The liver is a vital body organ (the second largest) that helps in detoxification of the harmful substances and chemicals, in addition to participating in various metabolic pathways. It is normal for the liver to contain some amount of fats. The problem arises when there is an excess deposition of fats (accounting to nearly 7- 10% of the total liver weight), a condition referred to as Steatosis or Fatty Liver. Fatty liver often interferes with the normal functioning of the liver triggering serious consequences.

Types of fatty liver

Alcoholic Fatty Liver: As the name suggests, the condition is an outcome of excessive alcohol consumption.
Nonalcoholic Fatty Liver (NAFL): Here the problem or the trigger is not alcohol. The excess fat deposition in NAFL (~10 % of the total liver weight) results from the inability of the liver to break down the fat molecules.
Nonalcoholic Steatohepatitis (NASH): In NASH, the liver tends to swell up due to excess buildup of fats in the liver tissue (alcohol is not the trigger in NASH)
Acute fatty liver of pregnancy: Some pregnant women may suffer from this fatal condition (extremely rare).
Causes of fatty liver
Fatty liver is a common condition that often results from unhealthy diet and lifestyle practices. In this context, it is important to mention that unlimited alcohol consumption plays a pivotal role in various liver disorders, with fatty liver being one of the most common consequences. In fact, steatosis is one of the earliest stages associated with alcohol related Liver disease. However, fatty liver is a reversible condition that can be successfully treated if diagnosed at an early stage.

The excess deposition of fats in the liver cells can be an outcome of medical conditions such as
Besides alcohol, obesity is one of the biggest factors responsible for fatty liver. As per a survey, 1 in every 50 obese people suffers from fatty liver and other related complications (scarring, liver hepatitis or liver cirrhosis).

In addition to obesity, hyperlipidemia (a medical term used to define increased levels of lipids in the blood), high blood pressure, diabetes mellitus may have a significant role in triggering fatty liver.
Rapid weight loss or malnutrition can, more than often, give rise to fatty liver and its related disorders.
The use of certain medications such as carbon tetrachloride, tetracycline, and corticosteroids may be a contributing factor in fatty liver and associated complications.
Genetics can also play a significant role in triggering steatosis in some people.
Though fatty liver can affect children and young adults, people in the age group of 40 - 60 years are more susceptible to the condition.
Symptoms associated with fatty liver
There are no characteristic symptoms associated with fatty liver. However, in general, a person may experience
  Abdominal discomfort
  Extreme tiredness

With time, a person left undiagnosed and untreated, may exhibit the following symptoms
  A changed appetite (there is often a loss of appetite)
  Sudden weight loss (unexplained)
  Weakness
  Abdominal pain

Fatty Liver - 4 Common Types Of It!

A stomach ulcer or gastric ulcer refers to the defects or breakdown in the mucosal lining in the stomach. The stomach contains acid, which helps in digestion and any break in the tissue lining may result in severe pain or bleeding in some cases. The pain is usually felt in the abdomen.
Stomach ulcers cause great discomfort and should be treated effectively. Here are the primary ways for treating stomach ulcers:
Antibiotics: In the case of H. pylori infection, you should take a course of more than two antibiotics, to be taken twice a day and must be continued for a week. Antibiotics such as amoxicillin, clarithromycin or metronidazole may be used in case of such stomach ulcers. However it is always recommended to consult a specialized doctor before consuming any of these medicines. After several weeks of using the antibiotics, you should get a test done for detection of H. pylori bacteria. If they are still present, you have to take different antibiotics.
Proton Pump Inhibitors: Proton pump inhibitors or PPIs helps in the reduction of the amount of acid produced by the stomach. This prevents damage to the ulcer and lets it heal naturally. PPIs are generally taken for four to eight weeks. The most common PPIs which are used for treating stomach ulcers are omeprazole, pantoprazole and lansoprazole.
H2 Receptor Antagonists: H2 receptor antagonists reduce the production of stomach acid and function the same as PPIs. The most common H2 receptor for treating stomach ulcers is ranitidine.
Antacids/ Alginate: All measures to treat stomach ulcers take several hours to show results. Your doctor may prescribe antacid medications for neutralizing the stomach acid. This will provide relief for the moment, but the relief is quite temporary and for a short span of time. By this time, the strong medicines most likely start working. There is a certain antacid medicine known as alginate. This develops a protective coating on the stomach lining. Antacids are available at all over the counter medicine stores and you should consult your doctor to get the best antacid which would work effectively on your stomach ulcer symptoms. You should take antacids before going to sleep or after taking meals.
Natural Remedies: Stomach ulcer can also be treated at home using natural remedies. Medicines may sometimes cause further digestive complications, so home remedies are much more easy to follow and do not have side effects. The best way is to follow a proper diet, which is comprised of certain food items that help in curing stomach ulcers. You should consume bananas, honey, garlic, green leafy vegetables like cabbage, licorice and capsaicin.
Stomach ulcers cause great pain and also bleeding in several cases. Proper treatment procedures should be taken in case of stomach ulcer. There are many medical remedies, as well as home remedies for treating stomach ulcers.

