Excess fat cells in the human body can settle under the skin and cause obesity, Additionally, they may even settle in specific organs and liver is one of them. When fat starts accumulating in the liver, a condition known as fatty liver manifests itself.

There are two types of fatty liver disease alcoholic and non-alcoholic. As the name suggests, the former is triggered by excessive alcohol consumption, whereas the latter takes place due to other reasons. While non-alcoholic fatty liver disease interferes with the normal functioning of the liver, alcoholic fatty liver disease has specific symptoms such as jaundice, fever, spider veins, and increase white blood cells (WBCs) count.

In the world of Ayurveda, the liver is a pitta organ, which is absolutely essential for normal digestion and elimination. Therefore, the pitta dosha should always be in balance so that toxins are eliminated by the liver from the body. A liver disease results when the pitta is aggravated, which can be treated with the help of lifestyle and dietary modifications, in addition to Ayurvedic remedies.

The following are some of the Ayurvedic tips and guidelines that can support liver healing and reduce the symptoms of fatty liver:



Avoid fatty and fried foods as these can further aggravate pitta and heating and overstimulating.
Incorporate cool and non-acidic food items such as berries, pears and melons into your diet.
Eat a combination of steamed vegetable and whole grains such as quinoa.
Consume aloe juice in moderate quantities as it is cooling.
Regularly consume a mixture of 2 grams of long pepper powder and 1 teaspoon honey once a day for complete 1 month.
Consume a decoction of giloy (Tinospora cordifolia), 30 ml, mixed with a teaspoon of honey once a day. 7. Drink plenty of water to cool the body down and eliminate toxins.
Consume 10 to 20 ml of bhumi amla juice.
Take 1 to 3 grams of kakuti powder twice a day with water after meals.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Fatty Liver Diseases - 8 Best Ayurvedic Home Remedies to Treat It

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

The human body with its multiple organs is a highly complicated structure and one or more organs often malfunction for various reasons. However, for some, no reasons are identified for this problem. One such is irritable bowel syndrome or IBS as it is commonly referred to.

It is a common disorder affecting the large intestine leading to alternate bouts of diarrhea and constipation, abdominal cramps and a feeling of fullness. It is common in people younger than 45 years of age, affects women more than men, and though the exact reason is not known, the following are attributed.

Physical/Physiologic reasons:

1. Signal issues between the brain and intestines: For various or even unknown reasons, the brain may not be able to send the right signal to the stomach to process food, making the stomach to be hyperactive and have an increased sense of pain or sensitivity or discomfort. Neurotransmitters, which are chemicals responsible for sending signals to various organs also could be involved.

2. Hormonal connection: Menstrual periods tend to aggravate symptoms of IBS, while postmenopausal women are largely free of IBS symptoms.

3. Genetics: People with a family history of IBS are more likely to develop IBS too.

4. Aggravating foods: Foods rich in carbohydrates, spicy foods, fatty foods, caffeine and alcohol aggravate IBS symptoms. Ability to absorb sugar could be a cause too.

5. Infections: Some people with IBS have certain bacteria identified in their gut which produces excessive gas and this could lead to altered bowel movements.

6. GI Motility Issues: Alterations in the way the food passes through the stomach can lead to either constipation (slow movement) or diarrhea (quicker movement). There could also be spasms and contractions after eating, especially if the stress levels are high.

7. Psychological issues: Panic disorder, anxiety, depression, and posttraumatic stress disorder are common in IBS patients. It is possible that they are not able to express their psychological stress, it manifests as physical symptoms. Stress increases symptoms of IBS and vice versa.

Management:

1. Manage stress: Meditation, yoga, support groups, medication and even hypnosis in severely stressed people helps control stress, providing great relief in IBS symptoms.

2. Lifestyle changes: Reduce alcohol and smoking

3. Dietary changes: Avoid aggravating foods, increase the amount of fiber if you have diarrhea and space out meals to avoid intestinal overload

4. Herbal remedies: Probiotics, peppermint oil and a variety of herbal medicines are available.

5. Symptomatic medications: Based on presenting symptoms, different medications including antibiotics for infections and motility drugs can be used. Anti anxiety and antidepressants are also prescribed to manage the psychological issues.

