Doris Obinna

The liver is the largest solid organ in the body. It is considered a gland because, among its many functions, it makes and secretes bile. Located in the upper right portion of the abdomen protected by the rib cage, it has two main lobes that are made up of tiny lobules.

The liver is an organ about the size of a football that sits just under the rib cage on the right side of the abdomen. It is essential for digesting food and ridding the body of toxic substances.

The liver cells have two different sources of blood supply: Hepatic artery and portal vein. The hepatic artery supplies oxygen rich blood pumped from the heart, while the portal vein supplies nutrients from the intestine and the spleen.

Normally, veins return blood from the body to the heart, but the portal vein allows nutrients and chemicals from the digestive tract to enter the liver for processing and filtering, prior to entering the general circulation. The portal vein also efficiently delivers the chemicals and proteins that liver cells need to produce the proteins, cholesterol and glycogen required for normal body activities.

The liver is responsible for many critical functions in the body. When it becomes diseased or injured, the loss of those functions can cause significant damage to the body. Liver disease is also referred to as hepatic disease.

According to experts, liver disease is a broad term that covers all the potential problems that cause the liver to fail to perform its designated functions. Usually, more than 75 per cent or three quarters of liver tissue needs to be affected before a decrease in function occurs.

Hepatologist, Dr. Mark Sonderup, said liver disease could be inherited (genetic) or caused by a variety of factors, such as viruses and alcohol use. Obesity is also associated with liver damage.

“Over time, damage to the liver results in scarring (cirrhosis). This can lead to liver failure, a life-threatening condition,” he said.

According to World Journal of Hepatology, the incidence of hepatocellular carcinoma (HCC), which is the most common liver cancer in adult, is known to be high in West Africa, with an approximate yearly mortality rate of 200, 000. Several factors are responsible for this. Early acquisition of risk factors, with vertical or horizontal transmission of hepatitis B (HBV), environmental food contaminants (aflatoxins), poor management of predisposing risk factors and poorly managed strategies for health delivery. There has been a low uptake of childhood immunisation for hepatitis B in many West African countries. Owing to late presentations, most sufferers of HCC die within weeks of their diagnosis.

Highlighted reasons for the specific disease pattern of HCC in West Africa include: high rate of risk factors; failure to identify risk populations; lack of effective treatment; and scarce resources for timely diagnosis. This is contrasted to the developed world, which generally has sufficient resources to detect cases early for curative treatment.

Causes

Liver disease has many causes. Research shows that parasites and viruses can infect the liver, causing inflammation that reduces liver function. The viruses that cause liver damage can be spread through blood or semen, contaminated food or water, or close Diseases, which affect the immune system and attack certain parts of the body (autoimmune) can affect the liver. Examples of autoimmune liver diseases include: Autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis.

An abnormal gene inherited from one or both parents can cause various substances to build up in the liver, resulting in liver damage. Genetic liver diseases include: Hemochromatosis, Hyperoxaluria and oxalosis, Wilson’s disease, Alpha-1 antitrypsin deficiency.

Risk factors

The factors that may increase your risk of liver disease include: Heavy alcohol use, injecting drugs using shared needles, tattoos or body piercings, blood transfusion, exposure to other people’s blood and body fluids, unprotected sex, exposure to certain chemicals or toxins, diabetes and obesity.

Prevention

To prevent liver disease, drink alcohol in moderation or abstain. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.

Get help if you use illicit intravenous drugs, and don’t share needles used to inject drugs. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.

If you are at increased risk of contracting hepatitis or if you’ve already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.

Take prescription and non-prescription drugs only when needed and only in recommended doses. Don’t mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or non-prescription drugs.

Avoid contact with other people’s blood and body fluids, as hepatitis viruses can be spread by accidental needle sticks or improper clean-up of blood or body fluids.

Make sure the room is ventilated, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer’s instructions.

When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask.

Symptoms

As there are over 100 diseases that can affect the liver, there are a wide variety of symptoms. Not only are the symptoms varied, they also differ in intensity and severity, from almost negligible to life-threatening.

According to Sonderup, symptoms of liver disease can vary and may even be confused with other conditions.

He however, said it is important to watch for warnings signs, declaring: “People with chronic liver disease often don’t experience any symptoms – a fact that results in people sometimes only presenting with disease once it’s at quite at an advanced stage.”

He said many of the symptoms, such as fatigue, diarrhoea, nausea, poor appetite, weakness an abdominal pain, are non-specific.

“Therefore, people with liver disease might not notice them at first. These symptoms may also confused with other conditions,” he said.

Sonderup said fibrosis (initial and reversible scarring of the liver) often has no symptoms to start with. He said: “As a result, it is often not diagnosed until it progresses. If it is diagnosed early, and treated appropriately, the liver may itself and not develop cirrhosis. However, as the liver becomes less and less able to perform its functions, symptoms become more obvious an specific.

“Liver pain can take several forms. Most people feel it as a dull, throbbing sensation in the upper right abdomen. Liver pain can also feel like a stabbing sensation that takes your breath away Sometimes this pain is accompanied by swelling and occasionally people feel radiating liver pain in their back or in their right shoulder blade.”

Treatment

Some liver problems could resolve themselves and leave no lasting damage. The liver c regenerate itself up to a point, but once cirrhosis (liver damage in which scar tissue replaces nor liver tissue) has set in, the damage to the liver irreversible and symptoms are more severe.

According to Sonderup, treating liver disease depends entirely on the condition one is suffer from, and may involve taking medication, und going surgery or getting a liver transplant.

He said: “The treatment also depends on whether you have acute or chronic liver disease, whether you are dealing with fibrosis or cirrhosis, and whether the liver disease is the result of a viral infection, an autoimmune hepatitis, a genetically inherited disease, fatty liver disease, excessive drinking and/or drug abuse, or whether there is a cancerous tumour in the liver.

“Before your doctor can decide on the most appropriate treatment, a correct diagnosis must be made.”

There are some remedies. If you experience liver pain in the morning after a heavy meal or a night of drinking alcohol, drink plenty of water. Try to avoid fatty or heavy foods for a few days, and sit up straight to take pressure off the liver. If the pain persists for more than several hours, you should set up an appointment with your doctor. If you’re experiencing nausea, dizziness, or hallucinations, in conjunction with liver pain, you may need emergency care.

The treatment for your liver pain will depend on what’s causing it. Treating your liver disease will probably start with addressing what you eat and drink.

Other lifestyle changes, such as losing weight and lowering your cholesterol, are other first lines of defence when it comes to treating the cause of liver pain.

Foods that heals the liver

According to a Nutritional Consultant Jesseah Robinson, fish like cod, salmon, and sardines are good sources. Also, veggies, including: broccoli, peas, and sweet potatoes, and fruits such as bananas, kiwi, and apricots.
Dairy foods, like milk and yogurt, are also high in potassium.

Robinson said as a liver support and aid, milk thistle is a powerful detoxifier. According to him, it helps rebuild liver cells while removing toxins from the body that are processed through the liver.

A study published in Digestive Diseases and Sciences said milk thistle has the power to improve mortality in patients with liver failure.