Sabtu, 03 September 2011

Kinds of liver disease


Cholestasis
            medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system such as can occur from a gallstone or malignancy and metabolic types of cholestasis which are disturbances in bile formation that can occur because of genetic defects or acquired as a side effect of many medications.
In medicine , cholestasis is a condition where bile cannot flow from the liver to the duodenum . Dalam kedokteran.
Cause
          The causes can be distinguished between primary cases (hereditary or genetically determined) and less frequent secondary cases (acquired during life). [ 16 ] People of Celtic (Irish, Scottish, Welsh) origin have a particularly high incidence of whom about 10% are carriers of the gene and 1% sufferers from the condition.

Treatment

Routine treatment in an otherwise-healthy person consists of regularly scheduled phlebotomies ( bloodletting ). When first diagnosed, the phlebotomies may be fairly frequent, perhaps as often as once a week, until iron levels can be brought to within normal range. Once iron and other markers are within the normal range, phlebotomies may be scheduled every other month or every three months depending upon the patient's rate of iron loading. For those unable to tolerate routine blood draws, there is a chelating agent available for use. The drug Deferoxamine binds with iron in the bloodstream and enhances its elimination via urine and faeces. Typical treatment for chronic iron overload requires subcutaneous injection over a period of 8–12 hours daily. Two newer iron chelating drugs that are licensed for use in patients receiving regular blood transfusions to treat thalassemia (and, thus, who develop iron overload as a result) are deferasirox and deferiprone .

Fatty Liver



Fatty liver , also known as fatty liver disease ( FLD ), is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (ie abnormal retention of lipids within a cell). espite having multiple causes, fatty liver can be considered a single disease that occurs worldwide in those with excessive alcohol intake and those who are obese (with or without effects of insulin resistance ). The condition is also associated with other diseases that influence fat metabolism . [ 1 ] Morphologically it is difficult to distinguish alcoholic FLD from non alcoholic FLD and both show micro- vesicular and macrovesicular fatty changes at different stages.
Accumulation of fat may also be accompanied by a progressive inflammation of the liver ( hepatitis ), called steatohepatitis . Akumulasi lemak juga bisa disertai dengan peradangan progresif hati ( hepatitis ), disebut steatohepatitis . By considering the contribution by alcohol, fatty liver may be termed alcoholic steatosis or non-alcoholic fatty liver disease (NAFLD), and the more severe forms as alcoholic steatohepatitis (part of alcoholic liver disease ) and non-alcoholic steatohepatitis (NASH).
Causes
Fatty liver is commonly associated with alcohol or metabolic syndrome ( diabetes , hypertension , obesity and dyslipidemia ) but can also be due to any one of many causes
Metabolic
Abetalipoproteinemia , glycogen storage diseases , Weber-Christian disease , acute fatty liver of pregnancy , lipodystrophy

Nutritional
Malnutrition , total parenteral nutrition , severe weight loss , refeeding syndrome , jejuno-ileal bypass , gastric bypass , jejunal diverticulosis with bacterial overgrowth

Drugs and toxins
Amiodarone , methotrexate , diltiazem , expired Tetracycline , highly active antiretroviral therapy , glucocorticoids , tamoxifen , environmental hepatotoxins (eg, phosphorus , mushroom poisoning )
Other
Inflammatory bowel disease , HIV , Hepatitis C especially genotype 3, and Alpha 1-antitrypsin deficiency.
Treatment
The treatment of fatty liver depends on what is causing it, and generally, treating the underlying cause will reverse the process of steatosis if implemented at early stage.

Hepatitis



Hepatitis (plural hepatitides) is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar (ἧπαρ), the root being hepat- (ἡπατ-), meaning liver, and suffix -itis, meaning "inflammation" (c. 1727).[1] The condition can be self-limiting (healing on its own) or can progress to fibrosis (scarring) and cirrhosis.
Hepatitis may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide, but it can also be due to toxins (notably alcohol, certain medications, some industrial organic solvents and plants), other infections and autoimmune diseases.

Causes

Chronic

[edit] Alcoholic hepatitis

Main article: Alcoholic hepatitis
Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset.
Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C.[citation needed] The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis.

[edit] Drug induced

Main article: Hepatotoxicity
A large number of drugs can cause hepatitis:[7]
The clinical course of drug-induced hepatitis is quite variable, depending on the drug and the patient's tendency to react to the drug. For example, halothane hepatitis can range from mild to fatal as can INH-induced hepatitis. Hormonal contraception can cause structural changes in the liver. Amiodarone hepatitis can be untreatable since the long half life of the drug (up to 60 days) means that there is no effective way to stop exposure to the drug. Statins can cause elevations of liver function blood tests normally without indicating an underlying hepatitis. Lastly, human variability is such that any drug can be a cause of hepatitis.

