Liver disease is a term for a collection of conditions, diseases, and infections that affect the cells, tissues, structures, or functions of the liver.

Causes

• Abnormal blood flow to the liver( Budd Chiari syndrome, Congestive heart failure)
• Accumulation of Cholesterol/triglycerides(steatosis)
• Alcohol abuse
• Chemicals (anabolic steroids and vinyl chloride )and minerals
• Eating unidentified mushrooms
• Drugs (acetaminophen, statins, niacin, nitrofurantoin, amoxicillin, clavulanic acid, tetracycline, isoniazid, oral contraceptives, methotrexate, disulfiram, and vitamin A, to name a few)
• Infiltration by abnormal cells
• Obstruction of bile flow(cholestasis, Primary biliary cirrhosis and primary sclerosing cholangitis)
• Infections — These could be viral (Hepatitis, Toxoplasmosis, Epstein Barr virus, Adenovirus fever, Cytomegalovirus) or non-viral (Rocky mountain spotted)
• Fatty liver disease
• Hereditary (Hemochromatosis, Wilson’s Disease)
• Gilbert’s Disease
• Cancers (hepatocellular carcinoma and cholangiocarcinoma
• Metastatic cancer (begin in the lung, breast, large intestine, stomach, and pancreas, Leukemia and Hodgkin’s lymphoma )
• Diseases(portal hypertension, hepatic encephalopathy  )

Symptoms and signs of liver diseases

• Abdominal pain in the upper right part of the stomach
• Dark urine
• Depression
• Diarrhoea
• Fatigue
• Generalized itching
• Hypoglycemia
• Jaundice
• Light-coloured stools
• Loss of appetite
• Loss of sex drive
• Low-grade fever
• Malaise,
• Muscle aches and pains
• Nausea
• Unusual weight loss or weight gain
• Varicose veins
• Vomiting

Investigations

• Blood tests

1. Serum transaminase
2. AST(Aspertate aminoitransferase)
3. ALT (Alanine transferase)
4. Biliary enzymes
5. GGT(Glutamyl transpeptidase)
6. ALP(Alkaline phosphatase)
7. Serum protein (albumin, globulin, Alpha-trypsin, ferritin, Alpha-fetoprotein)
8. Total serum bilirubin
9. Full blood count
10. Prothrombin time
11. Serum Lipase
12. BUN
13. Creatinine
14. Ammonia

• CT scan
• MRI
• Ultrasound
• Liver Biopsy

Treatment

• Bed rest
• Drink extra fluids to prevent dehydration
• Ayurvedic Medicines are very effective in liver diseases. There are a lot of preparations using herbs and metals. All work equally well in almost all types of liver diseases.

Complications

• Decreased Cognitive Function
• Liver Cancer
• Liver Failure
• Malnutrition and Weight Loss

Prevention

• Avoid alcohol and smoking
• Avoid drinking or using tap water when travelling abroad.
• Avoid illegal drug use( sharing injection equipment)
• Avoid the sharing of personal hygiene items( razors or nail clippers, towels, soaps)
• Avoid toxic substances
• Eat a balanced diet, get plenty of physical activity and rest
• Hepatitis A and hepatitis B can be prevented with vaccines.
• Practice good hygiene( washing hands after using the washroom or changing diapers)
• Practice the safest sex
• Use only prescribed medicines, especially vitamins and antibiotics.

Cirrhosis of liver

Causes

• Alcohol dependence and alcoholism
• Autoimmune hepatitis
• Chronic hepatitis B or C
• Congestive heart failure
• Coronary artery disease
• Cystic fibrosis
• Diabetes
• Exposure to certain toxins such as arsenic
• Glycogen storage diseases
• Hemochromatosis
• Obesity
• High triglyceride blood levels
• Intestinal bypass surgery
• Long-term treatment with corticosteroids
• Secondary biliary cirrhosis
• Wilson’s disease

Symptoms and signs

• Abdominal swelling
• Bleeding from gums
• Blood in vomit/faeces
• Difficulty breathing
• Easy bruising
• Oedema
• Encephalopathy (Extreme sleepiness, difficulty awakening, coma)
• Gynaecomastia
• Haemorrhoids
• Nosebleeds
• Poor appetite
• Scrotal swelling
• Small red, spider-like blood vessels under the skin
• Wasting
• Weakness

Treatment

Ayurvedic medicines are very effective in all liver diseases and are prescribed according to the Prakriti of a person and the extent of the disease.

