Is life worth living? It depends on the liver!
World
Liver Day falls on April 19 each year. Let's take a look at how to keep
your liver healthy through dietary and lifestyle changes, as well as at
the common liver diseases and the treatment options available for them.
But
first, let's take a look at what the liver really does and why it is so
important to take good care of it. The liver is the largest organ in
the human body, and carries out the most complicated functions. It
purifies and detoxifies the blood that comes from the intestines after
each meal, is involved in complex metabolic pathways (involving
breakdown and synthesis of carbohydrates, proteins and lipids), is a
storehouse of energy, is the manufacturing centre for many essential
immune-related substances... we could go on and on!
The liver is
also the only organ in the body that has the ability to regenerate
fully. After transient acute insults, it can come back to its original.
Chronic liver disease (cirrhosis) results when the insult persists and
overwhelms the liver's ability to recover. What does cirrhosis do to the
liver? It replaces healthy tissue with scar tissue. A slow process of
inflammation leads to scarring (fibrosis), which over years compromises
the liver's ability to function, leading to consequences such as
jaundice, fluid accumulation in the abdomen, bleeding in the gut, and
change in sensorium. Some will develop liver cancer.
Remember
that the liver can maintain full functions (with normal liver blood
tests) even at 30% capacity because of its huge reserve. So, you may
have no symptoms and your labs may show normal till it is late.
Sadly,
deaths from cirrhosis are rising every year. One reason is,
paradoxically, rising affluence. With that comes what is called the
price of prosperity: the metabolic syndrome – obesity, diabetes,
hypertension, high lipid levels, high uric acid levels, and the
consequent fatty liver. Not only can this progress to cirrhosis but it
can also result in the Big C: liver cancer. Another major reason is
increasing alcohol consumption and its increasing acceptability in
society. There is no safe level for alcohol consumption, but increasing
intake dramatically increases the risk, especially if it is coupled with
the metabolic syndrome and with tobacco consumption. Women are at
greater risk, with smaller quantities needed for damage – it's an unfair
world!
Blood-borne infections (hepatitis B and C) are other
major causes of liver cirrhosis, especially in India. Rarer causes
include genetic and immune conditions.
Then there is the
issue of acute liver diseases, commonly called 'jaundice' by lay
persons (remember there are many other causes of jaundice). This most
commonly results from water-borne infections such as hepatitis A and E;
in most cases, recovery is complete, and the liver gets back to normal.
But stay in touch with your doctor till full recovery.
Finally, some tips to keep your liver healthy:
Eat a balanced diet:
Select foods from all food groups: fruits, veggies, nuts, cereals,
pulses. It is much easier for the liver to handle vegetarian foods,
although small helpings of animal products are OK (except in chronic
liver disease – check this out with your treating doctor). Ask your
nutritionist about cooking oils.
Keep fit: Exercise regularly, and be cautious about weight gain – prevention is much easier than later attempts at reduction.
Maintain hygiene:
Make sure the food you have at home and outside is hygienic, cleansed
well before cooking. Avoid raw foods when in doubt. Wash hands after
using the washroom.
Say 'no' to tobacco, alcohol and drugs.
Practice safe sex.Vaccinate:
There are vaccines available against hepatitis A and B that are
effective for a lifetime. Check with your doctor whether you need these.
Fortunately, hepatitis B vaccination is now part of our national
primary vaccination schedule for new-borns.
Take care with tattoos and piercings, and avoid blood transfusions unless essential:
Make sure to check for proper sterilisation practices at establishments
if you are keen on getting tattoos and piercings on your body. Have a
high threshold for blood transfusions, even if all tests declare the
blood as 'safe'.
Test: If you have ever received
transfusion of blood or blood products, or had a tattoo/body piercing
done, even if several years ago, get yourself tested for hepatitis B and
C. You may not have symptoms for many years till the liver drops its
functions.
If there is a near family member with chronic liver disease or cancer, ask your doctor to screen you too.
To
conclude, you need to keep in mind that everything you eat, drink,
breathe or even absorb through your skin is filtered out through your
liver. Take positive steps to keep your liver healthy and seek timely
treatment. Prevention is always better than cure, but there is effective
treatment for many liver conditions, so meet the experts.
P. D.
Hinduja National Hospital and Medical Research Centre has a panel of
experienced gastroenterology physicians and surgeons who can guide you
through these situations.