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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
4. High cholesterol levels
5. Age greater than 50
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. If you wish to discuss about any specific problem, you can consult a Gastroenterologist.
Picture this, you're in a restaurant for a lunch date with your friend. It's a great place and the food is delicious. While you're having a super time, you suddenly start feeling a discomfort in your chest area, and your appetite completely goes down the drain. Chances are that you might be experiencing heartburn.
Heartburn is something which is used in both the literal and metaphorical senses. However, the discomfort it entails means that it is no joking matter and your food intake habits are probably responsible if you suffer from it!
The good thing about heartburn causing foods is that they are easily recognisable, which is quite great. But, they make up a large portion of people's normal diets, which is not as great, as they are hard to refrain from. A few common examples are listed below:
- Chocolate: To start off, there is something which is surprisingly a cause for heartburn and is likely to be the cause of a lot of disappointment: chocolate. The sad thing about chocolate is that the key things it is known to cause reflux. Take, for example, cocoa; it is a prime cause for reflux. Also, the caffeine in chocolate as well as something called theobromine is the major culprits of reflux. If a person who loves chocolate seems to be suffering from reflux, he or she knows why now!
- Coffee: Talking about caffeine, the automatic suspect that is coffee is deeply guilty, as well! Having coffee once in a while may not cause much harm but making it a habit leads to a person setting himself or herself up for a lot of heartburn.
- Soda: Anything which is acidic is not good for reflux but the thing is that most sodas are very acidic! This is also the case when it comes to fruit, though fruit is generally said to be good for the body. Certain types of fruit, like citrus fruit only worsens the effects of heartburn and can cause a whole load of discomfort to the person who eats them.
A lot of the foods, which should be avoided actually have their own health benefits. The case in point is garlic. But, a person should try to have food like cottage cheese or lean chicken, both of which do not cause any heartburn at all. Also, keeping away from food that is fried has a range of benefits from lower consumption of fat, to a reduced risk of cancer as well as a massive drop in heartburn. Deep fried foods should be avoided like the plague!
The rule of the thumb when it comes to the issue of heartburn is that if anything happens to be acidic, it is likely to cause heartburn to be aggravated. As long as a person can keep this in mind as a guiding principle, there is no way that they will be suffering from heartburn any more. If you wish to discuss about any specific problem, you can consult a dietitian-nutritionist.
I am 46 years old man mujhe 7 8 din se pet full hua hai aur bahut sare dakare aa rahi hai aur uneasy feel ho ra hai kuch homeopathy medicine suggest kijiye.
On a regular 26-33 day cycle for past 6 months. If one has had unprotected sexual act on the 5th day of period. Though there was no penetration. But there was ejaculation on the butt region outside. Soon it was washed with water. And an I pill was taken within 18 hrs after this act. This act took place in november 2015. There was bleeding for 2 days after 6 days from the I pill intake. With slight abdomen pain. N. Dizziness. Then in december got period for 4 days after 33 days from november period. And also in january got period for 4 days. Within a 30 day gap from december period. But in february 2016. Got period within 30 days gap. But only for 1 day. In december and january there was dizziness during the ovulation tym. In the meanwhile had taken 8 hpt with preganews. All morning samples. And all came negative. And also 2 beta hcg blood test was taken. First on 42 days from the sexual act of november and second on 63 days from sexual act of november. Both of which came <1 miu /ml. Also on 73 days from the sexual act. A pelvic sonography was taken. Which showed uterus is anteverted. Empty and measures 8.9cm*4.7cm*3.6cm. The problem now is I am sensitized to some peculiar type of smell. And also there is problem of some pain near my belly button. Also I find that my lower abdomen is slightly bulging. Though very soft. And can be pressed very easily. And my breast colour is also dark. So what is all these happening. Am I pregnant. Or the pregnancy is not there. please help me. As I do not want to get pregnant now. Also the november act was the first and last time I had any sexual act. please help me soon.
For the past one week I have been troubling with erection Every time I have an erection I feel pain in my lower abdomen Please suggest.
