Frequently Asked Questions

Frequently Asked Questions

Get answer of your queries related to health of liver, fatty liver Diseases, Cirhosis & Symptoms

Basic of Liver

No, it is only found in vertebrates.

The liver is an accessory digestive gland that produces bile, an alkaline compound which helps the breakdown of fat. Bile aids in digestion via the emulsification of lipids.

Yes, ithas many important functions including detoxification of various metabolites, and synthesis of proteins.

Estimates regarding the organs total number of functions vary, but textbooks generally cite it being around 500.

 

Terminology related to the liver often starts in hepat, the Greek word for liver. Same is the reson to call liver specialist as hepatologist.

 

Artificial livers are yet to be developed to promote long-term replacement in the absence of the liver.

 

Liver dialysis is a detoxification treatment for liver failure and has shown promise for patients with hepatorenal syndrome. It is similar to hemodialysis and based on the same principles.

The liver is a reddish-brown, wedge-shaped organ with four lobes of unequal size and shape. A human liver normally weighs approximately 1.5 kg, and has a width of about 15 cm (6 in). It is both the heaviest internal organ and the largest gland in the human body.

The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers around 75% of the livers blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; about half of the livers oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries

Cirrhosis

Cirrhosis is a condition in which the liver does not function properly due to long-term damage. This damage is characterized by the replacement of normal liver tissue by scar tissue. Typically, the disease develops slowly over months or years.

Fatty Liver

Fatty Liver is a condition where excess fat builds up in the liver.

Fatty liver is caused by:
i. Over-weight and obesity
ii. Metabolic conditions like Diabetes Mellitus and excess of Cholesterol or Triglycerides in the body.
iii. Viral infections like Hepatitis C, and more rarely by Hepatitis B.
iv. Insulin Resistance Syndrome
v. Obstructive Sleep Apnea
vi. In the West, the commonest cause is excess consumption of alcohol.
vii. Some drugs
viii. Sudden weight loss, starvation, intravenous feeding, and some
abdominal surgeries can also result in a fatty liver.
ix. Rarely it can be severe and life threatening complication in pregnancy
x. Idiopathic – sometimes no cause can be found

It can be typed several ways.
The commonest would be to classify according to the cause eg:
I. Idiopathic
II. Alcoholic Fatty Liver
III. Non Alcoholic Fatty Liver (NAFLD)
IV. Fatty Liver of Pregnancy
V. Secondary to other diseases like Diabetes etc.
Another way to classify Fatty Liver would be according to the histology
I. Alcoholic Liver Disease
II. Non Alcoholic fatty Liver (NAFLD)
III. Non Alcoholic Steato-Hepatitis (NASH)

This is the more common form of the disease and comprises about 70-80% of the disease burden. NAFLD was considered to be a benign change in the liver, often secondary to other diseases like Diabetes. The enzymes (ALT, AST and GGT) are mostly normal. It is associated with heart Disease, Metabolic syndrome, female infertility (Polycystic Ovarian Syndrome or PCOS), it can progress to NASH and can rarely cause liver cancer.

NASH on the other hand is the more rapidly progressive and aggressive disease form. In NASH the enzymes mentioned above are raised and there is evidence of liver cell damage on histology with replacement fibrosis, ultimately leading to cirrhosis and liver failure and cancer. This form makes up about 20-30% of the disease burden

Fatty liver is becoming more and more common as the world becomes more sedentary and has more food to eat. In Pakistan it is estimated that about 30-40% people are now fat and about 50-80% of them will have fatty
liver.

No, there is no definite symptom association. It can cause upper abdominal fullness and dragging pain, dyspepsia, gasses (flatulence) etc.

As yet there is no definitive treatment and no short cuts either. Whatever your weight, if you have fatty liver, try reducing your weight. Loss of 10% of the basal weight can often reverse the fatty liver. In grossly obese surgery may be recommended to reduce weight. There are some medicines but none works as well as reducing weight. Also if you have fatty liver other condition like Hepatitis must be ruled out.

Except for the rare Acute Fatty Liver of pregnancy which can be severe and even life threatening, all other Fatty Liver is slowly progressive. It takes years to develop a Fatty Liver and may take months to years of life style modification, exercise and weight reduction to get rid of it. Because of its potential complications it is necessary to work on it, but there is no emergency other than in pregnancy.

Hepatitis A

Hepatitis A is an infectious disease of the liver caused by the hepatitis A virus (HAV). It is usually spread by eating food or drinking water contaminated with infected feces.

The hepatitis A vaccine is effective for prevention. Some countries recommend it routinely for children and those at higher risk who have not previously been vaccinated. It appears to be effective for life.

Youre most likely to get hepatitis A from contaminated food or water or from close contact with a person or object thats infected. Mild cases of hepatitis A dont require treatment. Most people who are infected recover completely with no permanent liver damage

Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Hepatitis A signs and symptoms typically dont appear until youve had the virus for a few weeks. Every one doesn’t have the typical signs and symptoms. So need to consult a doctor.

The virus most commonly spreads when you eat or drink something contaminated with fecal matter, even just tiny amounts. It does not spread through sneezing or coughing.

Unlike other types of viral hepatitis, hepatitis A does not cause long-term liver damage, and it doesnt become chronic. In rare cases, hepatitis A can cause a sudden loss of liver function.

Hepatic Encephalopathy

Hepatic encephalopathy is caused by an accumulation of toxins in the bloodstream that are normally removed by the liver. This condition can result in coma and can prove fatal.

Jaundice

Jaundice, also known as (yarqan or peelia), is a yellowish or greenish pigmentation of the skin and whites of the eyes due to high bilirubin levels.

It is commonly associated with itchiness. The feces may be pale and the urine dark.

Levels of bilirubin in blood are normally below 1.0 mg/dL (17 µmol/L) and levels over 2–3 mg/dL (34-51 µmol/L) typically results in jaundice.

Yes, high bilirubin is divided into two types: unconjugated (indirect) and conjugated (direct).

No, few other conditions can also cause yellowish skin but are not jaundice include carotenemia from eating large amounts of certain foods and medications like rifampin.

There are varying causes of jaundice and treatment varies with the cause of jaundice.

Neonatal jaundice is usually harmless: this condition is often seen in infants around the second day after birth, lasting until day 8 in normal births, or to around day 14 in premature births.

Causes for neonatal jaundice include normal physiologic jaundice, jaundice due to formula supplementation, and some blood diseases.

 

Bilirubin count is lowered through bowel movements and urination, so frequent and effective feedings are especially important.

 

Jaundice itself is not a disease, but rather a sign of one of many possible underlying pathological processes that occur at some point along the normal physiological pathway of the metabolism of bilirubin in blood.