Alcoholic Liver Disease Tips

Fatty liver or steatosis refers to the condition in which excess fat gets accumulated in the liver causing the liver to dysfunction. Some percentage of fat in the liver is normal but if it gets beyond the figure of 5 to 10 percent, then it is surely a cause of concern. Such a condition warrants treatment and if fatty liver is not treated on time, it can lead to liver cirrhosis or cancer. Therefore, the signs and symptoms of fatty liver should be taken seriously.

Some of the common symptoms of fatty liver include pain in the abdomen, loss of weight, swelling in the foot, jaundice, and inflammation of the liver. Anyone who suffers from these symptoms is likely to suffer from fatty liver. But the good news is that it can be treated. There are medicines in Ayurveda, homoeopathy, and allopathy for fatty liver and if one talks about Ayurveda, it treats fatty liver with a holistic approach.

1. Fatty liver and Pitta Imbalance: Ayurveda works on the principles of managing vata, pitta, and kapha – the three physical energies present in the human body. It believes that when there is any imbalance in these energies, dosha (disease) affects the body. According to Ayurveda, pitta is related to the metabolic system of the human body, which governs ingestion, digestion, and excretion. The liver, being a part of the metabolic system, is further related to pitta and this is why, when the pitta gets aggravated, the liver becomes diseased and starts to dysfunction. Ayurveda says that pitta imbalance is responsible for fatty liver. In fact, the liver is known as pitta in Ayurveda. It says that when toxins begin to build up in the liver, the liver has to work extra and this causes inflammation, ultimately leading to liver problems. So, Ayurveda tries to correct this imbalance through herbal medicines and detoxification treatment procedures.

2. Ayurveda dos and don’ts: Ayurveda is a holistic science and therefore, it does not focus on suppressing the symptoms, similar to what allopathy does. It is also free from side effects and gives a permanent relief. But the patient undergoing Ayurvedic treatment has to be mindful of their lifestyle and eating habits. In the case of fatty liver, Ayurveda prohibits alcohol, smoking, and spicy and oily food. So, the patient should avoid these foods. These food items should not be taken by the patient during the treatment duration. Otherwise, the effect of the medicines will get nullified. Anyone who goes for Ayurvedic treatment should remember that diet and lifestyle is a part of the treatment process and both go hand in hand.

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

Cirrhosis is a severe problem of the liver, wherein the liver stops functioning properly due to long-term damage caused by its exposure to toxic substances like alcohol or viral infections. Every time the liver gets affected, it tries to repair itself through the body’s natural healing process. Now, due to this continuous healing process, scar tissue gets formed. With the progress of cirrhosis, resulting in the formation of more and more scar tissue, the liver becomes unable to function properly. 

What are the symptoms of Cirrhosis?
Usually, cirrhosis doesn’t have signs or symptoms till the time when extensive liver damage has occurred. In those cases, the signs and symptoms which occur include:

• One could sense discolouration in the eyes and skin, giving a clear indication of jaundice.
• Excess fluid might get accumulated in your abdomen, resulting in utter discomfort.
• One may not feel like having any food due to loss of appetite.
• You might have uneasiness and discomfort in your upper stomach, provoking you to vomit.
• There can be noticeable swelling in your legs, which make it difficult for you to walk properly.
• Drowsiness and slurred speech could also be associated as symptoms of cirrhosis.
• There might be redness in the palms of one’s hands.

So we see that there are numerous signs and symptoms which you could come across, giving a clear indication of the problem of cirrhosis.

Causes which lead to cirrhosis
There are various kinds of diseases and conditions, which can damage the liver and lead to cirrhosis. Some of the most common causes are:

• Chronic alcohol abuse over a long period of time can cause severe damage to the liver, hence resulting in cirrhosis.
• The virus out of chronic hepatitis B and C attacks the liver and gradually lead to the formation of scar tissue, thereby resulting in Cirrhosis.
• Accumulated fat in the liver due to the intake of an unhealthy diet.

