Liver Disease Management

What are the various liver conditions managed in gastroenterology?

Marengo Asia Hospitals provide a broad spectrum of therapeutic services with the purpose of treating various liver conditions, including:

• Treatment for Hepatitis B and C: Hepatitis B and C are long-term viral infections that can cause severe liver damage, which includes cirrhosis and primary liver cell cancer. This treatment for these infections usually involves antiviral medications, which are designed to suppress the virus, bring down the inflammation in the liver, and halt the further progression of the disease. This should result in a sustained virologic response, indicating the virus is no longer detected within the blood.
• NAFLD (Including NASH): A form of fatty liver that is not caused by alcohol is nonalcoholic fatty liver disease. When it progresses to non-alcoholic steatohepatitis, it causes liver fibrosis, cirrhosis, and later liver cancer. The therapeutic approach includes lifestyle transformations, such as weight loss, dietary modifications, and regular exercise, along with medicines to manage associated diseases like diabetes and high cholesterol.
• Alcoholic Liver Disease: This is caused by heavy consumption of alcohol, which induces chronic inflammation in the liver. Chronic inflammation will eventually lead to the liver becoming fatty and ending up in cirrhosis. The treatment is the cessation of the use of alcohol, nutritional support, and medications that reduce the inflammation of the liver and prevent further damage. In severe cases, liver transplantation may have to be considered.
• Autoimmune Liver Diseases: This group of disorders includes autoimmune hepatitis, PBC, and PSC. Immunosuppressive medications usually form a large part of the therapeutic approach for these conditions, which diminishes the inflammation in the liver and slows down the progress of the diseases. Regular monitoring is required to adjust treatment appropriately and manage adverse effects.
• Non-Cirrhotic Portal Hypertension (NCPF and EHPVO): Non-Cirrhotic Portal Hypertension is defined as increased pressure in the portal vein system in the absence of cirrhosis. It can be due to non-cirrhotic portal fibrosis or extrahepatic portal-vein obstruction. Treatment is directed at the primary cause, pharmacological reduction of portal pressures, and interventions that either prevent or treat complications of this condition, such as variceal bleeding.

What Are The Diagnostic Services Provided By Marengo Asia Hospitals Under Liver Disease Management?

Marengo Asia Hospitals offer a range of diagnostic services aimed at providing a thorough understanding of liver diseases, whether communicable or noncommunicable. These services include:

• Comprehensive Diagnosis of Liver Diseases (Communicable and Non-communicable): Liver diseases that are both communicable and non-communicable are diagnosed by many advanced diagnostic methods and techniques. Most of the conditions diagnosed and treated relate to liver functions, including viral hepatitis and hepatitis B and C, non-alcoholic fatty liver disease, alcoholic liver disease, autoimmune liver diseases, etc. Blood tests, imaging studies like ultrasound, CT scans MRI, and liver biopsy may be used to diagnose these conditions.
• Staging and Management: After a liver disease has been diagnosed, the disease has to be staged for its severity and extent. The staging forms a basis for the initiation of an appropriate treatment plan. The state-of-the-art methods to stage liver conditions at Marengo Asia Hospitals includes, but is not restricted to, FibroScan for the grading of liver fibrosis and other non-invasive imaging methods. This helps in deciding the appropriateness of management strategies, including the pace of progression and treatment protocol.

What Are The Various Therapeutic Services For Liver Disease Management?

Some of the therapeutic services for liver disease management include the following:

1. Antiviral Therapy

   In the management of chronic viral hepatitis, particularly Hepatitis B and C, antiviral therapy is very essential. The long-term antiviral medications applicable to Hepatitis B are entecavir, tenofovir, and lamivudine. These drugs suppress the replication of the hepatitis B virus, reducing the inflammation of the liver and decreasing the risk of the disease progression to cirrhosis or developing into liver cancer. Such treatment can often last several years or even more time, considering patient characteristics. In the case of Hepatitis C, direct-acting antivirals are prescribed that usually give excellent results in the effective cure of this infection. DAAs including sofosbuvir, ledipasvir and glecaprevir/pibrentasvir act at certain stages of the viral life cycle, providing cure in most of the cases. The treatment course usually runs for about 8-12 weeks. It has a high success rate with almost negligible side effects.

