The primary causes of fatty liver are weight gain, overuse of alcohol, diabetes, and insulin resistance. Insulin resistance means that the body has become less responsive to rising blood sugar levels. to compensate, the pancreas has to make more insulin and send it into the blood stream. Higher blood levels of insulin slow down the normal turnover of triglycerides in liver cells, so they build up.

most often, people with fatty livers don’t have any symptoms. like you, many people are diagnosed when a blood test shows elevated liver enzymes. Or a doctor detects an enlarged liver during a physical exam. sometimes, a large fatty liver is seen on an ultrasound or CT scan of the abdomen when the test is ordered for some other reason.

Untreated steatohepatitis can progress to cirrhosis of the liver — a serious condition where the liver becomes unable to do its job of cleaning toxins out of the bloodstream.

Eating healthier and decreasing alcohol use should help. But in my mind, it’s not enough. I recommend complete abstinence from alcohol and cutting calories to lose weight.

Exercise is a must. You can start slow, but you do want to progress to a minimum of 30 minutes of dedicated aerobic exercise daily. an hour of moderate intensity exercise most days of the week would be best.

I’m not sure if eating artichokes will help. But they surely won’t hurt as long as you don’t dip them in butter or mayonnaise.

(Howard LeWine, M.D., is a practicing internist at Brigham and Women’s Hospital, Boston, Mass., and chief medical editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)

(For additional consumer health information, please visit health.harvard.edu.)

(c) 2012. PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.

I'm planning a story where a character finds out he has cirrhosis, and it's in the final stages. How long is someone typically given to live if they are in the latter stages of this disease, and what symptoms might they experience?

A patient could develop fluid in the abdominal area.
This fluid is known as Ascites. it is caused because
the liver can no longer make a protein, known as
Albumin, efficiently. The fluid can keep building
up inside the patient and cause pressure to
develop against other organs and up against
the diaphragm, making it difficult for them to breathe
and feel like eatting. The doctor can remove this
fluid by a procedure known as paracentesis.
This is where they insert a needle connected to
a tube that leads to a vacuum bottle or bag. The
vacuum inside cause the fluid to be gently pulled
from the abdomen into this bottle. it is sent to
the lab to be tested then.

A person can develop fluid in other areas of the
body, also. This fluid is known as edema.
Mostly, this is seen in the legs and the feet.
It is caused because people who have Cirrhosis
of the liver tend to hold onto too much sodium in
their bodes. Most patients are told to elevate
their legs (do not massage them). they are
placed on diuretic and a "lower" sodium diet.

The patient will start to become easily confused
and disoriented. This condition is known as
Encephalopathy. it happens because certain
toxins, like ammonia, is able to pass the blood
brain barrier and go into the brain. The liver
used to take the ammonia…which is a byproduct
of the proteins we use…and convert it into urea
for the body to dispose of. The liver cells can
no longer do this efficiently…therefore the
ammonia stays in the blood.
People who have this problem are usually
placed on medications like Lactulose.
It is important they take the medication…because
they may end up in a coma, if this isn't done.
This conditions also causes them to have
sleep pattern changes and trembling in the
hands making it difficult for them to write.

Portal hypertension: As the liver cells die
off and form scar tissue inside the liver….
this blocks the flow of blood through the liver
on its way back to the heart. with Cirrhosis,
the liver is actually dying inside the patient.
The once soft, smooth organ has turned
into a enlarged spongy one with the development
of inflammation. with cirrhosis, it starts to
shrink and become hard textured.
The blood isn't able to go through the liver
and it backs up into the portal vein and into
other smaller vessels (varies)…not used to handling
this amount of blood and they can have weak spots
that can break open and bleed. These are
usually found in the esophagus, rectal area,
and belly button area. any blood seen in the
vomit, sputum, or in the rectal area is an
emergency. The doctor can go in and "band"
these varies to stop the bleeding.
The pressure inside the portal vein is known
as Portal hypertenstion.

Patients with cirrhosis tend to bruise and bleed
very easily. The liver is no longer able to make
the clotting factors that helps the blood to clot.

Patients are also extremely tired since the
body is trying to heal and also, other organs
are trying to compensate for what the liver
no longer can do. The liver does over 500
functions to keep the body well.

