Liver Disease
Why is Liver Disease Important?
Among its numerous functions, the liver is responsible for creating bile and releasing it into the gallbladder for storage through special ducts in the body. It acts as a filter for blood coming to and from the heart, ridding toxins from and delivering essential nutrients to the blood before it is circulated throughout the body. It plays a role in replacing blood cells that have been damaged or that have died, although this process is limited and severe internal bleeding other another condition may overwhelm the liver.
There are many types of liver disease, also known in medical terms as hepatic disease. As the large, filtering organ (sometimes referred to as a gland) is an essential part of digestion and regulation in the body, any damage can seriously affect a patient’s quality of life and should be treated as soon as problems are detected. Unfortunately, it’s not easy to catch liver disease early on because a faulty liver usually is able to function without causing symptoms for the patient until more than three-fourths of the entire organ is damaged. The liver also possesses an amazing reparative potential, unlike many other organs in the body so damage that has been accrued often will heal itself until scarring within the organ is overwhelming.
What Causes Liver Disease?
The most common reasons that a patient’s liver might be damaged are viral hepatitis, cholestasis, alcohol abuse and cancer—the latter usually ending in death because catching them early enough for effective medical treatment is very difficult. The liver can also malfunction as a result of drug abuse and other, less common medical conditions. Alcohol abuse is by far the most common cause of liver damage in the US. Alcohol has toxins in it that damage liver cells directly and can make liver tissue become inflamed (alcoholic hepatitis). If a patient consumes too much alcohol over time, then fat cells can start to accumulate in the liver cells and cause them to perform improperly (steatosis). In patients who do not drink or have not drank heavily, but are obese and have insulin resistance syndromes (such as diabetes or pre-diabetes) there is a potential to develop liver damage as a result of non-alcoholic fatty liver disease (NAFLD). This is an emerging problem in the US as the rate of obesity continues to rise. It is predicted by many experts that in 30 years this will be the predominant source of liver disease in the country, especially as advances in treatment of viral hepatitis emerge.
Other types of inflammation of liver tissue are categorized under hepatitis. Hepatitis occurs because liver cells become somehow infected. There are many types of hepatitis, but the most common are:
- Hepatitis A—occurs when patients accidently ingest small amounts of fecal matter that is infected with a virus. It causes temporary inflammation that will usually go away quickly on its own. Not many people are affected by this because there is a widely available vaccine for Hepatitis A.
- Hepatitis B—occurs when infection happens through the exchange of bodily fluids, whether that is through sexual contact or blood transfusion or sharing needles and mouth equipment. It is more likely to lead to chronic inflammation of liver tissue, which puts one at risk for liver cancer and cirrhosis. There’s also a vaccine available for Hepatitis B. Those who have chronic carrier states of hepatitis B may be candidates for treatment with long term anti-viral medication. You should see a gastroenterologist for more information if you have this disease.
- Hepatitis C—occurs when the liver becomes chronically inflamed. Infection is caused by the same methods as the causes of Hepatitis B. There’s no vaccine available for Hepatitis C. Until recently treatment options for hepatitis C were limited; however, very recently combination anti-viral therapies have become available and are very promising in the treatment and cure of this disease.
As with all forms of hepatitis or liver disease, prevention is key. Early treatment for those who have become infected or who have early signs of disease can help to prevent development of liver damage into cirrhosis (or end stage liver disease). Cirrhosis is very serious, and leads to death in most people. Liver transplantation is sometimes an option in certain patients, but given a huge organ shortage in this country, obtaining a liver can sometimes be very difficult.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014