Complications

• Ascites
• Oesophagal varices
• Hepatic encephalopathy
• Kidney failure
• Permanent liver damage and loss of normal liver function
• Portal hypertension

Ascites

Causes

• Cirrhosis 
• Acute liver failure

1. acute injury to liver cells
2. adverse reactions to medications
3. drug abuse

• Budd-Chiari syndrome (blockage of the hepatic veins)
• Metastatic Cancer
• Heart failure
• Nephrotic syndrome
• Disorders of the pancreas
  1. Acute pancreatitis
  2. Chronic pancreatitis
  3. Pancreatic cancer
• Direct irritation of the peritoneum
• Diseases of the ovary like cancer or Meigs syndrome
• Hypothyroidism

Symptoms And Signs

Mild-moderate

1. no symptoms
2. increased abdominal girth and size
3. shortness of breath
4. pleural effusions

• Due to cirrhosis of the liver-

1. leg swelling
2. easy bruising
3. enlargement of the breasts
4. confusion

• Due to heart failure

1. shortness of breath
2. oedema
3. paroxysmal nocturnal dyspnea

• Due to cancer

1. pain
2. weight loss
3. Fatigue
4. Abdominal distention.

• With spontaneous bacterial peritonitis

1. Abdominal pain
2. Fever.

Treatment

• Dietary salt restriction and medications assist the body in ridding itself of excess salt and fluid. 
• Ayurvedic medicines
• Liver Transplant

Complications

• Spontaneous bacterial peritonitis
• Hepatorenal syndrome

Gall Bladder Stones

Causes

Cholesterol Stones

• Obesity(especially in women)
• Pregnancy
• Hormonal therapy,(especially estrogen)
• Rapid loss of weight
• High triglycerides(as in diabetes),bilirubin
• Fewer bile salts
• Crohn’s disease
• Fasting
• Anti-cholesterol drugs(increase cholesterol in bile)

Pigment Stones

• Cirrhosis
• Biliary tract infections(brown pigment stones)
• Hereditary blood disorders (black pigment stones)
• Residual bile in the gall bladder(due to poor muscle tone)

Symptoms And Signs

• Pain
  • Steady gripping or gnawing severe pain in the upper right abdomen near the rib cage, radiating to the upper back.
  • Changing position, taking over-the-counter pain relievers, and passing gas does not relieve the pain
  • Pain typically occurs at the same time of day

• Dark urine, lighter stools, or both
• Fever, chills
• Jaundice
• Nausea or vomiting
• Rapid heartbeat and abrupt blood pressure drop

Acute cholecystitis

• Pain in the upper right abdomen is severe and constant
• Pain lasts for days.
• Pain frequently increases with inspiration
• Pain may also radiate to the back or occur under the shoulder blades, behind the breast bone, or on the left side.
• Fever and chills

Chronic Cholecystitis 

• gas
• nausea
• abdominal discomfort after meals
• Chronic diarrhoea (4 – 10 bowel movements every day for at least 3 months).

Investigations—

• Endoscopic ultrasonography (EUS)
• Magnetic resonance cholangiopancreatography (MRCP)
• Cholescintigraphy (HIDA scan
• Oral cholecystogram (OCG)
• Intravenous cholangiogram (IVC)

Treatment

• Ayurvedic medicines relieve the pain and other symptoms in 1-2 days. It takes nearly 4-5 months to get rid of gall stones depending on the size, number and location of gall stones.
• Surgical

1.  Laparoscopic cholecystectomy.
2. If gallstones are in the bile ducts, ERCP with endoscopic sphincterotomy is performed.

Complications

• Pancreatitis
• Gangrene
• Perforation of the gallbladder