What Is Jaundice? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Aching Pain On One Side Of The Body Could Signal Fatty Liver Disease
Liver Disease: Expert discusses risks and symptomsAs the name suggests, fatty liver disease is caused by a build-up of fat in the liver. Unlike alcoholic-related liver disease it has nothing to do with drinking too much alcohol.
If your liver is healthy it should contain little or no fat. However, it is thought one in three people in the UK are now living with the early stages of fatty liver disease.
This is due to rising rates of people who are overweight or obese.
In its early stages fatty liver disease often doesn't cause any issues. But if it progresses it can lead to serious liver damage and even liver failure.
Therefore, spotting signs of the condition could be potentially life saving and should be investigated if you have concerns.
One symptom in particular could be easy to miss - especially around the holiday season.
According to the NHS, fatty liver disease can cause a "dull, aching" pain in the tummy.
This could be dismissed as something less serious such as a stomach ache or indigestion caused by eating too much.
However, to know if this is linked to the liver the pain will be located on the right side of the abdomen, "over the lower right side of the ribs".
This might be accompanied by other symptoms such as:
If you are experiencing these signs you might have reached non-alcoholic steatohepatitis or fibrosis, which are more advanced stages of fatty liver disease.
But the most severe and final stage of liver disease is cirrhosis.
This occurs after years of damage where the liver becomes scarred, lumpy and shrivelled.
NHS Inform explains: "There are usually few symptoms during the early stages of cirrhosis.
"Noticeable problems tend to develop as the liver becomes more damaged.
"In early stage cirrhosis, the liver is able to function properly despite being damaged.
"As the condition progresses, symptoms tend to develop when functions of the liver are affected."
A common sign of cirrhosis that many people think of is jaundice, where the skin and whites of the eyes turn yellow.
However, there are many other symptoms including:
"You may also notice changes in your personality, problems sleeping (insomnia), memory loss, confusion and difficulty concentrating," NHS Inform adds.
If you experience any symptoms of fatty liver disease you should speak to your doctor.
Everything To Know About Alcoholic Liver Disease
Medically reviewed by Jay N. Yepuri, MD
Alcoholic liver disease (ALD) is caused by excessive alcohol consumption, which is defined as five or more drinks in a day or 15 or more drinks a week for men, and four or more drinks a day or eight or more drinks a week for women.
The liver is responsible for metabolizing or processing ethanol, the main component of alcohol. Over time, the liver of a person who drinks heavily can become damaged and cause alcoholic liver disease.
Early damage to the liver causes fat to deposit onto the liver, resulting in hepatic steatosis, or alcoholic fatty liver disease. Fatty liver disease often has no symptoms and can usually be reversed.
If the alcoholic liver disease is not treated, it can progress to later stages which include alcoholic hepatitis and cirrhosis, a scarring of the liver.
This article will discuss the stages of alcoholic liver disease, the possibilities of reversing the disease, typical symptoms, complications, diagnosis, treatment options, and how best to support the liver during treatment.
Alcoholic Liver Disease Stages: Reversibility and HealingAlcoholic liver disease ranges in severity. There are three stages of liver disease.
Alcoholic fatty liver disease appears early on as fat deposits accumulate in the liver. Often there are no symptoms. People who consume four to five standard drinks per day over decades can develop fatty liver disease.
Fatty liver disease can also develop after binge drinking, which is defined as drinking four to five drinks in two hours or less. About 90% of heavy drinkers will develop alcoholic fatty liver disease.
Alcoholic hepatitis occurs when the liver becomes damaged and inflamed. Symptoms include fever, jaundice (yellowing of the skin), malnourishment, swelling, and accumulation of fluid around the liver.
Although 90% of people who drink heavily develop fatty liver disease, only 20% to 40% will go on to develop alcoholic hepatitis.
Alcoholic cirrhosis is a progression of ALD in which scarring in the liver makes it difficult for that organ to function properly. Symptoms include weight loss, fatigue, muscle cramps, easy bruising, and jaundice.
Cirrhosis can lead to liver failure. In liver failure, the liver is severely damaged and can no longer function. Other organs, such as the kidneys, and body systems such as the respiratory system, may also begin to fail.
The prognosis for liver failure is poor and requires immediate treatment, often in the intensive care unit.
