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Last Updated: June 15, 2019
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Liver Disease: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

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.

How is the treatment done?

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.

Who is eligible for the treatment? (When is the treatment done?)

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.

Who is not eligible for the treatment?

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.

Are there any side effects?

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.

What are the post-treatment guidelines?

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.

How long does it take to recover?

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.

What is the price of the treatment in India?

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.

Are the results of the treatment permanent?

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.

What are the alternatives to the treatment?

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.

Popular Questions & Answers

Gall bladder stones detected 6 months back. Along with fatty liver grade 2 swelling. Avoided surgery that time. Now facing pain in right upper abdomen. Pls advise. I drink a lot. Should I get another usg done.

Hello and welcome to Lybrate. I have reviewed your query and here is my advice. Stop using alcohol first and do talk to a laparoscopic surgeon regarding your gall bladder stones. I suggest telephonic counseling for you. You can contact me for furt...
3 people found this helpful

My sgpt is 94 and sgot 101. I have done the hbv test which is negative. I am having daily 3 times motions since past 3 months. My doctor gave me a tablet crocin 400, my colon c and mac rd plus. Is this medicine help to reduce sgpt and sgot? Please suggest.

These medicines are for your symptoms. For sgot and sgpt please get evaluated by a proper hepatologist - hep c, autoimmune profile, wilsons panel. Stop all complementary and alternative medicines.
1 person found this helpful

My mother was 55 years old. Yesterday my mom done the lft test. Bt now the result of blood test i.e sgot-332, sgpt-195 &alkp-533, so can I start .tab ursodox plus, vit k ,&livfit syrup?

First you have to do a usg abdomen. Alkp is increased. Rule out obstructive jaundice first. Second differential can be drug related. Then a hepatologist will treat it as per diagnosis.

My ggt level is showing at 120. What medicines should I use to bring it down to normal level which is 50 as per thyrocare prescribed limits.

We do not target ggt rather we have to see the cause why it is elevated and then whether it really needs any treatment. Most common cause of elevated ggt is alcohol.
1 person found this helpful

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