Other possible causes can include:

• The genetic digestive disorder is another serious cause behind the occurrence of cirrhosis.
• Autoimmune hepatitis, where liver disease is caused by one’s body’s immune system.
• Iron is an important part of haemoglobin as it carries oxygen from our lungs to other parts of our body. The problem arises when too much iron gets accumulated in the system, which can poison organs like liver, heart and pancreas. Presence of too much iron in the liver cause cirrhosis.
• Poor formation of bile ducts.

Treatment
Treatment mainly depends on the underlying cause and extent of your liver damage. Some of the treatment options which doctors would adopt are:

• People should stop drinking immediately if the cirrhosis has been caused due to alcohol consumption.
• As one of the reasons for cirrhosis in non-alcoholic persons is obesity, so making a conscious attempt to lose weight is must if they want to get rid of this problem. Loss of weight and keeping blood sugar under check would gradually make the liver healthy.
• Damage to liver cells caused by hepatitis B or C can be healed through the specific treatment of these viruses.

Who is at risk?
All patients having cirrhosis.
It happens in non cirrhotics too.

What causes of cirrhosis commonly lead to hcc?
Hepatitis b related cirrhosis (most likely), hepatitis c, alcoholic cirrhosis, nash.

Is liver cancer curable?
Yes if diagnosed at an early stage.

Is there any treatment option for advanced hcc?
Yes there are options which can prolong the survival.

How to screen?
All cirrhotics need to get and ultrasound once a year and a blood test called serum alfa fetoprotein.

Liver cancer (hepatocellular carcinoma) most commonly affects patients with cirrhosis.

Can even occur in non cirrhotics.

More common in males.

Most commonly occurs in cirrhosis due to hepatitis b virus.

Other causes of cirrhosis that commonly lead to hepatocellular carcinoma (hcc)- hepatitis c virus, alcohol associated, non alcoholic fatty liver.

Is hcc curable?
Yes if detected at at early stage treatment options do exist.
 
If a patient is diagnosed to have hcc and it is at an advanced stage-- there are therapies today which can help to prolong the overall survival.

How to screen for hcc in patients of cirrhosis?
Most commonly available tests are abdominal ultrasound and serum alfa-feto protein.

When should a cirrhotic patient get screened for hcc?
Ideally every year with usg and if there is any worsening like sudden abdominal distension, weight loss over a month or so.

Alcoholic liver disease or cirrhosis is one of the most common disorders of the liver. Since the liver performs a vital function in the body, it is essential to maintain its health. There can be several causes for the cirrhosis of the liver. Here are some of the factors that you need to watch out for if you want to steer clear of alcoholic liver disease.

1. Excess alcohol consumption: While limited alcohol consumption does not cause major health issues, you need to understand how much is too much. Drinking too much for a prolonged period of time will cause damage to the liver cells, which will lead to alcoholic liver disease. So, if you are a heavy drinker, stop immediately or at least try to cut down on the amount that you ingest each day. More than three drinks per day for men and two drinks per day for women for 5 years will substantially increase the chances of the disease.
2. Beer Consumption: People who drink beer are at a greater risk of suffering from alcoholic liver disease than people who consume wine or other alcoholic beverages. The exact reason for this is not known, but if you are a wine drinker, you would be happy to know that you have lesser chances of damaging your liver.
3. Gender: Research has indicated that women take longer to metabolize the alcohol that they consume than men. This is why such drinks have a deeper impact on women’s bodies. For instance, even if a man and a woman drink the same amount of alcohol, it will cause more damage to the body of the woman than it will to the body of the man.
4. Obesity: Excess body weight can cause a host of harmful medical conditions, one of which is alcoholic liver disease. Maintaining an ideal body weight can go a long way in preventing the liver condition. Excess weight is a risk factor for both men and women. Pay attention to your diet and also ensure that you work out every day. Not only will such a lifestyle help you achieve a better liver, but it will also enhance your overall health.

