The liver plays a vital role to purify the blood, helps in digestion and fights infection. The rising cases of liver diseases can be serious and even fatal. The liver can be damaged due to the inflamed cell, bile flow can be obstructed, cholesterol can accumulate, blood flow to the liver may be compromised and liver tissue can be damaged by chemicals and minerals, or infiltrated by abnormal cells, like cancer cells.
Symptoms
Some of the early signs of the liver disorder include abdominal pain, abnormal stools and flu-like symptoms including fatigue, nausea, vomiting, muscle or joint pain and fever. Patients can also experience loss of appetite, swelling of abdomen and/or legs, bleeding and bruising more easily, dark urine, jaundice and sensitivity to medications experiencing stronger side effects
Stages of liver disorder
From the beginning of the condition to advanced liver disease, the damage progresses in these four stages:
Stage 1: Initial stage of liver disease includes inflammation of the liver or bile duct. This cause abdominal pain as the body tries to fight the infection. The symptoms are treatable.
Stage 2: Fibrosis of the liver damages or scarring from the first stage begins to block the normal blood flow of the liver.
Stage 3: Cirrhosis of the liver, this chronic condition, creates permanent scarring that blocks the blood flow. It causes serious conditions that increase the severity of the liver disease and is recognised as one of the leading causes of death in the US. Doctors focus treatment on managing the symptoms in order to prevent it.
Stage 4: Advanced liver disease signals the end of all normal liver function. Symptoms of liver failure include vomiting, diarrhoea and fatigue as well as the symptoms from stage 3. While the progression from cirrhosis to failure can take years, the damage is irreversible and eventual leads to death.
Diagnosis
The key to treating liver disease is to diagnose the condition as early as possible. The in depth diagnosis involves medical history and physical examination of the patient. In alcohol abused patient, it becomes little difficult to trace the medical history. Blood tests are crucial in assessing liver inflammation and function.
Tests
Some of the important blood tests that monitor liver inflammation and cell damage, kidney function and blood clotting function include liver Functions Tests (lFT), Renal Function Tests (RFT), Complete Blood Count (CBC), PT INR and Ammonia Blood test. Patients might also require to get an ultrasound done that can provide information about the appearance and the blood flow of the liver, and CT and MRI scan to determine changes in the liver in advanced cases of liver disease. The viral infection tests that are also considered for the diagnosis includes Hepatitis B and Hepatitis C tests.
TREATMENT
Treatment for liver disease depends on the diagnosis. The liver is one of the few organs in the body that can repair and regenerate itself. Some liver problems can be treated with lifestyle modifications, such as losing weight and lowering one’s cholesterol. Non-alcoholic fatty liver disease (NAFlD) is managed almost exclusively by modifying your diet and exercise routine. Alcohol is directly toxic to liver cells and can cause liver inflammation, referred to as alcoholic hepatitis. In chronic alcohol abuse, fat accumulation occurs in liver cells affecting their ability to function.
Other liver problems may be treated with medications or may require surgery. Treatment for liver disease that causes or has led to ultimately liver failure may require a liver transplant.
The Writer is Dr Manish Srivastava Consultant, surgical gastroenterology and liver transplant department Jaypee Hospital, Noida