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Friday, October 20, 2017

Liver Failure and Other Gallbladder Issues You Should Know

The second largest organ of the body is the liver, and it works real hard in performing various complex functions, which are:

  • Controlling the cholesterol levels
  • Remove toxins or poisons from the body, such as alcohol
  • Fighting illnesses and infections
  • Aid in clotting or thickening the blood
  • Releasing bile, which is a liquid that is the result of the breakdown of fats. It also aids digestion, too.

The early stages of liver disease don’t show any signs or symptoms until it has received fair damage. The possible symptoms of having the liver disease can be jaundice, weight loss and loss of appetite.

Liver disease is seen as any disturbance with the function of the liver wherein it causes illness to the person. The liver is the one responsible for many significant functions of the body. When it becomes injured or diseased, most of its functions can cause great damage to the body. Liver disease is often referred to as a hepatic disease.

The term liver damage or liver disease is a broad one covering all potential problems that are known to trigger the failure of the liver to perform its functions. Most of the time, over 75 percent of the liver tissue is to be affected before any of its functions starts to deteriorate.

The liver is located at the upper right of the abdomen, just right before the end of the rib cage. It comes with two main lobes that are made up with tiny lobules. There are two different blood supply sources of the liver cells. One is the hepatic artery wherein it supplies blood rich in oxygen pumped coming from the heart, while the other is the portal vein wherein it supplies nutrients coming from the spleen and the intestine.

The normal process is that the veins return the blood to the heart from the body, yet the portal vein allows the chemicals and nutrients are coming from the digestive tract to get in the liver for filtering before it enters the general circulation. The same source also delivers effectively the proteins and chemicals that the liver cells need to create cholesterol, glycogen, and proteins that the liver cells need for normal activities in the body.

Another important function of the liver is making bile, which is a fluid that is composed of various substances, chemicals, water and the bile acids, which is made from the stored cholesterol within the liver. The bile is first stored in the gallbladder, and as food gets in the first area of the small intestine called duodenum, bile is then secreted into this place to help food digestion.

The only organ of the body that can easily replace cells that have been damaged is the liver. But when enough cells get lost, the liver may not be able to keep up with the demands of the body.

Liver disease types

Here are some specific types of liver disease:

  • Non-alcoholic fatty liver disease – this is the accumulation of fat in the liver cells, which is usually seen among overweight people or obese
  • Liver disease related to alcohol – liver is damaged due to alcohol abuse, which usually leads to cirrhosis, a scarring of the liver
  • Haemochromatosis – this is an inherited problem wherein there is the gradual accumulation of iron within the body, usually appears around the liver.
  • Hepatitis – this is the swelling or inflammation of the liver which is caused either by viral infection or being exposed to damaging substances like the alcohol.
  • Primary biliary cirrhosis – a long-term and rare type of liver disease wherein it damages the liver’s bile ducts.

Causes of Liver Damage

There are various ways in which the liver can get damaged, and it depends on the lifestyle that the person is living.

  • The cells get inflamed, like with hepatitis
  • Obstruction of bile flow, like the cholestasis
  • Accumulation of cholesterol or triglycerides, like steatosis
  • The liver’s needed blood flow gets compromised.
  • Liver tissue gets damaged by minerals and chemicals, or they are invaded with abnormal cells such as the cancer cells.

Abuse with Alcohol

The most common cause of liver damage in North America alone is alcohol abuse. It is also the same issue with other parts of the world. Alcohol can be very toxic to the liver cells when they are consumed excessively, which eventually causes liver inflammation, which is called alcoholic hepatitis. With chronic alcohol abuse, the fat gets accumulated in the liver cells, which hinders the ability of the liver to function properly.

Cirrhosis

It is the last stage of the liver disease. The scarring of the liver and its loss of the functioning liver cells are the causes of the liver failure. It means that a significant number of liver cells get damaged before the entire organ fails to function properly.

Drug Induced liver disease

The liver cells get either permanently damaged or temporarily inflamed when it is exposed to certain drugs or medications. An overdose of some drugs or medications is what will cause the liver injury while the others can cause damage even when they are taken according to the dosage.

The excessive taking of acetaminophen like Panadol or Tylenol can also trigger liver failure. There is a reason why warning labels are printed in these drugs, especially with OTC medications. And it is also why the prescription narcotic and acetaminophen combinations such as Lortab, Vicodin, Tylenol #3, and Norco are limited to be taken in a day. Among patients that have abusive alcohol behaviors or underlying liver disease, the daily limit with taking the drugs above and medications get lowered and may be contra-indicated in these individuals.

The drug that is commonly prescribed to patients to control the elevated levels of cholesterol in the blood stations. Even if they are taken according to the right dose, there is a chance that liver inflammation may happen. The inflammation can be detected through a blood test that measures the enzymes present in the liver. Stopping this medication will usually result back to normal liver function.