If alcoholic liver disease is left untreated, it can progress to Hepatitis A or cirrhosis. Therefore, it is essential that you seek treatment as soon as you are diagnosed with the condition, in order to limit the damage to your health.

Non-alcoholic fatty liver disease is the most common form of liver disease as it affects about 80 to 100 million people in the US alone. It is described as a range of liver conditions which may affect people who either don’t drink alcohol or drink too little of it. The distinguishing feature of this disease is the presence of too much fat in the liver. It can occur in every age group. However, people in age groups of the 40s and 50s, who are susceptible to heart diseases because of diabetes and other lifestyle diseases, are the most vulnerable to this problem. Increased liver fat is not an isolated occurrence; it comes with reduced ability to use insulin, increased abdominal fat, high blood pressure, high triglyceride fat levels, etc.

Symptoms Of Non-alcoholic Fatty Liver Disease -

In the initial stages, there is no symptom. However, as the condition of the liver worsens it may give rise to an enlarged liver, pain in the right upper quadrant, fatigue, etc. One may also have other symptoms like swelling of the abdomen, dilation of blood vessels just below the skin, enlargement of breast tissues in men, enlargement of spleen, reddish appearance of palms, jaundice, etc.

Stages Of Non-alcoholic Fatty Liver -

• Steatosis: Also known as simple fatty liver, Steatosis is the initial stage of the disease. It is regarded as a benign deposit of fat in the liver which is usually diagnosed during diagnostic tests done for other reasons.

• Steatohepatitis: It is a serious form where the liver gets inflamed.

• Fibrosis: If the inflammation of liver persists, it may give rise to scarring of liver tissue and the nearby blood vessels. However, the liver may still be able to work normally.

• Cirrhosis: This is the most severe stage which occurs if you live with fibrosis for a long time. It leads to shrinkage of the liver and the liver becoming lumpy and scarred. This permanent damage can cause liver failure and also liver cancer. If you can improve your lifestyle in the meantime, you can prevent cirrhosis.

Complications - 

The most common complication of non-alcoholic fatty liver disease is fibrosis and cirrhosis. In fact, even fibrosis goes undetected most of the times. This is why liver damage is mostly diagnosed when someone is suffering from cirrhosis. Cirrhosis is also known as late-stage fibrosis of the liver. Cirrhosis is the response of the liver to various injuries like inflammation, fibrosis, etc. The liver always tries to counter the inflammation and in order to do that it gives rise to scarring. As the fight with inflammation continues, the fibrosis spreads and engulfs all of the liver.

If this process goes on unhindered, one can suffer from:

• Build up of fluid in the abdomen

• Drowsiness, slurred speech, confusion, etc.

• Liver cancer

• Liver failure

Take Away -

Complications of non-alcoholic liver disease progress from no symptoms to the severe symptoms that can make an individual suffer from critical conditions like liver cancer or liver failure.

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 the liver is ultimately fatal.

Ayurvedic  Treatment

1. 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 the 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.
2. Liver damage causes healthy cells to be replaced with scar tissue. This is preceded by a process of inflammation, swelling and 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.
3. 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.
4. 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.
5. 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.

Just like the name suggests, Non-Alcoholic Fatty Liver Disease (NAFLD) is a set of diseases that can affect the liver due to excess accumulation of fat. One common disease that arises from this condition is known as nonalcoholic steatohepatitis. This can lead to cirrhosis as well. NAFLD is very common in the Western Countries affecting close to 100 million people annually. Although it can occur in any age group, the most affected age group being the one between 40-50 million. With this condition, the risk of getting other diseases such as cardiovascular problems and type 2 diabetes increases considerably.

Symptoms: Non-alcoholic fatty liver shows symptoms such as fatigue, enlarged liver, and pain, discomfort in the upper abdomen. Some other symptoms that have been witnessed in patients suffering from NAFLD include the development of breasts in men, swelling of the abdomen, red palms, jaundice, swelling of the blood vessels etc.