Patients suffering from Irritable Bowel Syndrome experience severe abdominal pain, abdominal bloating along with cramping, gas, constipation and a constant urge to go to the toilet again and again. IBS is a health disorder where the large intestine or the colon is affected. This condition is a chronic one and requires long-term management. The symptoms are usually worse after eating and tend to occur in episodes. Although the disorder cannot be reversed, several symptoms can be managed or controlled by making lifestyle and dietary modifications. Most patients with IBS will experience flare-ups that last for a few days. For others, medical treatment is required.
Treatment and Care
Different procedures are used to treat IBS, which vary from person to person. However, one single treatment does not work with everyone.
Lifestyle and Dietary changes:
By making several basic modifications to your regular diet and activities, IBS improves with time. Here are some tips:
- You should avoid caffeine in any form such as coffee, tea or soda.
- You should increase the amount of fiber in your diet and include vegetables, fruits, whole grains and nuts.
- You must drink three to four glasses of water regularly.
- Smoking should be abstained from.
- You must undertake relaxation techniques and work out in order to reduce stress.
- Your amount of dairy product consumption must be reduced.
- You should eat frequent, small meals instead of fewer large meals.
- The most common food triggers, which lead to IBS are green onions, red wine, milk and red peppers. You should not consume these products.
- You should keep a record of the types of food you consume so that you can identify the IBS triggering food items.
- You should eliminate high gas producing food items from your diet. Food items which may result in passing excess amount of gas such as carbonated vegetables and vegetables such as cabbage, broccoli and cauliflower should not be consumed.
Several medicines are used to treat IBS. These include the following:
- Antispasmodics are used to control muscle spasms in the large intestine.
- Antidiarrhoeal medicines are used to control the symptoms of diarrhoea.
- Laxatives are prescribed for relief from constipation.
- Bulking agents like wheat bran and corn fibers are used to slow down the food movement through the digestive system. They also relieve symptoms.
- Antidepressants are also used in case of some patients with IBS for relief.
- In patients, whose symptoms occur due to bacterial overgrowth in the intestines, certain antibiotics may be used for treatment.
There are several triggers of IBS, which must be identified and treatment should be undertaken after that. For the proper identification and best treatment of IBS which suits your symptoms, it is essential you consult a gastroenterologist. Alternative treatment methods such as acupuncture, using certain herbs and probiotics can also be followed.
I am 35 years old, I have gastric problem for years, now I have running gas due to which the gas get blocks in the joints and I have pain in my fingers. I also find difficult which going motion, as gas release is more. I have take siddha medicines way back and dropped it. Please suggest me what I should do the overcome of this.
I having ibs my Dr. Prescribe librax I got relief but it is banned so he told normaxin rt but its not working for pls suggest any alternative medicine.
I am 26 years old. Dr. Please tell me how to loose stomach fat. Without food bhi my stomach seems big. I m suffering gastric problem.
Hello, I am Dr. Somasekhar Rao, gastroenterologist and hepatologist at the Apollo Hospitals, Jubilee Hill, Hyderabad. I would like to talk about cirrhosis of liver and its complications and how to manage those things. Basically cirrhosis of liver is nothing but the liver get shrunken and it becomes nodular and hard so the functions of the liver comes down. The functions which are there are 600 vital functions that a liver does normally in a human being and all these functions are compromised in a patient with cirrhosis.
Most important cause for cirrhosis is always alcohol and next comes viruses called hepatitis B and hepatitis C. The evolving most increasing cause no is nonalcoholic fatty liver disease. Fatty liver disease which we see on ultrasound can cause cirrhosis. Any patient in early cirrhosis may not present with any symptoms. The initial symptoms of decompensations would be:-
- There will be swelling in the fluid
- Swollen feet
- There will be distinction of abdomen because of accumulation of fluid in the abdominal cavity
- Patients may have jaundice.
- Sometimes they may present with a history of passing black color motion that means this patient is having bleeding in the gastrointestinal tract. It can be most common because of the swollen blood vessels called viruses in the esophagus.
