor liver transplant LDLT) or a brain dead donor (deceased donor liver transplant DDLT).

5. Chronic liver disease or Cirrhosis: It is the end result of slow damage to the liver, where many liver cells are damaged and replaced by fibrosis. Apart from viruses such as Hepatitis B and Hepatitis C, Alcohol is one of the most common causes of cirrhosis.

Drinking alcohol for years together causes irreversible liver damage causing cirrhosis. Alcohol can cause acute severe hepatitis, acute liver failure and chronic liver disease.  Patients with suspected heavy alcohol drink must-visit Hepatologist (Liver doctor ) for proper diagnosis of stage of liver damage and deaddiction programme. USG Abdomen, blood tests, endoscopy and Fibroscan is usually done to know the liver health.

Fatty liver is also known as non-alcohol fatty liver disease(NAFLD) is a lifestyle disorder due to lack of exercise, high fat diet, obesity and due to drugs. Fatty liver causes silent liver damage and if not recognised in time can cause irreversible liver damage and cirrhosis. The evaluation includes Liver function tests, Ultrasound abdomen, Fibroscan. Treatment includes daily moderate-intensity aerobic exercise, drinking coffee and a low-fat diet. Few medicines are available which help in the reversal of fatty liver.

What Should You Know About Liver Disorders?

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!

It s been long known about the numerous health benefits of beetroot. Surprisingly though, beetroot has some not-so-known qualities such as increasing stamina, removing skin blemishes and increasing the glow of the face. Apart from this, it can fetch benefits to the skin, hair and the overall health. In this article, we will discuss the benefits of beetroot consumption in vivid detail.

Reduces the impact of aging: Beetroot being a great antioxidant successfully blocks free radicals and helps to fight the symptoms of aging. All it requires is a medium slice beetroot. The juice should be extracted from it and the pulp needs to be removed. The juice then could be applied to the face using cotton balls. Applying this simple solution once in a week can fetch dramatic results.
Reduces blemish and pigmentation: Beetroot is one of the few vegetables that have a large amount of vitamin C embedded in it. It helps the skin to retain its original color, reduces blemishes and pigmentation. 3-4 cubes of beetroot serving twice a week should do the trick.
Hair loss: Beetroot is a great source of food to stay away from hair loss. Being a good source of potassium, beetroot can prevent hair loss and enhance hair growth. A weekly serving of 3-4 cube of beetroot over a span of few months will show visible results.
Improves liver function: Beetroot contains glutathione that is known to be a great agent for the liver. It acts as a detox diet and helps in functioning of the liver. This liver, in turn, helps the body to detox. Beetroot also helps in the regeneration of cells of the liver.
Boost hemoglobin: Beetroot is an excellent source of iron and folate. These are the nutrients that are required for the body to maintain an adequate amount of hemoglobin in the body. A deficiency in the hemoglobin level can lead to anemia. Regular consumption of beetroot can ensure that a person refrains from deadly diseases such as anemia.
Fight inflammation: Some typical symptoms of inflammation include infection, trauma etc. This is a sign of the immune system not acting efficiently against sudden panic. Some typical symptoms include pain, redness, swelling etc. Beetroot in known to have a super-efficient anti-inflammatory response. Injection of beetroot is often suggested by medical practitioners.
Cancer prevention: Beetroot can elevate the level of oxygen in the blood. Since cancer cells are acidic in nature, beetroot can successfully neutralize them due to its alkaline nature. Owing to this anti-cancer properties, oncologists often suggests the intake of beetroot juice on a regular basis to patients suffering from liver, rectal, colon and various other types of cancer. 2 glasses of beetroot juice are often recommended for cancer patients.

Beetroot (Chukundar) - 7 Reasons Why You Must Eat Them!

Dealing with liver Cirrhosis largely depends on its stage. While it is good to know and read about Cirrhosis, referring to some qualified medical personnel is the best course of action. If a person is already undergoing medical treatment, there are simple ways to deal with this condition.

Get treated in the early stages: Liver being one of the most self-healing organs, a person has good chances of healing, if a donor donates partial-liver. A doctor eradicates the distorted portion of the liver and replaces the same with a partial transplant from the donor. For the donor, it takes about 3-4 months to grow back the donated portion of the liver, while the patient might take 10-12 months to fully recover. This is possible in the early stages of Cirrhosis.
Stop the catalyst of liver Cirrhosis: It is essential to stop the underlying cause of Liver Cirrhosis. Stuff like saturated fat, alcohol, salt, OTC pain relievers, excess sugar etc should strictly need to be avoided to ensure the progression of liver Cirrhosis is slow. Studies have shown that moderate consumption of coffee can help to deal with Liver Cirrhosis.
Sodium free food: It is advised by most doctors that Cirrhosis patients refrain from consuming sodium-rich food. It helps a cirrhosis patient to bypass edema and ascites. This is extremely challenging, since food without sodium tastes bland and unappetizing. It is therefore suggested that healthy herbs, paprika, pepper etc are consumed to make up for sodium.
A balanced diet: A liver Cirrhosis patient should be extremely careful when it comes to choosing the right diet. They should consume lots of fresh fruits and green vegetables. While consumption of animal protein is not advised, the quota of protein should be fulfilled from peas, tofu, quinoa, etc.
A good exercise regime: Patients with liver Cirrhosis should ensure that an adequate exercise regime is followed so that the muscles do not get wasted. Exercise for half an hour also helps to lose weight and negate the chances of water retention in the body. Exercise should also be followed by lots of sleep, so that the body gets enough time to recover from the stress of exercise.
Avoid NSAIDs: If a person is suffering from liver Cirrhosis, using drugs such as naproxen, aspirin, ibuprofen, acetaminophen etc should be strictly avoided for mild pain and inflammation. These drugs can be highly toxic for a person suffering from Cirrhosis. It is wise to consult a doctor before consuming any medication.
Stay away from infection: A patient with liver Cirrhosis suffers from a compromised immune system. It is therefore advised that a patient stays away from possible bacteria, viral and such other chronic infection. Any infection can result in inflammation of the bile duct that causes scarring of the liver tissue.

Liver Cirrhosis - 7 Ways To Deal With The Problem!

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