Bile Acids (Total) Tips

World Hepatitis Day is recognized annually on July 28 to raise awareness of hepatitis, a condition that affects over 325 million people worldwide, and what steps are to be taken to strengthen the efforts in screening, prevention and control of the disease. The theme this year is Finding the Missing Millions . The campaign aims to increase global awareness and tackle the barriers to diagnosis so that not a single individual has to live with the condition without knowing.

Here are a few ways to spread awareness among the common people on this World Hepatitis Day

Identify the risk factors

Although everyone is prone to hepatitis, it is more common in some patients than in others. Different types of hepatitis A, B and C may affect people differently. Therefore, identifying the risk factors is crucial.

Hepatitis A is usually transmitted through contaminated food and water ingestion or contact with an infected person. It is more likely to affect people, who

Are young

Have been infected in the past or are not vaccinated

Reside in places with lack of safe drinking water and/poor sanitation

Live with someone who is infected

Have sexual relations with someone with hepatitis A

Use drugs recreationally

Hepatitis C and B are primarily transmitted through unprotected sex, during childbirth, and the use of contaminated needles. It is mostly seen in people, who

Are HIV+

Have a family history of hepatitis B

Are sexually involved with multiple partners

Use illicit drugs

Have a chronic liver or kidney disease

Works in healthcare and are possibly exposed to blood

Have been pierced with an infected needle

Hepatitis C mostly affects people, who

Have a history of organ donation or blood transfusion

Inject illicit drugs

Were born to HCV+ mothers

Works in healthcare and are likely to encounter needle-stick accidents

The common symptoms of hepatitis include loss of appetite, jaundice, abdominal pain, fever, dark urine, fatigue, vomiting and nausea, and diarrhoea. However, some people may be asymptotic. Identifying at-risk patients and encouraging screening can help lower the risk.

Encourage vaccinations

There are effective and safe vaccines for hepatitis B and A. CDC recommends the vaccine for hepatitis B for infants at birth and the vaccine for hepatitis A for 1-year old children. The series of vaccine for hepatitis B needs to be completed by 6-18 months of age. Although there is no vaccine for HCV at present, individuals can avoid certain activities that expose them to the infection to lower the risk. It is particularly important to avoid the use of injected drugs.

Provide educational resources

Most often, a person living with hepatitis is unaware of the condition unless symptoms start showing up. Screenings and vaccinations must be encouraged. There are many ways to raise awareness and spread the word through pamphlets, posters, social media, or by directly interacting with patients and encouraging others to do the same.

Participate actively

Even though the world observes World Hepatitis Day once a year, you can do your bit and be involved throughout the year to help raise awareness through different means. If you have any queries or questions concerning hepatitis, feel free to consult a doctor. Go for regular screening and follow-ups to keep track of your health.

World Hepatitis Day is a great opportunity to promote awareness worldwide. Nevertheless, it is important to take part in such campaigns actively all around the year to promote vaccinations and screenings. The above steps can help you spread the word and reduce the risk of hepatitis globally.

Viral hepatitis is a leading cause of deaths and disability across the globe. A growing public health concern, the disease affects millions of people every year. An estimated 500 million are infected with chronic hepatitis B or hepatitis C. Each year, nearly 1 million succumb to the disease due to complications arising from hepatitis, including liver cancer. Many people are residing with the disease while several others are at an increased risk.

Most people with a history of HCV or HBV are unaware of the chronic infections and hence, are at risk of developing complications that are more serious and unknowingly spreading the infection to others. Some people living are more likely to contract viral hepatitis. This includes those residing in areas with lack of or poor sanitation services, unsafe drinking water etc. Type C and type B viral hepatitis are commonly observed in patients who have had blood transfusions and organ transplants, as well as those working in healthcare settings.

Considering the staggering figures, it has become extremely important to adopt certain measures to raise awareness among people, and encourage safe practice and good hygiene to avoid and check the transmission of hepatitis. The primary prevention strategies include

Advocacy and increasing awareness of various types of viral hepatitis infections to control community transmission

Make vaccines available to all in order to encourage the prevention of HBV and HAV infections

Application of blood safety strategies the supply of blood depending on voluntary blood donations, public education on donor selection, blood donation, and screening of donated blood, blood components used for transfusion

Precautions to limit the spread of infection in the community and healthcare setting to avoid viral hepatitis and related diseases

Safe injection practices to protect against HCV and HBV transmission

Practice safe sex by limiting the number of sexual partners to one, using contraceptives to ward off infection transmission

Use of clean, needle and syringes to administer drugs intravenously

Adoption of certain occupational safety measures to avoid transmission among healthcare workers

Use and distribution of safe drinking water and food to prevent HEV and HAV infections

Secondary prevention strategy includes early diagnosis of the disease. It offers the best scope for effective medical intervention and prevention of further transmission. Early screening and diagnosis also allow the patient to adopt precautionary measures to improve immunity, specifically by abstaining from tobacco, alcohol and certain drugs, as well as control the spread of the disease to others.