Causes: Experts have not been able to identify the exact causes of NAFLD. However, it is pretty evident that this condition only arises when the liver fails to produce bile which is responsible for digesting the fat cells. The fat in turn deposits in the liver cells resulting in NAFLD. Some of the possible causes include the following:

• The resistance of insulin
• Type 2 diabetes
• High level of triglyceride in the blood
• Obesity

Risk Factors: There is a wide array of risk factors that can pose a threat of NAFLD. Some of them include metabolic syndrome, high cholesterol, hypothyroidism, type 2 diabetes, hypopituitarism, obesity, polycystic ovary syndrome etc.

Complications: The major complications of NAFLD is liver cirrhosis. This is a condition that results in scarring of the liver cells resulting in fibrosis. Some other complications include fluid accumulation in the liver, liver cancer, swelling of the vein etc.

Diet: A mediterranean diet is a perfect diet suited for patients suffering from NAFLD. It includes nuts, fish, vegetables, grains, fruits and olive oil. Fat should be eliminated from the diet by a significant bit. It is important to add the right kind of fat in the diet. Omega-3 fatty acid available in flaxseed oil, leafy vegetables, and nuts fits the bill. Studies have shown that vitamin D and E helps a great deal in fighting liver diseases. Some other food items that should be included in the diet are green-tea, red grapes, brazil nuts, raw garlic, wolfberry etc.

Treatment: Once the disease is diagnosed, a doctor’s first endeavour is to ensure that the patient loses weight through a combination of diet and exercise. Vaccination against hepatitis A and B is the next step that a doctor would ideally suggest. For patients who are suffering from cirrhosis, a liver transplant is the only viable option to increase mortality.

Having some fat in your liver is legit. But, if you have too much of fat say more than 5%-10% of the organ's weight then you are at risk of getting fatty liver disease. At the onset, you can do one important thing to help your liver stop drinking. It causes fatty liver disease.

There are two main types of fatty liver disease

• Alcoholic liver disease or ALD
• Non-alcoholic fatty liver disease or NAFLD
• If you are a woman who is pregnant, you can also get fatty liver disease.

Alcoholic Liver Disease (ALD)

• You can get ALD from drinking lots of alcohol. ALD can also present itself after a short period of heavy drinking.
• Genetics has a role to play in ALD. Genes can make you hit the bottle and increase your chances of becoming an alcoholic.
• Genes can also impact the way your body breaks down the alcohol you drink.

Other root causes of ALD are:

• Hep C doesn't cause ALD. it is one of the causes of fatty liver.
• Hep B is also a cause of fatty liver. There are certain medications which may be helpful from person to person besides lifestyle management.
• Excess iron in your body
• Obesity

Non-alcoholic Fatty Liver Disease (NAFLD)
The cause of NAFLD is not clear, but we know that it tends to run in families.
NAFLD is also more common in the middle-aged and the obese or, those who have high cholesterol and diabetes.

Other risk factors are:

• Certain medicines
• Viral hepatitis
• Auto-immune or inherited liver disease
• Gaining weight fast
• Malnutrition
• Acute Fatty Liver during Pregnancy
• Fat can build up in your liver when you're pregnant, causing this kind of fatty liver disease.
• It’s a serious condition as it can be risky for both you and your baby. It can cause liver or kidney failure in you and your child, both.
• Causes are unknown. But, hormones may play a role.

Symptoms of fatty liver disease
This disease can sometimes cause no symptoms for long. But, the things to look out for are-

• Feeling tired all the time
• Loss of appetite or weight
• General weakness
• Nausea
• Confusion and trouble concentrating
• Your liver can become larger
• Pain in the centre or right upper part of your belly

In ALD, your symptoms get worse after bouts of heavy drinking. Fatty liver disease is diagnosed during routine exams when your doctor notices your enlarged liver. Ultrasound, blood tests to check for certain enzymes and biopsy of the liver are performed to confirm it.