Though rare, liver cancer can develop from the damage that occurs with cirrhosis.
What Is Possible?Fatty liver disease can often be reversed by stopping drinking alcohol. After two to three weeks of abstaining from alcohol, fatty deposits disappear and liver biopsies appear normal.
However, if the person drinks alcohol again heavily, the fatty deposits will reappear.
What Stages Aren't Reversible?Although stopping drinking alcohol is the most effective treatment for alcoholic liver disease, it is not a complete cure. People who have progressed to alcoholic hepatitis or cirrhosis most likely will not be able to reverse the disease.
In these cases, treatment focuses on preventing further damage and treating other factors that can make the disease worse, such as infection and malnourishment.
Alcoholic Hepatitis vs. Viral HepatitisAlthough both types of hepatitis are marked by inflammation of the liver, alcoholic hepatitis is caused by excessive alcohol consumption, where viral hepatitis is caused by several viruses such as hepatitis A, B, C, D or E.
Permanent Damage From Alcoholic Liver DiseaseThe liver can usually repair itself and generate new cells. However, in advanced alcoholic liver disease, liver regeneration is impaired, resulting in permanent damage to the liver. This can result in liver failure.
Liver Failure StagesCirrhosis is considered end stage liver disease as it cannot be reversed and can lead to liver failure. Cirrhosis is further categorized as compensated and decompensated.
In compensated cirrhosis, the liver remains functioning, and many people have no symptoms. The median life expectancy from this point is 10 to 12 years.
In decompensated cirrhosis, symptoms become more apparent. Someone with decompensated cirrhosis may develop ascites (or fluid in the abdomen), gastrointestinal bleeding, and hepatic encephalopathy, in which the brain is affected. The median life expectancy drops to one to two years.
Help to Stop DrinkingIf you want to stop drinking, help is available. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a free helpline you can call at 800-662-4357. You can also visit FindTreatment.Gov to discover resources near you.
When Does Alcoholic Liver Disease Cause Symptoms?Alcoholic liver disease often begins without any symptoms.
Early SymptomsMost people will not experience symptoms in the early stages of ALD. Some may experience mild pain in the upper right side of the abdomen.
Progressive SymptomsSymptoms of ALD that has progressed include:
Jaundice
Malnutrition
Fever
Fatigue
Swelling
Brain function decline, known as hepatic encephalopathy, which can cause memory loss, confusion, slurred speech
Reduced muscle mass
Heart failure
Peripheral neuropathy, damage to the nerves outside the central nervous system (the brain and spinal cord), usually in the hands and feet
Left untreated, ALD can lead to other complications. ALD that has progressed can affect other parts of the body.
People with advanced ALD may experience complications such as:
Bleeding in the intestinal tract
Inflammation of the pancreas
Kidney distress
Acute respiratory distress syndrome, in which fluid collects in the lungs and deprives the body of oxygen
Infection
To diagnose ALD, a healthcare provider will assess alcohol use, ask about symptoms, and conduct several tests. An assessment of alcohol use will establish when alcohol consumption started, how much a person drinks, and how often.
At times, it may become necessary for a healthcare provider to talk with friends and relatives of the person with suspected ALD to establish the amount of alcohol consumed, as it may be difficult for the person to self-assess.
The signs and symptoms of ALD include but aren't limited to:
Nausea/vomiting
Fatigue
Weakness
Lack of appetite, loss of interest in food
Swollen or distended abdomen
Fluid buildup or swelling in the feet and ankles
Tests that may be conducted look at liver function. These include blood tests that measure liver enzymes, imaging tests such as ultrasound of the liver, a specialized test called Fibroscan, which looks for fibrosis (scarring) in the liver, and, in some cases, a biopsy of the liver (removing a sample of tissue for analysis in a lab).
Initial Treatment for Early Alcoholic Liver DiseaseAbstaining from drinking alcohol is the first step in treating ALD. A team of healthcare providers, which may include psychologists or addiction specialists, can help if you find it challenging to stop drinking.
Treatment also consists of evaluation for other risk factors that can damage the liver or put the liver at higher risk, such as infection with hepatitis C and metabolic syndrome.
Having hepatitis C or other liver diseases with heavy alcohol use can rapidly increase the development of cirrhosis. These diseases will also be treated.
