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 LIVER DISEASES
There are over 100 types of liver diseases, and because of more than 200 functions that the Liver plays, many can be life-threatening unless treated.
The Liver diseases have been listed down in alphabetical order. Click on the alphabet to read more about the diseases.
 
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Fatty Liver (NASH)  
 

Fatty Liver (NASH)

Disease condition

Fatty liver is the accumulation of fat in liver cells. Simple fatty liver is not a disease, since it does not damage the liver. Another term often used to describe this condition is fatty infiltration of the liver.

Fatty liver is also known as NASH, which stands for non- alcoholic steatorrhoeic hepatosis or non-alcoholic fatty liver Disease (NAFLD). Fatty liver is the collection of excessive amounts of triglycerides and other fats inside liver cells. Fatty liver disease can range from fatty liver alone (steatosis) to fatty liver associated with inflammation (steatohepatitis).

It resembles alcoholic liver disease, but occurs occur with the use of alcohol (alcohol-related fatty liver) or in the absence of alcohol (nonalcoholic fatty liver disease).

The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.

Disease Etiology:

Fat accumulates in the liver usually in connection with heavy use of alcohol, extreme weight gain or diabetes mellitus.

Fatty liver can also occur with poor diet and certain illnesses, such as tuberculosis, intestinal bypass surgery for obesity, and certain drugs such as corticosteroids.

It most often occurs in persons who are middle-aged and overweight or obese.

Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, but not every obese person or every patient with diabetes has NASH.

Some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver.

Symptoms


NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms--such as

Fatigue

Weight loss

Weakness

Once the disease is more advanced or cirrhosis develops. The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy.

Or NASH can slowly worsen, causing scarring or "fibrosis" to appear and accumulate in the liver. As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally.

Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure.

Diagnosis

NASH is a condition that can be identified by taking a sample of liver tissue (liver biopsy) and examining it under a microscope.

NASH is usually first suspected in a person who is found to have elevations in liver tests that are included in routine blood test panels, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST).

When further evaluation shows no apparent reason for liver disease (such as medications, viral hepatitis, or excessive use of alcohol) and when x-rays or imaging studies of the liver show fat, NASH is suspected.

The only means of proving a diagnosis of NASH and separating it from simple fatty liver is a liver biopsy.

NASH is diagnosed when examination of the tissue under the microscope shows fat along with inflammation and damage to liver cells. If there is fat without inflammation and damage, simple fatty liver or NAFLD is diagnosed.

An important piece of information learned from the biopsy is whether scar tissue has developed in the liver. Currently, no blood tests or scans can reliably provide this information.

Treatment – Medical, Surgical

Medical Treatment:

reduce their weight (if obese or overweight)

follow a balanced and healthy diet

increase physical activity

avoid alcohol

avoid unnecessary medications

Patients with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.

Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine.

Surgical Treatment:

Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH.

Life expectancy and Quality of Life

Left untreated, it can contribute to other illnesses. It is usually reversible once the cause of the problem is diagnosed and corrected.

Recent studies indicate that NASH can result in the development of fibrous tissue in the liver (fibrosis) in up to 40% of patients or cirrhosis in 5-10% of patients. It is not certain why some NASH patients will progress to this serious form of chronic liver disease while others do not. Studies report that the progression to fibrosis or cirrhosis for NASH patients is variable but can occasionally occur in less that 20 years.



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