Liver is the second largest and one of the most complex organs in the body, yet awareness regarding liver diseases continues to be low. This is why, World Liver Day is observed on April 19 every year — to create awareness about diseases related to the liver. Dr Prashant Vilas Bhangui, associate director, Institute of Liver Transplantation and Regenerative Medicine, Medanta Hospital, Gurugram answers some frequently asked questions related to liver diseases.
What is cirrhosis of the liver?
Liver disease initially starts off with fatty liver (where there is an accumulation of excess fat in the liver). This then progresses to fibrosis of the liver which leads to stiffness, and ultimately end-stage liver disease or cirrhosis, the expert added.
The most common causes of liver disease are viral hepatitis i.e., hepatitis C and hepatitis E, excessive consumption of alcohol, and an unhealthy lifestyle that may cause obesity. A patient who drinks alcohol for prolonged periods of time in substantial quantity ultimately develops cirrhosis. Additionally, people who are overweight, lead an unhealthy lifestyle, have unhealthy diet, lack physical activity, and suffer from co-morbid conditions like diabetes, hypertension, thyroid disorders, and abnormal cholesterol levels are at a risk of developing non-alcoholic fatty liver disease (NAFLD), which progresses to cirrhosis. NAFLD has become a leading cause of cirrhosis of the liver in many countries. Other congenital causes of cirrhosis in children are biliary atresia, metabolic disease of the liver. Some rare causes include autoimmune hepatitis, Wilson’s disease, and hemochromatosis.
Initially, a patient may experience constant lethargy, fatigability, swelling of the feet after walking, jaundice, fluid in the abdomen, episodes of bleeding, portal hypertension in the later stage leading to vomiting of blood, blood in stools, internal bleeding. Liver failure also affects other organs like kidney, and even leads to memory loss, and drowsiness.
If someone has a genetic pre-disposition to cirrhosis and has symptoms of liver disease or is suffering from viral hepatitis for a long period of time, they must get some blood tests, liver function tests, abdominal ultrasound, CT scan, and endoscopy done to understand the stage of cirrhosis they are at.
Compensated cirrhosis – The liver functions get damaged to a great extent; however, the body somehow copes with that liver function, sometimes to an extent of 50-60 per cent.
Decompensated cirrhosis – When the liver damage becomes more than about 70-80 per cent. The patients gets symptoms like swelling of the feet, accumulation of fluids in the abdomen, bleeding tendencies, and effects on other organs e.g., on kidneys and brain.
Can cirrhosis be cured?
Once the liver reaches the stage of cirrhosis, the disease becomes irreversible. Fatty liver and early stage of liver fibrosis can be cured through medications along with diet control, understanding causes, and taking proper actions to reverse the condition. Patients at the stage of cirrhosis are highly recommended medical therapies, to support the liver and prevent the progression of the disease. The doctor, based on the CTP (Child-Turcotte-Pugh) score, and other additional scores, determines the treatment procedure i.e., medical treatment or to undergo liver transplantation.
There are some high-risk individuals who may get exposed to hepatitis B and C like healthcare workers, and patients having blood transfusions, hould be extra vigilant and take extra precautions. The viral markers used to identify a range of Hepatitis B, C, and other viral infections needed to be checked at regular intervals. Experts suggest undergoing an annual check-up including a liver function test, and an ultrasound after the age of 45-50, blood tests are done for early detection, especially for the people who are diabetic, hypertensive, and have thyroid disorders.
People should avoid excessive consumption of alcohol, have a healthy diet, avoid fried and junk food, exercise regularly, avoiding smoking, etc.
Is it possible to “cleanse” the liver? Is it a myth?
It’s more of a myth than reality. There is nothing called cleansing a liver. One can take effective measures including liver-friendly juices, staying hydrated, and eating healthy foods that help in maintaining the healthy liver.