Saturday, August 27, 2011

A Healthy Liver Food Reference

The liver is the most efficient battery in the world. It supports in powering our body by storing energy and releasing it when required. It converts the food we eat into chemicals that are essential for life. It is therefore imperative that we make a wise choice of the food we eat so that it keeps such a vital organ as our liver always healthy.

These diet tips may help in ensuring a well-functioning liver.
-have a well balanced diet while you ensure to have low fat foods
-eat small, regular meals
- do not skip meals nor over-eat
- drink at least 6 to 8 glasses of fluids, preferably water, daily
- avoid alcohol (if you drink, have no more than 1 to 2 drinks on any occasion. Do not drink daily)
- Few herbal supplements may be harmful to the liver and overdose of few vitamins, especially Vitamin A, too may pose danger to the liver. Consult your doctor.
- Organic food is always preferable. The liver is less loaded if we intake lesser pesticides, chemicals, hormones, antibiotics etc.
- Eat fresh, in-season, firm and clean fruits and vegetables that are washed thoroughly prior to consumption to remove pesticides.
- Have as much of fruits and vegetables with bright pigments - like red, orange, green and yellow
- Maximise the intake of raw vegetables with high-sulphur content - like cabbage, cauliflower, broccoli, garlic, onions etc
-Instead of boiling, cook vegetables by baking or steaming which helps retain nutrients.
- Prefer whole-grain products over refined/bleached grain products (e.g. prefer wheat over Maida)

VEGETABLES: Carrots, Cabbage, Tomatoes, Broccoli, Sprouts, Lettuce, Asparagus, Spinach, Green peas, Potatoes, Yams

FRUITS: Papaya, Mangoes, Berries, Citrus fruits, Canned fruit with no sugar added or packed in its own juice, Avocado, Olives, Cantaloupe, Apples, Kiwi

BAKERY: Bread, rolls, pitas, tortillas, bagels etc

Whole-grain: Rye, Rice, Multi-grain, Stone ground

PASTA & NOODLES: Whole-grain, Rice noodles (fresh or dried), Corn noodles, Potato, Buckwheat

LEGUMES: Split peas (green and yellow), Lentils (red and brown), Chick peas, Kidney beans, Navy beans, Black beans, Pinto beans

NUTS & SEEDS: Almonds, Cashews, Walnuts, Hazelnuts, Pecans, Peanuts

DAIRY & BEVERAGES: Lower or reduced fat milk (skim or <2% fat), yogurt and cheese, Non-hydrogenated margarine, Fortified Soy milk, Rice milk (un-sweetened), Water (spring, distilled or filtered), Green tea (contains antioxidants)

A note on Coffee: Caffeine may tend to rid the body of minerals such as Calcium and may be avoided if you have liver disease or if you are menopausal or post-menopausal. Several recent studies however have reported that coffee may help in case of cirrhosis and liver cancer and as reported by few studies may even reduce the risk of liver cancer as compared to non-drinkers. However, it is recommended to consult your doctor to see whether coffee should or should not be avoided.

OILS (cold pressed virgin, vegetable and seed oils): Olive, Flaxseed, Safflower, Sunflower, Sesame, Canola, Peanut, Soybean, Corn

MEAT, EGGS & SEAFOOD (preferably free-range/wild): Chicken (with skin removed), Lamb, Lean cuts or lean/extra-lean ground beef or pork, Eggs, Tuna, Salmon, Mackerel, Trout, Char, Herring, Shellfish, Sardines

 RICE & GRAINS: Wheat, Couscous, Quinoa, Buckwheat , Rye, Barley, Oats, Bran, Brown rice, Wild rice, Amaranth, Brazil nuts

 100% fruit and vegetable juices (fresh/bottled/canned & additive-free)

This isn’t an exhaustive list of healthy food choices nor is it meant to replace the advice of your doctor or dietician. In case you suffer from a specific health condition or are looking for counseling on nutrition, please consult with your health care provider.

Visit Hospitals in Hyderabad for more details.

