martes, 3 de septiembre de 2019

What is liver disease?

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By Dr. Ananya Mandal, MDReviewed by April Cashin-Garbutt, MA (Editor)

The liver is one of the largest solid organs of the body. It is located in the upper right part of the abdomen. Most of the organ lies under cover of the rib cage.

Liver function

It is not just the liver’s size but also its functions that makes it so important.

Its major functions include processing the food that passes through the gut and converting it into energy that can be utilized by the body.

It is also a powerful detoxification center that handles many chemicals, alcohol, poisons and toxins as well as drugs and clears the blood.

The liver also makes bile and stores it in a small pouch like organ called the gall bladder. This bile helps in digestion especially fats.

Liver anatomy

The liver is divided into two major lobes that are further divided into lobules.

The liver gets blood supply fresh from the heart via the hepatic artery. It also receives blood from the portal vein that brings in blood rich in nutrients carried in from the gut or intestines.

The blood from the portal vein undergoes “offloading” of nutrients and “cleansing” of toxins at the liver.

Liver helps processing or metabolizing nutrients like glucose, cholesterol, drugs, stores iron etc.

Liver is one of the only organs in the human body that can regenerate its own damaged tissues. However with repeated damage and constant injury the liver may fail to perform its functions leading to liver failure. Liver failure may sometimes even be fatal. (1)

Causes of liver disease

Liver diseases may vary in causation.

They may be of short duration, acute liver disease, or long term, chronic liver disease. An acute liver disease may also convert into a chronic liver disease over time.

Some liver diseases are caused by infective viruses like Hepatitis virus (A, B and C).

Liver diseases also result from taking in some drugs or alcohol over long term. Sometimes the diseased liver over long term becomes shrunken and scarred.

Such a condition is called cirrhosis. Like other organs liver can also be afflicted with cancers. (2)

Types of liver disease

Alcohol related liver disease is one of the commonest toxin induced liver disease worldwide. In normal cases the liver breaks down alcohol in the body.

If there is too much intake over a long period of time the liver fails to perform its functions leading to a condition called Alcoholic Liver disease.

Alcohol-related liver disease may be of three types – fatty liver disease, alcoholic hepatitis and finally alcoholic cirrhosis.

The alcohol related liver disease begins as fatty deposits on the liver followed by inflammatory changes and finally irreversible tissue scarring or cirrhosis.

The hepatitis phase leads to swelling of the liver and damage. At the initial phases of alcohol liver disease if alcohol is discontinued the changes may be reversed. (3)

Liver disease may also be Non-Alcoholic called Non Alcoholic Fatty Liver Disease. This results in fat deposits on the liver and is seen in obese, diabetic and individuals with high blood cholesterol. It can affect 2-5% of the general population. (4)

Liver disease is thus a wide ranging term that includes all conditions that cause imbalance or disturbance of the functions of the liver.

Liver disease is also called hepatic disease. Since it is a large organ, nearly two thirds of the liver has to be affected for the symptoms of hepatic disease to show in most individuals.

If there is very high blood pressure in the portal vein the condition is termed portal hypertension. This can lead to cirrhosis, enlarged abdomen with fluid (ascitis), bleeding, enlarged spleen, and sometimes jaundice. Bleeding may occur in the esophagus or via rectum.

Portal hypertension is often a result of liver cirrhosis that results from chronic liver disease.

Portal hypertension may also sometimes lead to a condition called hepatic encephalopathy where the brain is affected and the person may go into coma. This is usually accompanied by liver failure. (5)