LIVER DESEASES

The liver is the largest and one of the most complex organs in the body. It is essential for survival. From ancient times the liver was considered an organ of fate. The Egyptians considered the liver to be the seat of the life force. It is located on the right side of the abdomen. It is respected by the surgeons for its inherent myths as well as because it is one of the most vascular organs in the abdomen.
Liver: is an essential organ for survival

The functions of the liver are numerous and complex :

* It produces bile, which aids in the digestion and absorption of fats and certain vitamins
* It is a large factory playing a key role in the metabolism of carbohydrates, fats, proteins which are consumed in the diet and acts as a storehouse for these substances.
* It is a major check post for micro - organisms as well as for various toxins absorbed from the intestines.
* It helps filter many chemical substances and waste products from the blood. Most medicines are cleaned from the bloodstream by the liver. The liver also metabolizes alcohol.
* It produces various protein molecules that are responsible for clotting of blood.

WHAT MAKES LIVER UNIQUE ?

RESERVE :
The liver functions continue to be normal even if 70% of the liver is damaged or removed. This explains why cancer patients survive after large potions of cancerous liver is removed. Similarly more than half of the normal liver can be removed for living donor liver transplant.

REGENERATION :
It's the only organ in the body which can regenerate itself after large portions of it is removed surgically. It usually takes 4-6 weeks for the liver to regenerate to 90% of its original volume.

Cirrhosis of liver :
In cirrhosis of the liver, scar tissue replaces normal, healthy tissue blocking the flow of blood through the organ and preventing it from working. Cirrhosis is the eighth leading cause of death by disease, killing about 25000 people each year. Also the cost of cirrhosis in terms of human suffering, hospital costs, and lost productivity is high. It is estimated that 10-15 lakh Rs are spent on each patient with cirrhosis on medicines and other hospital treatments, from the time of detection of disease to death of the patient. The average survival time of the patient with cirrhosis after liver failure sets in is 2 years.

Causes of Liver cirrhosis :

Alcoholic Liver Disease :
Alcoholic liver disease in early stages is preventable and the progress of disease can be halted by stopping alcohol.
Viral hepatitis :
Hepatitis may be caused by many viruses, each with a different presentation and prognosis. Hepatitis B is caused by the infectious Hepatitis B virus (HBV). The hepatitis B virus is primarily found in the blood of infected individuals. Transmission of HBV takes place via blood transfusion, percutaneous introduction (i.e. needlestick injury). Sexual transmission is also possible though inefficeint. Children of mothers with active HBV are also at risk of acquiring HBV. Hepatitis - B vaccine is the essential preventive measure. Hepatitis C virus infection causes low grade damage to the liver that over several decades can lead to cirrhosis. HCV is a major cause of acute hepatitis and chronic liver disease, including cirrhosis and liver cancer. HCV is spread primarily by direct contact with human blood. The major causes of HCV infection worldwide are use of unscreened blood transfusions, and re-use of needles and syringes that have not been adequately sterilized. No vaccine is currently available to prevent hepatitis C and treatment for chronic hepatitis C is available but expensive. The chance of cure with medicines is between 30%-80%, depending on the viral subtype.

Drugs, toxins and metabolic diseases :
Drug- induced hepatitis is rare and is caused by toxic exposure to certain medications, vitamins, herbal remedies, or food supplements. Usually, the toxicity occurs after taking the causative agent for several months.

Symptoms of Liver diseases :
In the early stages, the patients with cirrhosis suffer from non-specific complaints like Exhaustion, Fatigue, Loss of appetite, Nausea, Weakness, Weight loss and Itching. The disease may progress and the patient may develop complications like swelling over feet (Edema) or swelling of abdomen (Ascites), higher tendency for bruising and bleeding, yellowing of the skin and eyes (jaundice), altered mentation, neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or changes in sleep habits (Encephalopathy) due to Toxins in the blood or brain. Portal hypertension may develop leading to varices and they can rupture leading to vomiting of blood or bleeding through the rectum. Kidney failure may also develop in late stages. Diabetes may develop when the cirrhosis advances. Cirrhosis of liver is an irreversible disease.