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?

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!

Liver cirrhosis is characterized by the replacement of normal liver tissue with fibrous tissue. This condition occurs when the liver has been exposed to certain causative factors for a prolonged period of time. Liver cirrhosis can be compared to  Kumbhakaamla  as stated in Ayurveda.

In Ayurvedic terms, liver cirrhosis is through to result due to an extreme aggravation of the pitta dosha. The liver is considered as the seat of pitta and therefore, an aggravated pitta dosha affects the functioning of this vital organ that helps eliminate toxins from the body. It can lead to problems such as anemia, jaundice, hemorrhage, ascites, and liver and spleen enlargement. This may end up aggravating and dis-balancing other doshas as well.

Because of aggravation of the pitta dosha, all the functions of the pitta such clarity of skin complexion, hunger, digestion, and production of blood are seriously affected. Because of the aggravation, the rasa and rakta dhatus are severely affected followed by other dhatus.

Ayurvedic treatment for liver ailments is highly recommended as it is completely natural and does not result in any side effects. It helps reverse all of the symptoms of liver cirrhosis and other diseases while restoring the normal functioning of the liver. There are several Ayurvedic remedies that you can practice to relieve the symptoms of liver cirrhosis.



The following are some of the most common Ayurvedic tips for liver cirrhosis:

Patient must take expert opinion of an Ayurveda for the right treatment of liver cirrhosis
Cirrhosis is a complicated and serious situation thus, home remedies or any single herb treatment is not recommended.
Quit alcohol
Eat a well balanced and nutritious diet that contains a lot of fresh fruits and vegetables
Opt for sources of good fats such as nuts, seeds, avocado, soy and olives
Avoid packaged food items with added preservatives, including pickles
Ayurvedic treatment varies from person to person and therefore one must consult an expert and not try any home remedies.

Liver Cirrhosis Treatment With Ayurvedic Remedies 

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!! 

The liver is the place where all the toxins sit. Drugs, preservatives, alcohol, body toxins, chemicals are all metabolized in the liver. The basic function of the liver is to clear all the toxins from the body. When the liver receives too many toxins and it is unable to take so much burden, then the liver will give up. Gradually, the liver cells will be replaced with scar tissue. The liver tissues die completely. This condition or this stage is called cirrhosis of the liver.

What are the major causes of cirrhosis of the liver:
There can be many different causes for cirrhosis of the liver. Some of the major causes of this liver disease include:

People who consume a lot of alcohol for more than 10 to 12 years will have to face this problem. In the initial stage, it is going to be fatty liver, but at the later stage, the liver will be filled with fat and that disrupts the functioning of the liver. In the final stage, the liver function stops.
Hepatitis is one of the major reasons for cirrhosis of the liver. It is Hepatitis A that causes this health issue, others can also cause this problem.
Too many drugs for treating other health conditions.
Diabetes, obesity or other non-alcoholic fatty liver problems.
Symptoms of Cirrhosis of the Liver:

Jaundice
Weight gain or weight loss
Redness of palms.
Enlarged spleen
Clubbing of fingers
Fatigue or weakness
Patches on the skin
Menstrual cycle problems in women
Treatment for Cirrhosis of the Liver:
If cirrhosis of the liver is diagnosed at the early stage, then doctors will be able to treat it by finding the actual cause behind it. For example, if it is due to alcohol abuse, then giving up alcohol along with prescribed medication can help. If it is due to an overdose of some drugs, then it is important to find out the drugs and find an alternative for those medicines if they are to be taken.

Most of the time, modern medicine can only help by treating patients based on the symptoms. It provides relief from those symptoms and helps to avoid complications. But Unani medicine can help you treat this problem naturally without having to face any kind of complications.

Treating Talayyuf-e- Kabid (Cirrhosis of the Liver) with Unani medicine:
Unani medicine is a medicine made of natural herbs which will strengthen the liver tissues and will also help in restoring the size of the liver. You will find a number of medicines that can protect and heal the liver and also restore it to its normal shape and size.

Treating Talayyuf-e- Kabid (Cirrhosis Of Liver) With Unani Medicine

Miscarriage is a spontaneous abortion that occurs around the first to second trimester of pregnancy; wherein the foetus is automatically expelled from the uterus due to its inability to survive because of environmental influences or chromosomal abnormalities.

Unless the miscarriage occurs due to a severe health issue, the fertility of the woman may not necessarily be compromised. Studies show that one miscarriage doesn t predict the possibility of a future one. Once the bleeding and pain subside, it is the emotional trauma that must be addressed to begin with which poses a greater threat than the physical one.

The fertility of the woman remains unaltered and the body can be ready after the menstrual cycle returns to normal. However, it still requires some time for the woman to be physically and emotionally prepared to go through another pregnancy. The medical history and reasons behind miscarriage must be evaluated before the couple decides to try again.

Complications after miscarriage only occur if the woman is above 35 years of age or has a rather unhealthy lifestyle. The concept of fertility varies from person to person and it isn t possible to pass a common judgement about fertility in this scenario.

The gynaecologist mostly suggests couple therapy after the trauma of the miscarriage. The psychological loss is given more importance before considering another attempt by most doctors. The fertility loss only occurs with age and unhealthy lifestyle and it is widely accepted and proven that a miscarriage has little or nothing to do with it.

Ways to Increase Fertility

If a couple is certain they are ready to conceive again, there are a few things a woman can do to help her chances of becoming pregnant-

The first thing to do is to stop any unhealthy habits. These include smoking, drug use, or alcohol abuse. It s reported that high consumption levels of caffeine are detrimental to conception so that should also be limited.
Eliminating stress can also help. Eliminating stress is one of the most important factors in having a successful pregnancy. So, it makes sense that getting over-stressed can reduce fertility levels.
Eat healthy. If depression was experienced due to the miscarriage, it s possible that the woman s diet has not been the healthiest. It s common for women who have experienced a miscarriage to have a loss of appetite and not eat enough or to eat out of sorrow, eating too much. More attention should be paid to the diet and more healthy foods added to meals.
Talk to a Doctor

If a couple is having issues with fertility after early miscarriage, they should talk to a doctor. There are many options available. More than likely, the first thing the doctor will do is to test fertility levels of both the man and the woman. If you don't want to visit a doctor for this, there is a new at-home kit available called Fertell. This test, retailing for approximately $100, measures fertility levels for both a man and a woman.

If it is found that there is a loss of fertility after early miscarriage, fertility drugs or therapies may be prescribed for a period of time.

The doctor may report that there are no issues with fertility. At this point, it would be a good idea to use an ovulation predictor in order to time effective intercourse. This isn't the most romantic idea, but it may well be one of the most logical ways for a couple to conceive.

Bottom Line

Fertility is not normally decreased after miscarriage. A woman's fertility levels return to normal as soon as her menstrual cycle returns. Fertility may be decreased due to emotional issues as a result of the miscarriage. However, if a couple is ready, both physically and emotionally, there should be no physiological hindrances to conception.

The decision to try again is not an easy one. However, fertility won't typically be an issue.

Pregnancy - Understanding Fertility After Early Miscarriage!

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