Fatty liver

Fatty liver is the collection of excessive amounts of triglycerides and other fats inside liver cells. Also called steatosis, fatty liver can be a temporary or long-term condition, which is not harmful itself, but may indicate some other type of problem. Left untreated, it can contribute to other illnesses. It is usually reversible once the cause of the problem is diagnosed and corrected. The liver is the organ responsible for changing fats eaten in the diet to types of fat that can be stored and used by the body. Triglycerides are one of the forms of fat stored by the body and used for energy and new cell formation. The break down of fats in the liver can be disrupted by alcoholism, malnutrition, pregnancy, or poisoning. In fatty liver, large droplets of fat, containing mostly triglycerides, collect within cells of the liver. The condition is generally not painful and may go unnoticed for a long period of time. In severe cases, the liver can increase to over three times its normal size and may be painful and tender.

Fatty liver can be caused by certain chemical compounds, nutritional, or endocrine disorders. Drugs or chemical compounds that can cause fatty liver include alcohol, tetracycline, cortisone, phosphorous and carbon tetrachloride. Of these alcohol is by far the most common cause. Inflammation usually accompanies exposure to these toxins and is responsible for the associated symptoms of fever, fatigue and jaundice.

Nutritional causes of fat in the liver result from starvation, obesity, protein malnutrition and intestinal bypass operation for obesity. In obesity, the fatty deposits are accompanied by some inflammatory changes and mild scarring of the liver.

The endocrine causes of fatty liver include diabetes mellitus and fatty liver of pregnancy. In both cases, a large amount of fat can be rapidly deposited in the liver leading to expansion of the liver with tenderness in the upper right part of the abdomen. In diabetes this occurs only in juveniles. Fatty liver during pregnancy occurs near term and may result in premature termination of the pregnancy.

Fatty liver can be present in patients with alcoholic hepatitis and cirrhosis or may be an isolated finding. Present evidence shows that while fatty liver is usually present in excessive alcohol intake, it probably does not lead to the development of alcoholic hepatitis or cirrhosis. In fact, most individuals with alcoholic fatty liver do not develop the more serious forms of liver disease. However, continued alcohol ingestion has been known to cause alcoholic hepatitis and cirrhosis. Often, there are no symptoms associated with fatty liver. If there are symptoms, they can include pain under the rib cage on the right side of the body, swelling of the abdomen, jaundice, and fever. Symptoms that occur less often in alcoholic fatty liver, but more often in pregnancy related fatty liver, are nausea, vomiting, loss of appetite, and abdominal pain. Fatty liver,Fatty liver can be present in patients with alcoholic hepatitis ,Fatty liver, fatty liver include diabetes mellitus,Fatty liver,Fatty liver during pregnancy occurs near term ,Fatty liver,Fatty liver is the collection of excessive amounts of triglycerides and other fats inside liver cells.Fatty liver,

Hepatitis Prevention

Vaccination is the best way to prevent some of the hepatitis - A, B (which involves protection against hepatitis D virus). For hepatitis C, E, G viruses there are not vaccines available.

So, for preventing those diseases people should have a healthy lifestyle: using protection during sex, avoid sharing drugs, needles, syringes, personal care items that might have blood on them (razors, toothbrushes), washing hands with water and soap after every using of the bathroom, before and after preparing and eating food, avoid drinking water of unknown purity, etc.

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Liver Cancer

Liver cancer is a disease involving uncontrolled growth of cells within the liver.

Cancer in the liver may be primary or secondary, also called metastatic. Primary cancer arises within the liver and in its early stages exists only within the liver. People who have hepatitis B or C, viral infections of the liver, or cirrhosis of the liver are more likely than other people to develop primary liver cancer. At an early stage primary liver cancer may cause no symptoms at all. More advanced disease may cause loss of appetite, weight loss, fever, fatigue and weakness.

