Page 1 - Venkateshwar Hospitals E-Newsletter

ADVERTORIAL
World Liver Day

Message from The Chairman Non-Alcoholic Fatty liver disease

OMMONLY referred to as Fatty Liver dis- sults of routine blood tests including help improve the condition. might suggest that you take Vitamin E. Vita-
ease,is a now a days a common in which Liver Function tests and Scans (Ul- Usually,you should lose weight if min E can reduce some of the liver damage that
Cfat builds up in the liver.The liver is a big trasound/Fibroscan test) of you are overweight. It is impor- occurs as part of NASH.You should avoid drink-
organ in the upper right side of the abdomen. Liver tant not to lose weight too ing alcohol as it can worsen liver disease.
There are two types of fatty liver disease 1. A liver biopsy is done to quickly.Do not lose more than Fatty Liver is typically a lifelong chronic con-
Nonalcoholic fatty liver-The liver has fat buildup confirm fatty liver disease if 3.5 pounds (1.6 kilograms) a dition.It is difficult to predict the course of Fatty
but is not inflamed. 2. Nonalcoholic steato- other causes of liver disease week. Treat your high blood Liver.In some people Fatty Liver and sometimes
hepatitis (also called NASH) – In NASH,the liver cannot be ruled out with sugar, if you have high blood it leads to serious scarring of the liver, called
has fat buildup and is inflamed. standard imaging and blood sugar and treat your high cho- "cirrhosis." Cirrhosis can cause different symp-
People who drink too much alcohol can get a tests. lesterol, if you have high choles- toms, such as swelling in the legs, trouble
condition similar to Non-alcoholic fatty Liver terol. These changes can breathing,or feeling tired.
disease,but non-alcoholic fatty Liver disease is TREATMENT also reduce your chances Therefore,people who have Fatty Liver need
not related to drinking too much alcohol. Fatty Liver is not typically Dr.Amit Bhasin, MBBS,MD,DM, of having a heart attack or to see their doctor for regular check-ups.
Fatty Liver happens more often in some peo- treated directly. But the Sr.Consultant,Gastroenterology stroke. That is important Your doctor will do follow-up tests on a regu-
ple are overweight, have diabetes, have high condition can get better & Hepatology because people with Fatty lar basis like blood tests and Scans of Liver.
cholesterol,take certain medicines when other medical condi- Liver are often also at risk The usual Mantras for fatty liver are,follow a
Most people with fatty Liver have no symp- tions that often happen with fatty Liver get for heart disease and stroke. healthy lifestyle, avoid alcohol, control for dia-
“WITH The divine blessings of Lord toms. treated. For example, losing weight, and con- If you have a severe form of NASH but do not betes and cholesterol and maintain a healthy
Venkateshwara, we dedicate and strengthen our Fatty Liver is usually diagnosed from the re- trolling high blood sugar and cholesterol can also have diabetes or heart disease,your doctor weight.
services to the society by transforming our
humble efforts from education to health care. The Keeping the Liver Safe From Tumors and Cancer
Objective of the Venkateshwar Hospital would be
to provide solace to the suffering humanity with Dr Amardeep Yadav, a Senior Con- overall prognosis of patients transplant later. Transplantation is an ag-
a healing, soothing and humane touch.” sultant, Liver Transplant, GI Surgery & GI with HCC even in advance What all surgeries are gressive treatment, but oncologically a
Oncology at Venkateshwar Hospital, Delhi stages.Unfortunately,most done for liver cancer? more superior procedure that takes care of
Mr. Rajpal on the World Liver Day shares some impor- of these patients are ei- Liver cancer requires the diseased liver also.5-year survival rate
tant fact about liver tumours and cancers ther referred late by pri- surgery where all the tu- after transplant for HCC are 70-80% and if
with advise for early detection and treat- mary care physicians or morous part is removed size of tumor is less then 5cm then it can
ment for best results. avoid due to fear of leaving behind at-least reach upto 90%.
