How can you look after your Liver

By Dr Harold Gunatillake - Health Writer

Most of our people would worry about heart attacks, cholesterol levels, and not think of keeping the liver healthy by consuming healthy diets and restricting alcoholic beverages, including sweet drinks, to respect it deserves.

All foods you eat: Carbs, fats, proteins are broken down into absorbable nutrients by your gut enzymes and other juices. When it comes to carbs one has to think of eating unprocessed foods than processed ones. Then, of course, when it comes to carbs there are the resistant starches and fibre containing carbs. These latter non-absorbable forms are beneficial for the health of those microbes in the large gut to protect us from diseases and keep us healthy and boost our immune system.

The absorbed macro-nutrients enter the large veins called the ‘portal veins’ through which all your digested foods enter the liver. The fatty acids have a different pathway through the lacteal system. The portal system starts with many branches called capillaries in the gut and ends in many capillaries in the liver. It is built to carry nutrients in your blood after a meal from your intestines to the liver smoothly.

Like the heart it works like a factory day and night to keep you healthy. It looks after your metabolism, controls your blood lipids including cholesterol, removes toxins you eat through a detoxification process, fights infections and sends the bad stuff through your blood to the kidneys to be excreted.

How can you damage this wonderful factory you possess in your abdomen hidden under the diaphragm, more on the right side?

The liver is not a palpable organ on breathing deeply in and out and gently keeping your hand with stretched fingers, as the doctors normally do to check your liver. If the tips of your fingers touch the lower edge of the liver when deeply breathing out, then we call it a ‘palpable liver’.

In such a situation, the doctor will do many investigations, such as blood tests to check your liver functions, ultra-sounds, CT scans and MRIs, and so on.

An ultrasound is requested by a physician to determine the underlying cause of elevated levels of liver enzymes such as alanine transaminase, or ALT, and aspartate transaminase on doing liver function test on a specimen of blood

When the liver gets hurt it tends to swell. It is composed of millions of cells called hepatic cells and in between they are cushioned with fibrous (interstitial) tissues. When the hepatic cells swell due to infections like viral and bacterial infections the whole organ swells and disturbs its functions. When the tissues between cells gets damaged you get scarring called ‘fibrosis’.

At all times liver cells and the tissues in between must be kept healthy. With progressive disease the changes may not be reversible and may lead to hardening called cirrhosis and finally ends in liver failure.

What is bile
Bile is a complex fluid containing water, electrolytes and other organic molecules including bile acids, cholesterol, phospholipids and yellow coloured pigment bilirubin. Bile is excreted from the liver cells all the time and is stored in the gall bladder to be used at the time of consuming fatty food. It digests and absorbs fats and fat -soluble vitamins in the small intestines. Bilirubin is a waste product from the breakdown of red cells through haemolysis and excreted and eliminated in the feces.

When your liver inflames we call it hepatitis. In situations where excessive bile is secreted during inflammations of the liver or cause some obstruction to the outflow – your eyes (conjunctiva) tends to get yellow, your skin can feel itchy, and you’ll have early nausea and vomiting, loss of appetite and pain in your belly.

These are early symptoms of liver damage you should be aware during the early stages.

There is a condition called ‘Acute liver failure’ which can take only weeks or even days and it can be life-threatening, but most other conditions are chronic- meaning the onset of the disease process is gradual.

Liver diseases may be related to diseases, but also lifestyles that cause chronic damage as in fatty liver due to alcohol and consuming too much of sugary drinks.

Obesity could be one of the biggest concerns for liver disease. Putting on excess weight from eating food with added sugar, and lack of exercise, can give you a non-alcoholic fatty liver disease. In the early stages this is harmless, and most people do have it. Drinking too much alcohol produces an ‘alcoholic fatty liver disease. Both kinds of fatty liver may end up with hardening of the liver we call cirrhosis.

In early stages of both fatty livers often have no symptoms, so it remains undetected until it becomes more difficult to treat.

Now, studies have shown that gut bacteria release a compound may aid early diagnosis

When fat accumulates in the liver it interferes with the normal functioning. The people who are more prone to catch the disease include those with obesity, high blood pressure and type 2 diabetes.

So, if you wish to have a healthy liver eat less food containing added sugar, like corn syrup, eat a low carb and low-fat diet, with minimal alcohol consumption (2 drinks a day for males and one drink a day for females). Exercise daily and contemplate on a healthy lifestyle.

There are drugs and chemicals and even supplements that can cause severe liver damage. Check with your family doctor before you venture on any herbal and non-traditional supplements for better health.

Hepatitis may come in the form of A, B and C. Hepatitis A is from a virus and you will recovery fully within few weeks with care and rest. Do not share needles, have unprotected sex, or live in areas where food and water are not safe.

Look after your gut microbes to boost your immune system all the time. You need to consume probiotics daily and high fibre prebiotics to feed the microbes.

Your liver can get damaged due to autoimmune conditions and the condition is called autoimmune hepatitis.

There are multitude of ducts carrying bile away from the liver. These ducts can get blocked due to chronic inflammation and cause blockage due to scarring preventing bile being excreted into your intestines. It is called Primary sclerosing cholangitis and can cause severe hepatic cell damage. It is rare and is called Budd-Chiara syndrome.

In some situations, gall stones can block these bile ducts and cause liver damage.

Cancer of the liver

Cancer can start within the liver and any tumour of the liver is referred to as a ‘hepatoma’.  If the liver is damaged from fatty liver disease, cirrhosis, and any chronic liver disease the chances of contracting cancer are very high.

If you suffer from any liver disease, please get yourself examined and investigated regularly to detect early cancer.

You could get secondary cancer spread from other organs like the large bowel or prostate gland in males.

Genetic conditions
There is a rare liver disease which shows in babies or not until 40 or 50 years later. It is called Alpha-1antitrypsin deficiency. In this condition our body does not make enough of a special protein that protects against liver damage.

There is a condition called, ‘Hemochromatosis’ caused due to a build-up of iron in your liver. When too much of copper builds up in your liver the condition is referred to as Wilson disease.

Conclusions: This is only a brief account of liver affections. The lesson we all learn is that we should be aware of liver diseases and attempt to prevent them. Most hepatitis conditions, and fatty livers are preventable. Alcohol consumption should be controlled, and your weight needs regular check and restrict all forms of sugar, and that alone could damage your liver.

(Some reference to Visual Guide to Liver problems-WebMD)

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