Liver disease

Liver disease
Classification and external resources
Micrograph of non-alcoholic fatty liver disease, demonstrating marked macrovesicular steatosis. Trichrome stain.
MedlinePlus	000205
MeSH	D008107

Liver disease (also called hepatic disease) is a type of damage to or disease of the liver.

Signs and symptoms

The symptoms related to liver dysfunction include both physical signs and a variety of symptoms related to digestive problems, coagulopathies, blood sugar problems, immune disorders, abnormal absorption of fats, and metabolism problems.^{[citation needed]}

The malabsorption of fats may lead to symptoms that include indigestion, reflux, deficit of fat soluble vitamins, hemorrhoids, gallstones, intolerance to fatty foods, intolerance to alcohol, nausea and vomiting attacks, abdominal bloating, and constipation.

Nervous system disorders include depression, mood changes, especially anger and irritability, poor concentration and "foggy brain", overheating of the body, especially the face and torso, and recurrent headaches (including migraine) associated with nausea.

The blood sugar problems include hypoglycaemia.

Hypercholesterolemia: elevated LDL cholesterol, reduced HDL cholesterol, elevated triglycerides, clogged arteries leading to high blood pressure, heart attacks and strokes, build up of fat in other body organs (fatty degeneration of organs), lumps of fat in the skin (lipomas and other fatty tumors), excessive weight gain (which may lead to obesity), inability to lose weight even while dieting, sluggish metabolism, protuberant abdomen (pot belly), cellulite, fatty liver, and a roll of fat around the upper abdomen (liver roll) etc.^{[citation needed]} Or too low levels of lipids: hypocholesterolemia: low total cholesterol, low LDL and VLDL cholesterol, low triglyderides.

Types

There are more than a hundred kinds of liver disease [www.nhs.uk/Conditions/liver-disease/Pages/Introduction.aspx]. The most widely spread are as follows: [and then the list should be in order of (maybe only roughly) decreasing incidence rates in the world population, with at least some indication of incidence rates and significant variations with population type]

• Hepatitis, inflammation of the liver, is caused mainly by various viruses (viral hepatitis) but also by some liver toxins (e.g. alcoholic hepatitis), autoimmunity (autoimmune hepatitis) or hereditary conditions.
• Alcoholic liver disease is any hepatic manifestation of alcohol overconsumption, including fatty liver disease, alcoholic hepatitis, and cirrhosis. Analogous terms such as "drug-induced" or "toxic" liver disease are also used to refer to the range of disorders caused by various drugs and environmental chemicals.
• Fatty liver disease (hepatic steatosis) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells. Non-alcoholic fatty liver disease is a spectrum of disease associated with obesity and metabolic syndrome, among other causes. Fatty liver may lead to inflammatory disease (i.e. steatohepatitis) and, eventually, cirrhosis.
• Cirrhosis is the formation of fibrous tissue (fibrosis) in the place of liver cells that have died due to a variety of causes, including viral hepatitis, alcohol overconsumption, and other forms of liver toxicity. Cirrhosis causes chronic liver failure.
• Primary liver cancer most commonly manifests as hepatocellular carcinoma and/or cholangiocarcinoma; rarer forms include angiosarcoma and hemangiosarcoma of the liver. (Many liver malignancies are secondary lesions that have metastasized from primary cancers in the gastrointestinal tract and other organs, such as the kidneys, lungs, breast, or prostate.)
• Primary biliary cirrhosis is a serious autoimmune disease of the bile capillaries.
• Primary sclerosing cholangitis is a serious chronic inflammatory disease of the bile duct, which is believed to be autoimmune in origin.
• Budd–Chiari syndrome is the clinical picture caused by occlusion of the hepatic vein, which in some cases may lead to cirrhosis.
• Hereditary diseases that cause damage to the liver include hemochromatosis, involving accumulation of iron in the body, and Wilson's disease, which causes the body to retain copper. Liver damage is also a clinical feature of alpha 1-antitrypsin deficiency and glycogen storage disease type II.
• In transthyretin-related hereditary amyloidosis, the liver produces a mutated transthyretin protein which has severe neurodegenerative and/or cardiopathic effects. Liver transplantation can provide a curative treatment option.
• Gilbert's syndrome, a genetic disorder of bilirubin metabolism found in about 5% of the population, can cause mild jaundice.

There are also many pediatric liver diseases including: biliary atresia, alpha-1 antitrypsin deficiency, Alagille syndrome, and progressive familial intrahepatic cholestasis.

Diagnostics

A number of liver function tests (LFTs) are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products. serum proteins, serum albumin, serum globulin, A/G Ratio, alanine transaminase, aspartate transaminase, prothrombin time, partial thromboplastin time, platelet count.

Treatment

The most effective way to treat alcoholic liver disease and non-alcoholic fatty liver disease is to make lifestyle changes, such as:

• Cutting out alcohol
• Improving the diet
• Engaging in regular exercise

Anti-viral medications are available to treat infections such as Hepatitis B and Hepatitis C. This is an area of active research and drug development and today many treatments offer improved outcomes, by clearing or controlling the virus to slow any decline in the condition of your liver.

Other conditions may be managed by slowing down disease progression, for example:

• By using steroid-based drugs in autoimmune hepatitis.
• Regularly removing a quantity of blood from a vein (venesection) in the iron overload condition, hemochromatosis.
• Wilson’s disease, a condition where copper builds up in the body, can be managed with drugs which bind copper allowing it to be passed from your body in urine.
• In cholestatic liver disease (where the flow of bile is affected) a medication called ursodeoxycholic acid (URSO, also referred to as UDCA) may be given. Made from naturally occurring bile acid, it may offer some protection for the liver from the harmful chemicals in the bile, slowing damage.

See also

• Hepato-biliary diseases

References