So other presentations would be disorientation. Patient can have hepatic encephalopathy, the functions of the liver because the liver acts as a filter to many toxins. All these toxins enter into your brain and cause disorientation this is called hepatic encephalopathy.
So now we will talk about the treatment of cirrhosis. Whenever we see a patient with cirrhosis, most important thing is we will try and evaluate the cause of cirrhosis. See if the patient is a chronic alcoholic. We are taking a history of all college. The first thing is to cut down and stop intake of alcohol when the patient is in early cirrhosis. It can reverse the cirrhosis to normal liver. Most important and nutritional aspects along with some supportive medication but when a patient presents with complications already, then we will be treating only the complications. Once the cirrhosis sets in and he is in CTP. By the time. you see that the patient eventually progresses most of the time. We are trying to treat the complications of cirrhosis. Then a patient presents to us with bleeding then we will find out whether it is very variceal bleeding and there is a procedure called endoscopic variceal ligation to decrease the pressure of the varices blood pressure in the esophageal varices.
We have some medications which decrease the pressure. We treat these patients and we control the bleeding and a patient presents with fluid in the stomach abdominal cavity or fluid in the legs. These patients are treated with so called restricted diet. Also we give some tablets called diuretics which increase the urine output and decrease the fluid in the legs and in the abdominal cavity and a patient presents with hepatic encephalopathy. We treat hepatic encephalopathy by medications and we try to decrease the ammonia level which is released by cleansing the gut and all those things. So all these things are managing complications of cirrhosis. Very rarely we see a patient in early cirrhosis then we treat the host.
The cirrhosis can be reversible. It is very rare but eventually when we see a patient in complications, he would always be in a stage called CTPB where he will progress to CTBC. CTBC is the end stage of cirrhosis and at that point of time the patient is left only with option of liver transplant.
Liver transplantation is again transplantation. It can be a live donor transplantation or deceased donor transplantation. So Eventually when you see a patient in CTBC we have to plan for liver transplantation. In these patient he can wait maybe for 2 or 3 months meanwhile we will be managing for complications.
Abdominal pain can be triggered by a number of factors. Sometimes, it's mild enough to be overlooked while at others, the pain can be debilitating. Most abdominal problems start with the same symptoms and hence the cause of this pain can be a little difficult to pin point. In many cases, the location of the pain can help understand the factors that are triggering it.
Generalized pain can be simply be triggered by indigestion. On the other hand, it could also be a symptom of a number of illnesses like irritable bowel syndrome, appendicitis, viral gastroenteritis and intestinal obstructions etc. However, the former are more common. This type of pain resolves itself without medical intervention.
In other cases, abdominal pain can be localized to the upper or lower abdomen on the right or left side or in the centre of the abdomen. This sort of pain is usually sporadic and comes and goes with great intensity. In most cases, this sort of pain is a symptom of a serious problem and should not be ignored. One of the most common examples of localized abdominal pain is the pain caused by appendicitis in its later stages. Severe pain that is located just above the centre of the belly button could be a sign of pancreatitis. A burning sensation and severe cramps in the center of the stomach could point towards stomach ulcers that could cause perforations if left untreated. Other causes for this type of pain include endometriosis, ovarian cysts, angina, kidney infections and a spleen infection.
Mild stomach pain whether localized or general can be relieved using home remedies and does not often require medication. However, if the pain is severe or if it comes on suddenly, you must immediately consult a doctor. Another reason to consult a doctor is if the pain persists for more than 24 hours. If the pain is accompanied by black or bloody stools or vomiting and nausea, do not ignore it. Black stools are often an indicator of the presence of blood in the digestive tract. Abdominal pain that worsens with movement or is tender to touch is also something that should be shown to a doctor. Other reasons to consult a doctor are abdominal pain with persistent vomiting following meals and unexplained weight loss and a loss of appetite.
The bottom line is, that when it comes to abdominal pain, it's better to consult a doctor and be told that there's nothing to worry about rather than self medicate and wait for it to worsen.