The liver, which is the largest internal organ, is located in the right upper quadrant of the abdomen, just under the diaphragm.
What does the liver do?
The liver is a complex chemical factory that works 24 hours a day. Virtually all the blood returning to the heart from the intestinal tract passes through the liver. Therefore, everything you swallow gets absorbed into the bloodstream and eventually effects the liver. The liver is a complex organ which is essential to life. One simply cannot live without it.Specifically, the liver:
Cleanses the blood by:
Neutralising and destroying poisonous substances
Regulates the supply of body fuel by:
Producing, storing and supplying quick energy (glucose) to keep the mind alert and the body active
Producing, storing and exporting fat
Manufactures many essential body proteins involved in:
Transporting substances in the blood
The blood clotting mechanism
The bodies resistance to infection
Produces bile - this helps eliminate toxic substances within the body and aids in digestion
Regulates the balance of many hormones such as:
Cortisones and other adrenal hormones
Regulates the body's cholesterol level - the liver produces it, excretes it, and converts it into other essential substances
Regulates the supply of essential vitamins and minerals like iron and copper
Performs literally hundreds of other specific functions
Who does Liver disease affect?
Liver disease affects people of all ages. Today,one in every ten Indians suffers from some form of liver or biliary tract disease.
How common is Liver disease?
There are over 100 known liver diseases. The most common ones,such as gallstones, viral hepatitis, cirrhosis, cancer of the liver and some liver diseases prevalent in children.
Gallstones are formed in the gallbladder when cholesterol or pigments crystallise. They can vary in size - from the size of a grain of sand to that of a golf ball. Sometimes gallstones get stuck in the bile ducts causing severe abdominal pain. Gallstones occur in 20% of Indian women and 10% of men by the age of 60.
The tendency to form gallstones is partially inherited and is more common in people who are obese and in those who overeat or lose weight rapidly through the use of extreme diets.
Viral hepatitis is an inflammation of the liver caused by one of several viruses - hepatitis A, B, C (formerly non-A, non-B), D and E. Viral hepatitis A and E are transmitted by feco-oral route, via contaminated food or water and lead to acute hepatitis in most cases in which nausea, vomiting and jaundice occurs. Both these types are self-limiting illnesses and do not lead to chronicity. However, they can lead to liver failure in ~1% of patients, followed by death. Viral hepatitis A can be prevented by vaccination.
Viral hepatitis B and C are transmitted by contaminated needles, transfusion of blood or blood products which are not screened and by unprotected sex.
Hepatitis B and C lead to chronic liver disease in ~ 20-50% of cases and lead to cirrhosis and liver failure in some of these patients. Most of the patients with the disease are asymtomatic and are diagnosed vary late. If detected early on, liver disease progression can be prevented with the help of treatment and the virus can be suppressed or eradicated.
Alcohol-related liver disease
Alcohol-related liver disease, as in other parts of the world, is also a major problem in India. Alcohol intake in large quantities (>4 units/day) over a long period of time can cause significant liver disease, eventually resulting in cirrhosis and liver failure. However, with adequate treatment and abstinence (alcohol), the damage can be halted in a majority of the cases, and reversed in some cases.
Fatty liver or non-alcoholic fatty liver disease (NAFLD)
Fatty liver/NAFLD is a liver disease that is caused by the excess accumulation of fat in the liver, as seen in the case of alcoholics. Over the last decade, this has become one of the most important causes of liver disease in India. Those who are overweight or obese, have diabetes and high lipid levels in the blood are more likely to develop this disorder. Contrary to earlier belief, this condition does progress to end-stage liver disease, cirrhosis and liver failure. Once you are detected with fatty liver disease, a timely intervention, is required to prevent this.
Auto-immune chronic active hepatitis
In this condition, for unknown reasons, the body's immune system attacks the liver cells, often leading to chronic active hepatitis and cirrhosis. Some patients require to be treated with corticosteroids, which suppress the overactive immune response. Although it is called 'hepatitis', this disease is not infectious. It is most common in young women, but it can be found in all age groups and in men as well.
Liver disease in Indian children
Thousands of children, from infants to adolescents, suffer from liver diseases. Many die from such diseases every year. Some are born with a liver disease; others contract it at birth or early in life. The more common types of liver diseases that affect children are - chronic active hepatitis (B and C), biliary atresia, galactosemia, Wilson's disease and tyrosenamia.
Advances in liver transplantation offer hope for children with severe,irreversible liver disease.
Every year, thousands of Indians die from cirrhosis. If left untreated, any liver disease may result in cirrhosis (scarring of the liver). In India, the majority of deaths due to cirrhosis of the liver are related to viruses (in particular, hepatitis B & C) and alcohol abuse.
Cancer of the liver
In most cases, cancer of the liver originates in patients who have underlying cirrhosis. Cirrhosis, due to any cause, can develop into liver cancer. Cancer of the liver, if detected early, can be treated with surgery, radiological treatment or by liver transplantation.
What are the symptoms and signs of liver disease?
Consult your physician if you observe any of the following symptoms:
A yellow discolouration of the skin or eyes
The appearance of very dark urine or passage of pale, bloody or tar-like stools
Prolonged itching of the skin
Nausea or loss of appetite
Vomiting of blood
Severe prolonged abdominal pain
However, a majority of chronic liver diseases have no symptoms until the later stages.
How can you take care of your liver?
Maintain a healthy, well-balanced diet
Avoid taking medication unnecessarily
Do not exceed the maximum daily dose and do not mix alcohol and medication
If you drink alcohol, have two or less drinks a day
Protect yourself from viral hepatitis A and B by getting vaccinated
Avoid exposure to industrial chemicals
Eat healthy food, avoid fatty food and exercise regularly
What is a liver transplantation?
A liver transplantation is a life-saving operation which can be performed on children and adults with certain liver diseases, when no other treatment is available. The operation involves taking out the diseased liver and replacing it with a liver of suitable size and blood type. Overall, about 80-85% of adult patients and 75-80% of children survive a liver transplantation and resume normal lives, although they continue to depend on medication to prevent rejection of the organ.
Unfortunately, many patients succumb to liver disease before transplantation can be undertaken. Public awareness of the need for organ donation is an important element in the overall success of liver transplantation.
The liver is an incredibly hardworking organ. It performs hundreds of critical functions around the clock to keep our body healthy. That is why liver disease is such a serious risk to health and life. Millions of Indians have liver disease and don't even know it. In fact, liver disease is one of the top ten causes of death even though many forms of liver disease are preventable and many more, if detected early, can be treated effectively.
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