Tuesday, August 23, 2011

Liver care while travelling

Before your trip:
Talk to your doctor or an expert in travel medicine about health risks in the area you plan to visit. They can tell you how to keep yourself healthy when you travel to places where certain illnesses are a problem. They also can tell you about places that might not be safe for you to visit. Ask them if they know of doctors who treat people with liver-related infections in the region you plan to visit.
  • Traveler’s diarrhea is a common problem. Carry a 3- to 7-day supply of medicine (antibiotics) to treat it. A common drug for traveler’s diarrhea is ciprofloxacin. If you are pregnant, your doctor may suggest you take TMP- SMX (trimethoprim-sulfamethoxazole) instead.
  • Insect-borne diseases are also a major problem in many areas. Take a good supply of an insect repellent that contains 30 percent or less "Deet" with you. Plan to sleep under a mosquito net, preferably one treated with permethrin, in places where there is malaria or dengue fever. Unless you need to go there, avoid areas where yellow fever is found.
  • If you have medical insurance, check to see what it covers when you are away from home. Make sure your paperwork is in order, and take along proof of insurance when you travel.
  • Learn potential health risks and whether you need to be immunized. Hepatitis A, Hepatitis B, Hepatitis C, Malaria and Yellow Fever are some diseases you need to get vaccinated against.
  • Make sure all your medications are up-to-date and legal in the country you are travelling to.
  • Get a medical check-up at least 6 weeks before you are scheduled to leave.
  • Pack a first-aid kit, hand sanitizer and safe sex supplies.

During your trip:
Food and water might contain bacteria, viruses, or parasites that could make you sick.
  • Do not eat raw fruit and vegetables that you do not peel yourself, raw or undercooked seafood or meat, unpasteurized dairy products, or anything from a street vendor. Also, do not drink tap water, drinks made with tap water, or with ice made from tap water, or unpasteurized milk.
  • Food and drinks that are generally safe include steaming-hot foods, fruits that you peel yourself, bottled (especially carbonated) drinks, hot coffee or tea, beer, wine, and water that you bring to a rolling boil for1 full minute. If you can’t boil your water, you can filter and treat it with iodine or chlorine, but this will not work as well as boiling.
  • In many places, animals may roam more freely than they do in the area where you live. If you think animals have left droppings on beaches or other areas, always wear shoes and protective clothing and sit on a towel to avoid direct contact with the sand or soil.
  • Swimming can make you sick if you swallow water. You should never swim in water that might contain even very small amounts of sewage or animal waste.
  • Take all medications as prescribed by your doctor. If your doctor has you on a special diet, stick with it.
  • Keep a list of emergency numbers of hospitals and health providers.
  • Practice safe sex.

After your trip:
People behave differently when they travel, and this increases the risk of some medical conditions in recent travellers for reasons sometimes unrelated to the location travelled to. Causes of liver infection may be more likely in patients with travel history; cytomegalovirus - liver infection,  hepatitis A, hepatitis B, hepatitis C, hepatitis E. Make sure you monitor your health for at least two weeks after your trip. Make sure you visit your doctor for a thorough check-up if you have any doubts or show symptoms of infection.

Monday, August 22, 2011

Liver care while you drink alcohol

When you drink alcohol, it is absorbed into the bloodstream from the stomach and intestines. All blood from the stomach and intestines first goes through the liver before circulating around the whole body. So, the highest concentration of alcohol is in the blood flowing through the liver.

Liver cells contain enzymes (chemicals) which process (metabolise) alcohol. The enzymes break down alcohol into other chemicals which in turn are then broken down into water and carbon dioxide. These are then passed out in the urine and from the lungs. The liver cells can process only a certain amount of alcohol per hour. So, if you drink alcohol faster than your liver can deal with it, the level of alcohol in your bloodstream rises.
Your liver needs water to do its job. As alcohol acts as a diuretic (makes you pass urine), it dehydrates you and forces the liver to divert water from elsewhere. When the liver is processing alcohol it produces a substance called acetaldehyde. This has a toxic effect on the liver itself, as well as the brain and stomach lining. This is what causes your hangover. Acetaldehyde is subsequently broken down into chemical called acetate, which is broken down further into carbon dioxide and water outside the liver. Regular and heavy drinking over time can strain or disrupt this process, leading to alcoholic liver disease.
You are very unlikely to develop liver problems caused by alcohol if you drink within the recommended safe limits. That is:
  • Men should drink no more than 21 units of alcohol per week (and no more than four units in any one day).
  • Women should drink no more than 14 units of alcohol per week (and no more than three units in any one day).
  • Pregnant women. The exact amount that is safe is not known. Therefore, advice from experts is that pregnant women and women trying to become pregnant should not drink at all. If you do chose to drink when you are pregnant then limit it to one or two units, once or twice a week. And never binge drink or get drunk.
In general, the more you drink above the safe limits, the more harmful alcohol is likely to be. And remember, binge drinking can be harmful even though the weekly total may not seem too high. For example, if you only drink alcohol once or twice a week, but when you do you drink 4-5 pints of beer each time, or a bottle of wine each time, then this is a risk to your health.
Keep these pointers in mind;
Set limits. One way to make sure you do not drink to excess is to decide how many drinks your body can safely handle and do not exceed this limit during the course of the night. Unfortunately, it is not always easy to keep track, especially when playing drinking games. Such games may provide entertainment and a chance to feel included in a social group, but they contribute to excessive drinking. The atmosphere created by drinking games is dangerous because it causes you to drink more than you would usually through peer pressure and rapid rate of consumption. Chugging alcohol will delay awareness of how much alcohol is in your body because of the time it takes to raise your BAC.
Eat a meal before you drink. Food in the stomach will slow the entrance of alcohol into your bloodstream by preventing it from entering your small intestine which absorbs alcohol faster than the stomach. High protein foods, like cheese, are best at slowing down the effects of alcohol, and thus help prevent a hangover.
Steer clear of carbonation and shots. The carbon dioxide of carbonated drinks, like beer and soda, increases the pressure in your stomach, forcing alcohol out through the lining of your stomach into the bloodstream. The high concentration of alcohol in shots also means that your BAC will increase rapidly.
Alternate with non-alcoholic beverages. Not only will this slow your consumption of alcohol, but it will also counter the dehydrating effects of alcohol.
Don’t combine alcohol with other drugs. Alcohol’s effects are heightened by medicines that depress the central nervous system, such as sleeping pills, antihistamines, antidepressants, anti-anxiety drugs, and some painkillers. Other drugs have harmful interactions with alcohol as well, so it is best to consult a physician before drinking while on medication. The combination of illegal drugs and alcohol can also have adverse effects.
Don’t drink if you’re suffering fatigue. Exhaustion magnifies the effect of alcohol on the body. Unfortunately, alcohol is often used as a reward after periods of high stress that have overworked the body to fatigue.