Another medication of similar function with stations is the niacin, but liver inflammation only happens according to the dose taken. In the same manner, patients that have an underlying liver disease may be exposed to higher risk of liver disease because of medications like niacin. Studies have shown that niacin is not as effective as it was initially thought that it would be, particularly in controlling high cholesterol. Those who take niacin must first seek the health care professional to determine if there are other treatment options more appropriate.

There are more medications on the list that can trigger liver inflammation, wherein most of them get resolved when the medication is halted. These medications include the following:

  • Clavulanic acid and amoxicillin (Augmentin XR or Augmentin)
  • Nitrofurantoin (Macrobid, Furadantin, Macrodantin
  • Tetracycline (Sumycin)
  • Isoniazid (Laniazid, Nydrazid, INH)
  • Methotrexate (Trexall, Rheumatrex) this is a drug that is used in treating someone that has cancers or autoimmune disorders, but this comes with various side effects, including liver inflammation which can lead to the development of cirrhosis.
  • Disulfiram (Antabuse) a drug that is used in treating alcoholics, but tends to trigger liver inflammation
  • Herbal remedies
  • Excessive vitamins – can trigger liver failure, cirrhosis, and hepatitis

Symptoms

The symptoms of liver damage include:

  • Vomiting
  • Nausea
  • Jaundice, which is the yellow discoloration of the skin because of the elevated concentrations of bilirubin found in the bloodstream
  • Abdominal pain, most specifically concentrated at the right upper quadrant where the liver is
  • Weight loss, weakness, and fatigue may also happen

But there are different liver diseases, and the symptoms also vary depending on the kind of illness that the patient is going through, until only when the last phase of the liver failure happens.

Examples of symptoms with liver diseases triggered by certain diseases or conditions are:

  • An individual that has gallstones may experience pain at the right upper part of his or her abdomen. Another is when they vomit after eating a fatty or greasy meal. When the gallbladder gets infected, the person experiences fever.
  • With Gilbert’s disease, no symptoms appear at all. It is usually found through a blood test wherein it shows the bilirubin level is a bit elevated.
  • People with cirrhosis tend to experience progressive symptoms when their liver starts failing. Some of the symptoms are related directly to their liver’s inability in metabolizing the waste products of the body. Others are a failure of the organ to produce proteins that are needed for the body to function. It may even affect the blood clotting process, brain function, and secondary sex characteristics. The symptoms of cirrhosis include the following:
    • Bile salts are accumulated in the skin, resulting in itching
    • Easy bruising may happen because there is a decrease in the production of the clotting function
    • Enlarged breasts or gynecomastia happens among men because there is the imbalance of the sex hormones, more specifically the increase of estradiol
    • Lethargy and confusion may happen when the ammonia levels rise to the blood stream; ascites happen due to decreased production of protein
    • Impotence, also known as erectile dysfunction, shrinking testicles, and poor sex drive are all triggered due to the decrease of function in the sex hormones
    • Muscle wasting may happen since there is reduced production of protein

There might be increased pressure with the cirrhotic liver that affects the blood flow into the liver. The increased pressure within the portal vein can trigger the blood flow to slow down and at the same time swell up the blood vessels. Swollen veins get formed around the esophagus and the stomach, and have high risks for bleeding.

Treatment

Every liver disease comes with its specific treatment, and only a doctor can provide that. For example, one cause of liver damage is hepatitis A, wherein it needs supportive care to maintain the hydration, and at the same time the immune system of the body resolves and fights the infection. Individuals that have gallstones may need surgery to remove the gallbladder. Other illnesses associated with the liver may require long-term medical aid to minimize and control the consequence of the disease they are going through right now.

Patients with cirrhosis and those with liver failure are required to take medications as prescribed by their doctor to control the protein amount absorbed from their diet. The liver that is affected by cirrhosis may have difficulty with metabolizing the waste products. Thus it results to elevated ammonia levels in the blood and even hepatic encephalopathy. Water pills like diuretics and low sodium diet are required to reduce water retention.

Patients with huge amounts of ascites fluid, the excess fluid may need to be occasionally removed with a syringe and needle. With the use of local anesthetic, the needle is inserted into the abdominal wall then the fluid is taken out. These ascites fluid can develop into infection, and the paracentesis may also be used in a diagnostic test when looking for infection.

An operation might be needed if it is to treat portal hypertension. It is also used in reducing the risk of bleeding.

The final option is liver transplantation, which is a procedure done to patients wherein their liver has failed.

Prevention

  • Since the most common cause of liver damage is alcohol abuse, drinking in moderation is the best idea. Even if you were invited to a party, make sure you monitor your alcohol intake
  • As with the risk of contracting Hepatitis C and Hepatitis B, it can be reduced when you lower your exposure to people infected with it, particularly with their bodily fluids. Vaccination for hepatitis B and hepatitis A is also recommended.
  • Some populations are recommended to get screened for hepatitis C.
  • For fatty liver, it is an only healthy lifestyle that can help prevent it. Weight control, well-balanced diet, routine exercise and a reduction of alcohol intake will help prevent fatty liver. Just keep in mind that there are still people that develop fatty liver even with the best lifestyle practices.