The liver is one of the most ignored organs in the body. But in reality it is  one of the most important.Performing close to 500 functions the liver is one  of the most hardworking organs of the human body. It clear toxins from  blood, it releases strength and energy, it fights infection and even regenerates itself!Learning about it is the first step to keeping your liver healthy.

The liver is a marvellously resilient and vital organ that plays an indispensable role in nurturing and protecting our body everyday with clockwork precision. It has several key functions to perform:

It helps filter and dispose of toxic materials from the blood
Feeds our body the energy it needs to function
Wards off viruses and infections
Produces blood-clotting factors
Regulates sex hormones, cholesterol levels and vitamins and mineral supplies in our body.

The liver performs over 500 and odd functions, far more than any other organ in our body!

The liver rarely shows symptoms which is why it's important to get them checked at aLiver Clinic. However tell tale symptoms that can be watched out for are:

Fatigue
Upper abdominal pain
Itchy skin
Yellow eyes

What are the main liver problems?

Today 19th April, is World Liver Day .Obesity and liver diseases seems to have a direct correlation and obesity seems to be a trigger for liver diseases . Doctors say tha sedentary lifestyle is a major cause for ” Liver disease and obesity”

With liver transplants bringing in a bill of between Rs 12 to Rs 30 lakh, on World Liver Day doctors emphasize the need for nipping the problem in the bud so that liver disease can be prevented.

With the increase of obesity there seems to be a silent epidemic of non-alcoholic fatty liver problem, which gradually leads to severe liver damage.

“With changing dietary habits and a sedentary lifestyle, more obese people are showing up with fatty liver disease.

He said that since the cost is so high when it comes to liver transplants, it is of utmost importance that the cause is tackled at the root. Most of the causes which lead to end stage liver disease like alcoholism, obesity or hepatitis are controllable factors. “So it is essential that people are made aware of the triggers and how to prevent them,” added the doctor.

The increasing problem of Nonalcoholic fatty liver disease (NAFLD) occurs because of diversion of excess calories to synthesise fat in the liver and the inability of the liver to export the synthesised fat.

“Insulin resistance is the primary pathophysiology of this disorder. Excess fat in the liver causes inflammation, a stage called Non Alcoholic steatohepatitis (NASH) which is seen in around 25 per cent of NAFLD patients. Over time this inflammation causes progressive liver damage leading to cirrhosis and liver failure,” Dr. Poorna Chandra, Consultant Gastroenterologist, Fortis Hospitals.

The pricy transplant procedures and the expenses incurred for being on immunosuppressant drugs for one’s whole life are so high, that doctors insist on the need to tackle the problem at its onset, so that it does not graduate to end-stage liver disease.

Some of the Common Liver Related Diseases

• Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons

• Non-alcoholic fatty liver disease, a spectrum in disease, associated with obesity and characterized as an abundance of fat in the liver

• Cirrhosis Of The Liver :This  is the formation of fibrous tissue in the liver from replacing dead liver cells. Diagnosis is done by checking levels of Alanine transaminase and Asparatine transaminase (SGOT).

• Haemochromatosis, a hereditary disease causing the accumulation of iron in the body, eventually leading to liver damage.

• Cancer of the liver (primary hepatocellular carcinoma or cholangiocarcinoma and metastatic cancers, usually from other parts of the gastrointestinal tract).

• Wilson’s disease, a hereditary disease which causes the body to retain copper.

• Budd-Chiari syndrome, obstruction of the hepatic vein.

• Gilbert’s syndrome, a genetic disorder of bilirubin metabolism, found in about 5% of the population
  
  The best way to take preemptive steps to take care of your live is doing a  Liver Function Tests

A number of liver function tests are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products. LFT’s , serum proteins , serum albumin , serum globulin , A/G Ratio, alanine transaminase , aspartate transaminase , prothrombin time , partial thromboplastin time, platelet count.

Fortis Hospitals Mulund recently treated a complicated case of colorectal cancer through Minimally Invasive Surgery (MIS). At the time of the surgery, the patient had reached a critical phase where surgery was compulsorily needed to be performed.

Ms Anuprita, 64, experienced PR bleeding (rectal bleeding) with severe pain. She visited her family doctor who recommended few medicines which cured the bleeding and pain following which she visited Malaysia with her family.

While at Malaysia, she again experienced PR bleeding and had to come back to India to see the doctor. Family doctor recommended her to a surgeon who wrongly diagnosed it to be a case of piles and suggested surgery. She underwent surgery in October 2010.

Post surgery within two months she again experienced PR bleeding. Heavily dissatisfied from her previous experience, she started to look for the right and permanent answer to her problem.