Having a high body mass index (BMI, a calculation based on height and weight but not taking into account other variables affecting weight) has been shown to increase mortality rates (being subject to death) and the risk of liver cancer. Reducing weight if you're overweight, eating a healthy diet, and regular exercise can help someone with early ALD who has stopped drinking decrease their risk of advanced liver disease.
Treatment for End-Stage Alcoholic Liver DiseaseAfter stopping drinking, which is the first step in any treatment of ALD, an assessment will be made as to the extent of the damage and the overall state of the body.
Many people with ALD are malnourished (lacking proper nutrition) due to a variety of factors, such as lack of eating, vomiting, and malabsorption (difficulty absorbing nutrients from food). In general, the more severe the ALD, the more malnourished someone becomes.
Getting adequate proteins, calories, and nutrients can alleviate symptoms, improve quality of life, and decrease mortality.
Corticosteroids are used to treat severe alcoholic hepatitis by decreasing inflammation in the liver. Other medications, such as Pentoxil (pentoxifylline), may also be used.
A liver transplant may become necessary in end-stage ALD. However, eligibility may depend on being abstinent from alcohol for a specific length of time.
Liver Health During TreatmentWhile treating ALD it is important not only to abstain from alcohol but also become conscious of other factors that could affect the liver.
What to AvoidWhile treating ALD it is best to avoid:
Foods that are high in fat, salt, and sugar.
Fried foods
Raw or undercooked shellfish, such as clams and oysters
Medications that can affect the liver
To support liver function:
Eat a balanced diet that consists of fruits, veggies, whole grains, lean protein sources (may include some meats, fish, or beans), and dairy.
Eat high-fiber foods.
Drink a lot of water.
Your healthcare provider may also test you for individual nutrient deficiencies. Many people with alcoholic liver disease are deficient in B vitamins, zinc and vitamin D and it may become necessary to take supplements.
SummaryAlcoholic liver disease is caused by excessive consumption of alcohol. There are three stages—alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis.
While the early stages may have no symptoms, later stages can cause symptoms such as fatigue, swelling in the hands and legs, jaundice, loss of appetite, and weakness.
Early treatment can reverse alcoholic fatty liver disease. However, if the disease progresses, it is often not reversible. The standard first-line treatment is to stop drinking. Medications and lifestyle modifications may also be prescribed depending on the stage.
Eating a healthy diet, getting regular exercise, and avoiding liver-damaging foods such as fried foods, can also help the liver heal during treatment. In some cases, supplementation with vitamins may be recommended.
Read the original article on Verywell Health.
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Arianna 1
anastrozole
CONSUMER MEDICINE INFORMATION
What is in this leafletThis leaflet answers some common questions about ARIANNA 1.
It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have benefits and risks. Your doctor has weighed the risks of you taking ARIANNA 1 against the benefits expected for you.
If you have any concerns about taking this medicine, talk to your doctor or pharmacist.
Keep this leaflet with your medicine.
You may need to read it again.
What ARIANNA 1 is used forARIANNA 1 is a non-steroidal aromatase inhibitor, which reduces the amount of estrogen (female sex hormone) made by the body. In some types of breast cancer, estrogen can help the cancer cells grow. ARIANNA 1 may slow or stop the growth of cancer by blocking estrogen.
ARIANNA 1 is used to treat breast cancer in women who no longer have their menstrual periods either naturally, due to their age or after surgery, radiotherapy or chemotherapy.
Follow all directions given to you by your doctor.
They may differ from the information contained in this leaflet.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
Your doctor may have prescribed ARIANNA 1 for another reason.
ARIANNA 1 is only available with a doctor's prescription.
ARIANNA 1 is not addictive.
Before you take ARIANNA 1 When you must not take it
Do not take ARIANNA 1 if you are pregnant or intend to become pregnant.
There is a possibility of harm to the developing baby as the medicine may be absorbed within the womb.
Do not breastfeed while taking ARIANNA 1.
Your baby can take in ARIANNA 1 from breast milk if you are breast-feeding.
Do not take ARIANNA 1 if you are allergic to:
Anastrozole, the active ingredient of ARIANNA 1
Any of the other ingredients in ARIANNA 1, as listed at the end of this leaflet
Other anti-estrogen medicines.
