The liver performs over 500 functions and is considered to be one of the most important organs in the human body. The functions liver perform include regulating cholesterol and blood sugar, filtering out blood toxins, storing energy and making hormones and proteins. There are many diseases which liver can catch and most prominent being alcoholic liver disease

When a person consumes alcohol in excess, it leads to building up of fats, inflammation and scarring of the liver   which results in alcoholic liver disease.

The damage that occurs due to this disease in the liver can affect the whole body. Since the liver is generally highly effective in repairing and regenerating itself so the damage takes longer to come into notice. It often becomes distinctive by the time the damage is already irreversible.

This disease usually takes place in people between 40 and 50 years of age. This disease is most commonly seen in men. Certain cases have been seen where people may have inherited the risk for the disease.

Liver disease related to alcohol consumption fits into following 1 of 3 categories:

Fatty liver: This takes place due to acute consumption of alcohol. This state is generally reversible if alcohol isn t consumed.
Alcoholic hepatitis: This is an acute type of alcohol-induced liver injury which takes place when alcohol is consumed excessively over a long period of time. It can lead to liver failure and death as well.
Cirrhosis: Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by over consumptions of alcohol. It can also occur due to other reasons as well.
Some Facts about Alcoholic Liver Disease

It is the main cause of chronic liver disease in Western nations and the third most common cause of liver transplants.
Staying away from alcohol is the only way to the patient s recovery.
Jaundice and tremors are the most common symptoms of this disease.
Medication, lifestyle changes, and surgery are some available treatments.
Early signs of the Disease
The early signs of alcoholic liver disease are not much noticeable and affect many systems in the body.

Pain in the abdomen
Nausea and vomiting
Diarrhea
Decreased appetite
If these signs are left unattended and the patient continues to consume alcohol, it can lead to a faster damage to the liver.

The symptoms of this disease become noticeable usually during the later stage of liver disease. The symptoms of this disease include:

Jaundice
Edema or swelling of the lower limbs
A build-up of fluid in the abdomen, known as ascites
Fever and shivering
Extremely itchy skin
Clubbing of fingernails
Loss of weight
General weakness
Blood in vomit and stools
Bleeding and bruising more easily
More sensitive reactions to alcohol and drugs
In most patients with the alcoholic liver disease, the illness is not severe. You may not require hospitalization immediately as long you take necessary precaution like stopping the consumption of alcohol, take good nutrition and follow the advice of the doctor. However, in more severe cases, the doctor may be able to suggest the best line of treatment.

Alcoholic Liver Disease - Know The Symptoms!

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!

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!

Having some fat in your liver is legit. But, if you have too much of fat say more than 5%-10% of the organ's weight then you are at risk of getting fatty liver disease. At the onset, you can do one important thing to help your liver stop drinking. It causes fatty liver disease.

There are two main types of fatty liver disease

Alcoholic liver disease or ALD
Non-alcoholic fatty liver disease or NAFLD
If you are a woman who is pregnant, you can also get fatty liver disease.
Alcoholic Liver Disease (ALD)

You can get ALD from drinking lots of alcohol. ALD can also present itself after a short period of heavy drinking.
Genetics has a role to play in ALD. Genes can make you hit the bottle and increase your chances of becoming an alcoholic.
Genes can also impact the way your body breaks down the alcohol you drink.
Other root causes of ALD are:

Hep C doesn't cause ALD. it is one of the causes of fatty liver. 
Hep B is also a cause of fatty liver. There are certain medications which may be helpful from person to person besides lifestyle management.
Excess iron in your body
Obesity
Non-alcoholic Fatty Liver Disease (NAFLD)
The cause of NAFLD is not clear, but we know that it tends to run in families.
NAFLD is also more common in the middle-aged and the obese or, those who have high cholesterol and diabetes.

Other risk factors are:

Certain medicines
Viral hepatitis
Auto-immune or inherited liver disease
Gaining weight fast
Malnutrition
Acute Fatty Liver during Pregnancy
Fat can build up in your liver when you're pregnant, causing this kind of fatty liver disease.
It s a serious condition as it can be risky for both you and your baby. It can cause liver or kidney failure in you and your child, both.
Causes are unknown. But, hormones may play a role.
Symptoms of fatty liver disease
This disease can sometimes cause no symptoms for long. But, the things to look out for are-

Feeling tired all the time
Loss of appetite or weight
General weakness
Nausea
Confusion and trouble concentrating
Your liver can become larger
Pain in the centre or right upper part of your belly
In ALD, your symptoms get worse after bouts of heavy drinking. Fatty liver disease is diagnosed during routine exams when your doctor notices your enlarged liver. Ultrasound, blood tests to check for certain enzymes and biopsy of the liver are performed to confirm it.

Treatment

There is no specific treatment for the fatty liver disease.
You can manage it by managing your diabetes and giving up drinking. If you have ALD and you don t quit, you get complications like alcoholic hepatitis or cirrhosis.
Even if you have a non-alcoholic fatty liver disease, alcohol cessation helps.
Losing weight if you are overweight also helps to manage this disease and having a good balanced diet with exercise also shows benefits.

Fatty Liver Disease - Signs You Are Suffering From It!

In modern day societies of intense stress and work pressure, the average diet mostly comprises of street foods, packaged fast foods and processed foods. Such stress and overexposure to a lot of toxins (present in the processed food, fast foods, and street foods) disable the liver from performing its primary function of cleansing the toxic materials through the skin, the respiratory and the digestive system. Besides, this overexposure to toxins also disrupts bile formation, which hinders the absorption of necessary nutrients, resulting in a severe disruption in health. Also, liver is responsible for the proper functioning of the eyes, the brain, the kidneys and the joints in the body. Thereby, it is necessary to include these 7 foods in your diet which help to detoxify your liver from the excessive toxins and allow it to function properly.

    Avocado: Avocados contain a rich amount of the antioxidant glutathione, which helps the liver to fight against the toxins.
    Garlic: Garlic contains a rich amount of selenium and allicin, which helps to cleanse the liver. A little amount of garlic helps in the activating liver enzymes which in turn helps to eliminate the toxins from the body.
    Green tea: Green tea contains a rich amount of the plant antioxidant known as Catechin, which help the liver to function properly. It also helps to protect the liver from the toxins.
    Beets and Carrots: Beets and carrots contain a rich amount of beta - carotenes and plant flavonoids which help to regulate the overall function of the liver.
    Turmeric: A little amount of turmeric in your daily meal helps in the cleansing the liver by helping the enzymes to get rid of the toxic carcinogens.
    Green Vegetables: Green Vegetables like spinach, bitter gourd and chicory contains a rich amount of detoxifying components, which helps in the neutralization of heavy metals which in turn regulates the cleansing ability of the liver. Green vegetables also help in the simulation of the flow of bile.
    Grape Fruit: Grape fruit contains a rich amount of vitamin C and antioxidants which initiates the cleansing process of the liver. Grape fruit also help in the formation of enzymes that destroys toxins like carcinogens.

Cleanse Your Liver - 7 Natural Foods that Will Help You 

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!

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