There are more than hundred kinds of liver diseases. Some common liver diseases are as follows- Fasciollasis which is a parasitic infection of the liver. Several drugs are effective for this disease. The drug of choice for treating Fasciollasis is triclabendazole. Bithionol is also used a successful treatment. Hepatitis is the inflammation of liver tissue caused by various viruses (viral hepatitis), by liver toxins (alcoholic hepatitis), autoimmunity (autoimmune hepatitis) or hereditary conditions. Hepatitis A does not usually progress to chronic state and rarely requires hospitalization. Hepatitis B can be acute and chronic. Here patients are treated with antiviral therapy. Injectable interferon alpha was the first approved therapy for chronic hepatitis B. there are some other medications too for chronic Hepatitis B. Hepatitis C is much more likely to pass to a chronic state. The ultimate aim of treating Hepatitis C is prevention of hepatocellular carcinoma. Hepatitis D is difficult to treat. Effective treatments too are lacking. Hepatitis E is similar to Hepatitis A and its treatment includes rest and ensuring adequate nutrition and hydration. In case of alcoholic hepatitis the first line treatment is treatment of alcoholism. But a severe case of alcoholic hepatitis is difficult to treat. Alcoholic liver disease is the hepatic manifestation of alcohol over consumption including fatty liver disease, alcoholic hepatitis and chronic hepatitis with liver fibrosis or cirrhosis. Most important part of the treatment is stop the intake of alcohol. In case of liver cirrhosis mostly transplantation is th only definitive therapy. Cirrhosis is actually the formation of fibrous tissue in place of liver cells due to variety of causes. Cirrhosis causes chronic liver failure. Fatty liver disease (hepatic steatosis) is a condition where large vacuoles of triglyceride fat accumulates. Treatment depends on the underlying cause of the disease. Gilbert’s syndrome is a genetic disorder. Typically no treatment is needed but if jaundice is significant phenobarbital may be used.
For the treatment of various liver diseases a number of different treatments are available. Triclabendazole is used for the treatment of Fascioliasis. The drug works by preventing the polymerization of the molecule tubulin. Nitazoxanide is effective in trails but is not currently recommended. Treatment for Hepatitis A and hepatitis E is generally supportive and includes procedures like providing of intravenous hydration and maintaining adequate nutrition. This disease rearely requires hospitalization. In severe acute cases of Hepatitis B patients are treated with antiviral therapy, with nucleoside analogues such as entecavir or tenofovir. Experts recommend reserving treatment for severe acute cases and not mild to moderate. chronic hepatitis B aims to control viral replication. Treatments includes Pegylated interferon which is dosed once a week. Lamivudine is used in areas where newer agent have not been approved or are too costly. Entecavir is safe and well tolerated drug and is a first line treatment choice. Currently used first line treatments include PEG IFN, Entecavir and Tenofovir. Hepatitis C treatment includes prevention of hepatocellular carcinoma and the best way to reduce long term risk of HCC is to achieve sustained virological response. Currently available treatments include PEG IFN, Ribavirin. In high resource countries direct acting antiviral agents are used which targets proteins responsible for viral replication. Hepatitis D is difficult to treat. Inferno Alpha has proven effective at inhibiting viral activity but temporarily. Hospitalization may be required in case of severe cases of Hepatitis E. Alcoholic hepatitis treatment includes pentoxifylline, corticosteroids etc. Treatment of alcoholic liver disease include Sylimarin but with ambiguous result. In case of serious cases of fatty liver disease insulin resistance, hyperlipidemia , and those that reduce weight are beneficial to liver. For patients having non-alcoholic steatohepatitis there are no available therapies. Damage from Cirrhosis cannot be reversed but further progression can only be delayed and complications can be reduced. A healthy diet is encouraged. Some convetional medicines are Corticosteroids and Ursodiol. Wilon’s disease is treated with chelation therapy. Liver transplantation becomes necessary if liver damage cannot be controlled.
In case of transplantation there are some criterias which are considered for the safety of the patients. Physical criterias and a solid support system before the surgery are very important factors. If any one is undergoing symptoms like nausea, vomiting, right upper quadrant abdominal pain, jaundice, fatigue, weakness and weight loss then it is better to check whether these are indicating towards liver diseases.
