Liver Disease

The liver is the largest organ inside your body which is located in the upper right quadrant of the abdomen, below the diaphragm. It plays various important roles in many body functions like in protein production, blood clotting and metabolism of cholesterol, glucose (sugar) and iron.  It also helps in food digestion, energy storage, and excretion of toxic substances.

There are many type of liver diseases, some of which include viral infections like hepatitis A, hepatitis B and hepatitis C, damage due to harmful drugs, excessive alcohol intake, hemochromatosis and liver cirrhosis (scarring of liver tissue).

Jaundice or yellowing of the skin is a sign of liver disease. With time, damage to the liver can lead to liver failure which is a life-threatening condition.

Signs and symptoms of liver disease include:

• Yellowing of skin and eyes (jaundice)
• Abdominal pain 
• Swelling in the legs and ankles
• Itchy skin
• Dark urine color
• Pale, bloody or tar-colored stool
• Chronic fatigue
• Nausea and vomiting 
• Loss of appetite
• Tendency to bruise easily

Make an appointment with your doctor if you have any persistent symptom that worries you. 

Liver disease or damage can result due to various causes like:

• Excessive alcohol intake: Alcohol drinking is one of the biggest and most common cause of liver disease.
• Certain harmful chemicals can damage liver tissue.
• Blood flow abnormalities like compromised blood flow to liver.
• Hepatitis: Inflammation of the liver cells.
• Obstruction of bile flow for example, in cholestasis.
• High cholesterol or triglyceride levels.
• Prolonged usage of  medications or drugs can also cause of liver damage.
• Some herbal remedies with excessive amounts of vitamins like vitamin A, kava kava, ma-huang, and comfrey, can cause liver damage.
• Many mushrooms are poisonous to the liver and eating unidentified mushrooms gathered in the wild can be lethal.
• Other disorders: Hemochromatosis (iron overload), Wilson's disease (affects the body's ability to metabolize copper), Gilbert's disease (an abnormality in bilirubin metabolism in the liver), cancer and congestive heart failure may cause liver cirrhosis and liver failure.

Consult your physician if any symptom of liver disease appears to receive a diagnosis. You may then be referred to a doctor who specializes in the liver (hepatologist), if needed. Before consulting a doctor make sure that you:

• Do not eat solid food on the day before your appointment. 
• Have complete details about your symptoms, including even the information that may seem unrelated to the reason why you scheduled the appointment and write down them down, if needed. 
• Make a list of all your medications, vitamins and supplements. 
• Write down your key medical information, including other conditions. 
• Write down key personal information, including any recent changes or stressors in your life. 
• Ask a relative or friend to accompany you, to help you remember what the doctor says. 

You must clear your queries with your doctor. While making diagnosis your doctor will ask you some questions like:

• When did you first begin experiencing symptoms, and how severe are they? 
• Have your symptoms been continuous or occasional? 
• What if anything seems to improve or worsen your symptoms? 
• Have you had a fever?
• Have you ever had your skin or eyes turn yellow?
• What medications and supplements do you take? 
• How many days of the week do you drink alcohol? 
• Do you have any tattoos? 
• Does your job involve exposure to chemicals, blood or body fluids? 
• Have you ever had a blood transfusion? 
• Have you been told that you have had liver problems before?
• Has anyone in your family ever been diagnosed with liver disease?

The doctor advices you to undergo certain tests like:

• Blood tests
• Abdominal Ultrasound 
• ALT (Alanine Aminotransferase) Test 
• AMA (antimitochondrial-antibody) Test 
• AST (Aspartate Aminotransferase) Test 
• CT Scan-- Abdomen and Pelvis 
• ERCP (Endoscopic Retrograde Cholangiopancreatography) 
• Liver Biopsy 
• Liver Panel Magnetic Resonance Cholangiopancreatography (MRCP)  
• MRI of the Body (Chest, Abdomen, Pelvis) 
• Needle Biopsy 
• Protein Electrophoresis/Immunofixation Electrophoresis

The treatment for liver disease depends on the type of symptoms and the patient's risk factors for the incidence of the disease.

Some liver problems can be treated with change in the lifestyle, such as quitting alcohol or losing weight, typically a part of a medical program that includes careful monitoring of liver function.

Some liver problems can be treated with medications while others may require surgery.

Treatment for liver disease that causes liver failure may ultimately require a liver transplant.

To prevent liver disease:

• Avoid consuming too much of alcohol.
• Avoid to use illicit intravenous drugs.
• Use a condom during sex. 
• If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.
• Get vaccinated. Vaccination is available for Hepatitis A and B.
• Use medications wisely.
• Take prescription and nonprescription drugs only when needed and only in recommended doses. 
• Don't mix medications and alcohol. 
• Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs. 
• Avoid contact with other people's blood and body fluids. 
• Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids. 
• Take care with aerosol sprays. 
• Make sure the room is ventilated, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. 
• Protect your skin while using insecticides or other toxic chemicals. You can wear gloves, long sleeves, hat and mask.
• Maintain a healthy weight because obesity can cause non-alcoholic fatty liver disease.

No alternative remedies have been clinically proven to be able to treat liver disease. But some studies indicate that herbal medicine treatments are effective for clearance of hepatitis B virus but the quality of these research studies has been questioned.

On the other hand, some herbal supplements used as alternative medicine treatments can harm your liver. So, it is highly recommended that before taking any treatment talk to your doctor about the potential risks of the treatment.

Lifestyle modifications are necessary in order to cope with liver disease.

Except for some diseases like gallstone disease and some viral infections, most liver diseases can only be managed and not cured.

So, consult a doctor for the right advice and get proper medical care.

Maintain a healthy diet, stop consuming alcohol and do regular exercise.

There are several risks and complications associated with liver disease.

There are several factors which increases the risks of getting a liver disease some of which are described below:

• Excessive alcohol intake.
• Excessive use of medicines.
• Use of prohibited drugs 
• Sharing needles 
• Tattoos or body piercings 
• Blood transfusion 
• Unprotected sex 
• Exposure to certain harmful chemicals or toxins
• Diabetes 
• Obesity
• High levels of blood cholesterol and triglycerides

Complications of liver disease vary depending on the cause of the problem. But in extreme cases, untreated liver disease may progress to liver failure which is a life-threatening condition.