Saturday, August 20, 2011

Liver Cancer

Cancer of the liver is known as Hepatocellular Carcinoma. When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. This i common compared to primary liver cancer and frequently leads to confusion, because the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer. Liver cancer is the third most common cancer in the world, and the majority of patients with liver cancer will die within one year as a result of the cancer.
Causes, incidence, and risk factors
Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually seen in people ages 50 - 60. Hepatocellular carcinoma is not the same as metastatic liver cancer, which starts in another organ (such as the breast or colon) and spreads to the liver.
In most cases, the cause of liver cancer is usually scarring of the liver (cirrhosis). Cirrhosis may be caused due to alcohol abuse (the most common cause), certain autoimmune diseases of the liver, diseases that cause long-term inflammation of the liver, hepatitis B or C virus infection or too much iron in the body (hemochromatosis). Patients with hepatitis B or C are at risk for liver cancer, even if they do not have cirrhosis
Diabetes, obesity, anabolic steroids and tobacco use can also cause liver cancer.
·    Abdominal pain or tenderness, especially in the upper-right part
·    Easy bruising or bleeding
·    Enlarged abdomen
·    Weight-loss and lack of apetite
·    Yellow skin or eyes (jaundice)
Signs and tests
Physical examination may show an enlarged, tender liver.  The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein most effectively diagnoses liver cancer. A liver biopsy can make a definitive diagnosis of liver cancer, but the procedure requires an expert liver pathologist and is not necessary for all patients.
Aggressive surgery or a liver transplant can successfully treat small or slow-growing tumors if they are diagnosed early. However, few patients are diagnosed early. Chemotherapy and radiation treatments are not usually effective. However, they may be used to shrink large tumors so that surgery has a greater chance of success.
Ablative and local techniques such as chemoembolization, radioembolization, radiofrequency or cryoablation, and stereotactic radiosurgery can by very useful in controlling individual cancers for an extended time. Surgical resection (removal) of the tumor may be curative for a select group of individuals with liver cancer, specifically for those with small tumors and healthy liver function.
Sorafenib tosylate (Nexavar), an oral medicine that blocks tumor growth, is now approved for patients with advanced hepatocellular carcinoma. However please seek advice from a reputed doctor before taking any medication.
The usual outcome is poor, because only 10 - 20% of hepatocellular carcinomas can be removed completely using surgery. If the cancer cannot be completely removed, the disease is usually fatal within 3 - 6 months. However, survival can vary, and occasionally people will survive much longer than 6 months.
Complications include gastrointestinal bleeding, liver failure and spread (metastasis) of the carcinoma. Call your health care provider if you develop persistent abdominal pain, especially if you have a history of any liver disease.
Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future. Avoid drinking excessive amounts of alcohol. Certain patients may benefit from screening for hemochromatosis.
If you have chronic hepatitis or known cirrhosis, periodic screening with liver ultrasound or measurement of blood alpha fetoprotein levels may help detect this cancer early.