As there are many side effects of some drugs used for the treatment so it will be safe to check the eligibility before starting any treatment. Thus, it is advisable to consult a doctor for safety.
Common side effects of the drug Entecavir used for treating Hepatitis B are headache, nausea, high blood sugar and decreased kidney function. Severe side effects include enlargement of liver and high blood lactate levels. Tenofovir used to treat chronic hepatitis B has side effects like depression, rash, diarrhoea, weakness, pain and headache. Use of corticosteroids may be severe in some cases like it can cause anxiety, depression, can also cause sodium retention. Side effects of pentoxifylline which is used to treat alcoholic hepatitis are- belching, bloating, stomach discomfort, indigestion, nausea, dizziness, vomiting, flushing. Chelation therapy too has some side effects which are- dehydration, low blood calcium, harm to kidneys and lowered levels of dietary elements, etc.
There some after treatment guidelines that needed to be followed. After a patient has completed his/her treatment for Hepatitis C infection, the patient will require blood tests and doctor visits three to six months post-treatments. In case of cirrhosis a patient is generally taken care of by the liver specialist for a long term. Even if the patient is devoid of Hepatitis C infection, he/she will likely be monitored with some tests like blood test, imaging tests and upper endoscopy tests. If after completion of treatment virus remains, the patient needs to take a break and will be under watchful waiting and will be retreated if it is an option in future. It is instructed not to consume alcohol and stop smoking. Nicotine can make it more difficult to manage hepatitis B. many follow-up visits will be needed. After a liver transplant medicines are given like antimicrobial medicines, antirejection medicines, immune globin and steroid medicines. Maintaining a healthy weight is required and even some patients are given physical therapies. If a patient wants to become pregnant, it will be safe to wait for at least two years. Yearly skin exam is also necessary.
Different diseases of liver have different recovery time. Like for example in case of liver cirrhosis which is an end stage of liver, is mostly irreversible. And liver transplantation is the only therapy in that case. In rare cases, liver cirrhosis is reversible. In healthy patients (with Hepatitis B), 95-99 percent recover with no long lasting effects. Age and comorbid conditions can result in prolonged and severe illness. If a patient has clinical signs of ascites, peripheral edema, low serum albumin, etc, then they may require hospitalization. In many cases the treatment is curative but some therapies only aim to prevent further progression of diseases, reduce the symptoms of diseases or reverse the damage already done. So, treatment duration will vary based upon the disease and age and other health conditions of the patients.
Cost of treatment will depend on the health condition of the concerned patient. Liver transplantation is costly as it may amount to some lakhs. There are different kinds of kidney diseases and each require different treatment for different duration. Thus cost of treatment will also vary in each case.
Permanency of results depend on the disease. There remains a risk of rejection of the new organ in case of transplantations and patients may need to take immunosuppressive medications for the rest of their lives. Treatment of Hepatitis A in most cases are permanent. So is Hepatitis E treatment. In case of severe ailment hospitalization may be required and duration of treatment may get stretched.
Alternative treatments include variety of treatments. One of them is the ayurvedic treatment. Indian Echinacea, Yakrit Plihantak Churna improves liver function, Phyllanthus Niruri is a liver cleanser and liver detox capsules. Amla has liver protection properties. Licorice can cure ailments like non-alcoholic fatty liver disease. Amrith is known to clear toxin from the liver and strengthens its function. Some studies have shown that turmeric for its antiviral properties can be used prevent multiplication of viruses causing Hepatitis B and Hepatitis C. certain vegetables help liver secrete greater concentrations of important enzymes. Diet restrictions and life style modifications and de-addictions are some basic requirements to prevent and treat liver diseases.
The liver performs over 500 functions and is considered to be one of the most important organs in the human body. The functions liver perform include regulating cholesterol and blood sugar, filtering out blood toxins, storing energy and making hormones and proteins. There are many diseases which liver can catch and most prominent being alcoholic liver disease
When a person consumes alcohol in excess, it leads to building up of fats, inflammation and scarring of the liver – which results in alcoholic liver disease.
