The largest internal organ in the body, the liver, is also one of the silent heroes, which performs close to 500 functions. It produces energy, fights infections, gets rid of wastes, and is a metabolic factory.

There are four major types of liver diseases out of which alcoholic liver disease accounts for about 40% of them. Other types include non-alcoholic liver disease, viral hepatitis and autoimmune (chronic) hepatitis.

Risk factors: The severity of drinking habit is directly proportional to the chances of developing alcoholic liver disease. People who consume more amount of alcohol are more likely to develop the disease. However, it is also not necessary that every person who consumes alcohol develops liver disease.

Following are obvious risk factors for developing alcoholic liver disease.

1. Alcohol dependency: While enjoying a drink is not barred, getting the body dependent on alcohol for regular functioning is definitely a no-no. The rate of developing the disease in people dependent on alcohol is as high as 70%.

2. Females: The way alcohol is metabolized in females could have an effect on the higher risk they face in developing alcoholic liver disease.

3. Obesity: Excessive weight puts additional stress on the metabolic effects of the liver and therefore has a higher tendency to develop alcoholic liver disease.

4. Family history: Strong familial history increases the risk of developing alcoholic liver disease.

Symptoms: The difficulty in diagnosing the disease lies in the fact that there are no clear-cut symptoms that can indicate the diagnosis. Initial general symptoms include fatigue, poor appetite, abdominal pain, nausea, weight loss, loss of energy, and red spider nevi (spider-like blood vessels) on the skin.

As the liver function continues to worsen, there are additional symptoms like swelling of the legs due to fluid accumulation, swelling of the abdomen, jaundice (yellow mucous membranes and skin), redness of palms, impotence, breast swelling, easy bruising, cognitive problems and clay-colored stools. This stage will see liver scarring and subsequent cirrhosis. The second set of symptoms is more diagnostic. An experienced practitioner will be able to suspect and diagnose the alcoholic disease with a detailed history and some liver function tests.

Treatment: If identified early and alcohol habits are reversed, the damages of the liver can be completely reversed. In addition, the following lifestyle changes are suggested:

1. Low-salt diet

2. Hepatitis vaccines (A and B)

3. Medications to manage fluid retention, spontaneous bleeding and infections as the case may be

4. Excessive fluid accumulation in the abdomen may require removal

5. Shunt in the liver to repair blood flow

6. If cirrhosis stage is reached, a liver transplant may be required

While there are many ways to manage alcoholic liver disease, prevention is the best way. Limiting alcohol consumption can definitely help in the prevention of the disease.

All About Alcoholic Liver Disease

Sugar is the trigger to most of the diseases an adult faces in present times. Sugar is not only harmful for adults, but can pose severe threats to the health of a child as well, if not administered in monitored proportions. But again, sugar is indispensable when it comes to sweetening your drinks and desserts. In order to prevent yourself from the health hazards of sugar, you should know more about its scope and effects.
1. Sugar can lead to a fatty liver: Fatty liver is a troubling issue faced by many across the globe. It is wrong to think only alcoholics are subjected to this health condition. People who exercise little and consume huge amounts of fructose are also exposed to the threat of this disease. When a person doesn't do enough to burn up the existing amount of glycogen in his or her liver and take in fructose repeatedly, the liver turns that fructose into fat, impairing one's liver capabilities to a great extent.

2. Sugar may make you resistant to Leptin: Leptin is a hormone released by your fat cells. The hormone is particularly necessary as it sends signals to your brain telling it you are full and won't be requiring any more food. Fat people have more number of fat cells and thus additional Leptin too. The Leptin becomes inactive due to the effects of heightened blood triglycerides and insulin, both of which counter its functioning.

3. It is addictive and there lies the key to temptation: Sugar is enormously addictive. If you like sweetened products, you will find it hard to resist your cravings for cakes, cookies or chocolates. Sugar accelerates dopamine secretion; this hormone makes a person feel good. Dopamine is the hormone released on the consumption of drugs such as cocaine.

4. Calories in sugar are not balanced out with any mineral or vitamin: Because of its lack of nutrient value, sugar is said to have empty calories. Food items rich in sugar tend to make a person lethargic and slackened while depriving them of essential minerals and vitamins. It is therefore, best to not allow children to have pastries, chocolates or puddings in excess.

5. Sugar leads to extensive tooth decay: Sugar can accumulate on your teeth if you are having too many sweetened food items. This causes your teeth enamel to wear away, making it more prone to cavities and dental caries.

Why You Should Stay Away From Sugar?

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!

Cumin, also known as 'jeera' in the Indian subcontinent, is an ancient seed that has been prized for more than 3000 years. Ayurveda holds this spice in high regards and uses it for treating a host of health disorders including burning of excess fat.

Why are cumin seeds considered to aid in weight loss?