World Liver Day: Liver it up! surgery. It must be em- 30% of normal liver with
What are the types of liver cancer phasized that if proper blood supply and biliary What are the contraindications for
disease (cirrhosis) results - liver and the conditions predisposing a treatment is done on time, drainage. This is called liver transplant in liver and bile duct can-
can’t fulfil body requirements. Pa- person to develop them? then a cure rate of 70- resection which can be cers?
tients with cirrhosis are prone to Primary liver cancer that originates from 80% can be achieved, Dr Amardeep Yadav done if the liver is nor- Liver transplant cannot be done in termi-
develop liver cancer, others grad- liver cells (hepatocytes) is known as He- which is highest in any Senior Consultant,Liver Transplant, mal and tumors are in nally ill patient and strictly avoided if the
ually deteriorate. Symptoms com- patic Cell Carcinoma (HCC) and from bile solid organ cancer till GI Surgery& GI Oncology favorable location.But cancer spreads out of the liver. Portal vein
pel patients with cirrhosis to seek duct system called colangiocarcinomas. If now. resection has higher tumor thrombus, a condition where tumor
medical attention and complica- cancer spreads to the liver from other or- recurrence rate which spreads into the blood vessels of liver
tions develop which necessitate gans like breast,lungs,colon etc.,it is called What are the treatment options for can be upto 50-60%. In damaged liver (cir- which can be picked up on CT scan or ultra-
admission to hospital.Each hospi- secondary liver cancer.Anyone with family liver cancers/ HCC? rhotic liver) and multiple cancers in all of sound is a relative contraindication as
talisation puts patient at risk of history of liver cancer,aged above 20 years, Treatment of liver cancer depends on the the liver,resection is usually not possible as some of these patients can be transplanted
death and increases treatment certain ethnic origin,people suffering from stage of liver cancer depending on the size the cancerous liver has to be removed re- after special procedures giving radiother-
costs. At this stage of recurrent liver cirrhosis, especially due to alcohol, of tumor,number of liver tumors and if one placing it with normal liver. This is called apy by EBRT (External Beam Radio Therapy)
Dr K R Vasudevan episodes of decompensation or NAAFLD, hepatitis B, hepatitis C infection or both lobes of liver and condition of rest of liver transplant, where recurrence rate is or TARE with Itrium90(Trans Arterial Radio
Director GI Surgery,GI Oncology & development of liver cancer, the have high risk of developing HCC. These the liver. If any other structure in addition to less and survival chances better.If resection Embolization).
Liver Transplant
disease can’t be cured with med- people should be screened periodically liver are involved like blood vessels or can be done safely,it is the best option as it For bile duct cancers /colangiocarcino-
ication and most patients suc- with blood AFP levels and ultrasound of neighboring organs then treatment plan- is relatively less aggressive surgery,cost ef- mas, liver resection involving removal of
Dr K R Vasudevan, Director GI cumb to the disease in a few liver. If in doubt, they should undergo CT ning has to be done looking at overall pic- fective and life-long immunosuppressant the cancerous part with the adjoining liver
Surgery,GI Oncology & Liver months despite repeated visits triphasic scan of liver. ture.If cancer is picked up at an early stage are not required. If recurrence of tumour gives the best results. Patients are mostly
Transplant draws the attention to and admissions to hospital. The <2 cm size, then it can be managed with happens then a salvage transplant at a treated for liver infection(cholangitis) with
‘World Liver Day’ which is ob- best treatment for patients in this How is prognosis expected for liver non-surgical measures like RFA,TACE,TARE later stage can be done in 30-40% of these antibiotics,draining the obstructed bile sys-
served on 19 April with focus on stage is to replace the liver with a tumors? etc. After these procedures, follow up for patients. tem, assessment of volumes of liver to be
the liver - an organ vital to our new one - liver transplantation. Progress in treatment protocols, diagnosis new tumor or same tumor growing back is More than half of resection happen out- removed and remaining liver after surgery
well-being. In fact, without the and timely intervention has improved the important. side the liver making them unsuitable for to prevent liver failure post-surgery.
liver, one can survive only for a Liver transplantation, how
couple of days. But fortunately, effective is this procedure?