[edit] Other toxins

Other Toxins can cause hepatitis:

Treatment for hepatitis A

There is no specific treatment for HAV and most people fight off the virus naturally, returning to full health within a couple of months. The doctor will advise avoiding alcohol and fatty foods as these can be hard for the liver to process and may exacerbate the inflammation.
Patients should get plenty of rest and eat a nutritious diet. They should also ensure they do not spread HAV by washing their hands after using the toilet and before preparing food. Patients with more severe symptoms may be monitored in hospital for a short period.

Hepatitis A immunisation

Hepatitis A immunisation is given in a series of injections. The first single injection in the arm gives protection for a year. The second booster injection at 6 to 12 months extends protection for up to 10 years.
The hepatitis A vaccine may be routinely recommended for young children living in areas with high incidence of hepatitis A, and anyone travelling to countries where hepatitis A is endemic. In addition, immunisation may be recommended for people whose sexual practices are likely to put them at risk.
Immunisation may also be recommended to prevent hepatitis A developing if a person suspects they have been exposed to the virus.

Treatment for hepatitis B

In most countries a patient with a positive test result will be referred to a specialist who will carry out further tests to determine the degree to which hepatitis B may be affecting the liver, and what may be the best treatment options. In these tests a small sample of liver tissue may need to be taken (a liver biopsy).
In the majority of patients with active HBV, symptoms will not be severe and treatment will not be required. The patient will be monitored and after a few months the patient’s immune system should fight off the virus, giving the patient natural immunity.
In around 5% of adults, 30-50% of young children (aged 1-4), and 90% of infants, HBV infection will become chronic. The virus is more deadly to the young and those that are infected at birth have a 25% chance of developing a life-threatening liver-related illness.
Antiviral medication is given as treatment to those with chronic symptoms to help prevent further liver damage. These medications may be injected or given in pill form. Examples are Interferon Alpha, Lamivudine and Baraclude. Treatment usually lasts 6 months, during which time the patient will be carefully monitored.
Regardless of whether the infection is producing symptoms or not, the patient will be advised to avoid alcohol, get plenty of rest and maintain a healthy diet.

Hepatitis B immunisation

Three immunisation injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check they have worked. Immunity should last for at least 5 years.

Treatment for hepatitis C

To determine the extent to which the liver has been affected by hepatitis C, other tests may be carried out. These include liver function tests, which measure substances (specific proteins and enzymes) in the patient’s blood, showing how effectively the liver is working. A liver biopsy may also be carried out. A fine hollow needle is passed through the skin into the liver and a small sample is taken. The sample is then examined under a microscope to gauge the amount of liver damage (inflammation, scarring and cirrhosis).
Treatment combines the antiviral drugs interferon and ribavirin. Although treatment has improved in recent years, the success rates vary depending on which genotype the patient has and how long they have had hepatitis C. In 2011, the FDA approved a new drug called Victrelis (for the treatment of the genotype 1 strain of hepatitis C). When taken alongside existing drugs, Victrelis cured more than 60 percent of patients in clinical trials compared to between 20-40 percent of patients when existing drugs were taken alone.3 Unlike other drugs for hepatitis C, Victrelis is a protease inhibitor, similar to those used to treat HIV. Adherence to this drug is essential to prevent drug resistance.
The antiviral drugs may cause significant side effects that may be intolerable for some people. These include:
  • headaches
  • flu-like symptoms
  • nausea
  • tiredness
  • body aches
  • depression
  • skin rashes
A patient will also require regular check-ups to monitor their progress. It is important to remember that if HCV treatment is effective and the infection is cleared, this does not mean the patient has future immunity to hepatitis C.

Cirrhosis


 
cirrhosis (pronounced /sɪˈroʊsɪs/) is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated),[1][2][3] leading to loss of liver function. Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease, but has many other possible causes. Some cases are idiopathic, i.e., of unknown cause.
Ascites (fluid retention in the abdominal cavity) is the most common complication of cirrhosis, and is associated with a poor quality of life, increased risk of infection, and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from esophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis the only option is a liver transplant.
The word "cirrhosis" derives from Greek κιρρός [kirrhós] meaning yellowish, tawny (the orange-yellow colour of the diseased liver) + Eng. med. suff. -osis. While the clinical entity was known before, it was René Laennec who gave it the name "cirrhosis" in his 1819 work in which he also describes the stethoscope.[4]

