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?

Gall bladder stones can be painful. Until and unless it is surgically removed and cured from within, the pain continues to hinder daily life. The good news is that there are ways by which pain from gall bladder stones could be managed. 

Here is a list of quick, easy-to-follow remedies to counter the pain.

Heat Pack: Applying a heat pack or hot water bottle on to the stomach making sure that the heat is directly passed on to the gall bladder can give instant relief from the pain. The heat should be applied at an interval of half an hour and a layer of cloth should be placed in between the skin and the heat pack.
Over the counter medicine: In most cases, over the counter pain relief meds can make the pain go away. NSAIDs should be avoided until and unless suggested by the doctor. A pain relief medicine with anti-inflammatory properties will perfectly suit the gall bladder condition.
Try vegetable juice: While gulping vegetable juice might sound a little indifferent, it has instant benefits with no side effect. All it needs is to mix beetroot, cucumber, and carrot in equal proportions and extract the juice from it. The juice extracted from this mixture should be consumed twice in a week to flush out the toxins from the system and ease the gall bladder pain.
Citrus fruits: Citrus fruits such as lemon, orange etc. contains pectin that is believed to be a remover of stones and blockages. This is also believed to be a great agent for countering pain originating from the gall bladder. Consumption of 10-12 tablespoon of lemon juice extracted from fresh lemons followed by a glass of water will wither the pain away in few weeks.
A mixture of honey and turmeric: Honey s antiseptic nature prevents infection and the curcumin found in turmeric makes the bile more soluble in the gall bladder. These two herbs in tandem can ease the gall bladder pain and get relief from the stones too. A tablespoon of honey and 1 tablespoon of turmeric should be consumed daily to get the benefits.
Take the herbal route: There are several herbals that are believed to be extremely effective in treating pain origination from the gall bladder. Some of them include goldenseal, quebrapedra, catnip, fennel seed, yellow dock, rosemary, nettle, peppermint herbal tea etc.
Apple Cider Vinegar: Apple cider vinegar is acidic in nature and consumption of a quarter of a glass followed by a quarter of a glass of apple juice can show instant results. It should be consumed daily after breakfast. There are instances where the pain eases out within a matter of 15 minutes.

Gall Bladder Stone Pain - Tips To Help You Manage It!

One of the most common problems with the gastrointestinal system, peptic ulcers occur when the lining of the stomach - the esophagus or the small intestines, gets damaged. The damage occurs due to the development of sores on the lining which may be due to inflammation caused by certain bacteria, or due to erosion caused by the stomach acids. This can be a very painful disorder and end up severely limiting your life. Peptic ulcers can cause intense abdominal pain, vomiting nausea, indigestion and sudden unexplained weight loss.

The Homeopathic Approach to Curing Peptic Ulcers

The treatment of peptic ulcers in conventional medicine primarily revolves around the treatment of symptoms. The symptoms may be suppressed for some time but eventually come back sooner or later. This results in a vicious cycle where the treatment becomes less and less effective over time. Homeopathy, on the other hand, has an approach of trying to correct the problems from the root and over time, remove the very cause that results in the problem. Some of the things a homeopathic doctor may ask you would include  

Family history of ulcers
General health history of the family to determine hereditary health problems
Physical characteristics
Psychological tendencies and likes and dislikes among other information
Homeopathy takes into account not just the symptoms but the general constitution of the patient as well. This helps not only cure the ulcers but also the pre disposition to developing it again.

Effective Homeopathic Medications

Some of the most effective homeopathic medications used in the treatment of peptic ulcers are mentioned below. However, you shouldn t try to self-medicate as it is best to consult with a doctor who can properly diagnose the problems and prescribe medication which are specifically tailored for you.

