Liver disease

What are liver diseases?          

The liver is one of the biggest and most important organs. It plays a central role in metabolic processes such as keeping the body clean and breaking down nutrients, turning them into energy, while clearing toxins. 

Hepatic diseases are those which affect the liver and don’t allow it to do its job.        

There are different things that can affect the liver, such as viruses, genetic alterations, excess fat, or excessive alcohol consumption, as well as hepatocellular carcinoma, the primary liver cancer.

The most common liver diseases are hepatitis A, B, or C, cirrhosis, hepatocellular carcinoma, jaundice, fatty liver, and haemochromatosis.                

Disease prognosis

The main thing to note about liver diseases is that the liver is quite a resilient organ which can recover from smaller ailments and even function with only part of it being healthy.

It is a serious issue as until there is liver failure it is often not known that there is an issue with the organ, which is why until there is something serious like liver cancer, problems quite often go completely unnoticed.    

Hepatitis or other types of liver inflammation account for up to 80% of primary liver cancers. This is why hepatocellular cancer is a serious problem, and it is the third leading cause of death from cancer worldwide.  

What are the symptoms?  

Symptoms don’t tend to appear until the liver is quite damaged, and the most common ones are:    

  • Nausea and dizziness, which can lead to vomiting
  • Intense abdominal pain
  • Jaundice, which is yellowing of the skin due to high levels of bilirubin in the blood
  • Itchy skin
  • Fatigue
  • Bruising and bleeding easily  

Tests for liver diseases

Liver diseases don’t tend to have symptoms, and the patient quite often only finds out that they have a problem when they are having tests for something else. Some of the tests used to detect and diagnose liver issues include.    

  • Liver biopsy: a small needle is used to get a small sample of tissue to check for potential diseases.     
  • CT scan: three dimensional imaging of the liver, to check for anomalies.
  • Endoscopic retrograde cholangiopancreatography: is a technique that combines the use of endoscopy and fluoroscopy to check for any bile duct obstructions.   
  • Ultrasound: to check the liver.
  • Blood tests: are used to measure different substances in the blood.

What causes liver diseases?

There are different risk factors that increase the risk of developing liver disease, some include:

  • Excessive alcohol consumption
  • Injecting drugs
  • Blood transfusion prior to 1992
  • Tattoos and piercings done in unregulated places
  • Diabetes
  • Obesity
  • Prolonged exposure to chemical products

Liver diseases can have different causes, such as infections, viruses, or parasites, as well as immune system anomalies, genetic problems, or substance abuse, among others.  

How can they be prevented?   

There are many recommendations to prevent liver disease, including:

  • Drinking alcohol in moderation     
  • Being vaccinated
  • Being prudent with medications and avoid mixing them with alcohol   
  • Avoiding other people’s bodily fluids
  • Protecting skin           
  • Avoiding obesity         

What is the treatment? 

Surgical resection: is carried out on patients with single, asymptomatic tumours and who have good liver function.   

Liver transplant: in many cases this is the only option for patients with advanced liver disease.   

Ablation: heat is applied to the tissue.        

Chemoembolisation: is recommended for symptomatic patients who have unresectable carcinoma and who have a tumour that is too big to be treated with radiofrequency. 

Certain liver diseases are treated in particular ways:

Liver cancer: can be treated in different ways, depending on the tumour and the patient’s health.  

Cirrhosis: there is no cure for cirrhosis, however there are certain steps that can be taken to slow and relieve symptoms such as; stop drinking alcohol, limit medication intake, and follow a balanced diet with fruits, vegetables, and cereals.

Hepatitis: There isn’t a specific treatment for hepatitis A, and it will normally pass on its own within a couple of months, patients are recommended to eat less fats, avoid alcohol consumption, and rest. The recommendations for hepatitis B are similar to that of A, but there are also some medications that can keep the virus under control for many years. Treatment for hepatitis C tends to be a course of medication for between 30 to 48 weeks.   

Fatty liver: in cases of non-alcoholic fatty liver the patient is recommended to lose weight and ensure they have a balanced diet. If it is caused by medications, you should stop taking the medication. For alcohol-related liver disease, you are advised to stop drinking alcohol.  

What specialist should I see?

Gastroenterologists and hepatologists (who specialise in the liver and conditions affecting it) can treat liver disease, although internal medicine specialists can also be consulted.