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?

Hepatic Steatosis, better known as Fatty liver is a term which describes the condition where fat gets built up in the liver. The liver is the second largest organ in the body and it plays an important function of processing everything we eat or drink and then filter out harmful elements from the blood. This process gets interrupted if there is too much in the liver. We generally call the liver as fatty, when fat accounts for more than 5 to 10 percent of the weight of your liver.

The problem of fatty liver is quite common, affecting around 10 to 20 percent of people living in America without cirrhosis or inflammation. According to the American Liver Foundation, the majority of the cases of fatty liver are detected between ages 40 and 60.

Symptoms of fatty liver
Basically one cannot associate any symptom with fatty liver, though once this situation arises, people might experience fatigue or unusual discomfort in the abdomen.
Excess fat in the liver can lead to its inflammation and in that case, you might come across symptoms such as:

You don t feel like having any food due to poor appetite
One starts to lose weight
You might experience pain in the abdomen, which tends to interfere in your passing of urine.
As there is a loss of appetite, resulting in weight loss, muscles would start feeling weak.
Due to weakness in your muscles, you would easily get tired even when you have not any work that required a lot of exertion.
Causes of fatty liver
The most common reason behind fatty liver is alcohol. On the other hand, fatty liver can also occur among people, who are non-alcoholic.
In those circumstances, the fatty liver gets developed when the body creates too much fat or is unable to metabolize fat fast enough. The excess fat gets stored in the cells of the liver where it gets accumulated to form fatty liver disease.

The common causes for fatty liver, other than alcoholism are:

Obesity: Obesity is a condition when you gained too much bodyweight through accumulation of excess body fat. This becomes a major problem which leads to other problems like fatty liver.
Diabetes: Excess amount of blood sugar in your system, which results in diabetes, raises the risk of developing fatty liver disease.
Genetic Inheritance: If you have someone in your family, father, mother or anyone else, who has suffered from this problem of fatty liver, then it s quite certain that you might also catch up with this disease.
Treatment for fatty liver
You are always at risk if you get diagnosed with the problem of the fatty liver through blood tests, MRI scan and liver biopsy. Though there is no medication or surgery possible for treating this problem a doctor would provide certain recommendations to reduce the risk factors. These include:

Limiting or complete avoidance of alcohol
Keep a check on cholesterol and reduce the intake of sugar and other saturated fatty acids
Make a genuine attempt to lose weight
Control your blood sugar by walking daily and having a restricted diet

Fatty Liver Disease - Ways It Can Be Treated!

Alcoholic liver disease or cirrhosis is one of the most common disorders of the liver. Since the liver performs a vital function in the body, it is essential to maintain its health. There can be several causes for the cirrhosis of the liver. Here are some of the factors that you need to watch out for if you want to steer clear of alcoholic liver disease.

Excess alcohol consumption: While limited alcohol consumption does not cause major health issues, you need to understand how much is too much. Drinking too much for a prolonged period of time will cause damage to the liver cells, which will lead to alcoholic liver disease. So, if you are a heavy drinker, stop immediately or at least try to cut down on the amount that you ingest each day. More than three drinks per day for men and two drinks per day for women for 5 years will substantially increase the chances of the disease.
Beer Consumption: People who drink beer are at a greater risk of suffering from alcoholic liver disease than people who consume wine or other alcoholic beverages. The exact reason for this is not known, but if you are a wine drinker, you would be happy to know that you have lesser chances of damaging your liver.
Gender: Research has indicated that women take longer to metabolize the alcohol that they consume than men. This is why such drinks have a deeper impact on women s bodies. For instance, even if a man and a woman drink the same amount of alcohol, it will cause more damage to the body of the woman than it will to the body of the man.
Obesity: Excess body weight can cause a host of harmful medical conditions, one of which is alcoholic liver disease. Maintaining an ideal body weight can go a long way in preventing the liver condition. Excess weight is a risk factor for both men and women. Pay attention to your diet and also ensure that you work out every day. Not only will such a lifestyle help you achieve a better liver, but it will also enhance your overall health.
If alcoholic liver disease is left untreated, it can progress to Hepatitis A or cirrhosis. Therefore, it is essential that you seek treatment as soon as you are diagnosed with the condition, in order to limit the damage to your health.

The 4 Most Common Risk Factors For Alcoholic Liver Disease!

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 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!

Liver cirrhosis is characterized by the replacement of normal liver tissue with fibrous tissue. This condition occurs when the liver has been exposed to certain causative factors for a prolonged period of time. Liver cirrhosis can be compared to  Kumbhakaamla  as stated in Ayurveda.

In Ayurvedic terms, liver cirrhosis is through to result due to an extreme aggravation of the pitta dosha. The liver is considered as the seat of pitta and therefore, an aggravated pitta dosha affects the functioning of this vital organ that helps eliminate toxins from the body. It can lead to problems such as anemia, jaundice, hemorrhage, ascites, and liver and spleen enlargement. This may end up aggravating and dis-balancing other doshas as well.

Because of aggravation of the pitta dosha, all the functions of the pitta such clarity of skin complexion, hunger, digestion, and production of blood are seriously affected. Because of the aggravation, the rasa and rakta dhatus are severely affected followed by other dhatus.

Ayurvedic treatment for liver ailments is highly recommended as it is completely natural and does not result in any side effects. It helps reverse all of the symptoms of liver cirrhosis and other diseases while restoring the normal functioning of the liver. There are several Ayurvedic remedies that you can practice to relieve the symptoms of liver cirrhosis.



The following are some of the most common Ayurvedic tips for liver cirrhosis:

Patient must take expert opinion of an Ayurveda for the right treatment of liver cirrhosis
Cirrhosis is a complicated and serious situation thus, home remedies or any single herb treatment is not recommended.
Quit alcohol
Eat a well balanced and nutritious diet that contains a lot of fresh fruits and vegetables
Opt for sources of good fats such as nuts, seeds, avocado, soy and olives
Avoid packaged food items with added preservatives, including pickles
Ayurvedic treatment varies from person to person and therefore one must consult an expert and not try any home remedies.

Liver Cirrhosis Treatment With Ayurvedic Remedies 

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