gastro treatment
Book An Appointment

Spectrum of liver diseases

liver diseases treatment in Hyderabad

MAIN THREE PROBLEMS WHICH EFFECTS LIVER ARE:

  1. LIVER CIRRHOSIS.
  2. LIVER CANCERS
  3. HEPATITIS

LIVER CIRRHOSIS

It is the fibrosis of the liver due to many causes which leads to compromised function of the liver.

Causes for Liver Cirrhosis:

  1. Alcohol Induced.
  2. Viral Hepatitis (B And C).
  3. Storage Disorders (glycogen storage disorders).
  4. Autoimmune Hepatitis
  5. Biliary Atresia
  6. Cryptogenic
Liver disease treatment in Secunderabad

SYMPTOMS(LIVER CIRRHOSIS):

Generalised

  1. Generalised Malaise, Fatigue.
  2. Hand Tremors.
  3. Palmar Erythema.
  4. Gynecomastia.

Specific

  1. Jaundice.
  2. Blood Vomiting.
  3. Abdominal Distension (Ascites).
  4. Confusion, Disorientation, Coma (Hepatic Encephalopathy).

INVESTIGATIONS:

To Know the Status of Liver Function:

  1. Liver Function Test.
  2. Kidney Function Test.
  3. Coagulation Profile.

To evaluate the aetiology

  1. Viral Serology.
  2. Autoimmune Profile.

IMAGING:

  1. Ultrasound Abdomen,
  2. Fibro scan (Elastography),
  3. CECT Abdomen (Triphasic).

UPPER GI ENDOSCOPY (To look for varices).

STAGES OF LIVER CIRRHOSIS:

COMPENSATED

  1. Malaise/fatigue
  2. Anorexia
  3. Hand tremmers

DECOMPESATED

  1. Jaundice
  2. Abdominal distention due to accumulation of fluid in abdomen (ASCITES)
  3. Pedal Oedema
  4. Disorientation (HEPATIC ENCEPHALOPATHY)
  5. Blood vomiting
  6. Kidney failure symptoms (HEPATO RENAL SYNDROME)
  7. Shortness of breath (HEPATO PULMONARY SYNDROME)

SEVERITY OF THE CIRRHOSIS IS ESTIMATED BY VARIOUS SCORING SYSTEMS

CHILD PUGH SCORING {CPS}SYSTEM (Bradly used for medical management, surgical decision making). Divided into

  1. Mild
  2. Moderate
  3. severe

MELD (MODEL FOR END STAGE LIVER DISEASE). Includes

  1. INR
  2. Serum Creatinine
  3. Total bilirubin

PELD (FOR CHILDREN)

  1. INR.
  2. Total Bilirubin.
  3. Serum Albumin.
  4. Degree of Growth Failure.

Presently MELD is used for criteria for LIVER TRANSPLANTATION throughout the world.

TREATMENT:

COMPENSENTATED

  1. AVOID ALCOHOLISM.
  2. TREATMENT FOR VIRAL DISEASES.
  3. TREATMENT FOR AUTOIMMUNE DISEASES.
  4. LIVER PROTECTIVES
    1. S-Adenosyl -L-Methionine
    2. Ursodeoxycholic acid
    3. Calcium supplementation

To be under regular follow up with

  1. UGI Endoscopy 3 monthly (to look for varices).
  2. Ultrasound abdomen.
  3. CBP ,LFT,COAGULATION PROFILE, RFT (EVERY MONTH).

DECOMPENSATED(END STAGE LIVER DISEASE)

  1. MELD <14
    1. UGI ENDOSCOPY AND VARICEAL BANDING.
    2. DIURITICS ( FOR ASCITIS)
    3. MEDICATION FOR PREVENTION OF ENCEPHALOPATHY.
  2. MELD >14
    1. INCLUDES MANAGEMENT AS DESCRIBED ABOVE PLUS
    2. LIVER TRANSPLANTATION.

TRANSPLANT CAN BE DIVIDED INTO TWO TYPES.

