FATTY LIVER DISEASE
What is Fatty Liver Disease
It is deposition of excess fat in the liver tissue. In conditions of inefficient fat metabolism or excess production of fat, it gets deposited in the liver tissue. Fatty liver disease can occur in persons with or without consumption of alcohol.If it occurs in people with no or little alcohol intake it is called Non Alcoholic Fatty Liver Disease (NAFLD).
NON- ALCOHOLIC LIVER DISEASE (NAFLD)
Prevalence of NAFLD in India
Prevalence in rural India is around 10% and urban India 15-30%. The difference being due to dietary habits and lifestyle. It is emerging as the leading cause for end stage liver disease and subsequent Liver Transplants.
What are the risk factors
The risk factors include Overweight, Obesity, Diabetes, High Cholesterol or Triglycerides, Wrong dietary habits and Rapid weight loss.
What is NAFLD
NAFLD is a continuous spectrum of liver diseases that starts and progresses from (1) Steatosis: Non Alcoholic Fatty Liver (NAFL) (2) Nonalcoholic Steatohepatitis (NASH) : deposition of fat plus inflammation and fibrosis. (3) Cirrhosis of the Liver.
What are the symptoms of NAFLD
NAFLD is symptomless until the liver failure manifests in form of jaundice, ascites (water collection in abdomen) and altered mental status.
How is NAFLD diagnosed
Most people have simple NAFL and not NASH. Liver biopsy is the definitive evidence, however it is invasive, costly and associated with risk of complications. Non Invasive tests like Liver Electrography or Fibroscan can be used to estimate the stiffness and fat content in the liver.
Ultrasound of Liver along with Liver Function Test may offer diagnostic clues.
How to prevent NAFLD
Regular exercise, eating a healthy diet (low fat), to maintain a healthy weight is the cornerstone of preventive strategies. Avoid Alcohol & Liver toxic drugs.
What should I do if have risk factors
Please consult your Physician / Gastroenterologist to know more about the disease and the required diagnostic tests. Ask about Lifestyle and Dietary changes and if there is a treatment or medication for NAFLD.
ALCOHOLIC LIVER DISEASE (ALD)
What is Alcoholic Liver Disease
It is the toxic effect of Alcohol on the liver cells (hepatocytes). There are three types of disease in a continuum spectrum starting from Fatty liver, Alcoholic Hepatitis and Cirrhosis.
Fatty liver is the initial stage and reversible with abstinence. Alcoholic hepatitis is acute liver injury resulting from large quantities over a period of time. Cirrhosis is shrinking of liver where normal liver cells are replaced by fibrosis.
Prevalence of Alcoholic Liver Disease in India
As per WHO, around 30% of total Indian adult population consumes alcohol. Around 93% consume it in the form of spirits, 7% in the form of beer and ≤1% in the form of wine. Amongst heavy drinkers,20% will develop alcoholic hepatitis and 25 % will develop cirrhosis.
What are the risk factors
Daily consumption is the most important risk factor for Alcoholic liver disease. Intake of alcohol is measured as one unit. Each unit contains 8 gm of ethanol and is variable in various common beverages, e.g. 1/2 pint of beer, 1 measure of spirit, 1 glass wine or sherry.
Risk depends on the amount and frequency: high risk–160 gm/day, moderate– 80 gm/day, low–40 gm/day.
Consuming alcohol without any food intake, high concentration of drinks, mixing multiple alcoholic beverages and alcohol binge are some of the factors making aperson at increased risk for ALD.
What are the symptoms of Alcoholic Liver Disease
Abdominal pain or discomfort, Liver enlargement, Nausea or vomiting, Diarrhea, Fever, Jaundice, Ascites (fluid in abdomen), GI bleeding and altered sensorium can be some of the symptoms of ALD.
How is Alcoholic Liver Disease diagnosed
History of Alcohol intake coupled with symptoms form an important component of establishing a diagnosis. Liver Function Test (LFT), USG (Ultrasound) Liver and Liver Biopsy also aid in establishing the diagnosis and the stage of ALD.
How to prevent Alcoholic Liver Disease
Stopping Alcohol at an early stage is the only way.
