Your liver is one of the largest and most important organs in your body. Your liver is behind the lower right part of
your ribs. Your ribs help keep your liver from being injured. Your liver is very important to your health.
Your liver: Stores vitamins, sugars, fats and other nutrients from the food that you eat. Builds chemicals that your
body needs to stay healthy. Breaks down harmful substances, like alcohol and other toxic (poisonous) chemicals. Removes waste
products from your blood.
Makes sure that your body has just the right amount of other chemicals that it needs. Many diseases can affect your liver.
If you have one of these diseases, your liver may not work as well as it should.
Some of the most common diseases that can affect your liver include:
VIRAL HEPATITIS. Hepatitis is a medical term that means "inflammation (swelling) of the liver." Viruses that attack the
liver cause some of the most common forms of hepatitis. In most cases, your doctor can use a simple blood test to see if you
have been exposed to one of these viruses.
Three of the most common viruses that attack the liver are:
Hepatitis A Virus (HAV). The hepatitis A virus is usually spread through dirty food and water. If you get hepatitis A,
you may feel like you have the flu, and notice a yellowish color (called jaundice) in your skin or in the whites of your eyes.
Just about everyone recovers from hepatitis A without any problems.
Hepatitis B Virus (HBV). The hepatitis B virus is spread through blood, semen and vaginal fluid. You can get hepatitis
B if you have sex with an infected person. You can also get hepatitis B if you share needles or works to inject drugs.
Like HAV, HBV can make you feel sick for a short time. After that, most people with hepatitis B get better.
A small number (2%-6%) of people who get HBV infection have problems for a much longer time. In some cases, these problems
can cause permanent liver damage. Following your doctor's advice is the best way to make sure that you recover from HBV disease.
Hepatitis C Virus (HCV). HCV is mainly spread through the blood. If you share needles or works to inject drugs, you have
a high chance of getting HCV infection. People who had a blood transfusion before 1992 might find out that they are infected
with HCV, as well.
Unlike the other hepatitis viruses, the virus that causes HCV may not make you feel very sick. In fact, you can be infected
with the HCV and not even know it. Hepatitis C is still a serious illness. Most people who get HCV never get rid of the virus
completely. Over time, it can cause permanent liver problems, including cirrhosis and liver cancer (see descriptions below).
CIRRHOSIS. Cirrhosis is a medical term that means "scarring of the liver." When you have cirrhosis, large parts of your
liver are damaged. Because it has been damaged, your liver may not work as well as it should.
Cirrhosis of the liver is often the result of drinking too much alcohol. Other common causes of cirrhosis include hepatitis,
especially hepatitis C.
Cirrhosis can be very dangerous if it is not treated properly. It is important to follow your doctor's advice if you
LIVER CANCER. Like many other body organs, your liver can get cancer. Liver cancer is a disease in which some of the
cells in your liver begin to reproduce faster than they should. These cells form growths called tumors. Having hepatitis B
or hepatitis C can increase your chances of getting liver cancer. Liver cancer can be deadly. If you find out that you have
liver cancer, you need to get treated as soon as possible.
Your doctor can see how well your liver is working by looking at certain substances in your blood. When your liver is
working well, the levels of these substances are low. When your liver is not working as well as it should, they can become
much higher. These substances include liver enzymes (chemicals that your liver uses to do its work) and bilirubin .
Albumin is a protein made by the liver. The albumin level is below normal when the liver is injured.
Your doctor will compare the results of tests on your blood with the results that are normal for most people. If your
results are high, your doctor may suspect that you have a liver disease. Usually, your doctor will have to perform other tests
to make sure.
Your liver is one of the most important organs in your body, so it's a good idea to keep it healthy. There are many
things you can do to protect your liver, including:
Don't have unsafe sex.
Don't inject drugs like heroin or cocaine.
Don't share any personal items that might have blood on them.
Don't drink alcohol. Alcohol can also make liver diseases like hepatitis much worse.