Argentum Nitricum   One of the most effective medication in treating ulcers, Argentum Nitricum is usually prescribed when you experience sharp burning pains from peptic ulcers that radiate to different area of the abdomen. The pain is akin to the feeling of gnawing inside the stomach. Other symptoms such as vomiting, belching and nausea may also be present.
Nux Vomica   If you have peptic ulcers and even eating the slightest amount of food causes pain, then Nux vomica may be a good option and thus be prescribed by your doctor. Another indication in such cases is where the abdominal region is very sensitive and you may feel pain even with the slightest touch. Nux Vomica is also very effective if your peptic ulcer symptoms tend to get worse after the consumption of tea, coffee, spicy foods or alcoholic beverages.
Kali Bichromicum   Sometimes, peptic ulcers may cause the food in your stomach to sit like a heavy load immediately after meals. This can make you very uncomfortable and unable to do any other form of work. This is often times accompanied by a low appetite. In such cases, Kali Bichromicum has been seen to work wonders.
Lycopodium Clavatum   If you have burning pain in your stomach along with the bloating of your abdomen, then Lycopodium Clavatum is the best medication for you. Other indications for this medication are when ingestion of warm water helps relieve pain. If consuming certain vegetables such as cabbage and beans worsens the situation, then Lycopodium Clavatum could be the best medication in such a case.
Carbo-veg   An all-rounder in the field of homeopathy, Carbo-Veg is also effective when treating peptic ulcers which are accompanied by heartburn and acidity as well as sour belching. The pain from the ulcers may extend from the stomach all the way to the back. Other indication wherein Carbo-Veg may be effective is where the stomach area becomes very sensitive to touch and even small amounts of food may suddenly cause the symptoms to deteriorate.
Hydrastis Canadensis   Stomach or abdominal pain accompanied by weight loss is one of the major indications where this medication may be prescribed. The patient may become emaciated and have sharp cutting pains in the stomach. In such cases, Hydrastis has been seen to be very effective.
Graphites   This medication is extremely useful where along with the ulcer pain, you may end up vomiting your food immediately after a meal. A sensation which is painful and constrictive may be present in your stomach. Along with these symptoms, Graphites are also very effective when you suffer from excessive belching.
Phosphorus   If you exhibit typical symptoms of peptic ulcer such as sour belching and a burning sensation in the stomach after eating, Phosphorus could well be the panacea.

Treating Peptic Ulcers With Homeopathy

Fatty liver is a condition where excess fat is deposited on this organ. Also called as steatosis, this condition happens when more than 5- 10 percent of the weight of the liver is made up of fat.

Fatty liver is a common condition among people. A study from coastal regions of India found ~ 25% of healthy persons had patients had fatty liver on ultrasound.

It can occur at all ages including childhood, highest prevalence is in 40 50 year age group. Prevalence more in patient who are obese and in diabetic patients.

Types of Fatty Liver

1 Alcoholic fatty liver: This condition occurs when there is a heavy consumption of alcohol. Gastroenterologists recommend abstention from alcohol for this condition to subside. If the patient continues to consume alcohol, then liver cirrhosis may develop.

2 Non alcoholic fatty liver (NAFL): One may develop a fatty liver even if one is not an alcoholic. The liver in some cases is unable to process the fat in cells causing them to build-up on the organ.

When more than 10% of the liver is made of fat then this condition is called Non Alcoholic Fatty Liver (NAFL).

Non alcoholic steatohepatitis (NASH): When fatty liver is associated with inflammation in liver patient is said to be having Non alcoholic steatohepatitis. NASH is a more advanced stage of NAFLD, and has a higher risk of progressing to liver cirrhosis or hepatocellular carcinoma (HCC). These condition display symptoms like jaundice, vomiting, nausea, loss of appetite and abdominal pain. Blood test (LFT) shows raised enzymes level. Approx 5-8% of the Indian population has NASH. Consult a doctor if you are experiencing any of these symptoms.

3 Fatty liver during pregnancy: Occurring mainly in the third trimester, the symptoms of this condition are vomiting, nausea, pain the right part of the abdomen and jaundice.

Symptoms

During the early stages (fatty liver) of the disease, patients usually have no symptoms directly related to liver disease. However, people may experience a vague abdominal discomfort. If their liver is inflamed (NASH) then they may display symptoms of poor appetite, weight loss, pain in the abdomen and disorientation.

What causes fatty liver?

The most common cause of fatty liver is alcoholism. When the human liver is unable to metabolize fat fast enough or when there is an excess accumulation of fat on the liver cells then the liver becomes fatty. However, intake of high-fat foods may not result in a fatty liver.

