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 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?

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?

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 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

Cirrhosis of liver is slow and gradual replacement of normal healthy liver tissue with scar tissue which results in poor liver function and blockage of flow of blood through liver which comes from intestines. As more scar tissue replaces normal healthy liver, liver begins to fail.

What causes cirrhosis?

Alcohol: Amount of alcohol which can cause liver damage varies from person to person, however those who consume alcohol for long in significant amount are more prone to develop liver damage.
Hepatitis B or hepatitis C: Caused by hepatitis B and C viruses, respectively, which are acquired by contact with contaminated blood (like needlestick injury, blood transfusion, injection drug abuser), sexual contact with infected person and from mother to child during childbirth.
Non-alcoholic fatty liver disease (NAFLD): Caused by presence of extra fat in liver (after excluding significant alcohol intake) which causes inflammation and scarring leading to cirrhosis. Usually seen in patients who are overweight or obese, having diabetes, high fat in blood, high blood pressure or metabolic syndrome.
Drugs causing liver injury.
Others: Autoimmune hepatitis (body`s own immunity acting against liver), Wilson disease (build up of copper in body), hemochromatosis (excess of iron in body), certain bile duct disorders, etc.
What are the symptoms of cirrhosis?

Early disease can present with nonspecific symptoms like weakness, fatigue (loss of energy), decrease wish to take food, vomiting or nausea, weight loss, etc.
Advanced disease can present with fluid accumulation in legs (edema) or abdomen (ascites), facial puffiness, yellowish discoloration of eyes or urine (jaundice), redness of palm (palmer erythema), decrease urine output, small red lesions on skin, easy bleeding following trauma, blood coming out of mouth/anus/other body site, black colored feaces, mental confusion, flapping tremors of hand, etc. In men it can cause impotence, breast enlargement and shrinking of testis.
What are the complication of cirrhosis?

Portal hypertension: It is a common complication of cirrhosis which is due to increased pressure in portal vein. Portal vein is main blood vessel which carries blood to liver from stomach, intestines, spleen, gallbladder and pancreas. Because of scar formation in liver the normal flow of blood from these organs to liver is hampered. As a result of blockage of blood flow to liver there are few complications which can arise like accumulation of fluid in abdomen (ascites) and legs (edema), formation of enlarged veins (varices) in food pipe (esophagus), stomach, etc., enlargement of spleen (splenomegaly), mental confusion/altered behavior/altered sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).

Increase risk of infection because of immune system dysfunction.
Development of liver cancer (Hepatocellular carcinoma)
Easy brusibility or bleeding following light trauma.
Gall bladder stone formation
Metabolic bone disease
What are the stages of cirrhosis?

Compensated cirrhosis: Liver damage is damaged but no abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).
Decompensated cirrhosis: Presence of abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).
How cirrhosis is diagnosed?

Your doctor will take good history and do proper physical examination. If there is suspicion of cirrhosis then he will subject you to some blood test, ultrasound abdomen, fibroscan/elastography, upper GI endoscopy and if needed CT scan or MRI of abdomen or liver biopsy.

Ultrasound of abdomen in cirrhosis may shows coarse liver echotexture, nodular liver surface, dilated portal vein or collateral, enlarged spleen or abdominal fluid (ascites).

How to prevent cirrhosis?

Best way to avoid development of cirrhosis from predisposing stage of liver illness is to recognize and treat early. Few advices to keep liver healthy are:

Dietary modification: Eat healthy balanced diet. Avoid high calorie food or drinks, saturated fat, sugar and refined carbohydrates. Keep yourself hydrated.
Lifestyle modification: Maintain healthy body weight. Avoid being overweight or obese. Aerobic exercise (like brisk walk 30-45min/day atleast 5days/week) regularly helps to lower liver fat.
Avoid: Avoid use of contaminated needles, sharing of items of personal hygiene (like shaving razors, toothbrush, nail clippers, etc), use of illicit drugs, self medication with over the counter drugs or using drugs beyond doctor`s advice.
Practice safe protected sex
Alcohol
Motivate others: to stop drinking and follow hand hygiene and doctor`s advice.
Hand hygiene: Wash hand with soap and water regularly before eating, after going to toilet and after touching dirty objects.
Vaccination: For hepatitis A or hepatitis B, if you are not vaccinated or not already infected or unsafe antibody titre. Transmission rate of hepatitis B from mother to child at birth can be reduced with vaccination and immunization of newborn starting within 12 hours of birth as well as by using antiviral drugs (if indicated).
Prevent others from getting infected from you if you harbor virus causing liver damage.

How to treat cirrhosis?

Treatment of cirrhosis is based on cause of cirrhosis and complication of cirrhosis. Main aim of treatment in early stage of cirrhosis is to slow the progression of cirrhosis and prevent complications development

Stop alcohol, antiviral drugs for hepatitis b or hepatitis C, proper sugar level if diabetes, steroid or other medications for autoimmune hepatitis, medications to reduce copper from body in patients with Wilson`s disease, etc.
Drugs to lower portal pressure (beta-blocker or nitrates), drugs to remove fluid from body (diuretics), drugs to lower ammonia level for encephalopathy (lactulose and others), drugs to improve kidney function (albumin, terlipressin and others).
Opt for liver ransplant, If cirrhosis is life threatening or treatment of cirrhosis complication is ineffective.
Low salt high protein diet
Stop alcohol intake even if you have other cause of cirrhosis.
Stop smoking
Avoid over the counter drugs (especially pain killers)
Vaccinate if not done already or infected

Cirrhosis Of Liver - A Complete Guide!

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