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Fatty Liver: Causes, Symptoms, and Types

Too much alcohol consumption (a male who drinks 15 or more drinks per week and females who drink more than 8 are surely to get fatty liver – liver failure over 10-15 yrs)…reports Asian Lite News

Fatty liver is a condition where excess fat gets deposited in the liver, which increases its size. According to Shlloka Joshii, a Classical Hatha Yoga teacher, and Diet and Lifestyle expert, there are two types of fatty liver. Non-alcoholic fatty liver occurs in people who don’t drink alcohol or drink too little. It usually occurs in people who are obese, diabetic, or due to some medication. Alcoholic fatty liver is caused due to over alcohol consumption, where the liver is unable to process nutrients and metabolize fat. This further leads to scarring of the liver causing fibrosis/cirrhosis, a condition where the liver becomes inactive.

Symptoms

“Initially, one may feel tired or experience discomfort or pain in the right side of the upper abdomen, often after meals. In advanced stages, one might experience severe tenderness in the upper abdomen, loss of appetite, nausea, weakness, weight loss, abdominal distention (ascites), pale-coloured stools, muscle wasting, and swelling in the legs,” outlines Joshii.

Causes

Too much alcohol consumption (a male who drinks 15 or more drinks per week and females who drink more than 8 are surely to get fatty liver – liver failure over 10-15 yrs).

Obesity

Insulin resistance

Type 2 diabetes

Metabolic syndrome

High cholesterol levels (raised triglycerides)

Medicine side effects

Pregnancy

Genetic disorders

Infections like hepatitis C

Joshii shares five foods to cut out fatty liver

Lemon: Squeeze half a lemon into a glass of warm water and drink it on an empty stomach every day, it helps in flushing out the toxins and improves the liver’s health.

Papaya: Consume a bowl of papaya on an empty stomach, the enzymes present in papaya reduce the inflammation of the liver. It is a source of fiber, minerals, and antioxidants including vitamins A, C, and E.

Apples: Apples are a rich source of pectin, which helps cleanse the body and release toxins from the digestive system. Having an apple a day can prevent fatty liver. However, if you have Grade 2 or Grade 3 fatty liver, you can have up to three apples a day, one before each meal (breakfast, lunch, and dinner). Or apple cider vinegar: drink 20-40ml of Apple cider vinegar on an empty stomach.

Beetroots: Beetroots are known to stimulate bile juice and boost enzymatic activity as they are rich in vitamin C, carrying out similar functions. Carrots, rich in Vitamin A, help prevent liver disease and support the overall functions of the liver. Having 1 medium-sized beetroot or 1 medium-sized carrot per serving before food, as a salad, would be a good idea.

Green vegetables: High in chlorophyll and necessary antioxidants, green vegetables flush out toxins from the bloodstream and aid the liver. You can include healthy greens like spinach, green peas, okra, kale, broccoli, cauliflower, lettuce, etc., in your diet. We recommend consuming 100-150 grams of steamed or boiled vegetables before a meal, or they can be substituted for the meal itself.

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Covid impacts on liver

Nausea, vomiting, diarrhea, and pain in the abdomen have been reported in up to 15 percent of patients with Covid-19 infection. ..writes Avnish Seth

Covid has affected all the human lives in the world directly or indirectly. The resurgence and exponential spread of Covid-19 have brought great challenges to our healthcare system. Most deaths are a result of respiratory failure due to significant injury to the lungs. We have also learned that the virus may affect all parts of the digestive system including the food pipe, stomach, intestine, liver, and pancreas. This has implications in the diagnosis, management, and transmission of the disease.

Here are a few facts on the liver and the impact a Covid-19 infection can have on it:

How does the Covid-19 virus affect the liver?

The virus enters human cells by locking on to the angiotensin-converting enzyme (ACE-2) receptor. Besides the lungs, these receptors are expressed in the cells of the intestine, liver, and bile duct, thus making these organs prone to injury by the virus.

What are the gastrointestinal and liver manifestations in Covid-19?

Nausea, vomiting, diarrhea, and pain in the abdomen have been reported in up to 15 percent of patients with Covid-19 infection. Of note, up to 10 percent of patients with Covid-19 may present with these symptoms before or without respiratory features. It has been found that patients presenting with initial gastrointestinal symptoms may have a delay in hospital admission and a more severe course of illness as compared to those without. Injury to the liver injury may manifest as elevation of liver enzymes in liver function blood tests (LFT). Current data suggests that 19 percent of Covid-19 patients have abnormal levels of liver enzymes Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) during disease, with mostly mild elevation in serum bilirubin and Gamma-glutamyl transferase (GGT). In most patients, the liver injury is mild and transient, although severe liver damage has been reported.

How do patients with pre-existing liver disease handle Covid-19 infection?

The common causes of chronic liver disease in our country include alcohol abuse, non-alcoholic fatty liver disease, Hepatitis B, Hepatitis C, and autoimmunity. The immune system of these patients is weak, and they must remain extra careful as there is an increased risk for severe illness due to the virus. Liver injury due to the virus in patients with pre-existing chronic liver disease who may lead to acute on chronic liver failure (ACLF). More severe the Covid infection, greater is the extent of liver injury. Most medications used for treatment of Covid-19 also tend to injure the liver and there is a need for close monitoring and dosage adjustment as required.

What are the implications of Covid-19 in patients who have received a liver transplant? Is it safe to carry out liver transplant during these times?

There have been concerns that organ transplant recipients, who are on medications that reduce body immunity, may be more prone to infection with Covid-19 or have a more severe course of illness. It has now been consistently shown that use of majority of these medications is safe and may prevent severe Covid symptoms by blocking the cytokine storm. Outcome of Covid-19 infection is the same as healthy population in organ transplant recipients. It is no surprise that after initial apprehensions, transplant activity has resumed in the country, for those who need it most, as Covid-free pathways have been established.

Should patients with chronic liver disease and liver transplant recipients take the vaccine against Covid-19 virus?

The safety of vaccination in this cohort has been well established now. All such individuals who are eligible must take the vaccine at the earliest. They should not pick or choose or wait for the perfect vaccine. It is felt that the efficacy of vaccine in patients on immunosuppression drugs may be a trifle less than the normal population, but there are no additional risks.

Coronavirus.

What are the precautions that patients with liver disease should observe to prevent Covid-19 infection and poor outcomes?

As compared to healthy individuals, patients with underlying liver disease tend to do poorly with Covid-19. Hence, every attempt must be made to keep the liver as healthy as possible. Fatty liver disease provides an unhealthy environment on which the virus may flourish. Avoidance of fatty food, sweets and fast food coupled with regular exercise for 30 minutes a day at least 5 days a week are good for the liver. Excessive alcohol intake should be avoided. Patients who are suffering from Chronic Hepatitis due to Hepatitis B, Hepatitis C and auto-immunity must be regular with their medication. The availability of vaccine has brought hope that the pandemic may be controlled in a few months. Social distancing and prevention of transmission of virus will, however, continue to be of paramount importance as more and more vaccine-escape mutations in the virus are anticipated.

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