She was referred to Dr Anil Heroor at Fortis Hospital who prescribed few tests to the patient that confirmed colorectal cancer. Later, Dr Heroor suggested the MIS approach as the cancer was in its initial stage. Post surgery the cancer was completely removed and the patient was discharged within six days.

According to Dr Anil Heroor, Consultant Onco-surgeon, Fortis Hospitals, “MIS is the best possible way to treat cancers in general and specifically to ones that affect the uterus and intestines”.

Although MIS hasbecome common today for many illnesses, it is not performed on a large scale in an area like cancer. “Right expertise is needed to treat cancer through minimally invasive approach as many oncologists are not trained for minimally invasive surgery or minimally invasive surgeons are not oncologists. Today there are very few hospitals and surgeons with the right expertise to operate cancer through a minimally invasive way. MIS is safer compared to open surgery as pain is less, hospital stay is shorter and there is quicker recovery,” added Dr Heroor.  ( source :Livemint)

Dr Ramesh Agarwalla and patient after the breakthrough Surgery

The Medical Breakthrough Survery : See the Presentation

Team of experts led by Dr. Ramesh Agarwalla, Consultant Laparoscopic Surgeon at Fortis Hospitals Kolkata performed an advanced minimally invasive surgery on a 38 year old man who was suffering from a rare condition.

Mr. Tapan Kumar Biswas from Jharkhali village, 24 parganas was suffering from abdominal pain and was diagnosed as Crohn’s disease. He had multiple small ulcers in the intestine and complained of severe abdominal pain and blood in stool for a long time. Crohn’s disease leads to various other complications, and in the case of Mr. Tapan Kumar Biswas, it led to a very rare disorder where he was passing urine through his rectum and fecal matter (stool) through his urinary passage.

between the intestine and urinary bladder and the patient starts passing stool through his urinary passage and urine through his anal opening. When he was brought to us and on examination he was found to have urinary infection, abdominal pain, loose motion, passage of stool and gas through urinary tract and urine through rectum. His general condition was very weak and he weighed only 30kgs 27 kgs explained Dr. Ramesh Agarwalla

Since the patient was brought in a critical condition we had to first stabilize his condition before initiating any treatment. So once he was brought we administered IV antibiotic, IV steroid, nutritional support and anti inflammatory medicine. Later a CT scan showed that an abnormal connection had developed between his intestine and urinary bladder and hence he was passing wind and stool through his urinary passage and urine through his rectum said Dr. Debasis Dutta, Medical Gastroenterologist.

“Crohn’s disease patients need multiple surgeries and with an open surgery it may lead to difficulty in re-operating, hence we opted for the laparoscopic method to disconnect the abnormal connection between the colon and the urinary bladder. After disconnecting the abnormal connection between the intestine and the urinary bladder, a loop ileostomy (a loop of intestine was brought out through a small opening in the abdomen) was done to divert the faecal matter from the operated site temporarily. After disconnecting we did a procedure called ileostomy where we use a part of his intestine which was coming out through the hole in the abdominal cavity so that there is diversion of the faecal matter from the operated fistula side. The loop of intestine will be put back into the abdominal cavity after 6 weeks so that he can pass stool normally. The pouch will need to be put back after 6 weeks so that he passes stool normally. Post the surgery Tapan is passing urine normally through the urinary passage said Dr. Ramesh Agarwalla.

This patient was diagnosed with the disease in Vellore in Sept 2008 and was under treatment. Due to lack of financial support, he could not continue the treatment and hence his condition deteriorated over the years. This deterioration caused serious complication of Crohn’s disease, known as Colovesical fistula where an abnormal connection develops

Normally such cases are dealt with open surgery. Open surgery entails prolonged hospitalization, more pain, more chance of wound infection.  In this particular case the patient was very ill and weighed 27kgs only and it was doubtful whether he would have survived an open procedure. Moreover such patients have recurring surgical problems during their life time and it becomes difficult to subject them to repeated open surgery. Hence minimally invasive surgery for their surgical conditions is ideal but this is a highly complex surgery which needs a level of expertise and equipment and a team performing advanced minimally invasive surgery can only attempt it.

About Fortis Hospitals Kolkata –

Fortis Hospitals Kolkata is a 400 bedded super specialty hospital located on EM Bypass Road. It is a part of India’s leading healthcare providers – Fortis Healthcare focusing on the tertiary care of super specialty like cardiology and cardiac surgery, orthopedics, neurosciences, digestive care, urology & nephrology, emergency care and critical care. Our amenities include a 24-hour accident and emergency service including trauma treatment, ambulance services, blood bank, fully functional operation theatres, cardiac operation theatre, preventive health check, diagnostic and catheterization laboratory, critical and emergency care.