Although viral hepatitis is curable, access to treatment remains an issue in many parts of the world. Much needs to be done guarantee availability of and access to low-cost, reliable diagnostics and effective, safe treatment regimens, particularly in those regions of the world that are resource-constrained.

Who is at risk?
All patients having cirrhosis.
It happens in non cirrhotics too.

What causes of cirrhosis commonly lead to hcc?
Hepatitis b related cirrhosis (most likely), hepatitis c, alcoholic cirrhosis, nash.

Is liver cancer curable?
Yes if diagnosed at an early stage.

Is there any treatment option for advanced hcc?
Yes there are options which can prolong the survival.

How to screen?
All cirrhotics need to get and ultrasound once a year and a blood test called serum alfa fetoprotein.

Liver cancer (hepatocellular carcinoma) most commonly affects patients with cirrhosis.

Can even occur in non cirrhotics.

More common in males.

Most commonly occurs in cirrhosis due to hepatitis b virus.

Other causes of cirrhosis that commonly lead to hepatocellular carcinoma (hcc)- hepatitis c virus, alcohol associated, non alcoholic fatty liver.

Is hcc curable?
Yes if detected at at early stage treatment options do exist.

If a patient is diagnosed to have hcc and it is at an advanced stage-- there are therapies today which can help to prolong the overall survival.

How to screen for hcc in patients of cirrhosis?
Most commonly available tests are abdominal ultrasound and serum alfa-feto protein.

When should a cirrhotic patient get screened for hcc?
Ideally every year with usg and if there is any worsening like sudden abdominal distension, weight loss over a month or so.

Liver is a very important organ of your body. It is also the largest internal organ. Liver plays a pivotal role in food digestion, iron metabolism, regulation of blood clotting and removal of toxins from your body. Liver problems refer to the disruption of liver functions. There are various liver problems and diseases that you may encounter. Some of the liver problems are as follows:

Hepatitis A, B, C, D, E
Liver cirrhosis.
Fatty liver
Liver cancer
Wilson disease
Jaundice
The most common causes of the above-mentioned liver problems are

Fatty liver is generally caused due to obesity
Hepatitis A, B, C is caused due to viral infections
Consuming excess alcohol can cause liver cancer
Liver diseases like Wilson disease are caused due to genetic problems
Different liver problems have different symptoms. But there are some common symptoms for all liver diseases. The most common symptoms are mentioned below

Body fatigue
Pain in the abdomen
Change in urine and stool color
Nausea
Queasiness
Loss of weight and appetite
Yellowish discoloration of skin, eyes and nails.
Homeopathy can treat liver problems very effectively. The following are some of the solutions offered by homeopathy for different liver problems

1. If you are suffering from the problem of fatty liver, your doctor may recommend you medicines like Lycopodium, Phosphorus, Nux vomica
2. If you suffer from the problem of liver enlargement then your doctor may recommend you medicines like Carduus Marianus
3. Chionanthus and Taraxacum are medicines advised for liver problems like jaundice
4. Natrum sulphuricum may be recommended to you if you are suffering from problems like Liver cirrhosis

Homeopathic treatment for liver problems is very effective since it treats the medical condition according to specific symptoms

The liver is a critical organ as it plays a vital role in body metabolism and digestion. Liver diseases are a challenge for medical professionals, as often, these symptoms are not obvious until the disease has progressed to quite an advanced stage. In most cases, diagnosis in the early stage is very difficult, which can help in early intervention and disease arrest. It is not just the disease, but the causes and treatment of liver cancer are also surrounded by myths.

Read on to know some of the myths and facts about liver cancer.

