In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

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?

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 build-up of fat in the liver may lead to the development of a condition known as nonalcoholic steatohepatitis or NASH. This condition is not related to the consumption of alcohol and the inflammation is due to the buildup of fats in the liver. In most cases, there are no symptoms till the stage when the fat deposition causes inflammation and damages the liver cells. This also hinders the normal functioning of the liver and if not treated, it may lead to an extreme condition known as cirrhosis. However, NASH does not always get worse and with some precaution, it can be treated.

The cause behind the development of this disease is not alcohol consumption and it could be some environmental factor that triggers liver inflammation or heredity might be another reason. However, the risk of developing this disease is high for people who are obese, have metabolic syndrome, have high cholesterol or are resistant to insulin.

There are hardly any symptoms of NASH that are seen in the early stage of this condition. However, at a much-progressed stage, the following symptoms may be seen:

Weight loss
Fatigue and weakness
Upper abdomen pain
Diagnosing NASH requires undergoing several tests that include a blood test, a CT scan, an MRI scan and also an abdominal ultrasound.

Benefits of Ayurvedic remedies in managing NASH



There are remedies which help in detoxification of the liver. They also enhance the body s capacity to digest fats and prevent it from accumulating in the liver.
A few remedies are rich in vitamin C content as they are very effective in treating liver problems.
Some remedies are packed with the antioxidant and vitamin C. And, it is this vitamin C that helps the liver in producing the enzyme, glutathione, which neutralizes the toxins and detoxifies the liver of all of the toxins.
Some remedies contain catechins, which are known to enhance the functioning of the liver. They are great for blocking the fat stored in the liver and works wonder in fighting against diseases associated with the fatty liver disease.
There are some fruits that are effective in treating fatty liver diseases. These fruits burn the dietary fat rapidly and also improves the functioning of the liver if consumed regularly.
Some Ayurvedic remedies are a storehouse of the fat-soluble Vitamin E, and are known to protect your liver against the accumulation of fats and will keep your liver healthy.
Apart from including these natural ingredients in your diet, you will also have to reduce your body weight, reduce cholesterol level, control your diabetes, exercise regularly and stop consuming alcohol. However, home remedies are just supportive, but not a complete line of treatment for NASH so you cannot depend completely only on them. As mentioned NASH can disturb your normal liver functioning and if not treated it can lead to liver cirrhosis so take proper Ayurvedic treatment under the guidance of an Ayurvedic doctor.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Nonalcoholic Steatohepatitis (NASH) - Home Remedies That Can Help Treat It!

The term cirrhosis refers to liver scarring due to various diseases and conditions such as chronic alcoholism and hepatitis. Each time the liver gets injured, it tries to repair itself, resulting in the formation of the scar tissue. With the progression of cirrhosis, a number of tissues generate making the task of liver difficult. Since the liver is an important organ of the body due to its functionalities such as detoxification and nutrient generation, reduced function of liver poses a serious threat to the body.

Symptoms of liver cirrhosis:
Unfortunately, cirrhosis doesn t portray any conspicuous symptoms that can be easily identified until the scarring has reached a level of threat. Some of the common signs and symptoms of this disease include fatigue, nausea, itchy skin, drowsiness, enlarged breasts, testicular atrophy, fluid in the abdomen, bleeding from the mouth, leg swelling, redness in palms etc.

Causes of liver cirrhosis:
There could be an array of reasons for the occurrence of liver cirrhosis. The major causes include an accumulation of fat in the liver, chronic alcoholism and chronic hepatitis. Some of the other reasons include cystic fibrosis, bile duct deformation, Wilson s disease, hemochromatosis, schistosomiasis, continuous consumption of medicines such as methotrexate, a disease involving glycogen storage and Aalagille syndrome.

Complications involved in liver Cirrhosis:

High blood pressure: Cirrhosis results in slow blood movement through the passage of the liver resulting in an increased pressure on the vein that is responsible for carrying blood from the intestine to the liver. This increases the blood pressure in the body.
Swelling of abdomen and legs: Portal hypertension can result in accumulation of fluid in the leg and the abdomen due to the liver s inability to producing an important protein known as the albumin.
Spleen enlargement: Portal hypertension is responsible for changing the shape of the spleen. Decreased count of WBC and the platelets indicate towards portal hypertension and cirrhosis.
Bleeding: Portal hypertension doesn t let the blood flow in its normal path. It directs the blood to flow through smaller veins. The veins, in turn, swell and burst to cause a massive amount of bleeding.
Apart from these some of the other complications involve jaundice, liver cancer, infections, bone diseases and liver failure.

Diagnosis:
Liver cirrhosis doesn t get detected easily. It is often diagnosed with a routine blood test. Some of the lab tests that can help to identify cirrhosis include blood work to check organ function of liver and kidney. Your doctor might suggest other tests such as MRI scan, CT scan or liver biopsy.

Treatment:
Treatment for the underlying cause of liver cirrhosis is done to keep the disease under control. A doctor might treat you for weight loss, alcohol dependency, complications related to hepatitis, portal hypertension and hepatic encephalopathy. For advanced cases where the liver stops functioning, a doctor might suggest a patient go for a liver transplant.

Liver Cirrhosis - What You Must Know About It?

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

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