Secondary liver cancer is term for cancer that originates in another organ, such as the colon, stomach, pancreas and breast and then spreads to the liver. Because secondary cancer is present in at least two organs, the treatment possibilities are more limited than for primary liver cancer. As the cancer grows, pain may develop in the upper abdomen on the right side and may extend into the back and shoulder. With advanced disease, the signs of liver failure appear, which include abdominal swelling and a feeling of fullness or bloating and jaundice, a condition in which the skin and the whites of the eyes become yellow and the urine becomes dark.

Reviewed by health care specialists at UCSF Medical Center.

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Fat in the liver...

For years, scientists have warned people that having an apple-shaped figure or a beer belly is a health risk.

They said people with wide girths are more likely to have visceral or intra-abdominal fat, which increases their risk of diabetes, heart disease, stroke and some types of cancer.

But new research presented Sunday at the annual meeting of the Obesity Society shows that belly fat may not be the biggest bad guy behind some of the medical issues. "Fat in the liver is a more important indicator of health problems," says Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis.

Klein and colleagues recruited 31 obese men and women and looked at their visceral fat, which surrounds the organs in the belly, and their liver fat. Some people had high amounts of liver fat; others had normal amounts. A normal liver contains 5% fat or less, but a severe fatty liver may contain up to 50%, Klein says. The latter is referred to as non-alcoholic fatty liver disease.

Using several different medical tests, the researchers found that people with fatty livers:

•Make more triglycerides, which are released from the liver into their bloodstream and can increase the risk of heart disease.

•Are more likely to be resistant to the action of their own insulin, meaning their bodies don't regulate blood sugar properly, which can lead to type 2 diabetes, Klein says. Over time, high sugar levels damage large and small blood vessels, leading to heart disease, stroke, nerve damage, amputations, blindness and kidney disease.

"We do not yet know whether the liver fat is causing these health problems or is simply a very good indicator of health risk," he says. "Even though it looks like visceral fat itself might not cause harm, it is often high in people with increased liver fat."

About 30% of adults and a third of overweight children and adolescents have too much liver fat, he says. If you are obese, 30 or more pounds over a healthy weight, you are at a higher risk of having non-alcoholic fatty liver disease.

The bottom line: If you're too heavy, it's a good idea to trim down, he says. A weight loss of as little as 2% to 5% can cause a marked reduction in liver fat.

In a related study, Elisa Fabbrini of Washington University School of Medicine found that severely obese people who lost weight after gastric bypass surgery significantly lowered the fat in the liver.

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Artificial liver may extend lives

The first artificial organ for liver patients that uses immortalized human liver cells, the Extracorporeal Liver Assist Device, or ELAD®, is a bedside system that treats blood plasma, metabolizing toxins and synthesizing proteins just like a real liver does.

NewYork-Presbyterian Hospital/Columbia University Medical Center is currently one of only a small number of hospitals in the U.S. offering this therapy to acute liver failure patients as part of ongoing clinical trials.

"These studies are looking at how well the system can extend patients' lives until a liver transplant becomes available. We're also interested to see if it can relieve the burden on the patient's liver enough so that it can regenerate and regain some of its function," says Dr. Robert Brown, site principal investigator, chief of the Division of Abdominal Organ Transplantation, and director of the Center for Liver Disease and Transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center. Dr. Brown is also the Frank Cardile Professor of Medicine and Pediatrics (in Surgery) at Columbia University College of Physicians and Surgeons.

The ongoing studies look at whether ELAD liver support improves survival compared with standard medical therapy. Patients are randomly assigned to receive either standard medical therapy plus the ELAD system, or standard medical therapy alone. Patients eligible for the study have life-threatening acute liver failure, often due to an infection. Another trial open to patients with liver failure due to drug overdose without underlying liver disease is expected to begin enrollment later this year.

The current trials expand on prior results from Phase 1 and 2 trials in the U.S. and U.K., and a pivotal, randomized, controlled clinical trial at two sites in China during 2006 and 2007. In the latter study, 69 patients with hepatitis B or C who had suffered ALF were treated with either ELAD or standard therapy. Thirty-day transplant-free survival rates were statistically higher in the ELAD group compared with the control.

