Download Liver Basics

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Overviewoftheliver
LiverBasics
Yourliverisoneofthelargestandmostimportantorgansinyourbody.Youhaveonlyoneliver.Itisthesize
ofafootballandweighsabout3poundsintheaverage-sizeperson.Itisreddish-brown.Yourliverislocated
ontherightsideofyourabdomenbehindyourlowerribs,andyourribshelptoprotectyourliver.
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Theliverisafilter
Yourliverhasmanyimportantjobs.Oneofthejobsthattheliverdoesistoactasa"filter"for
yourbody;itfiltersordetoxifiestheblood.Almostallthebloodinyourbodypassesthrough
theliver.Asbloodpassesthroughtheliver,itbreaksdownsubstances,suchasprescriptionor
over-the-counterdrugs,streetdrugs,alcohol,andcaffeine.Ourbodiesnaturallyproducesomeharmful(toxic)
[10] chemicalsorpoisons,andtheliveralsobreaksthosedown.Inthiswaytheliveractsasafiltertocleanyourblood.
Theliverisafactory
Theliverisalsoa"chemicalfactory"--performingover500chemicalfunctionsinyourbody!Thelivertakescertain
materialsinyourbodyandturnsthemintosomethingelse.Forexample,yourliverturnsproteinsandsugarsintothings
thatyourbodyneeds.Theliverproducesblood-clottingfactorsthatareneededtohelpyouhealafteraninjury.Italso
[15] storesvitamins,hormones,cholesterol,andminerals.Yourliverletsgoofthesechemicalsandnutrientswhenyourbody
needsthem,andtheyflowintoyourbloodstream.Theliveralsoproducesagreenishfluidcalledbile.Tubes,called"bile
ducts,"connecttheliverandanotherorgan,thegallbladder,tothesmallintestine.Thebilethatismadebytheliverhelps
todigestfatsinthesmallintestine.
Summaryofliverfunctions
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Theliver:
• Filtersyourblood
• Makesproteins,includingblood-clottingfactors(neededtohelpyouheal)
• Storesvitamins,sugars,fats,andothernutrients
• Helpsregulatehormones
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• Releaseschemicalsandnutrientsintothebodywhenneeded
• Makesbileneededfordigestingfats
• Andmuchmore
Liverdiseaseandothercomplications
Liverdiseaseiscausedbydamagetotheliver.Liverdamagecanbecausedbymanythings,including:
• Viruses(suchasthehepatitisviruses)
• Drinkingalcoholheavily
• Beingveryoverweight
• Certainmedications--forexample,acetaminophen(Tylenol),cancausesevereliverdamageinpeoplewhoalsohave
heavyalcoholuse
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• Exposuretoindustrialchemicals,includingcleaningsolvents,aerosolizedpaints,andpaintthinners
Liverdamagecanleadtoliversthatareswollen,shrunken,hard,orscarred.Suchliversdonotworkwell,andyoucanget
verysick,orevendie,ifyourliverstopsworkingaltogether.
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Symptomsofliverdisease
Acute
Ifsomethinghappenstotheliversuddenly,itis"acute."Someacuteliverproblemswillcausesymptomssuddenlyaswell.
Symptomsofacuteliverdiseasecaninclude:
• Tirednessorweakness
• Jaundice(yellowingoftheeyesandskin)
• Fever
• Nauseaandvomiting
• Darkurineorverypalecoloredstools
• Painundertheribsontherightside
Uptohalfofallpeoplewithacuteliverdiseasehavenosymptomsatall.Sometypesofacuteliverdiseasegetbetter
withouttreatment,andtheliverhealsitselfentirely.Onrareoccasionsanacuteliverinjurycanrequirehospitalizationand
evenlivertransplantrightaway.
Chronic
Ifsomethingiscontinuingtoaffecttheliverovertime,after6monthsitis"chronic."Manypeoplewithchronicliver
problemswillhavenosymptomsatallandmaynotevenknowtheyhavealiverproblem.Sometimestheydevelop
symptomsonlywhentheliverhasbeendamagedformanyyears.
http://www.hepatitis.va.gov/patient/basics/liver-single-page.asp
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Hepatitis
Theword"hepatitis"meansinflammationorswellingoftheliver.Manythingscantriggerthis,andthehepatitisCvirusis
justoneofthem.Medications,alcohol,andevensomegeneticdiseasescancauseinflammation.(Geneticdiseasesare
onesthatarepasseddownfromyourbiologicalparents.)Sometimesliverinflammationgetsbetteronitsown,but
sometimes,asinthecaseofchronichepatitisC,treatmentwithmedicationsisrequiredtostoptheinflammation.Ifyou
havehepatitis,youneedtobeverycarefulnottodothingsthatmightirritateyourliverevenmore.Alcoholirritatesthe
liver,eveninsomeonewhodoesn'thaveanyotherliverproblems.