Some of the symptoms of an allergic reaction may include skin rash, itching or hives; swelling of the face, lips or tongue, which may cause difficulty in swallowing or breathing; wheezing or shortness of breath.
Do not take ARIANNA 1 if you are still having menstrual periods. ARIANNA 1 should only be taken by women who are no longer having menstrual periods.
Do not take ARIANNA 1 if you are male.
Men are not normally treated with ARIANNA 1.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
It may have no effect at all, or worse, an entirely unexpected effect if you take it after the expiry date.
If it has expired or is damaged, return it to your pharmacist for disposal.
Do not use it to treat any other complaints unless your doctor tells you to.
Do not give this medicine to anyone else.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Do not give ARIANNA 1 to a child.
ARIANNA 1 is not recommended for use in children.
Before you start to take itTell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.
Tell your doctor if you are pregnant or plan to become pregnant.
Tell your doctor if you are breast-feeding or plan to breast-feed.
ARIANNA 1 should not be used during pregnancy or while breast-feeding.
Tell your doctor if you have, or have had, any medical conditions, especially the following:
kidney disease
liver problems
osteoporosis, a family history of osteoporosis or risk factors for developing osteoporosis (such as a diet low in calcium, smoking, poor mobility, a slight build or treatment with steroid medicines)
Aromatase inhibitors may decrease bone mineral density (BMD) in women who have been through menopause, with a possible increased risk of fractures.
Your doctor may want to take special care if you have any of these conditions.
If you have not told your doctor about any of the above, tell him/her before you start taking ARIANNA 1.
Taking other medicinesTell your doctor or pharmacist if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines should not be taken with ARIANNA 1. These include:
Tamoxifen, a medicine used to treat breast cancer
any health food products that contain natural estrogens used for post-menopausal symptoms
any medicine that contains estrogen such as medicines used in Hormone Replacement Therapy (HRT) or oral contraceptives
medicines from a class called "Luteinising Hormone Releasing Hormone (LHRH) agonists", such as goserelin or leuprorelin.
Talk to your doctor or pharmacist if you have any concerns or questions about taking ARIANNA 1.
Your doctor can tell you what to do if you are taking any of these medicines.
If you are not sure whether you are taking any of these medicines, check with your doctor or pharmacist.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking ARIANNA 1.
How to take ARIANNA 1Follow all directions given to you by your doctor and pharmacist carefully.
They may differ from the information contained in this leaflet.
Your doctor or pharmacist will tell you how many tablets you will need to take each day. This depends on your condition and whether or not you are taking any other medicines.
If you do not understand the instructions on the pack, ask your doctor or pharmacist.
How to take itAlways swallow the tablets whole with plenty of water.
You can take the tablets with or without food.
How much to takeThe usual dose is one tablet every day.
When to take itTake your ARIANNA 1 at about the same time each day.
Taking your tablet(s) at about the same time each day will have the best effect. It will also help you remember when to take the tablets.
It does not matter whether you take ARIANNA 1 before or after food.
How long to take it forKeep taking ARIANNA 1 for as long as your doctor tells you to.
ARIANNA 1 helps to control your condition, but does not cure it. Therefore you must take ARIANNA 1 every day. Do not stop taking it unless your doctor tells you to, even if you feel better.
If you forget to take itIf you miss a dose, take it as soon as you remember, as long as it is 12 hours before the next dose is due. If it is less than 12 hours to the next dose, do not take the dose you have missed.
Do not take a double dose to make up for the dose you missed.
If you miss more than one dose, or are not sure what to do, check with your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist or doctor for some hints.
If you take too much (overdose)Immediately telephone your doctor, or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much ARIANNA 1. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
While you are taking ARIANNA 1 Things you must do
If you become pregnant while taking ARIANNA 1, tell your doctor immediately.
Your doctor needs to know immediately so that ARIANNA 1 can be replaced by another medicine.
Be sure to keep all your appointments with your doctor so your progress can be checked.
Before starting any new medicine, tell your doctor, dentist or pharmacist that you are taking ARIANNA 1.
Tell all the doctors, dentists and pharmacists who are treating you that you are taking ARIANNA 1.
If you go into hospital, please let the medical staff know that you are taking ARIANNA 1.
Things you must not doDo not take ARIANNA 1 for a longer time than your doctor has prescribed.