Treatment

• There is no specific treatment for the fatty liver disease.
• You can manage it by managing your diabetes and giving up drinking. If you have ALD and you don’t quit, you get complications like alcoholic hepatitis or cirrhosis.
• Even if you have a non-alcoholic fatty liver disease, alcohol cessation helps.
• Losing weight if you are overweight also helps to manage this disease and having a good balanced diet with exercise also shows benefits.

Liver Cirrhosis is a medical condition that results in severe scarring (often permanent and irreversible) of the liver. While there can be a myriad of factors giving rise to cirrhosis (such as repeated liver injury or unhealthy diet), the most common triggers include Hepatitis B, Hepatitis C, Alcohol, NASH (non-alcoholics teatohepatitis ). In addition to interfering with the healthy functioning of the liver, cirrhosis also gives rise to many serious and life-threatening complications such as Blood vomiting, Jaundice, Ascites (a condition characterized by an increased build-up of fluids in the abdomen), Hepatic Encephalopathy, Edema, Splenomegaly. In some men, cirrhosis can even give rise to Breast enlargement and Testicular Atrophy. 

Preventive measures to manage Cirrhosis and the associated complications 
In the case of cirrhosis triggered by Hepatitis, medications are used to treat the viral infection thereby avoiding any further liver damage. 

1. In people with cirrhosis resulting from alcohol abuse, the effectiveness of the treatment depends on how quickly a person can give up drinking (In some cases, the affected individual may have to undergo rehabilitation programmes to stop drinking). In addition to drinking, it is also beneficial to quit smoking as well. 
2. For excess fluid retention on the body, in addition to the medications (such as diuretics and antibiotics), doctors often recommend a low-sodium or low-salt diet. The use of a TIPS (Transjugular Intrahepatic Portosystemic Shunt) can also contribute to slow down the fluid build-up in the body. 
3. Medications may also be used to treat a host of serious complications (triggered by cirrhosis) such as Hepatic encephalopathy, weakness, itching, bruising, infections to provide some relief. 
4. However, in case of severe or complete liver damage and failure (advanced cirrhosis), a liver transplant may be recommended. A liver transplant, as indicative of the name, involves replacing the damaged or diseased liver of the recipient with a healthy liver from the donor. 

Unfortunately, once the liver has been scarred, there is little that can be done to reverse the damage. However timely diagnosis and treatment in the form of liver transplant can ensure long-term survival in these life-threatening illness. Cirrhotics should be under the regular follow-up to prevent the development of complications and timely referral for transplant. A damaged, cirrhotic liver is a fertile ground for the development of hepatocellular cancer(HCC). 

Routine imaging on follow-up is important to diagnose HCC at an early, curable stage. These patients require liver transplant at the earliest. Also, regular upper GI endoscopy and variceal banding should be done to prevent the development of life-threatening hematemesis ( Varieal bleeding ).

Severity of Cirrhosis can be estimated by two scoring tools easily available on smartphones. Child Turcotte pugh(CTP)’s scoring system , Child’s Stage and MELD scoring system . CTP score of >7 , Child B or MELD > 15 are candidates for liver transplant. Patient with decompensation(Hepatocellular cancer , Upper GI Bleed, Encephalotpathy, Refractory ascites, Hepato-renal syndrome, Hepatopulmonary syndrome) are candidates for liver transplant. 

Some other healthy modifications to control cirrhosis include

1. Choose your foods with care. Avoids foods that are high in sodium or are salty. Processed, canned, smoked, Barbecued foods, baked beans, ham, salami, bacon, caffeinated beverages, are best left avoided.
2. Increase your intake of fresh fruits, vegetables, foods rich in proteins. Having a large meal may be difficult in the case of cirrhosis. Instead, have small meals at regular time intervals. 
3. Some of the medicines such as Aspirin, NSAIDs (Advil, Aleve), Tylenol, can aggravate the liver damage. Thus, never have these medicines without consulting a physician. 
4. It is also necessary to get vaccinated against some of the viral infections including Hepatitis (A and B), influenza, pneumonia.