Liver Health

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As one of the largest organ in the body, your liver performs over 500 functions and its importance can hardly be over emphasized.

Liver Matters

The main function of the liver is to filter the blood from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. In this process, the liver secretes bile that ends up in the intestines. “Also, with the help of vitamin K, the liver produces proteins that are important in blood clotting. It breaks down old or damaged blood cells and it plays an important role in all metabolic processes in the body,” says Dr. Mihir Vora, Hepatology & Liver Transplant Physician, Global Hospitals Mumbai. Liver is responsible for metabolism of carbohydrates and synthesis of cholesterol and triglycerides. The carbohydrates are stored in liver and muscle cells in the form of glycogen, whenever required by the body, liver synthesizes glycogen into glucose (gylcogenolysis). All the toxins/drugs going from gut to body through the liver will be detoxified and modified accordingly to body requirements. “It has a very good role in body consistency and growth. Many of the hormones metabolized through liver. It is an essential and vital organ. It takes part as a major role in blood clotting mechanism, and also fasting condition to maintain blood glucose levels,” says Dr. Sharath Kote, DNB Medical Gastroenterology, Sparsh Hospital, Bengaluru.

Liver diseases are on the rise mainly due to change in the life style like increase in alcohol consumption and junk food intake. Typical problems associated with liver disease include long standing diabetes and obesity, hepatitis A, B, C and hepatitis E. Typical problems seen in liver disease are weakness, lack of strength, accumulation of water in the abdomen and in the legs. Jaundice and confusion are seen in later stages of the disease. “Fatty liver is commonly seen in alcoholics, diabetics and obese people and is due to imbalances in food intake. It is best treated by treating the underlying cause for example, if you take alcohol then stop it, if you are diabetic control it,” Dr. Mahesh Gopasetty, Senior Consultant, Hepato Pancreatic Biliary and Liver Transplant Surgery, Fortis Hospital, Bangalore. India has seen an alarming rise in the number of liver cases recently. This is because of two reasons- a continued number of cases of infective hepatitis either due to infected food and water (Hepatitis A and E) or due to blood or body fluid contact (Hepatitis B and C). “Hepatitis B and C can be present in the body for years without causing any symptoms and may cause liver failure in later life.  The other reason is the high number of lifestyle related disorders. Liver damage due to excessive alcohol intake or deposition of fat (fatty liver) is associated with an unhealthy diet, poor exercise or metabolic disorders such as diabetes.  Unfortunately, India suffers from a double epidemic of both communicable and non-communicable diseases, some of which also affect the liver,” avers Dr. Sonal Asthana, Senior Consultant, Department of Hepatobiliary Surgery and Multi-organ Transplantation, Aster CMI Hospital, Bengaluru.

Know the Signs

A 21-year-old gym instructor presented himself with fatigue and some abdominal pain Aster CMI Hospital. An ultrasound showed a severely fatty liver.  He led a fit life and was a teetotaller. When asked about his diet, he admitted to consuming three to four colas a day after his gym workout. He was advised to stop this, and, on doing so, his liver improved considerably. A repeat scan after three months showed a healthy liver.  High fructose corn syrup is a component in most sugary drinks and can cause severe fatty liver. Abdominal pain, abnormal stools, flu-like symptoms (fatigue, nausea, vomiting, muscle or joint pain, fever), loss of appetite and swelling of abdomen and/or legs are typical symptoms associated with liver disease. Dr. Prashant Shetty, Executive Director, iGenetic Diagnostics avers, “an ailing liver has prominent symptoms such as dark urine color, pale, bloody or tar-colored stool, loss of appetite, nausea or vomiting, yellowish skin and eyes, and swelling in the legs and ankles. One must get immediate medical help in case any of these signs persist longer than a few days.” Nonalcoholic steatohepatitis (NASH) is a liver inflammation and damage caused by a buildup of fat in the liver and is referred to as nonalcoholic fatty liver disease. “But in some people, the fat causes inflammation and damages cells in the liver. Because of the damage, the liver does not work as well as it should. NASH can get worse and cause scarring of the liver, which leads to cirrhosis. But the disease does not always get worse,” says Dr. Sandeep M.S, Consultant Gastroenterologist at Apollo Hospitals Bangalore.