Predisposing factor:

1 Diabetes mellitus

2 Obesity or being overweight

3 Hyperlipidemia or the condition where there are high levels of fat in the blood

4 Genetic reasons

5 Rapid loss of weight

6 Drugs: Aspirin, steroids, tamoxifen, tetracycline etc. cause side effects which also leads to fatty liver

7 Nutritional status (eg, overnutrition, severe malnutrition, total parenteral nutrition [TPN], or starvation diet)

8 Other health problems (eg, Hepatitis C infection, celiac sprue and Wilson disease)

Know More About Fatty Liver!

There is hardly any individual across the world, who has not experienced abdominal pain. In most instances, these aches are not very serious and can be diagnosed and treated by addressing the underlying condition. It is very crucial to recognize the symptoms which are severe and know when an individual should seek medical assistance. 

Most common causes of abdominal pain: 

Some of the most common causes of abdominal pain include Indigestion, infection, menstrual cramps. It may also be due to food poisoning and allergies, irritable bowel syndrome, gas formation and bloating, lactose intolerance, pelvic inflammatory disease or ulcers and hernia, gallstones and kidney stones, urinary tract infection, Crohn s Disease or gastroesophageal reflux disease. 

Some patients have abdominal pain but the source of pain lies in the spine. These patients are often seen by multiple doctors and have undergone many tests but their diagnosis is never established. These patients should visit a pain specialist to reach a diagnosis and treatment plan. They have conditions like neuropathies or facet joint arthritis which cause abdominal pain due to a condition known as referred pain. 

Symptoms of abdominal pain that are cause for concern: 

Abdominal pain along with any sign of dehydration or fever or is unable to pass stools.
Abdominal pain associated with tenderness in the abdomen, painful and frequent urinations or persistent loose motions or bloody/ tarry stools. 
Severe or recurrent abdominal pain. 
Determining the cause of abdominal pain and treating it.

Detailed medical history and thorough physical examination would be performed. Further tests like USG, Endoscopy etc may be needed to reach a diagnosis. 
The treatment of abdominal pain is entirely dependent on the cause of the pain.

Abdominal Pain - Know the Causes Behind It!

Diarrhea is not usually a serious condition but can be very uncomfortable and embarrassing. This can be caused by a number of factors including bacterial or viral infections, food poisoning, contaminated water etc. Thankfully, it is easy to treat and does not require medication unless it is very severe. Let us take a look some of the most effective ways to treat diarrhoea:

Drink Plenty of Water: Keeping your body hydrated when dealing with diarrhoea is very important. This is because your body loses a lot of water while passing stool. To hydrate your body, drink lots of water. You could also add oral rehydration salts to the water. Avoid drinking sodas, packaged juices and caffeinated drinks such as coffee as they can further dehydrate the body.
Probiotics: To function optimally, your digestion system requires good bacteria. Diarrhea is usually a sign that the bad bacteria levels have overtaken the good bacteria levels. Thus, you need to balance this equation. Probiotics are a source of good bacteria and are available in powder or pill form. It is also available naturally in foods like yoghurt, pickles and kimchi.
Eat the Right Food: When suffering from an upset stomach, eat food that is easy to digest. Food items such as bananas, rice, apples and dry toast are easy to digest and can help bulk up your stool. This is also known as the BRAT diet. You could also include a simple chicken soup, baked skinless chicken and oatmeal in your diet.
Drink a Little Tea: Tannins in black tea are good for the digestive system. They help calm inflammation in the intestines and help the body absorb fluids. Raspberry and blackberry leaf tea are ideal for diarrhoea. You could also try sipping caraway tea. Other teas such as chamomile tea help reduce spasms and calm the stomach. When looking for such teas, ensure that they are made from the leaf and not powdered. Also, do not drink any form of caffeinated tea.
Avoid Spicy Foods: Do not eat anything that is spicy or fried when you have an upset stomach. Also, avoid eating foods rich in fibre as they can make you feel bloated. Alcohol and milk are best left aside until your stomach has healed. Other foods you should avoid include chewing gums with artificial sweeteners, berries, beans, peas, prunes, peppers and ice cream.
If your diarrhoea does not improve, consult a doctor. If it lasts for more than 2 weeks, it could be a symptom of another underlying condition. 

Diarrhea - 5 Ways It Can Be Treated Effectively!

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