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Are You at Risk for Liver Disease?

September 13, 2011

Upcoming Seminar Will Discuss Symptoms and Treatment Options

If you think that the only people who suffer from liver disease are those who consistently consume alcohol, think again. While substantial alcohol abuse is the most common cause of liver disease, a recent study by the Swedish Research Council – published online in the May 23, 2011 edition of Annals of Medicine – indicated that obesity might constitute a greater risk for fatty liver disease than moderate alcohol consumption.

“Over the past decade, we’ve seen a substantial increase in a type of fatty liver disease called Nonalcoholic Steatohepatitis, or NASH, that is associated with obesity,” says Dr. Arun Srivatsa, a gastroenterologist at Washington Hospital. “In the past 10 years, the rate of obesity in adults has doubled. There also is some evidence the typical U.S. diet that is high in high-fructose corn syrup may contribute to fatty liver – much in the same way that force-feeding corn meal to geese produces the fatty liver ‘delicacy’ known as fois gras.’ 

NASH resembles the more common alcoholic fatty liver disease, but it can occur in people who drink little or no alcohol. With both diseases, fat cells build up in the liver and can lead to inflammation called hepatitis and even to cirrhosis, which is permanent scarring that can cause liver failure.

To help people learn more about liver function and disease, Dr. Srivatsa will be speaking at a free seminar on Tuesday, September 20 from 1 to 2:30 p.m.  The seminar, sponsored by Washington Hospital, will be held in the Conrad E. Anderson, M.D. Auditoriums at 2500 Mowry Avenue (Washington West) in Fremont. Register online at www.whhs.com

Why the Liver Is Important 

 “The liver is essentially a ‘processing, packaging and shipping factory’ that helps process all the nutrients from food that is digested in the stomach and intestines,” Dr. Srivatsa explains.

The liver produces a fluid called bile that aids in digestion of food in the small intestine. The liver also:

  • Converts extra glucose in the body to glycogen and stores it until the body needs more glucose.
  • Produces blood-clotting substances.
  • Processes and stores iron to produce red blood cells.
  • Manufactures cholesterol and other chemicals that transport fats throughout the body.
  • Produces amino acids for making proteins.
  • Removes toxins and wastes – including dead red blood cells (bilirubin) – that are eliminated from the body through the urine.

“Your survival depends on your liver,” he emphasizes. “If your liver is failing, there is no way to replace its function other than a liver transplant, which is an extreme option.”

Types of Liver Disease and Damage 

The National Institutes of Health estimates that one out of every 10 Americans is affected by liver disease. In addition to alcoholic fatty liver disease and NASH, there are numerous other common liver diseases.

“There are several types of hepatitis caused by viruses,” Dr. Srivatsa says. “Hepatitis A is usually transmitted through contaminated food or water, and you generally can recover without lasting damage. Both hepatitis B and C are spread by contact with an infected person’s blood or other body fluids. Hepatitis B often gets better on its own after a few months, but it may last a lifetime and lead to cirrhosis, liver failure or liver cancer. Most people with hepatitis C don’t show any symptoms for years. The disease does not get better by itself, and it also may lead to cirrhosis or cancer. There are vaccines available for hepatitis A and B, but not for hepatitis C.”

Certain medications also can damage the liver.

“Many prescription medications can affect the liver, so you should ask your doctor about the need for blood tests to measure liver function when starting a new medication,” Dr. Srivatsa says. “Over-the-counter medications also can cause liver damage. For example, acetaminophen can be toxic in too large a dose. Drinking alcohol while taking acetaminophen can compound the problem. Be sure to read the dosing guidelines for all over-the-counter medications and ask your doctor if you have questions about how much you should be taking.”

Symptoms, Diagnosis and Treatment 

The symptoms of liver disease can vary depending on the type of illness. For example, some people with viral hepatitis A, B and C may experience:

  • Loss of appetite
  •  Nausea and vomiting
  •  Diarrhea
  •  Pain over the liver in the right upper abdomen
  •  Yellowing of the skin and eyes (jaundice)
  • Swelling (edema) of the lower legs

“Quite often, the onset of a liver disease is gradual, and there are no early symptoms,” Dr. Srivatsa notes. “Once liver disease progresses to cirrhosis, people may develop symptoms such as mental confusion, bruising and swelling in the abdomen. 

Early liver disease often is picked up only by various blood tests performed in a regular physical exam. These blood tests measure the levels of certain liver enzymes as well as the levels of bilirubin and proteins such as albumin.

“A complete medical history and exam can help determine your risk for liver disease and determine whether further diagnostic tests may be needed,” says Dr. Srivatsa. “For example, an ultrasound of the liver could be helpful in distinguishing between hepatitis and end-stage liver disease.  In some cases, a needle biopsy might be needed to confirm diagnosis of a specific liver disease.”

Managing liver disease revolves around treating the underlying cause, preventing further liver damage and avoiding complications. Patients who continue to worsen despite treatment may be candidates for liver transplant.

“Unfortunately, there are more people waiting for transplants than there are organs available,” Dr. Srivatsa cautions. “So I encourage people to become organ donors, and I urge everyone to pay attention to their risk factors and adjust their lifestyles accordingly. A healthy diet, regular exercise, moderation in consumption of alcohol and cautious use of medications that can affect the liver may help prevent liver disease in the first place. 

To register to attend the upcoming seminar on September 20, visit www.whhs.com.

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