Artificial livers have been attempted since the 1960s. Because previous designs didn't use human liver cells, they couldn't adequately filter toxins or create chemicals essential to metabolism and blood-clotting.

With the ELAD system, four 12-inch cartridges containing cells derived from human liver cells and fibers are mounted on a standard blood-pumping unit. The patient's blood plasma flows inside of hollow fibers to allow appropriate two-way transfer of metabolites across the fiber membrane.

Liver transplantation is limited by the supply of donor livers. According to the United Network for Organ Sharing (UNOS), there were approximately 6,500 liver transplants performed in 2007; however, there are more than 16,000 patients on the waiting list. Each year only about one-third of those who need a donor liver will receive one, and many patients die while waiting.

Acute liver failure afflicts more than 30,000 Americans each year, including those with chronic liver diseases like hepatitis, as well as those whose livers were damaged, such as by taking too much acetaminophen pain medicine. If not treated effectively and promptly -- usually by transplantation -- patientsexperience organ failure, bleeding, coma and death. When a donor organ isn't available or if the patient is too sick for surgery, ELAD could be their only option.

Source: New York- Presbyterian Hospital

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Herbal Remedies for Liver - part III

Couch Grass Agropyron repens, elymus repens
A gentle, cleansing diuretic and female corrective agent. Antibiotic, emollient, tonic.

Lessens frequency and pain in bladder irritation, indicated for gout, enlarged prostate, cystitis, rheumatism, and jaundice. Anti-microbial, used for blood purifying, bladder, kidney, stomach stimulant, indicated for liver and spleen. Lymphatic cleanser, general use for healing lymphatic system. Indicated for bladder, lung, small intestine, and heart. Anti-inflammatory, used in conditions of cystitis, urethritis, and gallstones.

Used with other herbs to soothe irritation from kidney stones, and help to reduce or dissolve kidney stones. Also indicated for enlarged prostate gland conditions and to prevent further swelling. Minor indications for lower back pain, skin diseases, constipation, fevers, bronchitis, and to strengthen eyes.

Dandelion Root Leontodon taraxacum
Blood cleanser and purifier, diuretic, for juandice and digestive disturbances, calming, sedative, expectorant. Clears obstructions of liver, gallbladder, spleen, and benefits female organs. Detoxifies gallbladder, spleen, bladder, kidney, liver, stomach, pancreas. Neutralizes blood acidity, calms rheumatic conditions and benefits skin problems such as acne, eczema and psoriasis. A liver and digestive tonic, it promotes bile flow and acts as a mild laxative as well as clearing toxins from the blood. Reduces fluid retention, clears abscesses, boils, acne, gout, and joint inflammation and osteoarthritis. Improves and enriches blood flow to benefit tissues and reduce blood toxicity, and infection.

Also anti-cancerous, treats high blood pressure by reducing fluid retention, removes waste products from liver and gallbladder, benefits constipation and gout, dissolves gallstones, removes toxins in urine.

Buchu Leaves Barmosa betulina
Antiseptic for urinary system, diuretic to treat water retention, promotes sweating, benefits to bladder, stomach, lung.

Also for bloating and indigestion, reduction of calcification deposits and excess mineral accumulation in the tissues and organs. Used for relief of gassy conditions, indigestion, poor appetite, painfully slow digestion. Stimulates the uterus and promotes blood circulation, used for candida problems and prostatitis.

Useful to prevent recurring urethritis, cystitis, burning and painful urination, bed wetting problems, gallstones. Indicated for spleen, lungs, pancreas, high blood pressure, vaginal problems, hypoglycemia, and liver dysfunction. Also for eliminating and dissolving stones of the gall bladder and urinary system...

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Herbal Remedies for Liver Complaints part II

An unhappy liver can lead to fatigue, weight gain, mood swings and poor concentration. It can take a toll on your looks, too, giving you brittle nails, dull hair and unhealthy-looking skin. In extreme cases, it can progress to serious liver diseases such as cirrhosis.

So what can you do about it? Skip the booze and try a liver tonic instead.

You can do this the naturopathic way.

