What is Fatty Liver Disease

Fatty Liver Disease It is deposition of excess fat in the liver tissue. In conditions of inefficient fat metabolism or excess production of fat, fat gets deposited in the liver tissue. Fatty liver disease can occur in persons who may or may not consume alcohol. If it occurs in people with no or little alcohol intake it is called Non Alcoholic Fatty Liver Disease (NAFLD).


Prevalence of NAFLD in India

Prevalence in rural India is around 10% and urban India is between 15-30%. The percentage difference is due to dietary habits and lifestyle differences in rural and urban parts of India. NAFLD is rapidly emerging as the leading cause for end stage liver disease and subsequent Liver Transplants.

What are the risk factors

The risk factors include being overweight (Obesity), diabetes, high cholesterol or triglycerides, unhealthy 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. (4) End stage liver disease.

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.

What is Alcoholic Liver Disease

ALD 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 subsequently leading to Alcoholic Hepatitis and Cirrhosis.

Fatty liver is the initial stage and reversible with abstinence. Whereas, Alcoholic Hepatitis is acute liver injury resulting from large quantities of alcohol consumption over a period of time & Cirrhosis is the shrinking of liver wherein 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 a person 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)

What is Viral Hepatitis

Viral Hepatitis is an infection of the liver caused by a virus. There are many viruses that can cause hepatitis but the common ones are Hepatitis A virus, Hepatitis B virus, Hepatitis C virus and Hepatitis E virus.

Prevalence of Viral Hepatitis in India

Acute viral hepatitis is generally Hepatitis A & E whereas 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 Hepatitis A and 15-20% for Hepatitis E.

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.

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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 most common symptoms of CFS 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 established causes but some predisposing factors like hormonal imbalance, poor immunity, post viral infections and stress may increase the likelihood of suffering from CFS.

What are the complications of CFS

The most frequent complications of CFS are depression, social isolation, lifestyle restrictions and increased work absences.

What can be done to make life better

Please meet with your doctor if you suffer from the symptoms of CFS to find an appropriate treatment. Studies have shown benefits of Vitamin & Mineral supplements in improving fatigue, stamina and other CFS symptoms. 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 occur due to inadequate blood supply in the body, nerve compression or due to the deficiency of calcium, magnesium, potassium, I-carnitine, vitamin B12 vitamin D3 and/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 the muscle cramps. The doctor may prescribe vitamins & minerals or amino acids supplements. The doctor may need to modify your medications if that is the cause of debilitating cramps.

What is Myopathy

Myopathy is primarily a disease of muscle tissue caused due to muscle fiber dysfunction.

Myopathies can be congenital or acquired. They may involve the skeletal muscles (the climb muscles) or the heart muscles. Certain drugs may also be the cause.

What are the Symptoms of Myopathy

Muscle weakness and pain are the most common symptoms. In some cases, heart muscle weakness manifests as shortness of breath and heart failure.

What should I do if I have the above symptoms

Immediately meet with your doctor to find out the cause for the occurring symptoms. The doctor may advise you to take 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 in nature. Acquired myopathies may be treated by the treatment of the underlying disease. Studies have shown significant improvement in the symptoms with vitamin E, L Carnitine and Magnesium supplements taken along with routine medicines.

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