2. Lifestyle Modification and Management

   In liver diseases, particularly in metabolic disorders such as NAFLD, lifestyle modification and management take up a central role. Patients are advised to acquire good dietary practices and a regular amount of exercise to aid in the management of their conditions. Weight loss, particularly, has been useful in patients diagnosed with NAFLD and can reduce liver fat, alleviate inflammation, and generally improve liver function. Furthermore, treatment of associated conditions, such as diabetes and high cholesterol, should be managed by dietary intervention, exercise, and medications to improve liver health and prevent the progression of the disease.

3. Immunosuppressive Therapy

   Treatment of autoimmune liver disease is done using immunosuppressive therapy since it is a disease where one's immune system mistakenly attacks liver cells. In the case of autoimmune hepatitis, treatment generally includes corticosteroids such as prednisone and immunosuppressants like azathioprine that lower inflammation of the liver and immune-mediated damage to it. In these patients, ursodeoxycholic acid is prescribed for other autoimmune conditions like primary biliary cholangitis and primary sclerosing cholangitis, which are aimed at improving the flow of bile and protecting the liver from damage. These therapies are oriented to slow down the process of the disease, alleviate symptoms, and improve hepatic function.

4. Portal Hypertension Management

   Specific management strategies must be used in portal hypertension, which is defined by increased blood pressure within the portal vein system. Commonly, medications are administered to decrease the pressure within the portal system; for example, beta-blockers like propranolol are given to prevent major complications like variceal bleeding. Other therapeutic measures for conditions like esophageal varices, which are dilated veins prone to bleeding under elevated pressure, involve procedures like endoscopic band ligation. This may sometimes include interventions like transjugular intrahepatic portosystemic shunt for the decompression of the portal vein or some other serious complications.

5. Alcohol Cessation Programs

   For patients with alcoholic liver disease, the most important therapeutic measure is complete abstinence from alcohol. Programs stopping alcohol help patients quit drinking and stay sober. The programs typically include counseling, behavior therapy, and support groups that help overcome the psychological and social drives of addiction. Sometimes, naltrexone or acamprosate is prescribed for patients to reduce their desire to drink and prevent relapse. Successful alcohol cessation is necessary to forestall further damage to the liver and restoration of the liver's function and health in general.

6. Nutritional Support and Counseling

   Nutritional support and counseling are integral parts of the management of liver diseases. A nutritionist or a dietitian must design, with the help of the patient, a nutrition plan that will meet his/her case of liver condition and general health needs. This can include dietary adjustments to prevent and manage medical issues like NAFLD and cirrhosis by ensuring appropriate calorie and nutrient intake and avoiding foods that will further the pathogenesis of the liver. Nutritional factors that one needs to pay attention to in the care of patients with liver disease are protein intake, sodium levels, and deficiencies to make sure the liver functions properly and overall well-being is maintained.

7. Management of Complications

   Careful management of the complications of liver disease is important in preventing further deterioration and improving the quality of life. The presence of these complications, such as ascites, hepatic encephalopathy, and variceal bleeding, may need intervention. The treatments would vary from diuretics in the case of fluid retention to lactulose or rifaximin for encephalopathy, and in the case of variceal bleeding, endoscopic or surgical measures. The effective management of these complications is important to maintaining the health of the patient and avoiding severe consequences.