You can find liver supplements that contain herbs such as:

Yarrow (Achillea millefolium)

Some studies have shown that yarrow protects the liver from toxic chemical damage. Yarrow may also help treating hepatitis. If you have liver disease, ask your physician about using yarrow in addition to standard therapies. Yarrow tea can also help in cases of: -nausea -migraine -bleeding hemorrhoids -indigestion -stomach cramps -inflammation of the gastro-intestinal track Yarrow grows in meadows and pastures, by roadsides and paths. Common names: Milfoil, Knight's Milfoil, Nosebleed, Woundwort, Bloodwort ...

Ginger Tea

Ginger tea is believed to act as a tonic for your liver. It is also thought to improve digestion, relieve nausea and help ward off colds and flu.

1 piece fresh ginger root, about 2 inches (5 cm) long

4 cups (1 L) water

honey and lemon to taste

(optional)

Peel ginger root and slice it thinly. In a saucepan, bring water to a boil. Add ginger. Cover and reduce heat; simmer tea for 15 to 20 minutes. Strain the tea. Add honey and lemon to taste. Makes 4 servings.

Centaurium erythraea (Rafin.)-red centaury

Erythraea's bitter action stimulates digestive secretions; the secretion of gastric juice increases as soon as the herb acts on the mucous membranes of the mouth. It also stimulates the sympathetic system and circulation, and has a tonic effect on the blood vessels. Temporary leukocytosis has been noted, implying that the tonic action goes beyond the stomach. In Europe, Erythraea is used in anaemia and liver and gallbladder disease. It is gently laxative and, taken after meals, is an excellent remedy for heartburn. It can also enforce the action of anthelmintic herbs. Like many of the bitter tonics, it is effective in reducing fever and has been used as a quinine substitute in the past. Research has shown that this action is due in part to the phenolic acid component. Another constituent, gentiopicrin, has been reported to have antimalarial properties. Research also confirms the plant's potential for treating rheumatism and gout, as the alkaloid gentianine has demonstrated strongly anti-inflammatory properties.

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Herbal Remedies for Liver Complaints

Herb
	gentian (root) dandelion (root) milk thistle (seed)

-Gentian (root):Many gentians are difficult to grow outside their wild habitat, but several species are available in cultivation. Gentians are fully hardy and like full sun or partial shade, and neutral to acid soil that is rich in humus and well drained. They are popular inrock gardens.Gentians contain a unique combination of the phytochemicals seco-iridoids and xanthones. The seco-iridoids are bitter, and a gentian is the source of the most bitter compound known. No gentians are very poisonous, but due to their bitterness they are seldom eaten by animals.

-Dandelion:In traditional medicine, dandelion roots and leaves were used to treat liver problems. Native Americans also used dandelion decoctions (liquid made by boiling down the herb in water) to treat kidney disease, swelling, skin problems, heartburn, and stomach upset. Chinese medicinal practitioners traditionally used dandelion to treat digestive disorders, appendicitis, and breast problems (such as inflammation or lack of milk flow). In Europe, herbalists incorporated it into remedies for fever, boils, eye problems, diabetes, and diarrhea.

Today, dandelion roots are mainly used as an appetite stimulant, digestive aid, and for liver and gallbladder function. Dandelion leaves are used as a diuretic to stimulate the excretion of urine.

milk thistle (seed):

Treatment of Liver Disease - Hepatitis and Beyond:

Milk Thistle has been found in recent years to be a major player in the treatment of Liver Disease. Because it helps lower enzyme levels and facilitates the liver in its process of detoxifying the body. Among all known herbal remedies, Milk Thistle finds its place as the leader in herbs to treat liver disease. Physicians have prescribed Milk Thistle for Hepatitis to keep down inflammation, Cirrhosis to soften the liver, Liver Cancer to aid in detoxification, and many dysfunctions of the Gall Bladder System. It also helps protect the liver for those individuals that are taking prescription medications known to elevate liver enzymes.

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Herbal Remedies Hepatitis

An efficient way to fight against hepatitis is the usage of herbs in the form of hepatitis herbal remedies.If hepatitis is untreated for a long time, it may result in severe forms of liver disease like liver cancer or liver cirrhosis.

