Saturday, January 04, 2014

Understanding your liver diseases

Understanding your liver diseases

Liver is affected by several diseases. Some of the common diseases affecting the liver include alcoholic liver disease, non-alcoholic fatty liver disease or viral hepatitis. These diseases cause inflammation of the liver leading to complications such as severe liver scarring or cirrhosis. Liver cirrhosis can further progress to liver cancer or liver failure

Alcoholic liver disease is a common complication of excessive alcohol intake.1

Clinical Presentation

Affected individuals usually do not have any specific symptoms during the initial stages of the disease. In some instances, certain unspecific symptoms such as abdominal discomfort, nausea (sensation of vomiting), vomiting or diarrhea may be present. In those with advanced liver disease, specific symptoms such as jaundice, ascites (accumulation of fluid in the stomach), encephalopathy (a brain disorder), or bleeding in the stomach and intestine may be present.1

Who is at Risk?

The risk of developing alcoholic liver disease is high if you:2
  • Consume more than 25 g of alcohol (ethanol)/day or drink excessive amount of alcohol during each session
  • binge drink
  • Are a woman
  • Are obese, suffer from hepatitis infections, or have increased iron levels in blood

Subtypes of Alcoholic Liver Disease1

Steatosis This condition is also known as 'fatty liver'. In this condition, there is abnormal accumulation of fat (lipids) in the liver and occurs in about 80% of all heavy drinkers. Avoiding alcohol can reverse the condition but continued alcohol consumption can further lead to cirrhosis.
Alcoholic Hepatitis In this condition, inflammation in the liver is caused by prolonged consumption of alcohol. This condition occurs in 10-35% of heavy drinkers. Alcoholic hepatitis usually occurs following 15-20 years of excessive drinking. This condition is more severe in women.
Cirrhosis This is the most severe form of liver injury due to alcohol. The risk of cirrhosis is higher in continuous drinkers than in 'binge drinkers'. Cirrhosis develops in 10% of all heavy drinkers.
Complications of Alcoholic Liver Disease1 The complications of alcoholic liver disease include ascites, which is typically the first complication. Apart from ascites, other complications can include jaundice, variceal bleeding (bleeding due to rupture of blood vessels in the food pipe or oesophagus), infections and hepatic encephalopathy (a brain disorder caused due to failure in liver functions).


References

1. Walsh K, Alexander G. Alcoholic liver disease. Postgrad Med J. 2000;76:280-286.
2. European Association for the Study of the Liver EASL Clinical Practical Guidelines: Management of Alcoholic Liver Disease. J Hepatol. 2012;57:399-420.
3. Adams LA, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgrad Med J. 2006;82:315-322.
4. Puri P, Sanyal AJ. Nonalcoholic Fatty Liver Disease: Definitions, Risk Factors, and Workup. Clin Liver Dis. 2012; 1(4):99-103.
5. Chalasani N, Bjornsson E. Risk Factors for Idiosyncratic Drug-Induced Liver Injury. Gastroenterology. 2010; 138(7): 2246-2259.
6. information downloaded from http://who.int/topics/hepatitis/en/. Accessed on: 24.05.2013.
7. Hepatitis A. October 2012. Information downloaded from www.cdc.gov/hepatitis.
8. Hepatitis B. June 2012. Information downloaded from www.cdc.gov/hepatitis.
9. Hepatitis C. FAQs for Health Professionals. Information downloaded from www.cdc.gov/hepatitis.
10. Hepatitis C. Information downloaded from http://www.who.int/mediacentre/factsheets/fs164/en/
11. Ahmed MH, Barakat S, Almobarak AO. Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: Has the Time Come for Cardiologists to Be Hepatologists? J Obesity. 012, Article ID 483135.
12. Blendea MC, Thompson MJ, Malkani S. Diabetes and Chronic Liver Disease: Etiology and Pitfalls in Monitoring. Clin Diabetes.2010; 28(4):139-144.
13. Muhidin SO, Magan AA, Osman KA. The Relationship between Nonalcoholic Fatty Liver Disease and Colorectal Cancer: The Future Challenges and Outcomes of theMetabolic Syndrome. J Obesity. 2012, Article ID 637538.complication. Apart from ascites, other complications can include jaundice, variceal bleeding (bleeding due to rupture of blood vessels in the food pipe or oesophagus), infections and hepatic encephalopathy (a brain disorder caused due to failure in liver functions).


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