Liver and Liver Diseases

An Introduction to Liver Functions in Our Body and Liver Diseases

Last updated on September 29th, 2022 at 01:52 pm

Liver diseases are a group of disorders that affect the liver. They include hepatitis, cirrhosis, fatty liver disease, and more.

Hepatitis is an inflammation of the liver caused by viruses or bacteria. It may be acute or chronic. Chronic hepatitis can lead to cirrhosis.

Cirrhosis is the scarring of the liver due to long-term damage from alcohol abuse or other causes. Fatty liver disease occurs when fat accumulates in the liver.

Hepatocellular carcinoma is cancer of the liver.

Liver is the largest internal organ in our body

The liver is the largest solid organ in the body.

People may not know that the liver is also the largest gland in the body. The liver is two different glands. It is a secretory gland because it has a specialized structure that allows it to make and secrete bile into the bile ducts. 

It also is an endocrine gland since it makes and secretes chemicals directly into the blood that has effects on other organs in the body. Bile is a fluid that both aids in digestion and absorption of fats, as well as carries waste products into the intestine.

The liver weighs about three and a half pounds (1.6 kilograms). It measures, on average, about 8 inches (20 cm) horizontally (across), and 6.5 inches (17 cm) vertically (down), and is 4.5 inches (12 cm) thick.

The liver is the largest internal organ in the body. Its major functions are:

What are the liver functions in our body?

  1. Metabolize most of the nutrients that are absorbed by the intestine
  2. Store nutrients
  3. Produce proteins. Manufacture (synthesize) proteins, including albumin (to help maintain the volume of blood) and blood clotting factors.
  4. Synthesize, store, and process (metabolize) fats, including fatty acids (used for energy) and cholesterol
  5. Metabolize and store carbohydrates, which are used as the source for the sugar (glucose) in the blood then red blood cells and the brain use
  6. Form and secrete bile that contains bile acids to aid in the intestinal absorption of fats and the fat-soluble vitamins A, D, E, and K.
  7. Eliminate, by metabolizing and/or secreting the potentially harmful biochemical products produced by the body, such as bilirubin from the breakdown of old red blood cells, and ammonia from the breakdown of proteins
  8. Detoxify blood by removing medications, alcohol, and potentially harmful chemicals from the bloodstream and treating them chemically so they can be excreted by the digestive or urinary systems.

Because the liver comes in close contact with many harmful substances, it is protected against disease in two fundamental ways.

First, it can regenerate itself by repairing or replacing injured tissue.

Second, the liver has many cell units responsible for the same task. Therefore, if one area is injured, other cells will perform the functions of the injured section indefinitely or until the damage has been repaired.

Different liver disorders include hepatitis, cirrhosis, liver tumours, fatty liver, and liver abscess (collection of pus). The focus here will be the two most common forms: hepatitis and cirrhosis.

What is fatty liver disease?

Fatty liver can be classified as alcohol and non-alcohol-related. Alcohol is a direct toxin to the liver and can cause inflammation. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic related steatohepatitis (NASH) are markedly different illnesses and many potential causes are linked to fat accumulation in the liver.

What is liver hepatitis?

There is over one type of hepatitis, and although they have similar symptoms, they’re contracted in unique ways.

  • Hepatitis A is the most common and the most infectious, spreading easily from person to person like most other viruses. It affects millions around the world and handles over 2 million deaths a year.
  • Hepatitis B is gained through exposure to infected blood, vaginal fluids, or semen.
  • Hepatitis C
  • Hepatitis D is unique because it can only affect those that already have hepatitis B

Causes of liver hepatitis 

Hepatitis is an inflammation of the liver that can be caused by a virus, by inherited disorders, and sometimes by certain medications or toxins, such as alcohol and drugs. Scientists have identified four main types of viral hepatitis: hepatitis A, hepatitis B, hepatitis C, and hepatitis D. A fifth type, hepatitis E, is also found.

  • Hepatitis A is waterborne and spread mainly via sewage and contaminated food and water.
  • Hepatitis B is transmitted by contact with infected semen, blood, or vaginal secretions, and from mother to newborn. Hepatitis B is most commonly spread by unprotected sex and by sharing infected needles (including those used for tattooing, acupuncture, and ear piercing).
  • Hepatitis C spreads via direct blood-to-blood contact.
  • Hepatitis D is spread by infected needles and blood transfusions.

Improved screening of donated blood has reduced the risk of catching hepatitis B or C from blood transfusions. Both hepatitis B and C can be spread through the sharing of razors, toothbrushes, and nail clippers.

Symptoms of liver hepatitis

Both hepatitis and cirrhosis show few warning signs. In the acute phase of most forms of hepatitis, there are flu-like symptoms such as tiredness, fever, nausea, loss of appetite, and pain (usually under the ribs on the right side of the abdomen). There may also be some jaundice (yellowing of the skin and whites of the eyes.)

Following the acute stage, hepatitis A will be cleared from the body and lifelong immunity develops. In hepatitis B and C, viral particles may linger in the body, producing a chronic infection that lasts for years. This can eventually lead to liver cirrhosis and, sometimes, liver cancer.

