• Preventing Liver Disease

    Image for liver disease in women Your liver performs many vital jobs. Among other things, it removes toxins from your blood and stores vitamins, minerals, and fuel necessary to survive. Unfortunately, the liver is vulnerable to damage. What should you know to keep your liver healthy and prevent disease?

    What Your Liver Does

    Your liver is the largest and most complex organ in the body. It is responsible for breaking down and eliminating naturally occurring toxins as well as many types of medications. It also acts as a chemical factory, producing bile (necessary for digestion), clotting factors, other proteins in the blood, as well as cholesterol and various forms of fats.
    Just performing its duties makes your liver vulnerable to injury. For instance, deactivating potentially harmful drugs and medications is a hazardous job. Drug breakdown can damage liver cells and result in acute or chronic liver disease. Preventable factors that may damage your liver include alcohol and drug abuse, medications, infections, and certain health conditions. The most common causes of liver disease are:

    Types of Damage That Occur

    Sometimes liver damage is acute and potentially reversible. Other times it’s chronic and irreversible. Common signs of acute liver disease include abnormal liver blood tests, jaundice (yellowing of the skin and eyes), loss of appetite, nausea, itchy skin, fatigue, and abdominal pain.
    When damage becomes progressive and irreversible, it may lead to chronic liver disease. Permanent loss of liver function can result from a complication called cirrhosis, or scarring of the liver. In severe cases, a liver transplant may be required to sustain life.
    Other problems that are associated with chronic liver disease include fluid build-up in the abdomen (ascites), trouble thinking clearly ( encephalopathy ), gastrointestinal bleeding, bleeding disorders, and a greatly increased risk of liver cancer.

    Disease Prevention

    Since chronic liver disease cannot be cured, prevention is key. Here are some tips to help you reduce your risk of developing liver disease for each of the most common causes.

    Viral Hepatitis

    Several contagious viruses can cause of inflammation of the liver (hepatitis):
    • Hepatitis A and E are spread through contaminated food and water or by person-to-person contact. The infection usually does not progress to chronic hepatitis. Preventive measures include:
    • Get the hepatitis A vaccine if you are at high risk for hepatitis A
    • Wash your hands with soap and water. This is very important after using the bathroom or changing a diaper.
    • Wash your hands with soap and water before eating or preparing food.
    • Avoid using household utensils that a person with hepatitis A may touch. Make sure all household utensils are carefully cleaned.
    • Avoid sexual contact with a person with hepatitis A.
    • If you travel to a high risk region, take the following precautions:
      • Drink bottled water.
      • Avoid ice chips.
      • Wash fruits well.
      • Eat well-cooked food.
      • At least one month before travel, ask your doctor if you need a hepatitis A vaccine or immune globulin shot.
    • Hepatitis B , C , and D are transmitted through exposure to infected blood, sexual contact, childbirth (mother to child), or affected family members. The infection can progress to chronic hepatitis. Preventive measures include:
    • Use condoms or abstain from sex.
    • Limit your number of sexual partners.
    • Do not inject drugs. If you use IV drugs, get treatment to help you stop.
    • Never share needles or syringes.
    • Do not share personal items that might have blood on them, such as:
      • Razors
      • Toothbrushes
      • Manicuring tools
      • Pierced earrings
    • Get vaccinated against hepatitis B if you are at high risk for contracting hepatitis B
    • If you get a tattoo or body piercing, make sure the artist or piercer properly sterilizes the equipment. You might get infected if the tools have someone else's blood on them.
    • If you are a healthcare or public safety worker, always follow routine barrier precautions and safely handle needles and other sharp instruments.
    • Wear gloves when touching or cleaning up body fluids on personal items, such as:
      • Bandages
      • Band-aids
      • Tampons
      • Linens
    • Cover open cuts or wounds.
    • If you are pregnant, have a blood test for hepatitis B. Infants born to mothers with hepatitis B should be treated within 12 hours after birth.

    Heavy Alcohol Consumption

    Heavy alcohol consumption can result in damage to the liver cells and eventually cirrhosis. Preventive measures include:
    • Drink in moderation.
    • Don’t consume more than one daily drink if you’re a woman or two if you’re a man.
    • If you already have liver problems, don’t drink at all.

    Excess Weight

    This condition can cause a potentially harmful buildup of fat in the liver. Fatty liver disease usually causes no symptoms and may manifest as abnormal liver blood tests that can eventually progress to cirrhosis. If you are overweight, work to gradually lose excess weight through diet and exercise.

    Hemochromatosis

    Hemochromatosis is a relatively common hereditary disorder that causes excessive iron storage in the liver. This can eventually lead to impaired liver function and cirrhosis. Blood tests (for iron and iron-carrying protein) to detect the disease and phlebotomy (bloodletting) to treat the disease can prevent these complications, especially when diagnosed and treated early.

    Gallstones and Pancreatitis

    The gallbladder and the pancreas are connected to the liver through a system of ducts. Diseases like gallstones or pancreatitis that block the ducts can damage the liver. Relief of the obstruction to correct liver problems before they progress is essential, and can be done using either medical therapy or surgery.

    Medications and Supplements

    Many drugs can act as toxins to your liver. Common culprits include acetaminophen (when taken in excess), anesthetics, seizure medications, antibiotics used for tuberculosis , and some cholesterol reducers. Certain herbs and supplements can be toxic to the liver as well, including very high doses of vitamin A or niacin, comfrey, germander, coltsfoot, and sassafras.
    Always talk to your doctor about potential side effects before taking any supplements or medications, and ask if liver tests are advisable for any of your medications.

    Detection of Disease

    If liver disease does occur, the best time to detect it is early. Inform your doctor of any factors you have that may increase your risk for liver disease. Your doctor can monitor your liver function with blood tests and order further testing if necessary. If abnormalities persist, make sure your doctor follows up on them and adequately explains the cause or refers you to a gastroenterologist.

    RESOURCES

    American Liver Foundation http://www.liverfoundation.org

    Diseases of the Liver http://cpmcnet.columbia.edu/dept/gi/disliv.html

    CANADIAN RESOURCES

    The Canadian Association of Gastroenterology (CAG) http://www.cag-acg.org/

    Canadian Liver Foundation http://www.liver.ca/

    References

    Alan R. Hepatitis A. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15&topicID=81. Updated January 15, 2010. Accessed March 24, 2010.

    Kassel K. Hepatitis B. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15&topicID=81. Updated October 19, 2009. Accessed March 24, 2010.

    Resnick RH, Chopra S. Nonalcoholic steatohepatitis: a common hepatic disorder. Family Practice Recertification. 2002;24:43-50.

    Riley TR, Bhatti AM. Preventive strategies in chronic liver disease: Part I. Alcohol, vaccines, toxic medications and supplements, diet and exercise. American Family Physician. 2001;64:1555-1560.

    Riley TR, Bhatti AM. Preventive strategies in chronic liver disease: Part II. Cirrhosis. American Family Physician . 2001;64:1735-1740.

    Why you need to protect your liver. Consumer Reports on Health. April 2001;6-9.

    Yoshida EM. Abnormal liver function tests: What to do for the patient. Consultant. April 1, 2003;505-517.

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