Friday, August 19, 2011

Hepatitis C

What is Hepatitis C?
Hepatitis C infection is an infection of the liver caused by the hepatitis C virus (HCV). It is difficult for the human immune system to eliminate HCV from the body, and infection with HCV usually becomes chronic. Over decades, chronic infection with HCV damages the liver and can cause liver failure. Although the basic structure is common to all hepatitis C viruses, there are at least six distinctly different strains of the virus which have different genetic profiles (genotypes).The genetic diversity of HCV is one reason that it has been difficult to develop an effective vaccine since the vaccine must protect against all genotypes.

What causes Hepatitis C?
The exact causes of hepatitis c, for any particular hepatitis patient, are never conclusively proven. Unsafe blood transfusions, drug usage, unprotected sex and inadequate sterilizations are some of the causes.

Who is at risk of contracting Hepatitis C?
Currently, screening for HCV is not recommended as part of a routine physical examination. Rather, testing should be done among:
  • Individuals at high risk for infection including current and past users of injectable drugs and persons exposed to infected blood or organs from infected persons
  • Children born to chronically infected mothers
  • People who received blood, blood products, or transplanted organs prior to 1992
  • Persons with abnormal levels of liver enzymes in the blood.

What are the symptoms?
About 75% of people have no symptoms when they first acquire HCV infection. The remaining 25% may complain of fatigue, loss of appetite, muscle aches or fever. Yellowing of the skin or eyes (jaundice) is rare at this early stage of infection.
As cirrhosis develops, symptoms increase and may include: weakness, loss of appetite, weight loss, breast enlargement in men, a rash on the palms, difficulty with the clotting of blood, and spider-like blood vessels on the skin.
In patients with advanced cirrhosis, the liver begins to fail. This is a life-threatening problem. Confusion and even coma (encephalopathy) may result from the inability of the liver to process certain toxic substances.
Increased pressure in the blood vessels of the liver (portal hypertension) may cause fluid to build up in the abdominal cavity (ascites) and result in engorged veins in the swallowing tube (esophageal varices) that tear easily and can bleed suddenly and massively. Portal hypertension also can cause kidney failure or an enlarged spleen resulting in a decrease of blood cells and the development of (anemia), or the development of low platelets (thrombocytopenia), which can promote bleeding. In advanced cirrhosis, liver failure causes decreased production of clotting factors.

How is it diagnosed?
Screening tests are tests that are used to diagnose a condition or disease among individuals not known to have the disease. They are particularly useful for individuals who have risk factors for the condition or disease.
Recombinant immunoblot assay (RIBA) is used to confirm the positive results of EIAs since occasionally a positive EIA is a false positive, that is, the test is positive when HCV is not present. Although the direct detection of HCV RNA (HCV PCR) also is widely used to confirm the HCV infection, RIBA is still useful to differentiate false positive results in the few individuals whose immune systems have eliminated the virus but still have antibodies left over from the resolved infection.
Several tests (assays) are available to measure the amount of HCV RNA in a person's blood. These tests are referred to as molecular tests because they examine the virus at the molecular level. A single negative test for RNA does not mean that there is no infection because the virus may appear in the blood intermittently or may exist in small amounts. Newer tests have helped by detecting smaller and smaller amounts of virus in the blood.

How is it treated?
Patients with HCV infection should discuss treatment options with a physician who is experienced in treating the disease. Treatment is recommended in patients at increased risk for cirrhosis unless there are reasons that would make treatment unsafe. the decision regarding antiviral therapy in chronic HCV infection should be tailored to the individual patient with careful consideration of the risks and benefits.
All patients with HCV should be vaccinated against hepatitis B and hepatitis A. They also should be counseled on measures to prevent the spread of HCV and eliminating alcohol use. Finally, risk behaviors for HCV overlap with those of HIV, and all patients with HCV should be tested for HIV.

Wednesday, August 17, 2011

Hepatitis B

What is Hepatitis B?

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). When a person first gets hepatitis B, they are said to have an 'acute' infection. Most people are able to eliminate the virus and are cured of the infection. Some are not able to clear the virus and have 'chronic' infection with hepatitis B that is usually life-long.

How is Hepatitis B transmitted?

Hepatitis B is spread mainly by exposure to infected blood or body secretions. In infected individuals, the virus can be found in the blood, semen, vaginal discharge, breast milk, and saliva. Hepatitis B is not spread through food, water, or by casual contact. Hepatitis B also may be spread from infected mothers to their babies at birth (so-called 'vertical' transmission). Hepatitis B can be transmitted through transfused blood products, donated livers and other organs.