The damage that occurs due to this disease in the liver can affect the whole body. Since the liver is generally highly effective in repairing and regenerating itself so the damage takes longer to come into notice. It often becomes distinctive by the time the damage is already irreversible.
This disease usually takes place in people between 40 and 50 years of age. This disease is most commonly seen in men. Certain cases have been seen where people may have inherited the risk for the disease.
Liver disease related to alcohol consumption fits into following 1 of 3 categories:
Some Facts about Alcoholic Liver Disease
Early signs of the Disease
The early signs of alcoholic liver disease are not much noticeable and affect many systems in the body.
If these signs are left unattended and the patient continues to consume alcohol, it can lead to a faster damage to the liver.
The symptoms of this disease become noticeable usually during the later stage of liver disease. The symptoms of this disease include:
In most patients with the alcoholic liver disease, the illness is not severe. You may not require hospitalization immediately as long you take necessary precaution like stopping the consumption of alcohol, take good nutrition and follow the advice of the doctor. However, in more severe cases, the doctor may be able to suggest the best line of treatment.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The liver is a vital body organ (the second largest) that helps in detoxification of the harmful substances and chemicals, in addition to participating in various metabolic pathways. It is normal for the liver to contain some amount of fats. The problem arises when there is an excess deposition of fats (accounting to nearly 7- 10% of the total liver weight), a condition referred to as Steatosis or Fatty Liver. Fatty liver often interferes with the normal functioning of the liver triggering serious consequences.
Types of fatty liver
Causes of fatty liver
Fatty liver is a common condition that often results from unhealthy diet and lifestyle practices. In this context, it is important to mention that unlimited alcohol consumption plays a pivotal role in various liver disorders, with fatty liver being one of the most common consequences. In fact, steatosis is one of the earliest stages associated with alcohol related Liver disease. However, fatty liver is a reversible condition that can be successfully treated if diagnosed at an early stage.
The excess deposition of fats in the liver cells can be an outcome of medical conditions such as
Besides alcohol, obesity is one of the biggest factors responsible for fatty liver. As per a survey, 1 in every 50 obese people suffers from fatty liver and other related complications (scarring, liver hepatitis or liver cirrhosis).
Symptoms associated with fatty liver
There are no characteristic symptoms associated with fatty liver. However, in general, a person may experience
● Abdominal discomfort
● Extreme tiredness
With time, a person left undiagnosed and untreated, may exhibit the following symptoms
● A changed appetite (there is often a loss of appetite)
● Sudden weight loss (unexplained)
● Abdominal pain
In case you have a concern or query you can always consult an expert & get answers to your questions!
As you might already know, the liver performs some important functions for the body such as removing toxins from the blood stream, regulating the immune response, processing hormones, nutrients, and medications, production of bile, production of protein, etc. That’s why the liver is considered to be the most important organ of the human body, and it’s vital to have a healthy, functioning liver. However, in some cases, a person needs a liver transplant. This is a complex surgical procedure that aims at replacing a non-functioning liver with a healthy liver from a donor.
Why is liver transplant done?
Liver transplant is mostly done in cases where the conditions cannot be controlled with conventional treatment or people suffering from cancer. A liver failure generally happens over a period. But, there are cases where the liver might fail in a matter of days. This condition is termed as an acute liver failure.
Chronic liver failure, on the other hand, happens gradually and can be a result of a lot of factors; the most common being liver cirrhosis. The latter can befall due to reasons such as hepatitis C and B, liver fat, Wilson’s disease, alcohol abuse, etc.
When do you need a liver transplantation?
The liver carries various functions important function in the body. Any disease or damage to it can affect the functioning of many other organs and total body functioning. However, the good thing is that liver can regenerate itself and only when it is damaged to an extent that affects this regeneration process; that one needs to look at the various treatment options. Liver transplant is recommended as the last resort in case of serious life threatening liver diseases like the following-
For you to be eligible for a liver transplantation it is a must to remain sober for at least 6 months before the procedure happens.
Who can donate healthy liver for transplantation?
Ideally, a healthy liver is available for transplantation once the organ donor has died. However, due to the shortage of cadaver livers, transplantation of a portion of a healthy liver from a living donor was first attempted in the late 1980s. Today living donor liver transplantation (LDLT) is a common practice in quite a few medical institutes where up to 70% of the right side of the healthy liver is taken from the donor.