Causes

Cirrhosis has many possible causes; sometimes more than one cause is present in the same patient. In the Western World, chronic alcoholism and hepatitis C are the most common causes.
  • Alcoholic liver disease (ALD). Alcoholic cirrhosis develops for between 10% and 20% of individuals who drink heavily for a decade or more.[8] Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates. Patients may also have concurrent alcoholic hepatitis with fever, hepatomegaly, jaundice, and anorexia. AST and ALT are both elevated but less than 300 IU/L with a AST:ALT ratio > 2.0, a value rarely seen in other liver diseases. Liver biopsy may show hepatocyte necrosis, Mallory bodies, neutrophilic infiltration with perivenular inflammation.
  • Non-alcoholic steatohepatitis (NASH). In NASH, fat builds up in the liver and eventually causes scar tissue. This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and treatment with corticosteroid medications. This disorder is similar to that of alcoholic liver disease but patient does not have an alcohol history. Biopsy is needed for diagnosis.
  • Chronic hepatitis C. Infection with the hepatitis C virus causes inflammation of the liver and a variable grade of damage to the organ that over several decades can lead to cirrhosis. Cirrhosis caused by hepatitis C is the most common reason for liver transplant. Can be diagnosed with serologic assays that detect hepatitis C antibody or viral RNA. The enzyme immunoassay, EIA-2, is the most commonly used screening test in the US.
  • Chronic hepatitis B. The hepatitis B virus causes liver inflammation and injury that over several decades can lead to cirrhosis. Hepatitis D is dependent on the presence of hepatitis B and accelerates cirrhosis in co-infection. Chronic hepatitis B can be diagnosed with detection of HBsAG > 6 months after initial infection. HBeAG and HBV DNA are determined to assess whether patient will need antiviral therapy.
  • Primary biliary cirrhosis. May be asymptomatic or complain of fatigue, pruritus, and non-jaundice skin hyperpigmentation with hepatomegaly. There is prominent alkaline phosphatase elevation as well as elevations in cholesterol and bilirubin. Gold standard diagnosis is antimitochondrial antibodies with liver biopsy as confirmation if showing florid bile duct lesions. It is more common in women.
  • Primary sclerosing cholangitis. PSC is a progressive cholestatic disorder presenting with pruritus, steatorrhea, fat soluble vitamin deficiencies, and metabolic bone disease. There is a strong association with inflammatory bowel disease (IBD), especially ulcerative colitis. Diagnosis is best with contrast cholangiography showing diffuse, multifocal strictures and focal dilation of bile ducts, leading to a beaded appearance. Non-specific serum immunoglobulins may also be elevated.
  • Autoimmune hepatitis. This disease is caused by the immunologic damage to the liver causing inflammation and eventually scarring and cirrhosis. Findings include elevations in serum globulins, especially gamma globulins. Therapy with prednisone and/or azathioprine is beneficial. Cirrhosis due to autoimmune hepatitis still has 10-year survival of 90%+. There is no specific tool to diagnose autoimmune but it can be beneficial to initiate a trial of corticosteroids.
  • Hereditary hemochromatosis. Usually presents with family history of cirrhosis, skin hyperpigmentation, diabetes mellitus, pseudogout, and/or cardiomyopathy, all due to signs of iron overload. Labs will show fasting transferrin saturation of > 60% and ferritin > 300 ng/mL. Genetic testing may be used to identify HFE mutations. If these are present, biopsy may not need to be performed. Treatment is with phlebotomy to lower total body iron levels.
  • Wilson's disease. Autosomal recessive disorder characterized by low serum ceruloplasmin and increased hepatic copper content on liver biopsy. May also have Kayser-Fleischer rings in the cornea and altered mental status.
  • Alpha 1-antitrypsin deficiency (AAT). Autosomal recessive disorder. Patients may also have COPD, especially if they have a history of tobacco smoking. Serum AAT levels are low. Recombinant AAT is used to prevent lung disease due to AAT deficiency.
  • Cardiac cirrhosis. Due to chronic right sided heart failure which leads to liver congestion.
  • Certain parasitic infections (such as schistosomiasis)
  • Lysosomal acid lipase deficiency (LAL Deficiency) is a rare autosomal recessive genetic condition and is characterized by hepatomegaly, persistently abnormal LFTs and type II hyperlipidemia. Splenomegaly and evidence of mild hypersplenism may affect some patients. Untreated, LAL Deficiency may lead to fibrosis, cirrhosis, liver failure and death.

