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!

The liver is a vital organ in our body because it performs many important functions. This includes filtering harmful substances in our blood, producing bile to facilitate digestion of food, storing energy and nutrients as well as producing hormones and enzymes that the body uses for performing essential functions. However, too much consumption of alcohol can affect the liver, lead to serious consequences related to our health, and also result in an alcohol-related liver disease (ALD). An ALD may, in turn, cause disruption of the digestion process and weaker immune system. It may even increase the risk of developing cancer.

Causes:

As the name suggests, the prime cause behind the development of alcohol-induced liver disease is the consumption of alcohol for a long duration. However, some of the other causes behind the development of alcohol-induced liver disease include the presence of an existing liver disease such as fatty liver or hepatitis, inherited liver disease, or a liver disease induced due to excessive or prolonged consumption of certain drugs.

Alcohol-induced liver diseases (ALD) can be of three types. 

Alcoholic fatty liver disease: Alcoholic fatty liver disease or steatosis occurs due to the deposition of fats in the liver, which is an end result of excessive alcohol consumption.
Alcoholic hepatitis: Too much of alcohol consumption can also lead to liver inflammation, which is called alcoholic hepatitis.
Alcoholic cirrhosis: This alcoholic-liver disease occurs when the liver is scarred due to excessive consumption of alcohol. In this case, the healthy and soft liver tissues are replaced with dead and hard tissues.
Symptoms: Some of the signs and symptoms, mostly related to ALD, are not noticed in the initial stage. It is only after a few years that the symptoms may appear. Some of the common symptoms include abdominal pain, loss of appetite and weight loss, swelling in the abdomen as well as the legs, feet, and ankles, a yellowish appearance of the skin, itchy skin with hair loss, and bleeding and complications such as liver cancer or ascites.

Diagnosing alcohol-related liver disease is based on your history of alcohol consumption. But, there is no single test that can detect this type of disease, so a combination of tests will be suggested by your physician before a specific type of alcoholic liver disease is diagnosed.



Ayurvedic Treatment

Ayurveda is known to be greatly beneficial for the treatment of alcohol-induced liver diseases. The use of natural ingredients like herbs can not only treat the liver disease but also promote the overall well-being of the liver. The treatment will include abstinence from alcohol, as it is very important when it comes to undoing the damage that alcohol has caused to your liver.

There are some home remedies also which are only supportive in case of Alcoholic fatty liver, but if you are suffering from alcoholic hepatitis and ALD related liver cirrhosis you must need proper line of treatment under a well experienced and expert Ayurvedic doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!

Alcohol Related Liver Diseases - Ways Ayurveda Can Help With It!

Ulcerative colitis is a disorder that causes inflammations and ulcers inside your colon, affecting the entire digestive system. The disease grows over time and symptoms start to worsen over a prolonged period, rather than the problem showing up suddenly. Severe cases of ulcerative colitis may even be fatal if treatment does not resolve some of the complications arising from the condition.

Causes of Ulcerative Colitis-
The exact cause for the inflammatory bowel disease is unknown. Improper diet and lifestyle can aggravate the symptoms, but do not cause the condition. Some possible causes for the disease include-

Improper functioning of the body s immune system causes it to recognize the colon as a foreign body.
Genetic factors and hereditary may also be held accountable in some instances.
Risk factors for the condition include old age and family history of the condition.

Symptoms of Ulcerative Colitis-
Here are some common symptoms associated with the condition-

Bloody diarrhoea
Rectal pain
Weight loss
Pain in the abdominal region along with cramping
Fever
Urgency to defecate
Inadequate bowel movement despite the feeling of urgency
How can you prevent ulcerative colitis?
Ulcerative colitis cannot be prevented as the exact cause for the condition is unknown. However, there are simple steps that will help manage the symptoms.

