Liver health

The liver

The liver is located in the right upper quadrant of the abdomen, just below the diaphragm and the rib cage. It is anatomically divided into a left and right lobe. The liver weighs approximately 1400g and is the second largest organ in the human body. It receives nearly 25% of the cardiac output (The amount of blood your heart pumps in one minute) approximately 1500ml of blood flow per minute. This is achieved by the portal vein and hepatic artery.

Since the liver has such a rich and systemic blood supply, the liver is a prime site for the metastatic spread of cancer, especially from the GI tract, breast, and lung. It performs over 500 functions, this includes protein, lipid, carbohydrate metabolism as well as drug metabolism and excretion. Iron is also stored in the liver/bone marrow to make red blood cells which carries oxygen in our bodies. The liver adjusts cholesterol levels, builds proteins, and makes bile, which helps you absorb fats, stores sugar for when you really need it and regulates hormone levels

Liver health and diseases

Many health problems can keep your liver from functioning properly and cause disease.

Alcoholic Liver Disease. Alcoholic liver disease is a result of alcohol abuse. Repeated episodes of acute injury ultimately cause necrosis, fibrosis, and regeneration, leading to cirrhosis.

Cholestasis. This happens when the flow of bile from your liver is limited or blocked. Cholestasis can be caused by certain drugs, genetic factors or even pregnancy. It can also occur from a blockage caused by a tumour, or a gallstone stuck in the body’s digestive system.

Cirrhosis. An irreversible alteration of normal liver architecture, characterized by hepatic injury, fibrosis, and nodular regeneration. Heavy alcohol use and viruses like hepatitis are common causes of cirrhosis. Not all patients will Cirrhosis develop life-threatening complications.

Hepatitis. This is the name for any condition involving inflammation of your liver. There are many different types, acute, viral, toxic, chronic, and alcoholic hepatitis. Hepatitis can lead to liver failure, liver cancer and other life- threatening conditions.

Non-alcoholic Fatty Liver Disease (NAFLD). A form of chronic liver disease associated with the metabolic syndrome. This is an umbrella term for a wide range of liver diseases. NAFLD is diagnosed when there are no other causes of secondary hepatic fat accumulation (e.g., heavy alcohol consumption)

Lifestyle

• Get vaccinated for hepatitis. Hepatitis A and B are viral diseases of the liver. While many children have now been immunized, many adults have not. Ask your doctor if you are at risk.
• Avoid contaminated needles while tattoos and piercing.
• Avoid toxins like drugs and some medicines that can harm your liver.
• Practice safe sex because there is no vaccine for hepatitis C. Hepatitis B and C can develop into chronic conditions that may eventually destroy your liver. They are transmitted by blood and other bodily fluids.
• Wash your hands: Hepatitis A is spread through contact with contaminated food or water.
• Avoid smoking and the use of tabaco products.
• Pesticides and other toxins can damage your liver. Read warning labels on the chemicals you use.

Diet

• Don’t eat foods high in fat, sugar, and salt.
• Stay away from a lot of fried foods including fast food restaurant meals.
• Raw or undercooked shellfish such as oysters and clams are a definite no-no.
• Try to limit alcohol consumption to no more than one drink a day if you’re a woman and two drinks a day if you’re a man.
• Eat a balanced diet: Select foods from all food groups: Grains, fruits, vegetables, meat and beans, milk, and oil.
• Eat food with fibre: Fibre helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your body’s fibre needs.
• Drink lots of water: It prevents dehydration, and it helps your liver to function better.

Exercise

• Maintain your body mass index in the normal range (18 to 25) by eating healthy and exercising on a regular basis to decrease your risk of developing non-alcoholic fatty liver disease (NAFLD).

Screening

• Blood Test – several blood tests are commonly used to assess liver function, these range from measuring the enzymes (AST and ALT) of the liver as well as levels of albumin, clotting factors and bilirubin.
• Imaging Tests – Ultrasound, CT scan, MRI gives a detailed picture of the liver and abdominal part.
• Biopsy – A small part of the tissue is removed to diagnose the type of liver disease by means of inserting a needle through the skin and aspirating liver cells. Most biopsies are performed as day-case procedures.

References

• Mohan, Y., 2022. Liver – Anatomy, Functions, Diseases, Diagnosis, Tips – LeoGenic Healthcare Pvt Ltd. [online] LeoGenic Healthcare Pvt Ltd. [Accessed 19 August 2022].
• Mcphee, S.J. and Hammer, G.D. (2019). Pathophysiology of disease: an introduction to clinical medicine. 8th ed. New York: Mcgraw-Hill Education Medical.
• American Liver Foundation. 2022. Liver Disease Diets – American Liver Foundation. [online] [Accessed 19 August 2022].
• Hopkinsmedicine.org. 2022. 5 Ways to Be Kind to Your Liver. [online] [Accessed 19 August 2022].