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Liver Disease
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 The term "liver disease" applies to many diseases and disorders that cause the liver to function improperly or stop the liver from functioning.  Liver disease is a collection of conditions, diseases, and infections that affect the cells, tissues, structures, or functions of the liver.
The liver is an important organ located in the upper right quadrant of the abdomen. The liver:

Filters the blood

Makes bile, a substance that helps digest fat and excrete certain fatty substances

Processes and hooks fats to carriers (including cholesterol), and storing sugars, helping the body transport and save energy.

Makes important proteins, such as most of those involved in blood clotting

Metabolizing many medications, such as barbiturates, sedatives, and amphetamines

Stores iron

Stores copper

Stores vitamins A and D, and several of the B vitamins

Makes important proteins like albumin that regulate fluid transport in the blood and kidneys.

Helps break down and recycle red blood cells

If the liver becomes inflamed or infected, its ability to perform these functions may be impaired. Liver disease and infections are caused by a variety of conditions including Viral Infections, bacterial invasion, and chemical or physical changes within the body. The most common cause of liver damage is malnutrition, especially that which occurs with alcoholism.

Symptoms of liver disease may be acute, occurring suddenly, or chronic, developing slowly over a long period of time. Chronic liver disease is much more common than acute. The rates of chronic liver disease for men are two times higher than for women. Liver disease may range from mild to severe depending on the type of disease present.

Symptoms
 
Symptoms partly depend on the type and the extent of liver disease. In many cases, there may be no symptoms. Symptoms that are common to a number of different types of liver disease include: 

 

Causes

·        congenital birth defects, or abnormalities of the liver present at birth

·        metabolic disorders, or defects in basic body processes

·        viral or Bacterial Infections

·        alcohol or poisoning by toxins

·        certain medications that are toxic to the liver

·        nutritional deficiencies

·        trauma, or injury

Liver diseases most likely to be seen in children include:

·        Galactosemia - an inherited disease in which the body can not tolerate certain sugars in milk. These sugars can build up, causing serious damage to the liver and other organs of the body.

·        Alagille's syndrome -  a condition in which the bile ducts narrow and deteriorate, especially during the first year of life

·        Alpha 1- antitrypsin deficiency -  a genetic liver disease in children that can lead to hepatitis and Cirrhosis of the liver

·        neonatal hepatitis - it is hepatitis that occurs in a newborn during the first few months of life

·        Tyrosinemia - a disorder that causes serious problems with liver metabolism

·        Hemorrhagic telangiectasia - a condition in which thin blood vessels allow frequent and easy Bleeding of the skin and digestive tract

·        Reye's syndrome - a condition that causes a buildup of fat in the liver. This condition has been linked In some cases to use of aspirin, especially in conjunction with chickenpox, influenza, or other illnesses with Fever.

·        Wilson's disease -  an inherited condition that causes a buildup of the mineral copper in the liver

·        Thalassemia - a group of hereditary anemia’s, or low red blood cell counts

·        Biliary atresia - a condition in which the bile ducts extending from the liver to the intestine are too small in diameter or are missing

·        Chronic active hepatitis -  an inflammation of the liver that causes severe scarring and interference with liver function

·        Cancer of the liver  - it may result from Cancer in other parts of the body that have spread to the liver

Liver diseases most likely to be seen in adults include:

·        Cirrhosis - it is a serious condition that causes tissues and cells in the liver to be replaced by scar tissue.

·        Type I glycogen storage disease - it causes problems in controlling blood sugars when a person fasts

·        Porphyria – It is a condition that causes a malfunction in how the body uses porphyrins.

·        Hemochromatosis - a condition which causes the body to absorb and store too much iron. The iron buildup causes damage to the liver and other organs.

·        Primary sclerosing cholangitis -  a condition that causes the bile ducts of the liver to narrow due to inflammation and scarring

·        Sarcoidosis - a disease that causes a buildup of lesions within the liver and other organs of the body

·        Gallstones - may block the bile duct

·        Hepatitis - an inflammation and infection of the liver caused by any of several viruses

·        Cystic disease of the liver - causes lesions and fluid-filled masses in the liver

Alcohol-related liver diseases include:

·        Fatty liver disease.  This causes an enlarged liver.

·        Alcoholic hepatitis.

·        Alcoholic cirrhosis.

 Prevention

Some, but not all, liver diseases can be prevented. Hepatitis A and hepatitis B can be prevented with vaccines.

Other ways to decrease the risk of infectious liver disease include:

·        practicing good hygiene, such as washing hands well after using the restroom or changing diapers

·        avoiding drinking or using tap water when traveling internationally

·        avoiding illegal drug use, especially sharing injection equipment

·        Practicing safest sex. Practicing safer sex provides less protection.

·        avoiding the sharing of personal hygiene items, such as razors or nail clippers

·        avoiding toxic substances and excess alcohol consumption

·        using medications only as directed

·        using caution around industrial chemicals

·        eating a well balanced diet following the food guide pyramid

·        getting an injection of immune globulin after exposure to hepatitis A

·        using recommended safety precautions in healthcare and day care work

Diagnosis

A doctor can determine whether a person's symptoms, medical history, and physical exams are consistent with liver disease. Hepatomegaly, an enlarged, firm liver, and other signs of liver disease may be found on examination.

Other tests can be used to diagnosis liver disease. These include blood tests, such as:

liver function tests – they are blood tests that check a wide variety of liver enzymes and byproducts
a complete blood count (CBC) – they look at the type and number of blood cells in the body
abdominal X-rays
ultrasounds - they to show size of abdominal organs and the presence of masses
an upper GI study -  they can detect abnormalities in the esophagus caused by liver disease
liver scans with radio tagged substances - this test shows changes in the liver structure
·                 ERCP or endoscopic retrograde cholangiopancreatography. A thin tube called an endoscope is used to view various structures in and around the liver.

·                 abdominal CT scan or abdominal MRI - provides more information about the liver structure and function

In some cases, the only way to diagnose certain liver diseases is by a liver biopsy. This procedure involves the removal of a tiny piece of liver tissue for examination under a microscope. Liver biopsies may have to be done frequently to see how the disease is making headway or reacting to treatment.

 Treatments

 ·                 bed rest

·                 drinking extra fluids to prevent dehydration

·                 avoiding unnecessary medications

·                 avoiding alcohol

·                 eating a well balanced diet for liver disease

·                 taking medications that stop Nausea

Additional treatment will depend on the type and the extent of disease. Treating hepatitis B, hepatitis C, and hepatitis D may involve the use of medications such as the antiviral medication alpha interferon. Other medications used to treat liver disease may include ribavirin, lamivudine, steroids, and antibiotics.

To treat Wilson's disease, the doctors may prescribe trientine or penicillamine. If these medications cannot be tolerated, the person may be asked to take Zinc acetate.


Hemochromatosis is treated by removing a pint of blood once or twice a week for several months to a year, depending on the severity of the condition. This will effectively deplete the excess iron.


Vitamin and mineral supplements are given to prevent complications from primary biliary cirrhosis. These include vitamin A, vitamin D, vitamin E, vitamin K, and calcium. Cholestyramine may be given to help relieve itching.

Biliary atresia may be treated with a procedure called the Kasai surgery, a procedure in which the surgeon replaces the bile ducts with part of the baby's intestine.

Acute fulminant hepatitis can cause life-threatening liver failure. This requires a hospital stay and treatment for the Bleeding disorder, encephalopathy, and nutritional problems. Sometimes, the only effective treatment for certain liver diseases is a liver transplant.