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 Smoking, Drinking & Addiction

April 2012
Liver Infections: Keep Your Watch
Dr Anand K Khakhar & Dr Manish C Varma
Liver is a vital organ that performs complex functions like making bile, which helps in digestion of food, processing food to give energy, helping the body to get rid of toxic wastes and filtering infections and many others. There are over 300 billion specialised cells in the liver that perform these functions.

Unlike dialysis for kidney failure, there is no effective means of artificially replacing the liver function. A healthy liver is therefore imperative for survival

Consequences Of Liver Injury
Liver is a unique organ in the sense that it has an immense capacity to regenerate. However, sustained injury to the liver, without adequate time for healing can lead to progressive decline in the functions of the liver. This will eventually lead to an irreversible
condition called liver cirrhosis and liver failure. Liver failure may commonly manifest as:

  • Jaundice
  • Ascites (accumulation of fluid in the belly)
  • Encephalopathy (clouding of consciousness and confusion)
  • Bleeding into the stomach causing bloody vomiting or blood in stools
Unfortunately, the self-healing capacity of the liver, along with the fact that the liver has a significant reserve, makes the liver a silent sufferer and these signs and symptoms appear only after a significant part of the liver is damaged, in most of the cases irreversibly so.
Appearance of any of these potentially life threatening signs and symptoms should prompt people to seek medical help immediately.

Management And Treatment
Once the diagnosis of cirrhosis is made, the patients need to be managed with medicines based on their symptoms. A liver transplant is recommended when all treatment options fail and any further inaction is deemed fatal. Although, transplantation of the liver is a curative option for people with end stage liver disease, the most effective strategy against liver disease is prevention. The way to prevent liver disease is to adopt a liver friendly lifestyle, be aware of the risk factors and avoid them – screening for viral infections, vaccinations and treatment of infections when required. Most importantly, never hesitate in seeking information or medical help.
Causes Of Liver Diseases
The three most common factors that account for majority of liver diseases in our
context are alcohol, obesity and viral infections:
Alcohol - Alcohol is best avoided, as there is no safe way of consuming alcohol.
However, the damaging effects can be reduced by:
  • Limiting intake to two small drinks a day
  • Never mixing the drinks
  • Never taking it with medicines such as paracetamol
  • Never drinking alone or on an empty stomach
  • Giving alcohol free breaks of at least 6 weeks every year
Alcohol should be strictly avoided in presence of any pre-existing liver disease or co-existing risk factors

Obesity - Changing diet pattern with the inclusion of ‘junk foods’ in our dietary habits along with sedentary lifestyle has resulted in increased incidence of obesity, hyperlipidemia and diabetes. This can result in increased fat deposition in the liver, which over time can result in cirrhosis. Healthy eating habits and exercise should be incorporated in daily life to avoid these risk factors.

Viral infections (Hepatitis B and C) – Liver infections can be caused by:
  • Bacteria
  • Viruses
  • Fungus
  • Amoeba
  • Parasites like liver-flukes and tape-worms
Viral infections are of the greatest consequence as far as development of chronic liver disease is concerned. The common viruses that affect the liver are the Hepatitis A, B and C viruses. Hepatitis A infection can be severe in the acute phase but almost never leads to chronic liver disease. The B and C viruses can give rise to cirrhosis. Both these viruses get transmitted via blood and body fluids and from mother to baby at the time of delivery.

Effective medicines are now available for these infections and early detection
offers a chance for treatment, possible cure, and protection against subsequent
development of chronic liver disease. Vaccine is available for Hepatitis B and is
strongly recommended.

In many cases, more than one of these factors may be present.

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