What are the symptoms?

Acute hepatitis B is the period of illness that occurs during the first one to four months after acquiring the virus. Only 30% to 50% of adults develop significant symptoms during acute infection. Early symptoms may be non-specific, including fever, a flu-like illness, and joint pains. Symptoms of acute hepatitis may include: fatigue, loss of appetite, nausea, jaundice (yellowing of the skin and eyes), and pain in the upper right abdomen (due to the inflamed liver).
Rarely, acute hepatitis damages the liver so badly it can no longer function. This life-threatening condition is called "fulminant hepatitis." Patients with fulminant hepatitis are at risk of developing bleeding problems and coma resulting from the failure of the liver. Patients with fulminant hepatitis should be evaluated for liver transplantation
Patients with chronic hepatitis B develop symptoms in proportion to the degree of abnormalities in these functions. The signs and symptoms of chronic hepatitis B vary widely depending on the severity of the liver damage. They range from few and relatively mild signs and symptoms to signs and symptoms of severe liver disease such as cirrhosis or liver failure.
Most individuals with chronic hepatitis B remain symptom free for many years or decades. During this time, the patient's blood tests usually are normal or only mildly abnormal. Some patients may deteriorate and develop inflammation or symptoms, putting them at risk for developing cirrhosis

How is it diagnosed?

Infection with hepatitis B is suspected when the medical history and the physical examination reveal risk factors for the infection or symptoms and signs that are suggestive of hepatitis B. Abnormalities in the liver tests (blood tests) also can raise suspicion; however, abnormal liver tests can result from many conditions that affect the liver. The diagnosis of hepatitis B can be made only with specific hepatitis B virus blood tests. These tests are known as hepatitis 'markers' or 'serology.'
Markers found in the blood can confirm hepatitis B infection and differentiate acute from chronic infection. These markers are substances produced by the hepatitis B virus (antigens) and antibodies produced by the immune system to fight the virus. Hepatitis B virus has three antigens for which there are commonly-used tests - the surface antigen (HBsAg), the core antigen (HBcAg) and the e antigen (HBeAg).

How is it treated?

Acute infection with hepatitis B usually does not require treatment. In rare cases, however, the infection may cause life-threatening liver failure. Patients with liver failure due to acute hepatitis B should be evaluated for liver transplantation.
If a person is chronically infected with hepatitis B and has few signs or symptoms of complications, medications usually are not used. These patients are watched carefully and given periodic blood tests. In chronic hepatitis B, the goal of treatment is to reduce the risk of complications including cirrhosis and liver failure. The medications in current use for chronic hepatitis B include the interferons and nucleoside/nucleotide analogues. There are no accepted guidelines that tell how every patient should be treated. As a result, treatment is individualized.

Tuesday, August 16, 2011

Know Hepatitis A

What is Hepatitis A?
Hepatitis A, formerly known as infectious hepatitis is an acute infectious disease of the liver caused by the hepatitis A virus (Hep A), an RNA virus, transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person.

What causes Hepatitis A?
Hepatitis A is caused by a virus (hepatitis A virus, or HAV) that multiplies in liver cells and is shed in stool.

Who gets Hepatitis A?
Anyone can get hepatitis A, but some people are at higher risk, including
  • people who travel to developing countries
  • people who live with someone who has hepatitis A
  • people who use illegal drugs, including noninjection drugs
  • men who have sex with men
You could get hepatitis A through contact with an infected person's stool.
You could get hepatitis A from:
  • eating food made by an infected person who didn't wash his or her hands after using the bathroom
  • drinking untreated water or eating food washed in untreated water
  • placing a finger or object in your mouth that came into contact with an infected person's stool
  • having close personal contact with an infected person, such as through sex or caring for someone who is ill
You cannot get hepatitis A from:
  • someone sneezing or coughing on you
  • sitting next to a person who has hepatitis A
  • hugging an infected person

What are the symptoms?
Children younger than age 6 often have no symptoms. Older children and adults often get mild, flulike symptoms, including

How is it diagnosed?
Blood tests will show if you have hepatitis A.

How is it treated?
Hepatitis A usually gets better in a few weeks without treatment. Get lots of rest and avoid drinking alcohol, which bothers the liver. Your doctor may suggest medicines to help relieve your symptoms, or medicines you may want to avoid. If symptoms persist, especially if you are an older person, then you should see a doctor again.
When you recover, your body will have learned to fight off a future hepatitis A infection. However, you can still get other kinds of hepatitis.