Get vaccinations (shots) against HAV and HBV. A simple series of shots can protect most people from getting infected
with the viruses that cause hepatitis A and B. There is currently no vaccine against the virus that causes hepatitis C.
Make sure that the water you drink and the food you eat are clean. Most cases of infection with HAV result from poor
cleanliness, especially in restaurants and cafeterias.
If you take any medications, make sure your doctor knows about them. Also tell your doctor about any over the counter
medicines, supplements, natural or herbal remedies that you use. Certain medicines taken at the same time can cause damage
to your liver, even if you can buy them without a prescription.
Many chemicals that are inhaled or swallowed can damage the liver. Among these are drugs, industrial solvents and pollutants.
Almost every known drug has at one time or another been implicated as a cause of liver damage.
Chemicals which damage the liver fall onto two groups:
(1) Predictable liver toxins - These damage the liver regularly following exposure to a certain amount of the substance.
(2) Unpredictable liver toxins - These cause damage in only a small percentage of people exposed to them.
The reason the liver is so susciptable to injury by chemicals and drugs seems to be linked to the liver's unique function
of processing the chemicals and drugs which enter the blood stream. Many of these chemicals are difficult for the kidneys
to excrete out of the body. The liver helps by removing these chemicals from the blood stream and changing them into products
that can be readily removed through the bile or urine. In this process, unstable toxic products are sometimes produced. These
can attack and injure the liver. Predictable toxic chemical injury usually involves this type of mechanism. Examples are the
cleaning solvent, carbon tetrachloride, and the pain medication, acetaminophen. Acetaminophen is present in many over-the-counter
and prescription pain killers (e.g. Tylenol, Nyquil, Percocet, Excedrin, Darvocet, Vicodin) and is usually safe when taken
as prescribed. When acetaminophen is taken in excessive doses, either at once or over a period of time, severe damage to the
liver may occur. Acetaminophen is toxic at lower doses in individuals who are regular, excessive (over two drinks each day)
consumers of alcohol, which is also toxic to the liver. In fact, alcohol is by far the most common cause of toxic chemical
damage to the liver in our society.
The unpredictable type injury can be produced by many drugs and appears to involve an allergic reaction that is directed
at the liver. Many different medicinal drugs (e.g. antibiotics, seizure medications and anesthetics) can cause this type of
reaction in susceptible individuals.
Symptoms of chemical injury to the liver can resemble any form of acute or chronic liver disease. Acute liver injury
can resemble viral hepatitis or blockage of the bile ducts. In other cases, a patient with fever, abdominal pain and jaundice
may have a form of chemical injury that can be confused with conditions such as stones blocking the bile ducts that may require
other surgery. Chemicals can also cause chronic liver disease and cirrhosis. Usually, chronic liver disease develops only
after long-term use of the drug. Excessive exposure to certain drugs and chemicals may cause tumors of the liver. An important
example is the group of drugs known as anabolic steroids, best known for their use in body building.
Liver damage is common in people who are regular, illegal drug users. Most instances of liver damage in these individuals
result from viral hepatitis caused by sharing contaminated needles and using alcohol. However, certain commonly abused drugs
(e.g. cocaine) may be capable of producing liver damage.
The Diagnosis of Chemical Liver Injury:
Usually it must be based on circumstantial evidence, as there are no specific tests. In any patient with liver disease,
close attention needs to be given to the drugs used and the environmental and occupational exposures. No chemical is too trivial
to be considered. Timing may be helpful, since many forms of chemical liver injury will occur days to weeks after the first
exposure. However, there are exceptions in which a drug is taken for many months before liver injury or exposure to the toxic
substance. In most cases, there will be rapid improvement in days or weeks after removal of the chemical. When drug allergy
is involved, giving the patient the drug again will lead to a rapid worsening of the liver disease. This is a conclusive test,
but is rarely justified because of the risk to the patient.
Even if chronic liver disease has developed, removal of exposure to the offending chemical or drug can lead to rapid
improvement. Usually, no other specific therapy is needed. If there is any concern regarding a particular drug or chemical,
a physician or poison control center (located in major hospital centers) should be consulted.