Summary:"Hepatitis"meansinflammationoftheliver.Itcanbecausedby:
• Geneticdiseases
• Medications(includingover-the-counterdrugs)
• Alcohol
• Viralhepatitis(suchashepatitisA,hepatitisB,andhepatitisC)
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Fibrosisandcirrhosis
Anythingthatdamagestheliverovermanyyearscanleadthelivertoformscartissue.Fibrosisisthefirststageofliverscarring.
Whenscartissuebuildsupandtakesovermostoftheliver,thisisamoreseriousproblemcalledcirrhosis(pronounced"sir-o
[70] sis").Scartissuecannotperformanyofthejobsofnormallivercells,andthiscausesapersonwithcirrhosistoslowlybecomeill.
Noteveryonewithhepatitisorachronicliverproblemwilldevelopcirrhosis.Cirrhosisdoesnothappenovernight.Intheearly
yearsofhavingcirrhosis,manypeoplewillhavenoobvioussignsorbeillandmanymaynotevenbeawaretheyhavecirrhosisat
all.Cirrhosiscanbecausedbyanythingthatdamagestheliverafteryearsofirritation,notjustalcohol.However,heavyalcohol
useandhavingthehepatitisCvirusforalongtime(suchas20to30years)increasesyourrisk.Overtime,cirrhosiscanleada
[75] persontobecomeill.Symptomscanincludefatigue,difficultythinkingclearly,fluidintheabdomen,bleedingintheintestines,
andpoorbloodclotting.Anyonewhohascirrhosis,withorwithoutsymptoms,needsveryclosemedicalattention.
Alcoholicliverdisease
AlcoholicliverdiseaseisacommonformofliverdiseaseintheUnitedStates.Peoplegetalcoholicliverdiseasebydrinking
largeamountsofalcoholformanyyears.Itdoesn'tmatterwhetherthealcoholcomesfromhardliquor,beer,orwine.Any
typeofalcoholcancauseliverdamage.Oneunitofanalcoholicbeveragecontains10gramsofalcohol.Aunitisroughly
equivalentto:
• one12-ouncebottleofbeer(5%alcohol)
• one4-ounceglassofwine(12%alcohol)
• one1-ounceshotofhardliquor(40%alcohol)
Sohowmuchalcoholistoomuch?Itdependsonwhetheryou'reamanorawoman.Studieshaveshownthatwomen
experienceliverdiseaseatlowerlevelsofalcoholintakethanmen.Manyliverspecialistswouldagreethatliverdiseaseis
likelyattheselevels:Forwomen:4ormoreunitsofalcoholdailyforatleastayear;Formen:6ormoreunitsofalcohol
dailyforatleastayear.Somepeoplewillexperienceliverdamageeveniftheydrinkmuchless.Thegoodnewsisthatthe
liversofheavydrinkerscanimproveiftheystopdrinkingentirely.
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Fattyliver
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Fattyliveristhebuildupoffatinlivercells.ItisprobablythemostcommontypeofliverdiseaseintheUnitedStates.Fattyliver
byitselfrarelyleadstosevereliverdamage.Fattylivercanresultfromdrinkingtoomuchalcohol.Itcanalsohappeninpeople
whorarelydrink.Inthiscase,itiscalled"nonalcoholicfattyliverdisease"or"nonalcoholicsteatohepatitis,"orNASH.("steato-"
meansfat.)WithNASH,apatient'slivershowssomeinflammationthatinsomecasescanleadtoliverdamageandcirrhosis
[95] (scarringofthelivertissue).Itisnotclearwhyfatbuildsupintheliver,butpeoplearemorelikelytodeveloptheconditionif
theyhavediabetes,areoverweight,orhavehighlevelsofcholesterolorbloodfats(called"triglycerides").Theamountoffatin
thelivermaydecreasewhenoverweightpeopleloseweight,whendiabeticshavewell-controlledbloodsugars,andwhen
cholesterolandtriglyceridelevelsarelowered.
Livercancer
[100}Likeallotherbodyorgans,yourlivercangetcancer.Livercancerisadiseaseinwhichsomeofthecellsinyourliverbeginto
reproducefasterthantheyshould.Thiscanleadtolivertumors,whicharegenerallydiagnosedbytakingpicturesoftheliver
withultrasound,computerizedtomography(CT)scan,ormagneticresonanceimaging(MRI).HavinghepatitisBorhepatitisC
canincreaseyourchancesofgettinglivercancer,calledhepatocellularcarcinoma(or"HCC").Mostpeoplewithlivercancerdo
nothaveanysymptomsfromitearlyon.Thosewhodohavesymptomsoftenhavesomepainintheareaoftheirliver(rightside
[105] oftheabdomen,undertheribs),ortheymayhaveabuild-upoffluidintheirabdomen(called"ascites").Livercancerisvery
seriousandcanbedeadly.Ifyoufindoutthatyouhavelivercancer,youneedtogettreatedassoonaspossible.