Liver cancer is caused by alcohol: This is one of the most common myth, which is not true. While alcohol definitely has a role to play in liver cancer, not all victims are alcoholics. Non-alcoholic fatty liver disease (NAFLD) which puts a person at risk for liver cancer is not related to alcohol and is seen in people who are obese, diabetic, high cholesterol and have no connection with alcohol. There is also no correlation between the amount of alcohol and the severity of liver damage. However, stopping alcohol consumption altogether definitely helps in improving the liver condition.
Liver cancer can be detected on routine tests: While abnormal protein levels on routine blood tests indicate abnormal liver, it is most often ignored and does not get diagnosed further. However, this should be taken up in detail and should be diagnosed. Early diagnosis greatly improves prognosis and can reduce treatment costs significantly. The chances of liver regeneration also would be greatly improved.
Routine medications can lead to liver cancer: Liver plays a very important role in metabolism, and most drugs are liver-toxic. Taken over a period of time, they can cause incremental damage and lead to liver cancer. Some are more toxic than others, so asking for the effect of the liver is always a good question.
Cirrhosis is a precursor to liver cancer: This is definitely true, as left untreated, liver cirrhosis can lead to cancer. The added danger is that cirrhosis also is a silent disease, with often no symptoms and gets detected quite late. Periodic tests for cirrhosis in a patient who has a family history and alcohol consumption is a must.
Lifestyle has no connection to liver cancer: Absolutely wrong. A good healthy lifestyle including healthy weight, good portions of fresh fruits and vegetables, proper exercise, minimal alcohol use, and no smoking helps not just the liver but overall health. These play a cumulative effect on liver health, and having a good lifestyle, can help in delaying onset even in a person who is predisposed to cirrhosis and/or liver cancer through family history.
Liver cancer is definitely a silent killer, but keeping eyes open definitely, helps.

Jaundice is a medical condition, which is characterized by the yellow coloring of the skin and eyes. It generally occurs when there is an excess of bilirubin in your system. Bilirubin is a yellow pigment formed in the liver by the breakdown of red blood cells. It normally gets discharged by the liver along with other dead red blood cells. So if you are suffering from jaundice, it usually indicates that you have some serious problems regarding the functioning of your liver, pancreas, or gallbladder.

Signs and symptoms:
Signs and symptoms commonly associated with jaundice include:

Yellow-tinted eyes and skin
The whites of your eyes may turn orange or brown in color
Dark urine
Pale stools
High fatigue and vomiting (in severe cases)
Causes:
Jaundice, as mentioned above, occurs when there is an excess of bilirubin and the liver is incapable of metabolizing it along with the old red blood cells. It is more common in infants than in adults, because their livers are not fully developed. However, it is also a frequent occurrence in adults and could be a potential sign of any of the following problems:



Liver infection
Scarring of the liver, or cirrhosis
Hepatitis
Alcohol abuse
Liver cancer
Gallstones
Pancreatic cancer
Blood disorders, like hemolytic anemia
Parasites in the liver
Abnormal reactions to or overdose of medication
Diagnosis:
Diagnostic tests may include:

Jaundice is diagnosed primarily by taking blood tests, to help measure the amount of bilirubin as well as to trace the presence of other diseases like Hepatitis.
Liver function tests in order to make comparisons between levels of certain proteins and enzymes when the liver is in good shape and when it is damaged.
Liver biopsies, where samples of liver tissue are first extracted and later examined under a microscope.
Imaging studies, consisting of abdominal ultrasounds, computed tomography scans and magnetic resonance images (MRI) tests.

HepatitisThe problem of hepatitis is related to an inflammatory condition of liver. It occurs mainly due to infection caused by virus but there are other possible causes as well. Hepatitis can be temporary or viral. Temporary hepatitis, which is acute in nature, gets resolved on its own. Viral hepatitis can be of five types, A, B, C, D and E.

Now, let us discuss about the causes behind each type of hepatitis, which results in liver problem.

Causes

The fact that we have identified five types of Hepatitis, A, B, C, D and E, let s take a look at the causes behind the occurrence of all these types:

Hepatitis A: The most common way through which this type of virus gets transmitted, is through consuming food or water contaminated by wastes from a person infected with hepatitis A.
Hepatitis B: One can suffer from Hepatitis B, if one comes in contact with infectious body fluids like blood, secretions from vagina, semen, taking drugs through injections, containing the virus of Hepatitis B.
Hepatitis C: This is also transmitted when someone comes in direct contact with fluids of an infected person, through injection drugs and sexual contact. As per the reports of Union Health Ministry, about 1.2 crore people of India are suffering from Hepatitis C, with the worst affected region being North India.
Hepatitis D: It is a rare form of hepatitis, also known as delta hepatitis, occurs as a result of coming into direct contact with infected blood. Hepatitis D is rare because it only takes place in conjunction with hepatitis B infection.
Hepatitis E: This virus is mainly caused in areas of poor sanitation. It is a waterborne disease, resulting from ingesting faecal matter that contaminates water supply. Cases of Hepatitis E have been mainly reported in Middle East, Asia, Central America and Africa.
Symptoms Of Hepatitis

Hepatitis, in its initial phase is called the acute phase. The following symptoms along with mild flu are visible:

Loss of appetite
Fatigue
Joint pains
Pain in the abdomen
Nausea
Weight loss
Jaundice
Though this phase is not really dangerous but for some patients, it can result in liver failure leading to death.