Do not let yourself run out of ARIANNA 1 over the weekend or on holidays.
Do not stop taking ARIANNA 1 unless you have discussed it with your doctor.
Do not use ARIANNA 1 to treat any other conditions unless your doctor tells you to.
Do not give ARIANNA 1 to anyone else, even if they have the same condition as you.
Things to be careful ofEffects on driving and operating machinery.
ARIANNA 1 may occasionally cause drowsiness, dizziness or other symptoms which could affect your ability to drive or operate machinery. Make sure you know how you are affected by this medicine before you drive or use machinery.
Side effectsTell your doctor or pharmacist as soon as possible if you do not feel well while you are taking ARIANNA 1.
ARIANNA 1 helps most postmenopausal women with breast cancer, but it may have unwanted side effects in some people.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. Side effects may happen at the start of treatment or they may happen after you have been taking your medicine for some time. You may need medical treatment if you get some of the side effects.
If you get any side effects do not stop taking ARIANNA 1 without first talking to your doctor or pharmacist.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
hot flushes
lack of energy
feeling sleepy
vaginal dryness
vaginal bleeding
joint pain or stiffness
bone loss (osteoporosis)
thinning of hair (hair loss)
mild skin rash
feeling sick (nausea)
headache
diarrhoea
loss of appetite (anorexia)
vomiting
carpal tunnel syndrome (tingling, pain, coldness, weakness in parts of hand)
pins and needles
loss of taste or changing taste of food or drink
feeling depressed.
ARIANNA 1 may be associated with changes in your blood, urine or liver. Your doctor may want to perform tests from time to time to check on your progress and detect any unwanted side effects.
The above list includes the more common side effects of ARIANNA 1, some of which may disappear with continued treatment. Mostly these are mild to moderate in nature.
If any of the following happen, tell your doctor immediately or go to Accident and Emergency at the nearest hospital:
sudden signs of allergy such as shortness of breath, wheezing or difficulty in breathing; swelling of the face, lips, tongue or any other parts of the body; rash, itching or hives on the skin
extremely severe skin reactions (Stevens-Johnson syndrome) with lesions, ulcers or blisters
liver pain or swelling and/or a general feeling of unwell with or without jaundice (yellowing of the skin and eyes).
The above list includes very serious side effects. You may require urgent medical attention or hospitalisation. These side effects are rare.
Uncommon side effects can include trigger finger which is a condition in which one of your fingers or your thumb catches in a bent position. These side effects are generally mild to moderate and often resolve themselves over time.
Tell your doctor if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some people. Tell your doctor if you notice any other effects.
After taking ARIANNA 1 Storage
Keep ARIANNA 1 where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Keep your tablets in the original pack until it is time to take them.
If you take the tablets out of the pack they will not keep well.
Keep your tablets in a cool dry place where the temperature stays below 25°C.
Do not store ARIANNA 1 or any other medicine in the bathroom or near a sink.
Do not leave ARIANNA 1 in the car or on window sills.
Heat and dampness can destroy some medicines.
DisposalIf your doctor tells you to stop taking ARIANNA 1, or your tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
Product description What it looks like
ARIANNA 1 is available in 1 tablet strength:
1 mg - white to off white, round, biconvex, film-coated tablets debossed with "AHI" on one side and plain on other side
ARIANNA 1 comes in blister packs containing 30 tablets.
IngredientsThe active ingredient in ARIANNA 1 is anastrozole.
Each ARIANNA 1 tablet contains 1 mg of anastrozole.
The tablets also contain the following inactive ingredients:
Lactose monohydrate
Hypromellose
Sodium starch glycollate type A
Macrogol 300
Magnesium stearate
Povidone
Titanium dioxide
ARIANNA 1 contains lactose.
SupplierARIANNA 1 is supplied by:
Alphapharm Pty Ltd trading as Viatris
Level 1, 30 The Bond
30-34 Hickson Road
Millers Point NSW 2000
www.Viatris.Com.Au
Phone: 1800 274 276
This leaflet was prepared in January 2023.
Australian registration number:
ARIANNA 1 1 mg film-coated tablet blister pack - AUST R 259991
ARIANNA® is a Viatris company trade mark
ARIANNA 1_cmi\Jan23/00
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