http://www.hepatitis.va.gov/patient/basics/liver-single-page.asp
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[107] Livertransplants
Livertransplantsareconsideredonlywhenapatientmightdiefromliverdisease.Thisissometimesthecasewhenapatienthas
livercancerorwhensomeonehasadvancedliverdiseaseandtheliverhasstoppedfunctioningproperly.Beingconsideredfora
[110] livertransplantdoesnotmeanthatapatientisindangerofdyingrightaway.Livertransplantationisalongprocessthatinvolves
alotofmedicalcare.Afteratransplant,apatientneedslifelongdrugstokeepthebodyfromrejectingthenewliver,andlifelong
follow-upcarefromaspecialist.Survivalratesafteratransplantarehigherthan90%at1year,andpatientsusuallyhaveagood
qualityoflifeaftertheirrecovery.
Testsforliverdamage
[115] Mostpeoplewithchronicliverdiseasewillhavenoongoingsymptoms,andthedamagewillbedetectedonlybybloodtests.The
tests(calleda“liverpanel”)measure:
• yourlevelofliverenzymes(seenextsection)
• yourlevelofbilirubin(pronounced"billy-roo-bin"),whichriseswhentheliverisnotworkingwell
• aproteincalledalbumin(pronounced"al-byoo-min"),whoselevelsgodownwhentheliverisdamaged
[120] Doctorscanrunmorebloodtestsiftheyneedtoinordertofindoutwhatiscausingthedamagetoyourliver.Ultrasound,CAT
scans,andMRIarethethreemainmethodsoftakingpicturesoftheliver.Theycanoftenshowiftheliverinjuryhasbecome
serious.Aliverbiopsy,inwhichaneedleisusedtotakeasampleoftheliveritself,cantellevenmoreabouttheliver'shealth.
Somepeoplewithliverproblemscanhaveaswollenliver.Othersmayhaveseverescarringorashrunkenliver.Duringan
examination,adoctorcanfeelthelivertofindoutifitisshrunken,hard,orswollen.
[125] Liverenzymes
Enzymesareproteinsfoundinyourbodythatspeedupcertainchemicalreactions.Liverenzymes
performthesejobswithintheliver.Twoofthecommonaminotransferaseenzymesareknownas
"AST"and"ALT."Iftheliverisdamaged,ASTandALTpassintothebloodstream.Whenyourdoctor
looksattheresultsfromyourbloodtests,ASTandALTvaluesarehigherthannormalifyourliveris
[130] damaged.Thedamagetothelivercancomefromviruses,suchasthehepatitisCvirus,over-thecounterdrugs,andprescriptionandstreetdrugs.Ifyourdoctorstartsyouonacertainmedication,heorshemayneedto
monitoryourbloodchemistriestomakesurethemedicationisnotcausingfurtherharmtoyourliver.
Reversingliverdamage
Theliverisoneoftheonlyorgansinthebodythatisabletoreplacedamagedtissuewithnewcellsratherthanscartissue.
[135] Forexample,anoverdoseofacetaminophen(Tylenol)candestroyhalfofaperson'slivercellsinlessthanaweek.Barring
complications,thelivercanrepairitselfcompletelyand,withinamonth,thepatientwillshownosignsofdamage.
However,sometimesthelivergetsoverwhelmedandcan'trepairitselfcompletely,especiallyifit'sstillunderattackfroma
virus,drug,oralcohol.Scartissuedevelops,whichbecomesdifficulttoreverse,andcanleadtocirrhosis.
Keepingyourliverhealthy
[140] Herearesomethingstorememberaboutkeepingyourliverhealthy:
• Don'thaveunsafesexualcontact.
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• Don'tinjectdrugslikeheroinorcocaine.
• Don'tdrinkalcohol.Alcoholisapoisontotheliverandalsocanmakeliverdiseasessuchashepatitismuch
worse.Ifyoudodrink,drinklightly.
• Don'tshareanypersonalitemssuchasrazorsortoothbrushesthatmighthavebloodonthem.
• AskyourdoctoraboutgettingvaccinatedagainsthepatitisAandB.Thereiscurrentlynovaccineagainstthe
hepatitisCvirus.
• Followstrictfoodsafetyguidelines.Makesurethatthewateryoudrinkandthefoodyoueatareclean,
especiallywhentravelingtoothercountries.MostcasesofinfectionwithhepatitisAresultfrompoor
cleanlinessduringfoodpreparation.
• Ifyoutakeanymedications,makesureyourdoctorknowsaboutthem.Alsotellyourdoctoraboutanyover-thecountermedicines,supplements,andnaturalorherbalremediesthatyouuse.Certainmedicinestakenatthe
sametimecancausedamagetoyourliver,evenifyoucanbuythemwithoutaprescription.
• Maintainahealthybodyweight.
• Controlbloodsugarsifyouhavediabetes.
• Keepcholesterolandbloodfatswithintherecommendedrange.
http://www.hepatitis.va.gov/patient/basics/liver-single-page.asp