8. Liver Transplantation

   Liver transplantation is considered for patients who have end-stage liver illness or acute liver failure. It is typically utilized when other treatment alternatives are no longer effective. In this process, a damaged liver is replaced by a healthy donor liver, which may greatly enhance survival and quality of life. Before transplantation, the healthcare provider conducts a thorough evaluation to determine the patient's suitability for the procedure. He/she may conduct an assessment of their physical and nutritional status, their history of drugs, whether they have any possible complications, and their family history. The aftercare basically includes, among other things, some very powerful immunosuppressive drugs that can prevent the rejection of the new liver besides continuous monitoring of the health and functioning of the transplanted organ. Thus, liver transplantation offers a way to save the life of a patient faced with serious liver disease and to live a healthier and longer life.

What Are The Advantages Of Liver Disease Management?

The therapeutic services provided under gastroenterology for liver disease management offer several advantages:

• Targeted Treatment: Therapies target the exact and specific liver disease that a patient may be experiencing, guaranteeing patients the best available treatment in light of the most recent clinical guidelines and study findings.
• Prevention of Disease Progression: Administered therapy at an early stage can entirely halt the progression of liver diseases, for example, to a more advanced stage of illness, such as cirrhosis or primary liver carcinoma.
• Improvement in Quality of Life: Effective management of liver diseases can vastly improve the quality of life for patients by reducing symptoms, preventing complications, and looking after overall well-being.
• Multidisciplinary Care: The management of liver diseases is very often institutional, involving a team of specialists from hepatologists to dietitians and transplant surgeons who are capable of providing comprehensive care on all parameters of health.
• Advanced Therapeutic Options: At Marengo Asia Hospitals, antiviral therapies, immunosuppressive drugs, and minimally invasive procedures are some of the avant-garde therapeutic options provided to make sure that a patient gets the best care possible.

Liver disease management at Marengo Asia Hospitals includes a broad range of diagnostic and therapeutic services to make sure that liver conditions are diagnosed accurately, treated effectively, and monitored carefully with the aim of better patient outcomes and improvement in the quality of life.

What is liver regeneration therapy?

Liver regeneration therapy is a pioneering treatment approach that stimulates natural repair and regeneration in the liver due to conditions related to liver disease or damage. The liver maintains much functionality and a capability of regeneration, however it gets impaired during a severe and chronic disease process. Liver regeneration therapy enhances this process ( regeneration) through various means, thereby acting in the restoration of liver function and potentially slowing or averting the need for a liver transplant.

Key Approaches in Liver Regenerative Therapy:

Some of the key approaches to liver regenerative therapy include the following:

• Stem Cell Therapy: Stem cell therapy utilizes the efficacy of stem cells, including MSCs (mesenchymal stem cells), in the regrowth of liver tissue. MSCs can differentiate into liver cells and also produce growth factors that help in healing and reducing inflammation.
• Growth Factor Therapy: Growth factor therapy is one such type of therapy that involves the administration of growth factors, including HGF proteins, to stimulate liver cell growth and repair. This approach, by augmenting such natural regeneration signals, tries to drive liver tissue repair much faster and can be quite instrumental in handling both chronic liver diseases and acute liver injuries.
• Gene Therapy: Gene therapy involves either the addition or modification of genes in liver cells to enhance their regeneration and rectify genetic defects. It can be used to enhance cell proliferation, improve liver functions, or even target the genetic causes of liver diseases for personalized treatments in severe conditions of the liver.
• Small Molecule Therapy: In small molecule therapy, specific cell pathways are activated using medications to stimulate liver regeneration. These drugs can promote the proliferation and survival of liver cells. This is a less invasive treatment that can easily be administered and support the liver's natural repair processes.
• Cellular Reprogramming: Cell reprogramming represents a novel approach. In this process, non-liver cells, usually fibroblast cells, are transformed into liver cells by the introduction of specific factors. The reprogrammed cells can replace the damaged tissue of the liver and thus represent a new strategy for generating liver cells independent of stem cells or donors and hence have a lower chance of provoking immune rejection.

Marengo Asia Hospitals is one of the most innovative medical institutions, pioneering advanced liver regeneration therapy for the treatment and management of liver diseases at an advanced stage. Our advanced treatments power the natural healing abilities of the liver, offering renewed hope for a better outcome in patients with such serious conditions of the liver.