| The
Liver
The liver is the largest organ in the body. It
is found high in the right upper abdomen, behind the ribs. It is
a very complex organ and has many functions. They include:
- Storing energy in the form of sugar (glucose)
- Storing vitamins, iron, and other minerals
- Making proteins, including blood clotting factors, to keep the
body healthy and help it grow
- Processing worn out red blood cells
- Making bile which is needed for food digestion
- Metabolizing or breaking down many medications and alcohol
- Killing germs that enter the body through the intestine
The liver shoulders a heavy workload for the body and almost never
complains. It even has a remarkable power to regenerate itself. Still
it should not be taken for granted. Certain conditions that develop,
such as fatty liver and steatohepatitis, may be signs of liver injury
that can lead to permanent liver damage.
Viral Hepatitis (Jaundice)
The term viral hepatitis is usually used to describe infections
caused by agents whose primary tissue tropism is the liver. To date,
at least five hepatitis viruses have been recognized, and these have
been named:-Hepatitis A, B, C, D and E. Acute hepatitis may also
occur as part of the clinical course of a number of viral infections,
including human cytomegalovirus, Epstein-Barr virus, herpes simplex
virus, yellow fever virus and rubella.
The majority of infections are totally asymptomatic, but common clinical
features include: anorexia, nausea, vomiting, right upper quadrant
pain and raised liver enzymes AST and ALT. Jaundice is the hall mark
of infection, but tends to develop late.
Hepatitis virus A and E are infected through oral route (food and
drinks) and B, C, D are through parenteral route - e.g. injections,
blood transfusion, sexual, tattooing, acupuncture. Hepatitis B is
the only DNA genome virus particle and all others are RNA only. Hepatitis
B is dangerous as it can lead to cancer of liver (hepatocellular
carcinoma). Epidemic or endemic type of jaundice is caused by either
A or E. One hepatitis G has been reported from the blood of a surgeon
but not widely reported.
In enteric types, the viral particles multiply in the intestines
and later reach liver where it enters hepatocytes and produce inflammation
causing liver to swell. Mild fever could be there initially with
body pain. Later develops jaundice. In parenteral types, viral particles
reach blood and produce viremia with symptoms. Further enters hepatocytes
to produce jaundice and later it leads to severe liver damage and
even liver failure and death. Carrier state is there who are prone
to spread the infection through parenteral route. Various vaccines
are developed now to prevent this dreadful disease. Serum vaccines
and recombinant DNA technology (yeast) HBsAg vaccines.
Fatty Liver
Fatty liver is just what its name suggests: the build-up of fat
in the liver cells. Although this is not a normal condition, fat
in the liver usually causes no damage by itself. However, on some
occasions it can be a sign that other more harmful conditions are
progressing. Fatty liver may be associated with or may lead to inflammation
of the liver.
 Cause It would seem logical that eating fatty foods
would cause a fatty liver, but this is not the case. The liver does
play an important role in the metabolism or breakdown of fats. Something
goes wrong in this process of metabolism, but it is still not known
what causes fat to build-up in the liver. It is known that fat accumulates
in the liver with a number of conditions. The most common is obesity.
Fatty liver is also associated with diabetes mellitus, high blood triglycerides,
and the heavy use of alcohol. It may occur with certain illnesses such
as tuberculosis and malnutrition, intestinal bypass surgery for obesity,
excess vitamin A in the body, or the use of certain drugs such as valproic
acid and corticosteroids. Sometimes fatty liver occurs as a complication
of pregnancy.
Symptoms and Diagnosis There are usually no symptoms
that are noticeable to the patient. In fact, fatty liver is frequently
uncovered during a routine physical examination. There may be a rise
in certain liver enzymes found in the blood, and sometimes the liver
is slightly enlarged. Fatty liver may also be discovered while the
physician is evaluating a patient for other illnesses. For example,
an ultrasound scan of the abdomen done for other reasons may show fat
in the liver. To be certain of a diagnosis of fatty liver, the physician
may recommend a liver biopsy. Under local anesthesia, a slender needle
is inserted through the right lower chest. A small piece of liver tissue
is taken out with the needle and examined under a microscope.
Cirrhosis of liver
When the scar tissue as a result of inflammation (hepatitis) in
liver replaces normal and healthy tissue, blocking the flow of blood
through this organ and preventing it from working as it should, is
called Cirrhosis of liver. Cirrhosis is most commonly caused by alcoholism
and hepatitis C, and was the 12th leading cause of death in the United
States in 2000, killing about 26,000 people each year. Alcoholic
Cirrhosis is the leading common type leading to fatal liver failure.
Causes Cirrhosis has many causes. In the United States,
chronic alcoholism and hepatitis C are the most common ones.
Symptoms Many people with cirrhosis have no symptoms
in the early stages of the disease. However, as scar tissue replaces
healthy cells, liver function starts to fail and a person may experience
the following symptoms: exhaustion, fatigue, loss of appetite, nausea,
weakness, weight loss, abdominal pain, spider-like blood vessels (spider
angiomas) that develop on the skin. As the disease progresses, complications
may develop. In some people, these may be the first signs of the disease.
Complications of Cirrhosis Loss of liver function
affects the body in many ways. Following are the common problems, or
complications, caused by cirrhosis. Edema and ascites, Bruising and
bleeding, Jaundice, Itching, Gallstones, Toxins in the blood or brain,
Portal hypertension, Varices, Insulin resistance and type 2 diabetes,
Liver cancer and Problems in other organs. |