The liver is a key organ in metabolism and will have some amount of fat. However, excessive fat accumulation in the liver can be abnormal and is referred to as fatty liver. If the fat content exceeds anything more than 5% to 10% of the liver s weight, it would be referred to as fatty liver.

Types - There are mainly two types based on causes:

Alcoholic fatty liver: This is very common in people who consume excessive amounts of alcohol. Even a one-off instance of binge drinking can cause increased fat accumulation in the liver, but it would not produce any symptoms though. Preexisting hepatitis, pregnancy, obesity, and genetic predisposition may also lead to alcoholic liver disease.
Non-alcoholic liver disease: This is the less common type of fatty liver, and there would be no alcoholic abuse history here. However, there could be genetic predisposition, obesity, autoimmune liver disease, malnutrition, which can lead to this condition.
Symptoms

Fatty liver disease is a chronic condition with insidious onset (meaning to say, the exact time of onset cannot be pinpointed). However, as the disease condition progresses, symptoms will become evident, which can trigger a medical evaluation to identify the fatty liver. Some of the symptoms include:

Excessive fatigue and weakness
Unexplained weight loss
Loss of appetite
Nausea
Trouble focusing and concentrating
Impaired judgment
Constant, slow enlargement of the liver can cause pain in the right upper quadrant of the abdomen (where the liver is)
There could be jaundice, where the skin and the white of the eyes turn pale yellow
Symptoms of liver failure, including increased levels of proteins in the chemical tests.
Diagnosis

As noted earlier, it is not easy to identify liver disease, as there are no specific symptoms. However, the above symptoms could point to a potential fatty liver.

Blood tests, especially for liver enzymes
Ultrasound, where the liver is imaged to look for any structural changes
Biopsy, where liver tissue is extracted to confirm the diagnosis of fatty liver
Treatment

There is no specific treatment for fatty liver. It can be managed through the following, where symptoms reduce in severity, and overall prognosis improves.

Diabetes control: There is a relation between how well diabetes is controlled and severity of fatty liver. Improving diabetes control ensures fatty liver does not progress.
Alcohol: Cutting down or even better quitting alcohol, definitely helps improve symptoms. If it is alcohol induced fatty liver, alcohol should be stopped.
Weight management: Obesity and fatty liver are related, so weight management is essential.
Healthy diet: Eating a healthy diet and regular exercise regimen also helps improve symptoms of fatty liver.

Fatty Liver - Signs You Are Suffering From It!

Tummy tuck also known as an abdominoplasty, a tummy tuck surgery is a form of cosmetic surgery, which is used to remove excess fat and skin from the abdomen as well as tighten the muscles in your abdominal regions. Similar to 'mommy makeovers' (a procedure applicable after pregnancy, which helps women restore their figure). 


Tummy tuck surgery is used to help patients treat that loose and sagging skin who have experienced excessive weight loss within a relatively short period of time. Although, it is usually done for cosmetic reasons, it does provide a large number of medical benefits, such as:


1. Reduction in stress urinary incontinence: Stress Urinary Incontinence is a bladder control problem that is characterized by involuntary urination because of exercises or normal bodily functions such as sneezing or coughing which might put pressure on the bladder. In some women, (SUI) can develop after a vaginal birth. The condition does not generally require a surgery. However, research has shown that in severe cases, abdominoplasty is helpful in patients who do not have a caesarean section. A slight bladder obstruction is made during the procedure using soft tissue which reduces the incontinence.


2. Better posture and improved abdominal tone: Strong muscles tend to become weak after multiple pregnancies and extreme weight loss. In these cases, diet and exercise are not enough. Abdominoplasty surgically removes excess fat and skin thereby, tightening weak muscles and flattening the abdomen. It is noticed that after the surgery, the patients develop an improved posture due to the tightened muscles supporting the spine. This helps in relieving a variety of back pains.


3. Correction of ventral hernia: Ventral Hernia is the bulging out of tissues through a defect, opening or past incisions within the wall muscles of the abdomen. In such a case, the surgeon may opt for Abdominoplasty to support the abdominal wall and prevent recurrences.


Medical Benefits of Tummy Tuck Surgery 

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!

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

A number of health problems today are caused by an unhealthy lifestyle. One such condition is a fatty liver or collection of fat in the liver. The buildup of fats in the liver is known as Fatty Liver. The liver processes everything that you eat or drink and filters harmful substances from the blood. If too much fat has accumulated in the liver, this process gets interfered with. These fat cells cause inflammation of the liver tissues which in time can lead to scarring and liver fibrosis. On its own, a fatty liver is relatively harmless but when it reaches this stage, it can be life threatening.

The reasons for Fatty Liver can be alcoholism, incorrect diet, obesity, diabetes, or even excess use of medication.

If ignored or left untreated, many liver diseases will lead to permanent and irreversible damage to the liver and can be a significant threat to your health. But, there is no standard form of treatment for a fatty liver. If diagnosed in its early stages, treating the underlying cause can stop the progression of the disease and even resolve it. Homeopathy addresses the underlying causes of a disease and hence is an ideal form of treatment for a fatty liver. It can reduce the symptoms of this disease, improve liver functioning and even reverse the condition if treatment is started early.

The Homeopathic medicines, which are made of natural substances, are given to patients after studying the unique symptoms experienced by each individual. Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. Homoeopathy is very proficient in managing all the symptoms of Fatty liver disease and furthermore plays a vital role in preventing relapse of the condition.

Some of the most common homeopathic medicines for fatty liver are

    Chelidonium: This is often used to treat a fatty liver accompanied by right upper abdominal pain. In such cases, the liver may be enlarged and the patient also usually suffers from constipation or experience nausea and vomiting. The patient will also probably suffer from excessive weakness and have a desire for hot food and drinks.

    Lycopodium: A fatty liver accompanied by acidity can be treated with this type of homeopathic medication. In such cases, the patient will also complain of bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks.

    Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching. In some cases, the patient may also experience pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool.

    Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head.

    Nux Vomica: homeopathic remedy for fatty liver with pain in abdomen after eating.

Nux vomica is great for any abdominal problem including fatty liver caused by excessive consumption of alcohol. These patients often suffer from abdominal pain a few hours after eating with sour or bitter tasting belches. They may constantly feel the urge to pass stool but are unable to do so.

Though homeopathic remedies have negligible side effects when taken in low dosages, they should never be self-prescribed. If you suffer from a fatty liver, consult a homeopathic doctor immediately who can diagnose it properly and treat you accordingly.

5 Homeopathic Remedies for Fatty Liver

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