An effective detoxifier: Ayurveda considers the accumulation of toxins to cause weight gain and other medical conditions. While certain toxins are easily removed with water, fatty toxins stick to cells and disrupt cell metabolism resulting in weight gain. To detox such hard-to-remove toxins, cumin seeds are predominantly used in Ayurveda. The seeds remove excess kapha from the intestines and detox liver effectively.
Lowers cholesterol that aids in burning fat effectively: Black cumin is rich in phytosterols which are plant fats resembling cholesterol present in animal fats. When consumed, they limit the amount of cholesterol absorbed by the body. Taking a tablespoon of cumin seeds every day has been medically proven to lower the amount of cholesterol up to 10 percent and bad cholesterol up to 14 percent. This reduction in addition to the cholesterol-lowering measures that you may have adopted would be helpful in burning fat much faster. Taking about 2 grams of cumin seeds combined with light freehand or aerobic exercises can lead to subsequent weight loss in people who lead a sedentary lifestyle.
Lowers blood sugar levels and regulates metabolism: Any person with high blood sugar levels is aware that low insulin levels tend to create a craving for sweets and carbs while high insulin levels can cause extreme thirst and fatigue. Cumin seeds have been proven to lower the blood sugar levels. It lowers blood sugar levels by increasing insulin and glucose sensitivity. In this way, black cumin seeds can aid you to shed off extra pounds by improving the blood glucose levels as well as glucose absorption. In addition to all these benefits, black cumin seeds contain high amounts of oleic acid which is a fatty acid causing acceleration in the way in which the body burns fat.
Other benefits from cumin seeds: Constipation and indigestion are other common reasons for weight gain. An excellent source of fiber, antioxidants, and that has anti-flatulent properties, the cumin seeds can cure constipation, bloating and heaviness, thus, aiding in weight loss. Lack of sleep may also be causing weight gain. Cumin seeds can cure you of insomnia, thus. regulating your sleep pattern and metabolism.
Hence, cumin seeds are a simple and effective ayurvedic remedy for weight loss. Cumin seeds are more potent, and you can take a spoon of roasted or plain cumin seeds every day. Obese or normal, irrespective of your weight, taking cumin seeds regularly have quite a few benefits.

1 Tablespoon Of Cumin - Know How It Can Work Wonders!

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?

Nuts and dry fruits are probably the oldest and traditional superfoods which our mothers have diligently offered us for our good health. Packed with proteins, iron, magnesium, healthy fats, vitamin B and fiber, these nutritional powerhouses are a must in our diet, but only in a limited quantity. Yes, taking almonds, dates, cashews, pistachios, and walnuts in excess amount can lead to excessive body heat, giving rise to nasty pimples and rashes. Not more than 2 tablespoons of dry fruits are recommended in a day because of their sugar content, they can easily help to put on weight by adding excess calories.

But, how true is the claim or is it a myth? Let's find out.

Here is a brief overview of how overconsumption of dry fruit is detrimental to health:

Weight gain: Studies conducted by researchers over the years has revealed that it takes over 3500 calories to gain 1 pound of weight. However, consuming just 250 calories from dry fruits can result in over 2 pounds of weight in a single month. A sudden increase in weight can bring in other complications such as obesity, menstrual problems in women, high blood pressure, etc. It is therefore imperative to avoid excess intake of dry fruits. To ensure minimum intake of calories, we could focus on dates, apricot, cranberries, blueberries, etc.
Asthma: Sulphur dioxide is often used to process dry fruits. Studies revealed that this foul-smelling gas isn t very harmful when consumed in limited quantities. But, as per food safety experts, the permissible limit of Sulphur dioxide in humans should not be more than 20 mg per day as it can cause asthma, allergic reaction and skin rashes in an individual.
Gastrointestinal problems: Food items with high fiber content help in regular bowel movement and smooth blood flow. However, consuming too much fiber can lead to bloating, diarrhea, flatulence, cramps and constipation. This is exactly the case with dry fruits as well. They contain fiber and have the capacity to wreak havoc in the intestinal lining on overconsumption. Gradual and steady consumption of dry fruits over a period of time can mitigate this risk. 
Tooth decay: Dry fruits that are available in the market come with a thick coat of sugar so that they do not infuse moisture and stick to each other. This sugar significantly contributes to tooth decay. This is the reason why overconsumption of dry foot should be avoided.
Sugar crash: Most dry fruits have a high glycaemic index which can quickly surge blood sugar levels and spike energy levels. Therefore, patients suffering from high pressure should strictly refrain from dry fruits.
While the cons appear frightening, do not cross the nuts off the grocery list completely. Dry fruits when consumed under control, can be really helpful. So remember that moderation is the key. And in case you have a concern or query you can always consult an expert & get answers to all your questions!

Dry Fruits - 5 Reasons Why You Must Not Eat Too Many!

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