How to diagnose liver hepatitis?

Diagnose hepatitis with blood tests and complete personal history. If you have;

  • Used intravenous drugs
  • Recently eaten shellfish from polluted waters
  • Travelled to countries where hepatitis infections are common
  • Had a blood transfusion or been in contact with fresh blood
  • Had potentially risky sexual practices
  • Taken certain medications in the past few months

What is liver cirrhosis?

The second type of liver disorder is called cirrhosis. It’s the final stage of many forms of liver disease. Cirrhosis involves permanent scarring of the liver that can severely affect the proper functioning of the organ.

Causes of liver cirrhosis 

The principal cause of cirrhosis is a chronic infection with the hepatitis C virus. Other causes include:

  • Long-term, excessive alcohol consumption
  • Chronic infection with hepatitis B virus
  • Inherited disorders of iron and copper metabolism
  • Severe reactions to certain medications
  • Fatty liver caused by obesity
  • Infections from bacteria and parasites usually found in the tropics
  • Repeated episodes of heart failure with liver congestion and bile-duct obstruction

With cirrhosis, the liver tissue is irreversibly and progressively destroyed because of infection, poison, or some other disease. Normal liver tissue is replaced by scars and areas of regenerating liver cells.

Symptoms of liver cirrhosis 

  • abdominal pain
  • general fatigue
  • intestinal bleeding
  • itching
  • jaundice (yellowing of the skin and eyes)
  • loss of interest in sex
  • nausea and vomiting
  • small red, spider-like blood vessels under the skin or easy bruising
  • swelling in the abdomen and legs caused by fluid accumulation
  • weakness
  • weight loss

If you have cirrhosis, seek emergency help if you experience any of:

  • mental confusion
  • rectal bleeding
  • vomiting blood

How to diagnose liver cirrhosis?

Diagnosis of cirrhosis is based on your clinical or medical history and appearance, and blood test results. A liver biopsy may also be performed to confirm the diagnosis.

What is the treatment for liver cirrhosis?

There is no specific treatment for acute hepatitis. Bed rest isn’t always essential, although you may feel better if you limit your amount of physical activity. It is important to maintain an adequate intake of calories. Your doctor may recommend small, frequent high-calorie meals with plenty of fluids. Alcohol should be avoided or limited to help the liver recover. If you cannot eat or drink, you may be hospitalized.

Some people with chronic hepatitis B or C may benefit from medications that can slow the replication (reproduction) of the virus to decrease the amount of virus in the body. The risks and benefits of these medications should be discussed with your doctor.

With hepatitis B or C, your doctor may check blood periodically for a few months to watch for any continuing signs of inflammation in the liver. It isn’t usually necessary to isolate people with hepatitis, but those who are close to someone with hepatitis should know how the virus spreads. Hand-washing after going to the bathroom is very important.

If you are travelling to countries where hepatitis is common, check with your doctor or travel medicine clinic to see if you are a candidate for hepatitis A or B immunization. There is no immunization against hepatitis C.

While there are no effective treatments for liver cirrhosis, its progression can be reduced by complete abstinence from alcohol. Caution should also be taken when considering the use of medications that can worsen liver disease. For example, people with cirrhosis should discuss with their doctor how much acetaminophen they can take safely because acetaminophen is metabolized by the liver. Sometimes anti-inflammatory medications need to be avoided.

Treatment is mainly focused on complications and may include salt restriction to combat fluid retention, diuretic medications (“water pills” that help get rid of excess water in the body), a low-protein diet, and vitamin supplements such as vitamins K, A, and D. Itching may be controlled with special medications. Laxatives may be prescribed to speed up the removal of toxins from the system. Sometimes, a liver transplant may be necessary.

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What are the tests for liver function?

Damage to the liver often gives rise to telltale abnormalities in certain blood tests (suggesting liver disease), the so-called liver blood tests (for example, ALT, AST, and alkaline phosphatase enzymes). The liver blood tests often are collectively referred to as liver function tests. But abnormalities in only some of them (i.e., elevated bilirubin, low albumin, and prolonged prothrombin time) reflect abnormal function of the liver. And, it turns out that abnormalities of the other liver blood tests may reflect the actual injury to the liver. For example, viral hepatitis can cause the ALT or AST enzymes in injured liver cells to spill into the bloodstream and increase their level in the blood.

Sometimes, the pattern of liver blood test abnormalities provides a clue as to the type of liver disease. For example, an AST to ALT ratio greater than two (as long as both are less than nine times normal) suggests alcoholic hepatitis or cirrhosis of any type.

Other blood tests are more specific for the diagnosis of particular liver diseases. For example, there are antibody tests for most of the different viral hepatitis and immunological tests for primary biliary cirrhosis (anti-mitochondrial antibodies) or chronic autoimmune hepatitis (smooth muscle antibody). There are special tests for hemochromatosis (iron-related tests), Wilson’s disease (copper-related tests), and liver cancer (tumour markers).

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