What should I do if I consume Alcohol or have symptoms suggestive of
Please consult your Physician / Gastroenterologist to know more about the disease and the required diagnostic tests. Ask about Lifestyle and Dietary changes and the suitable treatment or medication for ALD (Alcoholic Liver Disease)
VIRAL HEPATITIS
What is Viral Hepatitis
It is an infection of the liver by a virus. There are many viruses that can cause hepatitis. The common ones are Hepatitis A virus, Hepatitis B virus, Hepatitis C virus, Hepatitis E virus. There are other viruses also which can lead to viral hepatitis.
Prevalence of Viral Hepatitis in India
Acute viral hepatitis is generally Hepatitis A & E. Chronic hepatitis is Hepatitis B & C. As per studies the prevalence of viral hepatitis B in India is 2-5% and Hepatitis C is 1%. Hepatitis A and E have regional differences in prevalence around 8-10% for A and 15-20% for B.
What are the risk factors
Viral hepatitis A and E are transmitted through contaminated water and food. Hepatitis B and C are transmitted through blood or sexual contact.
What are the symptoms of Viral Hepatitis
Acute Viral hepatitis present as jaundice, nausea, vomiting and weakness in the body. Chronic hepatitis presents as cirrhosis of the liver and end stage liver failure. Asymptomatic Chronic hepatitis is also picked up on routine screening during blood donation or preoperative assessment before a procedure.
How is Viral Hepatitis diagnosed
Viral hepatitis is diagnosed by classical presentation of acute viral hepatitis. Liver Function Test (LFT), Viral markers for A, E, B & C and by USG (Ultrasound) Liver. Liver Biopsy may also be needed in cases of chronic hepatitis.
How to prevent Viral Hepatitis
Hepatitis A and E can be prevented by the use of vaccination, good personal hygiene, avoiding unhygienic sources of food and drinking water. Hepatitis B and C can be prevented by adopting safe sexual practices & avoiding high risk behavior. Diligent screening of blood products and medical instrument sterilization are also important preventive steps.
What should I do if I have symptoms suggestive of Viral Hepatitis
Please consult your Physician / Gastroenterologist to know more about the disease and the required diagnostic tests and the available treatment.
How can we help?
Chronic Fatigue Syndrome(CFS)
What is CFS
CFS is a condition which manifests as extreme fatigue, tiredness and exhaustion without any medical reasons for it. It worsens with physical activity while rest has no impact.
What are the symptoms of CFS
The main symptoms are fatigue, memory loss, lack in concentration, unexplained muscle or joint pains, headaches, non-refreshing sleep cycles and extreme exhaustion lasting more than 24 hours after any physical or mental exercise.
What causes CFS
There are no causes but some predisposing factors like hormonal imbalance, poor immunity, post viral infections and stress.
What are the complications of CFS
The main complications are depression, social isolation, lifestyle restrictions and increased work absences.
What can be done to make life better
Please meet your doctor to find out a remedy. People do benefit with supplements of vitamin E, L Carnitine and Magnesium. Some people benefit from low dose of antidepressants too.
Muscle cramps
What are muscle cramps
They are sudden involuntary spasms of the muscles.
What are the causes of muscle cramps
Cramps can be due to inadequate blood supply in the body, nerve compression or due to the deficiency of calcium, magnesium, potassium, l carnitine, vitamin b12 and d3 or vitamin e.
Use of certain medications like diuretics, statins (cholesterol reducing medicines) or beta blockers can also cause cramping.
What can I do to feel better
Consult your doctor to find out the exact cause of muscle cramps. The doctor may prescribe vitamin supplements, minerals or amino acids. He may modify your medications if that is the cause of debilitating cramps.
Myopathies
What is Myopathy
Myopathies are primary disease of muscle due to muscle fiber dysfunction.
They can be congenital or acquired. It may involve the skeletal muscles (the climb muscles) or heart muscles. Certain drugs may also be the cause.
What are the Symptoms of Myopathy
Muscle weakness and pain are the most common symptoms. Heart muscle weakness manifests as shortness of breath and heart failure in some cases.
What should I do if I have the above symptoms
Immediately meet your doctor to find out the cause of symptoms. He may advise you some tests like CPK, LDH or ECHO for the heart.
What is the treatment for this disorder
Congenital myopathies have no treatment and are progressive. Acquiredmyopathies may be treated bytreatment of underlying disease. Supplementation with vitamin E , L Carnitine and Magnesium may help.