the liver is a benevolent organ and Results of liver transplantation are Crusader against Alcoholism for Liver Longevity
can be kept healthy by practising good, majority of them will go on
(common) measures to keep body to live normal lives for many years -
healthy. Let us get to know more some of these patients are surviv- On the occasion of World Liver Day, for 50% of mortality related to liver transplant only after abstaining from one must not go beyond it. Upto 10 gms of al-
from him. ing over 40 years after transplan- Dr Rohit Goyal, who is passionate about cirrhosis. In India, alcohol is the alcohol for a period of atleast 6 cohol in a week for women and upto 20 gms
tation.These patients regain their eradicating alcoholism for a healthy liver, has underlying cause in 34% of all months. But now early trans- for men is supposed to be safe. Liver damage
What leads to liver being dis- full vitality, are able to perform stepped up awareness to blunt the menace. liver cirrhosis cases and more plant can also be considered usually occurs with weekly alcohol intake of
eased and how can it be their duties and accomplish their He has packed extensive experience within a than 50% of patients with after appropriate counselling > 30 gms for women and > 50 gms for men
managed? desires - like return to full time span of 13 years in various liver related inter- other liver disease also con- if patient is critically sick. for more than 5 years. Generally, people do not
Liver damage occurs slowly, over work,(including the army) and per- ventions as Senior Consultant, Gastroenterol- sume significant alcohol. adhere to the limits and that is the root of the
years, usually gives us indication form all activities like climbing ogy and Hepatology, in Delhi’s premier hospi- About 90% of heavy drinkers What are the symptoms problem.
and time to investigate and course snow clad mountains and play all tals Max Superspeciality Hospital, Patparganj develop fatty liver and 10% of a sick liver when alco-
correct.We may be unaware of on- sports.This is not possible without a and BLK Superspeciality, Rajendra Place. He develop liver cirrhosis. Patient hol abuse is excessive? What are the reasons for increased alco-
going damage like in viral infec- transplant operation. shares his views on the subject. with liver cirrhosis have The most common symp- hol intake by people despite evident
tions - hepatitis, or some genetic progressive risk of devel- Dr Rohit Goyal toms include jaundice, fa- harmful effects?
abnormalities where we can’t help Could you share about liver What are the kinds of liver diseases oping liver failure and Senior Consultant,Gastroenterology tigue, loss of body mass Overall, per capita alcohol consumption
prevent the damage till symptoms treatment at Venkateshwar prevalent in the world, and particularly liver cancer, which is and Hepatology and a pale look. If liver cir- worldwide has increased with people starting
(problems) appear.Often it is from Hospital? in India? about 1 percent in a year. rhosis sets in, patient may to take alcohol at a much younger age. Also,
reasons we know - alcohol intake Liver transplantation started in In- The major causes of liver diseases worldwide develop accumulation of proportion of women with alcohol related liver
and fatty liver, and it is upto us to dia on a large scale in the 2000’s, and in India are similar. In India, the common- Liver is regenerative, so how does that fluid in the belly, drowsiness and memory loss diseases is rising. In India, lifestyle have
limit further damage. Either way, we now perform one of the largest est causes for liver diseases are alcohol (ALD); help in managing diseases related to it? or the vomiting of blood through the mouth changed drastically. Professional related
the liver gives us time… If we are number of transplants in the obesity and diabetes related fatty liver (Non-al- The good thing about liver being a regenerative or the stool, and internal bleeding may hap- stress, increased purchasing power, easy avail-
able to prevent further damage, world. At Venkateshwar Hospital, coholic Fatty Liver Disease or NAFLD) and He- organ is that if the person is detected early for pen. Other internal organs like heart and ability of alcohol and peer pressures are con-
the liver recovers completely, es- we have an experienced team patitis B and C viruses. The proportion varies ALD and is counselled to abstain from it, then nerves can also be damaged by alcohol leading tributing to rising alcohol consumption. Recre-
pecially if action is taken early. which has been performing trans- in different parts of the country e.g., Hepatitis the early part of the disease can be reversed to heart failure, burning sensation, numbness ational use of alcohol and drugs is rising, and
plants for the last 2 years,both live C is most common in the north, NAFLD is more and the liver can go back to normal. In ad- and weakness of limbs. its addiction difficult to break. Lack of aware-
How fatal is liver cirrhosis? related and deceased donor trans- pronounced in the west, while alcohol and He- vanced stages of liver cirrhosis, transplant may ness about harmful effects of alcohol in middle
If not controlled, end stage liver plants,on adults and children. patitis B are most prevalent in the east, North- be the only treatment option. Previously, pa- What is the safe limit of alcohol intake? and lower economic sections may also con-
east and south. Worldwide, alcohol accounts tient having liver cirrhosis could undergo liver Alcohol intake limits are clearly defined and tribute to the menace.