Ways to Treat Stomach Ulcers

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!

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?

There are many different Ayurvedic medicines used in the treatment of ulcerative colitis, and one of the most common ways of treatment is to use a combination of the four best medicines, which work in unison to get rid of the disease.

Kutazghan vati: This medicine is derived from the tree Kutaz. Its scientific name is Halorrhreana anti dysentrica. The name itself suggests how effective the tree is in treating the disease. Diarrhea can occur due to many reasons, and one of the reasons is ulcerative colitis. If diarrhea is due to this, then it can get treated by taking Kutazghan Vati tablets, which are made from the bark of the tree.
Pitta balance with calcium compounds: When pitta or the gastric juices flow more inside the intestines, it leads to bleeding due to the ulcers inside, which needs to be balanced and controlled. The use of calcium compound rich Ayurvedic medicines serve the perfect remedy. Calcium is extracted from naturally occurring things like pearls and corals. When the tablets made from such calcium compounds are consumed, the inflammation within the colon goes down, bleeding reduces and gradually stops, and the internal irritation diminishes.
Vatsakadi churna: Tablets made from elements like fennel, coriander, Aegle Marmelos, Nutmeg, pomegranate, Green Cardamom, work like magic in treating ulcerative colitis. These are all ulcer healing items, proven beneficial for ages, and cure fast. The main function of a combination of these herbs is in restoring the metabolic imbalance carried on in the body. The ulcers are healed soon with their use, and the body balance is restored.
Arjuna capsules: One of the wound healing barks, really very famous in Ayurveda, is the bark of the Arjuna (Terminalia Arjuna) tree. This helps in many ways to heal wounds, and specially the endothelial layer inside the body arteries are healed from injuries related to free radicals, stress and other toxins. The same effects of the Arjuna tablets are seen inside the inner layers of the intestines. The ulcers are cleaned with time with the consumption of these tablets, while the bleeding also stops, and the diarrhea which was due to the inflamed colon gets cured. Moreover, the hemoglobin level is also normalized in the body, which was once affected due to bloody diarrhea.
Ulcerative colitis is a painful situation, but can be healed totally with proper administration of Ayurvedic medicines. These 4 essential medicines must be taken in combination without suddenly stopping them. They must be continued until the symptoms and irritation go away.

Ayurvedic Treatment For Ulcerative Colitis!

Urinary tract infection (UTI) is usually caused by inflammation or bacteria in the urinary tract. Pregnant mothers are most susceptible to this infection, especially after the sixth week and before the twenty fourth week of pregnancy. This usually happens due to the alterations that take place in the urinary tract during pregnancy.

Also, a growing uterus can block the urine drainage from this part of the body, leading to the accumulation of bacteria which causes infection. The symptoms are uncomfortable and even painful. These include pain and burning sensation, frequent urination, fever and chills. So how can you prevent UTI during pregnancy? we have a few tips for you!

- Hydration: The best thing you can do to both prevent and treat a urinary tract infection is to start drinking at least six to eight glasses of water in a day. Another good way to prevent and treat UTIs is with the help of cranberry juice which has powerful antioxidants that flush toxins out of your system effectively. You will, however, need to ensure that the cranberry juice is fresh and natural, without any sweeteners.

- Hygiene: Keeping yourself clean is one of the most important ways in which you can avoid UTI. It is best to clean from front to back, rather than the other way, so that you drive away bacteria and dirt. Also, make sure that you wash your private parts with warm water infused with a few drops of normal liquid antibacterial, so that you can be sure that the bacteria do not get a chance to thrive and affect your system. Also, remember to use soaps, washes and creams that have a mild formula, rather than a harsh chemical concoction. Hygiene for this area of the body includes keeping it dry.

- Diet: Your diet should have plenty of fluids and lemons or other citrus food that are rich in vitamin c, as this is a good vitamin to keep bacteria at bay. Also, you should eliminate sweet and refined products to ensure that you do not contract UTI. Other foods to avoid include caffeine and alcohol.

- Clothing: Wear airy and cotton based undergarments that are breathable and have a soft texture. This non abrasive type clothing can also help in keeping the area dry, so that bacteria does not get a chance to develop, as they typically need a damp environment for growth. Change your undergarments twice a day, if need be, and avoid wearing trousers and shorts that are too tight.

These tips and many others including urinating as soon as the urge sets in, can help in fighting the risk of contracting UTI during pregnancy.

Tips To Prevent UTI During Pregnancy

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