Treatment for Hepatitis

Treatment options for different types of hepatitis are:

Hepatitis A: This doesn t require treatment as it is short-term in nature. In case the symptoms cause a lot of discomfort, then bed rest is recommended. Vaccine is available to prevent this infection.
Hepatitis B: Acute Hepatitis B doesn t require treatment either. Its chronic form can be treated with antiviral medications. This can be prevented with vaccination.
Hepatitis C: This type of hepatitis, both in its acute and chronic forms, is treated through antiviral medications.
Hepatitis D: According to a study in 2013, a drug known as alpha interferon is used to treat this type of hepatitis but unfortunately this only comes to the rescue of 25-30% people.
Hepatitis E: This acute form of hepatitis gets resolved on its own. Adequate rest, drinking sufficient amount of water and taking enough nutrients in their food are some of the ways to get healed from this disease.

Liver cancer is when the cells in the liver grow uncontrolled. As the liver filters blood from all parts of the body, one of the most common reasons for liver cancer is perhaps metastasis, which is spread from other parts. Through the blood, cancer cells from other parts reach the liver for filtration and can then make the organ cancerous.

In addition to this, there are other risk factors that can lead to liver cancer. For example, people suffering from obesity, alcohol and tobacco abuse, viral hepatitis (B or C), chronic liver disease (especially in men, who are more prone than women to develop cancer), cirrhosis and someone who has a history of prolonged use of steroids can suffer from the disease. Also, while liver cancer is very rare in the Americas, it is very common in Africa and Southeast Asia as the prevalence of hepatitis is higher in these regions.

When it comes to the symptoms, it s acceptable that liver cancer is insidious, and the exact point of origin cannot be identified. It continues to grow until symptoms become evident, which are also nonspecific. Before analyzing your health on your own, it s always recommendable to seek an expert s final word on it. Let s take a look at the top signs that might point out towards liver cancer.

Abdominal pain: When you suffer a strong pain in the abdominal area, especially in the upper portion on the right side, it can signal a lump or a growing tumor in the liver. This can also be accompanied by middle or lower back pain.
Weight loss: Many a time, women who suffer from a sudden loss of weight can be going through a deadly disease like this one. In most cases, these weight loss cases show no attempts on the patient s side, that is, the weight loss occurred for unknown reasons. A loss of appetite, without any reasons, is another indicator. These can result due to unexplained reasons and should be taken seriously.
White, chalky stools: This one is another tell-tale sign of liver cancer. Often, people tend to ignore stools in light, flaky colors. It is always better to consult a doctor, as you might be ignoring a sign of potential cancer.
Bloating: When you feel certain heaviness or bloating in the upper part of the abdomen due to fluid accumulation it indicates, which is one of the indicators for testing liver cancer.
Frequent body conditions: Apart from the above-mentioned symptoms, one can also consider personal health history when facing any liver-related problems. Recurring severe nausea and vomiting and general signs of lethargy and weakness can also indicate liver cancer. Also, personal health history with claims the patient suffered from jaundice (due to the accumulation of bile pigments in the sclera and skin) can also be taken into consideration.

A liver transplant surgery involves surgically substituting a problematic liver with a healthy liver from a different person. Usually, the healthy liver is taken from a person who has recently passed away. In some cases, a living person may also give away part of the liver. Usually, living donors are members of the family or someone who has a good blood type match. The liver regenerates lost tissues after a surgery; hence, the donor s liver becomes normal within a few weeks of surgery.

You may require a liver transplant if your liver does not function optimally, owing to the below mentioned conditions:

Cirrhosis: This is a chronic disease of the liver wherein, scar tissues replace healthy tissues in the liver, thus, not allowing the liver to function optimally.
Metabolic disease: Disorders that modify the activity of the chemicals in the body
Acute hepatic necrosis: This is a disorder that causes the healthy tissues in the liver to die
Autoimmune disorders or liver cancer: Autoimmune disorders can cause healthy tissues in the liver to die as the immune system in the body starts attacking healthy tissues. Formation of malignant tumors in the liver can impair liver functioning.

Procedure
You have to undergo certain procedures before the surgery is conducted; a general health exam, imaging tests, blood tests and a psychological exam are conducted before the surgery. Based on the functioning of the liver and some other factors, your suitability for the transplant will be determined.
The procedure begins with general anesthesia, following which an incision is made in the abdomen. The liver is then removed and replaced with a healthy one. Once the procedure is completed, the surgeon closes the incision with stitches.

Aftercare
Once the procedure is done with, you are kept in the intensive care unit for a few days. The doctor will monitor your progress and put you on medications. After the recovery, you will have to undergo check-ups at regular intervals. You may also have to take medications such as immunosuppressant to prevent your immune system from attacking the liver.