Prevention against liver diseases

Dr. Piyush Ranjan

 Dr. Piyush Ranjan DM(Gastro), is famous Consultant Gastroenterologist, Therapeutic Endoscapist & Hepatologist engaged with Sir Ganga Ram Hospital and has his own Gastro & Liver Clinic in Dwarka, New Delhi. He born on 23rd March, 1970. He did his MD (Medicine) from Maulana Azad Medical College in the year 1999 & DM(Gastroenterology) from Sanjay Gandhi PGI, Lucknow in 2003. He has a special interest in Therapeutic Endoscopy, ERCP. He received many prestigious awards from various organizations for his valuable contribution in the medical field.

He is married to Dr. Seema Thakur who herself is a Consultant Clinical Genetecist with Fortis Hospital, New Delhi. She also did her MD (Obs and Gynae) from Patna Medical College in 1999 & DM(Genetics) from Sanjay Gandhi PGI, Lucknow in 2004. Dr. Ranjan is fond of writing articles, let’s find out useful information related to his field in the following article:

From the Desk of Dr. Piyush Ranjan

Know About Your Liver- Functions of liver

Liver is located in the right upper part of the abdomen just below the rib cage and it weighs around 1.5 kg. It is a complex organ and plays a central role in metabolic functions.

Symptoms of liver disease
Most striking manifestation of liver diseases is jaundice, which means yellow discoloration of sclera of eyeball and is associated with dark yellow urine. Other common manifestation of liver disease is ascites that is swelling of abdomen due to fluid in the abdomen. This is associated with swelling of feet also. Advanced liver diseases can lead to loss of consciousness that is coma. Bleeding from gastrointestinal tract in form of vomiting of blood or black stools can be associated with liver disease. Most commonly early liver diseases are detected on routine screening liver function tests.

Causes of liver diseases
The major causes of liver diseases are viral hepatitis (A, B C, D & E) and alcohol intake. Apart from this a number of drugs including indigenous drugs cause liver damage. Many diseases, which affect any other part of body, can involve liver, like liver can be affected in typhoid, malaria, dengue fever. Disease like diabetes and obesity are common causes of fat deposition in liver, which in long term can cause liver damage. Cancer arising in any organ of abdomen can spread into liver. There are a number of inherited diseases, which affect liver.

Among the hepatitis viruses, Hepatitis A and E causes jaundice, which is self-limiting. Hepatitis B and C cause chronic infection of liver, which can be cause cirrhosis of liver. Hepatitis A and E spread through contaminated water whereas hepatitis B and C spread from blood transfusion, sexual contact and intravenous drug abuse. Alcohol is very important cause of liver disease and when taken in excess of a particular amount causes liver damage.

Consequence of liver disease
Any kind of long-term damage to the liver leads to cirrhosis of liver. Cirrhosis is a condition in which the normal cells of liver are lost and are replaced by fibrotic bands. Cirrhosis is an irreversible form of liver damage and when number of liver cells fall below a certain level signs of liver failure ensue. The most dreaded complication of liver cirrhosis is liver cancer. Certain disease like hepatitis B infection can lead to liver cancer without causing cirrhosis.

Healthy liver and cirrhotic liver

Steps to prevent liver diseases
The concept of prevention of liver diseases has still not caught up. However to a large extent they are preventable. Most important aspect of prevention of liver disease is decreasing alcohol intake. Alcohol consumption is on rise in society across all strata and gender barrier. Decreasing alcohol intake is of paramount importance for people who consume alcohol for a long time.

Hepatitis B and C are spread by blood transfusion, injection abuse and sexual contact. Getting blood from proper blood bank and not from professional donors is very important, It not only protects from hepatitis B & C but also from HIV infection. Avoiding needle sharing and sexual promiscuity are important.

There is a very effective vaccine for hepatitis B infection and all children should be vaccinated at birth. There is no vaccine available for hepatitis C at present. Treatment of hepatitis B & C has seen giant strides and today the scenario is much brighter than what it was in the past. Pegylated interferon forms the mainstay of treatment for both forms of chronic hepatitis.

Hepatitis A & E are transmitted through water and food. Maintaining good hygiene for water is the mainstay of prevention of viral hepatitis A & E. There is a vaccine for hepatitis A which offers adequate protection. There is no vaccine for hepatitis E.

Avoiding unprescribed and indigenous drug intake is very important as liver bears the brunt of all forms of medications. In western world paracetamol overdose is most important cause of acute liver failure.

Decreasing weight by obese individuals is very important. As most of the liver diseases are asymptomatic in the initial part it is important to have a liver function tests and an screening ultrasound, specially for people who are at risk; like people also consume alcohol, are obese and have family members suffering from liver diseases.

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