Diet change- You need to stop eating certain foods, such as, dairy products, beans, broccoli, cabbage and anything spicy. Instead, fibre intake must be increased drastically.
Exercise- Mild exercise or activities have a profound impact on managing the condition.
Avoiding stress
Drinking plenty of fluids
Role of Homeopathy in Managing Ulcerative Colitis-
Homeopathy follows a natural and holistic approach to deal with the condition. It does not merely treat the symptoms, but looks to cure the underlying cause for those symptoms. Homeopathic remedies will greatly bolster the overall condition of the body s immune system. Furthermore, the bloody diarrhoea accompanying the disease will also stop with proper homeopathic treatment.

Ulcerative Colitis - Does Homeopathic Treatments Work?

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!

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!

Cirrhosis of the liver is a chronic and progressive condition in which the liver gets damaged and healthy liver tissue is replaced with scar tissue, ultimately causing dysfunction of the liver. Liver damage obstructs the circulation to the liver and also hinders the processing of nutrients, hormones, drugs, toxins as well as the production of proteins and other substances made by the liver. Liver cirrhosis is caused due to hepatitis C, fatty liver, alcohol abuse, viral infections, inherited diseases, and as a toxic reaction to drugs and environmental waste products. The modern management of this condition involves diet modification, reduction in salt intake, total abstinence from alcohol, and avoiding all the causative factors of this condition.

Cirrhosis of liver causes multiple symptoms in the body including fluid collection in the abdomen, bleeding varices in the stomach, chronic heart failure, damage to the central nervous system, and various metabolic disorders in the body. Advanced cirrhosis of liver is ultimately fatal.

Ayurvedic Treatment

It is therefore of prime importance to commence treatment at the earliest possible. It is of utmost importance to treat the known cause of the condition. Ayurvedic herbal medicines have a definite action on the hepatic cells and can effectively treat inflammation within the liver. Ayurvedic medicines can also treat infection as well as metabolic dysfunction of the liver, and protect it from the toxic effects of drugs and environmental wastes. Ayurvedic medicines can therefore be effectively used to treat all the known causes of liver cirrhosis.
Liver damage causes healthy cells to be replaced with scar tissue. This is preceded by a process of inflammation, swellingand gradual death of the liver cells. Early institution of Ayurvedic treatment can help dramatically reduce inflammation and swelling and thereby preserve the liver cells and prevent unnecessary damage. Even in the early phase of scar deposition. Ayurvedic herbal medicines can help remove scar tissue, minimize permanent liver damage, and help regenerate damaged or near-dead cells Ayurvedic herbal medicines, therefore, form a comprehensive treatment therapy for liver cirrhosis.
The other symptoms resulting from liver cirrhosis such as ascites, esophageal varices, congestive cardiac failure and metabolic disorders start improving automatically when the obstruction in the liver is treated and removed. However, Ayurvedic medicines can treat these symptoms independently too, if these are observed to be severe in the affected individual and require urgent medical care. Improved functioning of the liver also helps to improve the overall metabolism and nutrition of the body and metabolize toxic substances within the body. Prompt and aggressive Ayurvedic treatment, therefore, helps comprehensively treat liver cirrhosis and significantly reduce morbidity and mortality resulting from this disease.
Cirrhosis can also adversely affect the central nervous system and cause psychotic symptoms and permanent nerve damage. Prompt treatment with Ayurvedic herbal medicines also helps to preserve the brain function and treat the associated symptoms. If required, brain damage can be treated separately with herbal medicines which strengthen the nervous system and help rejuvenate nerve cells. Medicines which act on the nervous system also help improve confidence and self-control and are therefore equally useful in helping the affected individual abstain completely from alcohol, which is a known and predominant cause of cirrhosis.
Depending upon the severity of the condition, most individuals affected with cirrhosis require regular and aggressive Ayurvedic herbal treatment for periods ranging from six to eighteen months, in order to obtain significant benefit and a possible complete cure from the condition. Ayurvedic treatment thus has a definite role to play in the management and treatment of cirrhosis.

Cirrhosis Liver - Ayurvedic Remedies That Can Help!

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