The most ordinary form of remedy for the patients of unceasing condition of hepatitis C is administering Pegylated Interferon injections once a week. At the same time, patients are also introduced to herbs as a complementary aid to relieve this problem. However, it is wise to consult an herbalist before making use of any herb as a medication against hepatitis.
To this day, no hepatitis herbal cure has been methodically proven as effectual healing agent but shows considerable quality in the reduction of the symptoms of hepatitis.

Regardless of the fact that no studies fully corroborate the effectiveness of herbs in therapeutically treating this disease, some patients believe in using herbs to gain relief. They make use of herbs to help with hepatitis or in some cases, to deal with the side effects of interferon, which is a conventional remedy for hepatitis.
An efficient way to fight against hepatitis is the usage of herbs in the form of hepatitis herbal remedies.If hepatitis is untreated for a long time, it may result in severe forms of liver disease like liver cancer or liver cirrhosis.

Some powerful hepatitis herbal remedies make use of extracts from the parts of plants such as Astragalus, Eclipta, Lycium Berry, Sophora, Privet fruit, White Peony, Melia fruit, Licorice etc.

The extracts of the above mentioned medicinal herbs can be consumed orally for treating Hepatitis.
Popular amongst them is Milk Thistle that contains Silymarin, which is a powerful anti-oxidant as well as a tissue growth promoter. Milk thistle seeds extract can be consumed orally to get relief from liver problems.

The German health authorities have approved Milk Thistle as a complementary treatment for liver cirrhosis, hepatitis, and other liver problems.
The other herbs which could be helpful as a medicine for treating hepatitis C are Licorice root, Ginseng, ginger, St. John’s Wort, Bupleurum Root, Privet Fruit, Melia Fruit, Lycium Berry, Andrographis, Astragalus Root, etc. The extracts of the above mentioned medicinal herbs can be consumed orally for treating Hepatitis.

Though the herbs as a hepatitis herbal cure are known to have a number of positive effects on the body of a hepatitis affected person, their credibility as medication is still under testing.

These herbs are capable of lowering the hepatitis viral load, halting the progression of the disorder and reducing or normalizing the enzyme levels in the liver.

A diet that is low in synthetic as well as natural saturated fats helps to keep the liver in good health. Inclusion of lecithin, essential fatty acids, green leafy vegetables, Vitamin C and Vitamin E in one’s daily diet can also be classified as one of the Hepatitis herbal remedies.

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Home Remedies for Cirrhosis of the Liver

The black seeds of papaya have been found beneficial in the treatment of cirrhosis of the liver, caused by alcoholism and malnutrition.

A tablespoon of juice obtained by grinding the seeds, mixed with ten drops of fresh lime juice, should be given once or twice daily for about a month as a medicine for this disease.

The herb trailing eclipta, botanically known as eclipta alba, has proved invaluable in cirrhosis of the liver.

The juice of all parts of this plant should be taken in doses of one teaspoon, mixed with one teaspoon of honey, three times daily.Picrorhiza, botanically known as picrorhiza kurroa, is a drug of choice in ayurveda for cirrhosis of the liver among adults. The root of the herb is given in powdered form.

A tablespoon of the powder, mixed with an equal quantity of honey, should be administered thrice daily. In case of accompanying constipation, the dose should be increased to double and should be given with a cup of warm water, three to four times a day. It stimulates the liver to produce more bile, the excretion of which relieves congestion of the liver and the tissues.

The juice of carrots, in combination with spinach juice, has been found beneficial in the treatment of cirrhosis of the liver. Spinach juice-200 ml, should be mixed with 300 ml of carrot juice to prepare 500 ml or half a litre of combined juices. Alternatively, 300 ml of carrot juice, combined with 100 ml each of cucumber and beet juices can be used effectively.