Treatment
1. Preventing further damage. You can’t reverse what has been done but you can stop having any more damage done. It is important to stop consuming alcohol which is one of the biggest damage contributors to the liver. You will also need to make sure that your consumption of drugs or medications is monitored. Stay away from non-steroidal anti-inflammatory drugs since this can make the condition worse. A well balanced diet is also essential to preventing any more damage. Eat a lot of fruits and vegetables and try to stay away from fats although small servings may be helpful for a balanced diet.
2. Use Liver Supplements. There are certain vitamins and minerals which can help to make sure that the liver stays healthy and recuperates faster. Iron supplements, Vitamins K, Vitamin B and minerals can all help restore the functions of the liver. You will find that there are actually special liver supplements in the market which already combine all the needed vitamins and minerals. These may be used alone for prevention or alongside other treatments to further enhance the way the condition is dealt with.
3. Go natural. Many of the liver cirrhosis treatments today will involve medication or some extreme actions such as a liver transplant or blood treatments. Some may feel that this only adds to the current problem. Natural solutions such as herbal treatments and diets can be used to treat liver cirrhosis while avoiding the more drastic measures. Many people prefer this type of treatment since it does not introduce any chemicals or drugs to the body and is non-invasive as well. Aside from herbal treatments there are also complete guides that will help you treat this disease naturally by helping you redo your lifestyle.

About 80 to 90 percent of people survive liver transplantation. Survival rates have improved over the past several years because of drugs such as cyclosporine and tacrolimus, which suppress the immune system and keep it from attacking and damaging the new liver.





Liver Cancer





 

Causes

 

Treatment

Liver Cancer Diet
Let's start with most simple part of this program: Liver Cancer diet. When it comes to diet, it is very important to avoid eating  Toxins  and   Foods that Kill. Please follow those links and learn what are The Toxins I am talking about and what are those  " Foods that Kill". Now, important part of your diet should also be  Water Cure.  Please, become familiar with  Water Cure. Your Diet should contain: Foods That Heal, Vegetable juices,  Fats that Heal,  Unrefined Sea Salt. Also, try to understand food tolerance. You can not find the right Liver Cancer diet, unless you fully understand and learn about food tolerance.
Take some time to implement and learn all what you have read here, and then continue reading further.

Body Cleansing (Liver Cancer)
Now, let's start with body cleansing. Body cleansing is extremely important part of every prevention and curing program. You are guessing: "Dietary changes you made are also a form of cleansing." But, most people need more then this, especially when it comes to liver health. Body Cleansing is even important for children. Our internal organs can hold a lot toxins, and sometimes, it is impossible to get those toxins out, without doing cleansing. Our liver can contain hundreds of intrahepatic stones. Those stones will block bile flow, and affect the bases of your health, your digestion. Another problem are parasites. You must learn as much as possible about parasites. And, don't forget also dental toxins.
Let start with cleansing program. You are suppose to do cleansing in this order:
  1. Bowel cleanse with parasite cleanse
  2. Dental cleanup (if you can afford it)
  3. Kidney Cleanse and
  4. Liver cleanse.
Body Cleansing for Adults:
  2. Dental cleanup - dental work may be one cofactor of your disease: amalgam, root canal, nickel crowns, cavitations (pocket inside jaw bone left after extraction of the wisdom and molar teeth )
Make sure you visit those pages and get more info. Dental cleanup can take many years. If you have a lot of dental metal, do not rush to replace it all at once.
Bowel cleanse should be done at least once a year.
Liver cleanse is a procedure that, for best results, should be repeated at least 6 - 10 times, every 2 or 3 weeks.
Kidney cleanse is simple and cheap, many herbs can be used to cleanse kidneys. If you have no kidney stones, even Water Cure could be enough!
Body Cleansing for kids:
  2. Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse:

Physical Activity (Liver Cancer)
Physical Activity helps cleansing, it brings balance and relieves stress.
Psycho-physical activities will help you balance your body and will help you relief accumulated stress.  You will have to find a form of  exercise that suit you. I will just give you a few examples:
Mini Trampoline jumping - rebounding!
Meditation
Walk or jog in the nature : Forest, Mountain , river /   sea / lake side, beach ... fishing, photo-safari, rowing, riding, golf, ...
Tai Chi, Chi Gong, Meditation ...
Yoga - Hatha, Meditation, Chinese Yoga ...
Martial Arts: Karate, Judo, Kung Fu, Teakwood, Budokai, Uechi, Aikido ...
Dancing, Aerobics, Gymnastics, Stretching ...
Swimming in non-chlorinated water !  ( Best in minerals rich water - Ocean ! )
Weight lifting,  ....
Do not exhaust yourself !
Do not exercise with full stomach !  (You may take a walk!)
Do not hurt yourself !



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