Take Care

The best way to fight liver disease is to have a good diet coupled with regular exercise is the most effective way to achieve healthy liver and immune system. “Try to maintain a healthy weight for height. If you carry any excess weight on your middle, it can cause insulin resistance and develop fatty liver. Minimize the amount of time spent in prolonged sitting, get moving. Practice muscle strength training two days/week and limit the consumption of alcohol. Avoid dieting as these make your weight yo-yo and put extra load on liver. Quit smoking as it is directly linked to liver cancer. Some herbal supplements can be toxic to the liver. Consult a doctor/dietician before consuming them, example kombucha tea,” says Kejal Sheth, Nutritionist, Weight Management Expert and Founder of Nutrivity.in, an online diet and nutrition platform. Dr. Hitendra Garg, Senior Consultant Gastroenterology and Hepatology, Indraprastha Apollo Hospitals, New Delhi adds, “my advice is to ensure regular physical activity and follow a healthy, well balanced diet. I would encourage everyone to exercise for about 30 to 45 mins a day for 5 days a week, which can be a combination of walking with moderate intensity workouts. Also increase consumption of fruit and vegetables, water, antioxidants and avoid high calorie and high fat food.”

Natural Remedies

Ayurveda has very effective natural detoxification remedy which helps to eliminate toxins from liver, improves metabolism of fats, proteins, improves digestion and absorption of food nutrients and rejuvenates damaged liver cells. Dr Vrunda Lotlikar, Medical Consultant, Birla Ayurveda says, “Ayurveda describes Virechan and Basti as best detoxification procedure for healthy liver. Virechan is regime of consumption of medicated ghee for 4-5 days in increasing order every day morning on empty stomach along with Abhyamgam (Body massage with medicated oil). On the 7th day of regime, Ayurvedic purgatives in the form of tablets, churnam, lehyam are given orally to person on empty stomach which induces purgation (evacuation of bowels). The toxins accumulated all over body are eliminated and liver is cleansed. Basti involves administering medicated oil and decoction (Kashyam) through anal route. Basti procedure is excellent detoxification procedures to remove toxins from gastro-intestinal tract.”

Eat Right

Making right choices when it comes to food can allow you to have a long and healthy life. Some good foods for healthy liver include having citrus fruits like oranges, lemons, and grapefruit as they increase your immunity and helps fight infections. Beetroot reduces inflammation, avocados are powerhouse of nutrients, apples helps cleanse the body toxins, walnuts helps in liver cleansing, green tea are full of antioxidants and really good for health and turmeric also aids in the cleansing process,” says Dr. Deepak Parashar, Medical Officer, Healthians, an online diagnostic service. Olive oil, flaxseeds, green leafy vegetables, garlic, coffee, blueberries and cranberries are also beneficial for liver health. While nearly every cell in the body is able to metabolize glucose, only the liver cells can handle fructose. Too much fructose can overwhelm the liver and cause irreparable damage. “Limit foods that are high in refined sugars and high-fructose corn syrup, such as soft drinks, baked goods and sweets. Avoid fried foods including fast food restaurant meals and raw or under-cooked shellfish such as oysters and clams. Stick to natural sources of sugar (fruit for example) instead. Make healthy food choices like whole grains, fiber rich foods like vegetables and fruits, nuts, Fish rich in omega 3 fatty acids,” says Dr. Raja Indana, Strategy & Care Team Lead, mfine, an online doctor consultation platform.

Take Care

Liver health can be affected even if you maintain a good lifestyle as it is susceptible to hepatic infections, which can be caught through contaminated water and food sources, infected blood, needles and syringes and even through sexual transmission. Medications such as anti-TB drugs can also cause harm to the liver. It is important for people to be aware of these risks and take every precaution to protect their liver’s health in the long term. Dr. Gowri Kulkarni, Heads of operations, Docsapp, a doctor consultation app concludes, “usually, we put a lot of emphasis on heart and kidney disorders. Since the liver is a very big organ in the body, it is capable of functioning even in a damaged condition. The symptoms of liver damage are visible only after the liver is 80% damaged due to which the damage becomes irreversible. Therefore, one should be extremely aware of their drinking patterns, eating habits and lifestyle choices.”

This story first appeared in Smartlife Magazine’s Sep 2018 issue here:

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