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Liver Biopsy

Liver biopsy is not necessary for diagnosis, but it is helpful for grading the severity of disease and staging the degree of fibrosis and permanent architectural damage. Hematoxylin and eosin stains and Masson's trichrome stain are used to grade the amount of necrosis and inflammation and to stage the degree of fibrosis. Specific immunohistochemical stains for HCV have not been developed for routine use. Liver biopsy is also helpful in ruling out other causes of liver disease, such as alcoholic liver injury or iron overload.

HCV causes the following changes in liver tissue:

Necrosis and inflammation around the portal areas, so-called "piecemeal necrosis."

Necrosis of hepatocytes and focal inflammation in the liver parenchyma.

Inflammatory cells in the portal areas ("portal inflammation").

Fibrosis, with early stages being confined to the portal tracts, intermediate stages being expansion of the portal tracts and bridging between portal areas or to the central area, and late stages being frank cirrhosis characterized by architectural disruption of the liver with fibrosis and regeneration.

Grading and Staging of hepatitis by assigning scores for severity are helpful in managing patients with chronic hepatitis. The degree of inflammation and necrosis can be assessed as none, minimal, mild, moderate, or severe. The degree of fibrosis can be assessed similarly. Scoring systems are particularly helpful in clinical studies on chronic hepatitis.

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How does liver damage occur in hepatitis C infection?

The presence of HCV in the liver triggers the human immune system, which leads to inflammation. Over time (usually decades), prolonged inflammation may cause scarring. Extensive scarring in the liver is calledcirrhosis.

When the liver becomes cirrhotic, the liver fails to perform its normal functions, (liver failure), and this leads to serious complications and even death. Cirrhotic livers also are more prone to become cancerous.

How is hepatitis C virus spread and how can transmission be prevented?

HCV is spread (transmitted) most efficiently through inadvertent exposure to infected blood.

• The most common route of transmission is needles shared among users of illicit drugs.
  
  
• Accidental needle-sticks in healthcare workers also have transmitted the virus.
  
  
• The average risk of getting HCV from a stick with a contaminated needle is 1.8% (range 0% to 10%).
  
  
• Prior to 1992, some people acquired the infection from transfusions of blood or blood products. Since 1992, all blood products are screened for HCV, and cases of HCV due to blood transfusionnow are extremely rare.
  
  
• HCV also can be passed from mother to unborn child. Approximately 4 of every 100 infants born to HCV-infected mothers become infected with the virus.
  
  
• A small number of cases are transmitted through sexual intercourse. The risk of transmission of HCV from an infected individual to a non-infected spouse or partner without the use ofcondoms over a lifetime has been estimated to be 1% to 4%
  
  
• Finally, there have been some outbreaks of HCV when instruments or sharp tool have been re-used without appropriate cleaning between patients.

Transmission of HCV can be prevented in several ways.

• Programs have been aimed at avoiding needle sharing among drug addicts. Needle exchange programs and educational interventions have reduced high-risk behaviors. However, the population of drug addicts is a difficult population to reach, and rates of HCV remain high among addicts (30% of younger users).
  
  
• Among healthcare workers, safe needle-usage techniques have been developed to reduce accidental needle-sticks. Newer syringes have self-capping needle systems that avoid the need to manually replace a cap after drawing blood and reduce the risk of needle-sticks.
  
  
• There is no clear way to prevent transmission of the HCV from mother to child.
  
  
• Persons with multiple sexual partners should use barrier precautions such as condoms to limit the risk of HCV as well as other sexually-transmitted diseases.
  
  
• Monogamous couples should consider the low risk of transmission when deciding whether to use condoms during intercourse. Some couples may decide to use them and some may not.
  
  
• Screening tests for blood products have almost eliminated the risk of transmission through transfusion, estimated by the CDC to be less than one in two million transfused blood products.
  
  
• People with HCV should not share razors or toothbrushes with others.
  
  
• It is critical that physicians and clinics follow manufacturer's directions for sterilizing/cleaning instruments and that disposable sharp instruments be discarded properly.

It is important to realize that HCV is not spread by casual contact. Thus, shaking hands, kissing, and hugging are not behaviors that increase the risk of transmission. There is no need to use special isolation procedures when dealing with infected patients.

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