To learn more about the disease, here is a link
that may be of help to you:
medicinenet.com/cirrhosis/art…
unos.org/SharedContentDocumen…

The doctors are the only one to determine how long
a patient may survive once diagnosed. they usually
do a liver biopsy. they then take blood tests to
see how far advanced the disease may be.
Patient are placed on the transplant list according to
how much time the doctor decides the patient may
have left to live if they do not receive a transplant.
Once on the transplant list and the doctor observes
the blood work, they are given a MELD score.
The MELD score runs from 6 to 40. if a patient is
closer to a 6, they are the healthiest on the list and
may even be taken off the list…if they continue to
get better. As the patient goes up the ladder closer
to the 40 mark: they are sicker, have more signs
and symptoms, and are more in need of a transplant
sooner. if they reach the 40 mark: they have a very
short time to live and may die if an organ doesn't
become available for them.

Hope this information is of some help to you.
Best wishes

Jan 31, 2010 Lisa Smith

Before Hep C – Carnival Cruise PhotoA person can harbor the disease of hepatitis C for 30 years without knowing it. Learn what to look for. A simple blood test will show evidence. Avoid getting hep C.

Hepatitis C is a blood borne disease and virus. Usually, it is spread by way of a dirty needle. it is also related to cirrhosis of the liver. Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). Infection is most common among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s.

Anyone who has ever come in contact with a dirty needle, especially common in drug use, should have a blood test screening for hepatitis C. The virus may also be transmitted through accidental needle sticks with infected blood in the medical field. However, since 1992, hepatitis C has been screened in all blood donations, thus blood transfusions are no longer a cause of spreading the infection

Hepatitis C is not related to the other hepatitis viruses, A and B.

Cirrhosis of the Liver Due to Hepatitis C

Usually the first indication a person has been infected with hepatitis C, or any other liver damage, is elevated liver enzymes in a simple blood test. Of course, by the time it shows up in a blood test, liver damage is already present. this is why it is important to have a blood test to screen for hepatitis, if one has been exposed to the virus or has used intravenous drugs. even if one has only had a few experiences using needles with drugs, being screened for hepatitis is strongly advised.

Once cirrhosis of the liver is present, it is the end stage of hepatitis C. it may take 20 to 30 years before any symptoms are evident, and when they are, it is the cirrhosis of the liver, which provides the symptoms.

Drinking a lot of coffee daily helps clean the liver, which also aids in prolonging the onset of any symptoms. Drinking alcohol, however, can bring on symptoms sooner. Alcohol scars the liver, causing cirrhosis of the liver. The inflammation caused by the hepatitis results in cirrhosis over time, without the presence of alcohol. even a casual drinker, who only has an occasional drink, needs to abstain from drinking any alcohol, if diagnosed with hepatitis.

What are the Treatments?

The liver’s main function is to purify the blood. Consequently, the liver is always renewing itself. that is why the hepatitis C virus usually lies dormant for 20 or 30 years.

There are antidotal medications and treatments , which have grueling side effects and are difficult to get through. However, they are successful in keeping the disease from advancing, or at bay. Treatments for one at the end-stage of the disease may include paracentesis, which is large needle aspiration, of ascites, diuretics, and the protein albumin. The damaged liver is no longer able to produce enough albumin, which is needed to prevent low blood volume.

Another treatment, of the condition of end-stage hepatitis C is the banding of the enlarged varices, from the esophagus to stomach.

Of course, liver transplant is a treatment, but it is often difficult process to get a patient healthy enough for the surgery, and often proves too difficult.

What are the Symptoms?

These end-stage treatments are usually only involved in acute cases of hepatitis C. Acute cases, are often the result of years of denial of the subtle symptoms, or not so subtle symptoms. In these cases, patients usually die within a couple of months of serious symptoms, like massive swelling of the legs and abdominal cavity. In the after photo below, the patient is wearing size 4X pants. The fluid building up in the body, is ascites.

The majority of the time, the symptoms may be so mild, that one hardly pays attention to them. General fatigue is the most commonly ignored symptom. this will often advance to depression. Loss of appetite and weight loss occur as the disease progress.

Yellowing of the eyes (jaundice) is a common symptom which is often ignored.

Swelling of the ankles is often the first symptom to get one’s attention. The swelling, however, is an indication of advanced disease. There is still time to treat the disease, however, and a doctor should be consulted immediately to decide the best course of treatment.

medicinenet.com Hepatitis C (accessed January 28, 2010)

• Before Hep C – Carnival Cruise Photo

• After Hep C – Lisa M. Smith

• What Jaundice Looks like in Skin – Lisa M. Smith