Common Liver Diseases
Alcoholic Liver Disease
It is of the most common reasons for liver diseases including cirrhosis is chronic and excessive alcohol intake. This leads to the replacement of healthy liver tissue with scar tissue. Damage to liver due to alcohol abuse generally goes thorough 3 phases - Fatty liver, Alcoholic hepatitis and Cirrhosis.
NAFLD and NASH
- Fatty Liver aka Steatosis - In this condition, there is accumulation of fat inside liver cells. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).Heavy alcohol users tend to get this condition in their early years of alcohol abuse. Most of the times the condition goes unnoticed as it doesn’t produce any symptoms. The condition is largely reversible if one completely stops taking alcohol
- Alcoholic Hepatitis - This is the second stage of alcoholic liver disease in which liver cells suffer damage and get destroyed as a result of inflammation. Jaundice is the most common symptom of this stage along with nausea, vomiting, loss of appetite, weight loss, fatigue etc
- Cirrhosis - This is the last and final stage of Alcoholic Liver Disease. At this stage, the disease has reached a point of no return. In this stage the healthy liver tissue gets replaced by permanent scar tissue. It is at this stage that a large number of complications begin to occur. The only definitive treatment for this stage is a liver transplant
The other way fat accumulates in people who drink little or no alcohol is consumption highly saturated fatty foods. The condition is termed as Non Alcoholic Fatty Liver Disease (NAFLD). People who are obese, have diabetes are at greater risk of developing this condition. The more severe form of NAFLD is Non-alcoholic Steatohepatitis (NASH). In this condition, the liver cells suffer inflammation and start to get damaged. NASH remains one of the leading causes of liver cirrhosis requiring liver transplant.
Viral Hepatitis is one of the commonest causes of hepatitis across the world. It can be of following types :
Drug Induced Hepatitis
Hepatitis A and E- Hepatitis A is typically caused by consuming contaminated food and water. Infection is mild in most cases with most patients making full recovery and becoming immune from further hepatitis A infection. However, in some cases it can cause severe and life threatening illness. Vaccines are available to prevent Hepatitis A. Hepatitis E spread is similar to hepatitis A and is becoming an increasingly common cause of outbreaks. There is a vaccine for Hepatitis E but not as widely available
Hepatitis B - Chronic hepatitis B is a leading cause of liver cirrhosis which can also lead to liver cancer. About 4 crore people of India suffer from Hepatitis B. As many as 95% of the infected people do not even know that they are infected. Common modes of spread include exposure to body fluids of infected people, unsafe sexual practices and mother-to-child transmission. Healthcare workers are at greater risk due to needle stick injuries while caring for hepatitis B infected patients. Effective vaccines are available Hepatitis B and it is advised that everyone who is not suffering from this disease should take them
Hepatitis C - About a crore people in India suffer from hepatitis C. The virus is mostly transmitted via transfusion of blood and blood products if appropriate care is not taken to screen the blood products. Currently there is no vaccine for this virus
Hepatitis D - Hepatitis D occurs only in those who are infected with Hepatitis B. The dual infection causes serious illness with worse outcomes. Hepatitis B vaccine also offers protection from Hepatitis D
It is a relatively rare condition caused by intake of excessive amounts of certain medicines (painkillers like Aspirin, paracetamol etc., vitamins, herbal remedies, and some food supplements). In most cases, a patient may be taking a medicine for several months before it reaches a toxic level and affects liver. In some cases the harm caused to liver can be rapid if one takes too much of some medicines, such as acetaminophen.
Liver cirrhosis is the end stage of liver injury that has reached a point of no return. It attributable to a variety of causes such as alcohol, viral hepatitis and non alcoholic fatty liver disease etc. This happens when prolonged and sustained liver injury causes the liver to replace its healthy tissue with permanent scar tissue in an attempt to heal itself. It is at this stage that a large number of complications (as mentioned earlier) begin to occur.
Treatment for cirrhosis depends on the cause and extent of liver damage. Liver cirrhosis can not be reversed, hence the goal of treatment is to slow the progression of scar tissue and to prevent or treat symptoms and complications of cirrhosis. In advanced cases of cirrhosis where liver has stopped to function, liver transplant remains the only treatment option.
The commonest type of liver cancer is called hepatocellular carcinoma (HCC) which begins in the liver cell (hepatocyte). Other less common type of liver cancers are intrahepatic cholangiocarcinoma and hepatoblastoma.
Some cancers begin in other areas of the body (such as intestines, lung or breast) and then spread to the liver. They are called metastatic cancer instead of liver cancer.
Risk factors for developing Hepato-cellular carcinoma are:
- Chronic infection with Hepatitis B virus and Hepatitis C virus
- Liver cirrhosis
- Non-alcoholic fatty liver disease (NAFLD)
- Exposure to aflatoxins - Crops such as corn and peanuts can become contaminated with aflatoxins
- Excessive alcohol consumption
- Certain inherited liver diseases - Hemochromatoses and Wilson's disease