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!

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?

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 

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!

Liver is a very important organ of your body. It is also the largest internal organ. Liver plays a pivotal role in food digestion, iron metabolism, regulation of blood clotting and removal of toxins from your body. Liver problems refer to the disruption of liver functions. There are various liver problems and diseases that you may encounter. Some of the liver problems are as follows:

Hepatitis A, B, C, D, E
Liver cirrhosis.
Fatty liver
Liver cancer
Wilson disease
Jaundice
The most common causes of the above mentioned liver problems are

Fatty liver is generally caused due to obesity
Hepatitis A, B, C is caused due to viral infections
Consuming excess alcohol can cause liver cancer
Liver diseases like Wilson disease is caused due to genetic problems
Different liver problems have different symptoms. But there are some common symptoms for all liver diseases. The most common symptoms are mentioned below

Body fatigue
Pain in the abdomen
Change in urine and stool color
Nausea
Queasiness
Loss of weight and appetite
Yellowish discoloration of skin, eyes and nails.
Homeopathy can treat liver problems very effectively. The following are some of the solutions offered by homeopathy for different liver problems
1. If you are suffering from the problem of fatty liver, your doctor may recommend you medicines like Lycopodium, Phosphorus, Nux vomica
2. If you suffer from the problem of liver enlargement then your doctor may recommend you medicines like Carduus Marianus
3. Chionanthus and Taraxacum are medicines advised for liver problems like jaundice
4. Natrum sulphuricum may be recommended to you if you are suffering from problems like Liver cirrhosis
Homeopathic treatment for liver problems is very effective since it treats the medical condition according to specific symptoms

Liver Problems - How they Can be Treated with Homeopathic Remedies?

Liver, one of the most hardworking organs in your body sits snugly in the upper right part of your abdomen, beneath the diaphragm. This organ is a multi-tasker and it works tirelessly all day. Your body needs the energy to carry out all its tasks. You may have a vague idea that the food you eat plies your body with strength. But where does this energy come from? How is it produced? Your liver has a hand in it. Have we piqued your curiosity? Do you want to know how it acts as your body s power source? Read on!

Utilization of carbohydrates
Carbohydrates are a macro-nutrient that are vital for energy production. They are present in foods such as wheat, rice, potatoes, apples, bananas etc. But in the form you consume them, carbohydrates will not energize you. So your body converts them into glucose and stores them in your liver as glycogen. Glucose gives you energy. When your body senses your energy levels are dropping, the liver releases some glycogen that immediately perks you up.

Breaking down proteins
Your liver also breaks down protein by deaminating them to initiate the Krebs/Citric Acid Cycle. It is your liver that starts changing the amino acids so that proteins can enter the Citric Acid Cycle in which they will be converted into the kind of energy that is usable.

Metabolism of fats
Do you know how your liver plays a part in metabolism? It does its bit in the breakdown of fats with the help of bile. And when fats are broken down, you get energy.

Greater liver efficiency with Ayurveda
The ancient Indian medicinal science Ayurveda deals extensively with the liver. Ayurveda can tell you what you can do to ensure that your liver stays healthy and strong. And if you have developed any liver-related disease, such as Hepatitis A, Hepatitis B, Hepatitis C, Liver Cirrhosis or Autoimmune Hepatitis, then Ayurveda can deal with these illnesses. So if you have been diagnosed with any liver illness please take suggestion from an Ayurvedic liver specialist who will have answers to all your liver problems.
Your liver is your source of energy. That is why you have to take excellent care of your liver so that it does not give out on you.
Though there are ways in Ayurveda to treat Liver Diseases and keep liver healthy, it is always advisable to consult an ayurvedic liver specialist before opting for any medicine or remedy.

Your Liver Is Your Power Engine - Learn More!

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