In terms of causes, symptoms, or treatment, IBS requires a very individualized approach and your doctor is the right person to discuss this with and decide.

Irritable Bowel Syndrome - Symptoms and Management

Bowel movement is one of the most important clues about an individual s health, as it gives a real idea of the gastrointestinal condition as well as overall health. One shall have to get familiar with the regular appearance of stool to spot the issues beforehand; however, the day to day alterations in the appearance does not mean that there is a problem with your health as one may notice short-term abnormalities based on what he or she is eating every day. 

But in case an unexplained change lasts for over a week or so, it is a sign of some strange happening in the gastrointestinal tract.

Hard pieces of faeces that are hard to pass: If the bowel movement is straining to pass, then the individual is constipated. Some people think that they are not suffering from constipation, but their stool is always hard and comes out in pieces rather than soft stool that passes out effortlessly. The most common reason behind such stool is a lack of fibre in the diet. According to general recommendations, an adult male must take at least 38 grams of fibre while an adult female must take about 25 grams of fibre. It is recommended to maintain a food journal to track the daily nutrients intake, and in case there is a lack of fibre in the diet, it can be stacked up with whole grains, fruits, beans and nuts.
Black or bright red coloured poop: If the stool has a deep red appearance, it would indicate that a part of the bowel is bleeding. In most circumstances, the blood in the stool is caused by the benign haemorrhoids, but it could also be due to some ulcers in the colon or stomach or even cancer. That is why it is extremely crucial to bring it to the doctor s notice. There are different types of over-the-counter medications which turn the stool into black colour. This sort of discolouration is entirely temporary and may stay along for a few days even after stopping the medicine.
A loose stool which is not diarrhoea: Loose stool but not diarrhoea may mean that the individual is suffering from celiac disease. Although the illness is quite uncommon, most people who suffer from it are not aware of the condition. The appearance of the stool is the largest and most reliable signs of having celiac disease. Individuals affected with celiac disease are not able to tolerate gluten, and it destroys the villi in the lining of the small intestine. As a result, the nutrients are unabsorbed, and the stool becomes loose. Switching to a gluten-free diet for about 2 to 3 weeks can aid in alleviating the disease.
If the appearance of the stool remains abnormal for weeks together, it is important to talk to a doctor to find out if there is something serious underlying. Bowel movement is the truest sign of the intestinal health, and thus, should not be ignored. 

Bowel Movement - What It Says About Your Health?

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!

Peptic ulcer indicates the growth of painful ulcers or sores in the lining of your stomach, digestive tract or small intestine. Ulcers, though curable, can result in serious health problems if are not treated at an early stage. Peptic ulcers occur as a result of the reaction of pepsin and stomach acid. There are many causes responsible for the growth of peptic ulcers; they are mentioned below:

    Smoking regularly
    Consuming Alcohol
    Taking medicines like aspirin, painkillers frequently
    Production of excess acid
    Radiation Therapy

The most common symptoms of peptic ulcer are as follows:

    A burning sensation in the stomach
    Vomiting or nausea
    Pain in the abdomen region
    A burning sensation in your heart
    Loss of appetite and weight
    Passage of blood through stool

Homeopathy offers effective remedies for peptic ulcer. Some of them are mentioned below:

    Crotalus horridus: This is an effective homeopathic medicine for treating peptic ulcer. If you show symptoms of frequent vomiting and passage of blood with vomit, then your doctor may recommend you this medicine.
    Graphites: If you experience a burning sensation in your stomach, your doctor may advice you this medicine.
    Uranium Nitricum: It is usually recommended for ulcers in the small intestine region and gastric ulcer.
    Kalkeriya ars: This medicine may be recommended to you by doctors if you show symptoms like pain in your stomach.
    Argentum nit: Your doctor may recommend you this medicine if you show symptoms of vomiting or indigestion.

Along with the aforesaid remedies, a change in lifestyle is also required to cure peptic ulcer completely.

Homeopathic Remedies for Peptic Ulcers

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