Apart from the liver portion, a small part of a blood vessel in the leg is also removed from the donor’s body to connect the donated liver portion to the recipient. Due to this complex process, the donor may need a hospital stay for a week or longer. During this time the donor’s liver begins to heal and regenerate itself. Full regeneration generally takes six to eight weeks. In case of the recipient, it takes a bit longer for the transplanted portion to reach full function and the appropriate size. Thus the ability of the liver to regenerate helps both the donor and recipient to have a normal functioning liver in some time.
Risks and Benefits of Liver Transplantations
A good transplant centre ensures that all the safety measures are followed during the liver transplantation by the transplant surgeon and there is no risk of complications like bleeding, infection, blocked blood vessels bile ducts in the liver. A successful liver transplant increases the life span of the donor by a few years. However, the new liver can also get infected with hepatitis if it is not treated alongside. Also, relapse to alcohol use after transplant causes damage to the new liver, so stay sober and stay healthy.
What are different phases involved in the process?
Is there a post-surgery procedure?
Once the patient is matched and the surgery takes place, a patient is likely to be in the intensive care unit for a few days followed by frequent check-ups for the first few months and the medicine continues for the rest of the life.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Liver transplant in the only curative option available for patient who develop cirrhosis of liver due to any cause ( Chronic Hepatitis B , Chronic Hepatitis C, Alcoholic Cirrhosis, NASH etc). Once patient has been diagnosed with cirrhosis it can not be reversed with any non-surgical treatment . Over a period of time patient may develop worsening in liver function resulting in complications of cirrhosis (bloody vomitus, black stools, jaundice , altered sensorium, renal dysfunction, abdominal swelling etc) labeled as “decompensated cirrhosis”. These patients require Liver transplant at the earliest and should be reffered to a liver transplant centre immediately. Ideally all patient diagnosed with cirrhosis should be under the follow-up of a gastroenterologist/Hepatologist. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient.
Before the Liver transplant
All recipient and Living donor go thorough evaluation before the transplant process that includes blood investigations, Imaging studies, Cardiac and pulmonary fitness tests, multidisciplinary consultation before the clearance for liver transplant is achieved. The healthcare provider will explain the entire procedure. The healthcare provider is also supposed to answer all your questions. You would be needed to sign a consent form that allows the doctor to do the surgery. Eating food is not allowed at least 8 hours before the surgery. If you cannot stay relaxed before the surgery, a sedative will be given.
After the Liver Tranplsant
The recipient surgery lasts for anywhere between 12-16 hrs and donor surgery for 8-12 hrs. After the surgical procedure is complete, you will be taken to the intensive care unit (ICU)and will be closely watched for several days.
Immediately After the Surgery
You will most likely have a tube in your throat. This is so that you can breathe with the help of a machine (a ventilator) until you can breathe on your own. The ventilator tube will be removed on next morning when all parameters are found to be satisfactory. All parameters are monitored by round the clock critical care doctors and staff for a few days. The recipient has to stay in the hospital for three weeks and the donor is discharged in one week.
Blood samples will be collected on a regular basis to check the functioning of the new liver. Antibiotics will be infused via IV channels to prevent you from infections. The area where the operation was done should always be kept clean after you have reached home. Any stitches or surgical sutures will be removed at a follow-up visit.
Complications that may arise
Blocked blood vessels to the new liver, bleeding, an infection, leakage of bile or blocked bile ducts, or the new liver not working for a short time right after surgery are a few complications that may arise. Not to aggravate the condition, in the case of a complication, it is imperative to visit your doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!
A fifty-four years old Marwari patient from Assam presented with progressive jaundice and intermittent episodes of abdominal pain for three months. CT scan of abdomen showed a small (1.5 x 1.5 cm) mass in the bifurcation of common bile duct which is causing biliary tract obstruction and hence jaundice. Portal nodes were not enlarged and there was no lesion in the liver parenchyma. At presentation, serum bilirubin level was high (14.7 mg/dl). Endoscopic biopsy and brushing cytology was adenocarcinoma and clinic-radiological diagnosis was ‘Klatskin tumour’.