  1. DDLT (DECEASED DONOR LIVER TRANSPLANT): ORGAN WILL BE PROCURED FROM BRAIN DEAD PATIENT.
  2. LDLT (LIVE DONOR LIVER TRANSPLANT): PART OF THE ORGAN WILL BE PROCURED FROM FIRST DEGREE RELATIVE.

MANAGEMENT POST LIVER TRANSPLANT PATIENT:

  1. IMMUNO THERAPY DRUGS:
    1. STEROIDS
    2. TACROLIMUS
    3. MYCOPHENOPHENOLATE MOFETIL
  2. ANTIVIRAL
  3. ANTIBACTERIAL
  4. ANTIFUNGAL DRUGS

IMMUNOSUPRESIVE DRUGS WILL BE TAPERED DOWN OVER 6 MONTHS TO 1 YEAR.

LIVER CANCERS (Hepatocellular Cancer)

All the causes leading to cirrhosis will lead to liver cancers, very rarely it can be seen without cirrhosis.

Symptoms won’t be seen Until the Advanced Stage of The Liver Cancer.

SYMPTOMS(Liver Cancer):

  1. Jaundice
  2. Blood Vomiting
  3. Melena
  4. Loss of appetite/loss of weight.
  5. Accumulation fluid in abdomen(Ascites).
Liver disease treatment in Secunderabad

To know the stage of the disease:

  1. CECT ABDOMEN(TRIPHASIC)/MRI

To Know the Status of Liver Function:

  1. Liver Function Test.
  2. Kidney Function Test.
  3. Coagulation Profile
  4. UGI Endoscopy.

To evaluate the aetiology

  1. Viral Serology
  2. Autoimmune Profile.
  3. Serum AFP.

IMAGING:

  1. Ultrasound Abdomen
  2. Fibro scan (Elastography)
  3. CECT Abdomen (Triphasic)

TREATMENT:

Liver disease treatment in Secunderabad
  1. TACE (Trans arterial chemo embolization).
  2. PS (Performance status).

CRITERIA FOR LIVER TRANSPLANTATION IN LIVER CANCERS:

Liver disease treatment in Secunderabad

HEPATITIS

IT IS THE INFLAMATION OF THE LIVER DUE TO VARIOUS CAUSES.

CAUSES:

  1. Viral
    1. Hepatitis Virus (A,B,C,D,E).
      1. A, D, E Hepatitis virus is mostly self limiting,but some times may lead fulminant hepatic failure
      2. B, C Leads to Chronic Liver Disease
    2. HIV.
    3. Adeno Virus.
    4. EBV.
  2. Drug Induced (Paracetamol Poisoning).
  3. Auto Immune.
  4. Rare Diseases Like Wilsons Disease, Alpha 1 Antitrypsin Deficiency.
Liver disease treatment in Secunderabad

EFFECTS:

  1. Generalised Weakness, Malaise, Fatigue, Lassitude
  2. Loss Of Appetite
  3. Yellowish Discoloration Of Eyes
  4. High Coloured Urine
  5. Early Bruising.

DIAGNOSIS:

To Know the Status of Liver Function:

  1. Liver Function Test.
  2. Kidney Function Test.
  3. Coagulation Profile
  4. Ultrasound

To evaluate the aetiology

  1. Viral Serology.
  2. Autoimmune Profile.
  3. Sr copper
  4. Sr iron.

TREATMENT:

Depends on the etiology:

  1. Hepatitis A, D, E:
    1. MILD DISEASE
      1. Symptomatic Treatment
      2. Liver Protective Medication.
    2. FULMINENET DISEASE
      1. May Require Urgent Liver Transplantation.
  2. Hepatitis B, C
    1. Antiviral Therapy.
    2. Liver Protective Medication.
  3. Drug Induced
    1. Supportive care
    2. May Require Urgent Liver Transplantation for fulminant disease.

Blogs List

A Team with patient care group known for best outcome

For Appointments: +91 76809 24108For Emergency: +91 95732 01103