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!

Pregnancy is a blissful period, even with all the discomfort associated with it. And with proper awareness and caution, it is possible to keep pregnancy-related complications at bay to have a smooth sailing experience till you deliver the little bundle of joy.

Some women have health issues during pregnancy, while others suffer from disorders before pregnancy, leading to complications at the time of the pregnancy. It is very crucial for women to receive proper health care, both before and during pregnancy to reduce the risks of complications. Here are some common pregnancy complications that you should know about before you start planning a family.

Anemia: Anemia is a condition where you have lower than the desired number of healthy red blood cells. To deal with this condition, it is important to treat the underlying cause of anaemia. The most common symptom of this complication is feeling tired and weak even with the slightest physical exertions. You will have to eat a proper diet that consists of folic acid and iron supplements. Your healthcare provider will have to regularly monitor the iron levels during the time of pregnancy.
High blood pressure: Chronic high blood pressure before as well as during pregnancy puts the mother and the baby at risk. It is associated with increased maternal complications such as placental abruption, preeclampsia, and gestational diabetes. It puts you at risk of preterm delivery and even infant death. It is crucial to handle this condition before pregnancy to mitigate the complications.
Obesity: Recent studies suggest that the heavier a woman is before pregnancy, the greater are her chances of developing pregnancy complications. Research suggests that obesity during pregnancy is related to increased use of health care services along with longer hospital stay after the delivery. It may also cause complications like gestational diabetes and stillbirth.
Urinary tract infections or UTI: A urinary tract infection is a bacterial infection of the urinary tract. The common symptoms of this disease include fever and shakiness, pain and burning sensation at the time of passing urine, a pressure in the lower belly, an urge to use the bathroom often along with reddish and cloudy urine. If you think you have this complication, you should consult your doctor immediately. Your doctor will most likely prescribe treatment for the same.
Placenta previa: Placenta previa occurs when a baby's placenta partially or totally covers the mother's cervix   the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. You'll need a C-section to deliver your baby if the placenta previa doesn't resolve.
Talk to your gynaecologist if you think there is even the slightest chance of suffering from one of these complications to avoid the further dire consequences.

5 Pregnancy Complications That You Should Not Ignore!

Liver is a very important organ of your body. It is also the largest internal organ. Liver plays a pivotal role in food digestion, iron metabolism, regulation of blood clotting and removal of toxins from your body. Liver problems refer to the disruption of liver functions. There are various liver problems and diseases that you may encounter. Some of the liver problems are as follows:

Hepatitis A, B, C, D, E
Liver cirrhosis.
Fatty liver
Liver cancer
Wilson disease
Jaundice
The most common causes of the above mentioned liver problems are

Fatty liver is generally caused due to obesity
Hepatitis A, B, C is caused due to viral infections
Consuming excess alcohol can cause liver cancer
Liver diseases like Wilson disease is caused due to genetic problems
Different liver problems have different symptoms. But there are some common symptoms for all liver diseases. The most common symptoms are mentioned below

Body fatigue
Pain in the abdomen
Change in urine and stool color
Nausea
Queasiness
Loss of weight and appetite
Yellowish discoloration of skin, eyes and nails.
Homeopathy can treat liver problems very effectively. The following are some of the solutions offered by homeopathy for different liver problems
1. If you are suffering from the problem of fatty liver, your doctor may recommend you medicines like Lycopodium, Phosphorus, Nux vomica
2. If you suffer from the problem of liver enlargement then your doctor may recommend you medicines like Carduus Marianus
3. Chionanthus and Taraxacum are medicines advised for liver problems like jaundice
4. Natrum sulphuricum may be recommended to you if you are suffering from problems like Liver cirrhosis
Homeopathic treatment for liver problems is very effective since it treats the medical condition according to specific symptoms

Liver Problems - How they Can be Treated with Homeopathic Remedies?

Recurrent pregnancy loss refers to the situation when three consecutive pregnancy loss takes place. A pregnancy loss is a clinically defined pregnancy which ends before twenty weeks.

Causes of recurrent pregnancy loss

Major cases of pregnancy loss occur due to genetic abnormalities and chromosomal abnormalities. The abnormality may occur from the sperm, egg or the early developed embryo.
Recurrent pregnancy loss may occur in a woman due to ascending maternal age. This happens because of poor quality of the egg, which further leads to chromosomal abnormalities. In some cases, the pregnant mother or the father can have some gene irregularities. In such cases, the would-be-born infant is affected, and this causes pregnancy loss or miscarriage.
Uterus abnormalities also lead to recurrent pregnancy loss. This may happen because of poor supply of blood to the uterus. Abnormalities in the uterus are in-born in some women and in others these may develop over time.
Women having a poor immune system are likely to suffer pregnancy loss. Abnormalities in hormone secretion like thyroid or diabetes may also cause pregnancy loss in women.
If a woman suffers from abnormalities in blood clotting, the chances of miscarriage are enhanced.
Testing for recurrent pregnancy loss
Several tests and examinations should be carried out for detection of pregnancy loss. 

Karyotype analysis of the woman and her male partner has to be conducted. Karyotype refers to the genetic or chromosomal constituents of an individual and this test is carried out to detect abnormalities in genes and chromosomes of the parents, which cause miscarriage when passed on to the developing infant.
Another test includes the evaluation of the uterus and the uterine cavity. This is done by ultrasound, saline ultrasound, MRI, hysterosalpingogram X  ray or by hysteroscopy. These tests help to get information on the uterus shape, about fibroid presence, detect abnormalities within the uterus and observe the opening and closing of the tubes. Tests to detect the functioning of hormones are also carried out.
Treatment
The treatment for women with recurrent pregnancy loss depends upon the underlying causes of the pregnancy loss.

In case of patients with karyotypic abnormalities, genetic counselling is recommended, where a specialist is consulted to know about chromosomal abnormalities.
Prenatal genetic studies are carried out by some couples to know about the offspring s genetic make-up. This is done with chorionic villus sampling or with amniocentesis. A process known as in vitro fertilization can be carried out.
In case of uterine abnormalities, a surgery may be performed and medications for reducing blood clot are used if antiphospolipid syndrome is detected.
Recurrent pregnancy loss may happen due to various reasons and proper tests, and treatment procedures should be carried out for curing pregnancy loss. This phenomenon affects a woman and her partner deeply.

Recurrent Pregnancy Loss - Know the Reasons Behind 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!

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?

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