Understanding the Significance of the Liver

What does the liver do?

Here’s a breakdown of the key functions of the liver:

- Processing Nutrients or Metabolism: The liver metabolizes and processes the essential nutrients from the food we consume. It processes the nutrients like carbohydrates, fats and proteins, converts them into energy and stores it for future use. The liver also aids in the regulation of glucose levels in our bloodstream.

- Detoxification and Filtering Blood:The liver filters and removes harmful substances such as medications and toxins from our blood. The liver metabolizes such harmful substances into less harmful compounds that can be excreted from the body.

- Bile Production:The liver manufactures bile, a essential substance for assisting in the digestion and absorption of fats within the small intestine.

- Protein Synthesis:Through protein synthesis, particularly of albumin and clotting factors, the liver maintains fluid balance and promotes effective blood clotting respectively.

- Immune Function:One of the functionalities of the liver involves supporting the body's immune response by eliminating bacteria and toxins from the bloodstream and generating immune factors.

- Vitamin and mineral storage:The liver stores vitamins including A, D, E & K, minerals such as iron & copper and glycogen (a form of stored glucose) for later use by the body.

- Hormone activation and deactivation:The liver activates and deactivates certain hormones to regulate various bodily processes.

What are the parts of the liver?

The liver consists of several distinct parts or lobes, each contributing to its overall function. The major parts of liver include:

Right Lobe:This is the largest lobe of the liver and is situated on the right side of the abdomen. It makes up about 60% of the liver and performs a wide range of metabolic and detoxification functions.

Left Lobe:The left lobe is the smaller of the two major lobes (right and left lobe). It is located on the left side of the abdomen. It also contributes to metabolic processes and detoxification.

Caudate Lobe:It is a smaller lobe compared to the left and right lobes. It is located at the posterior part of the liver and the caudate lobe is smaller in size and sits between the left and right lobes. It also aids in bile drainage and metabolic functions.

Quadrate Lobe:This is the smallest lobe in the liver and is situated below the left lobe and right next to the gallbladder. It plays a role in bile production and storage.

Porta Hepatis:This major part of the liver is not a lobe but a central area where the hepatic artery, portal vein, and bile duct enter and exit the liver. It functions as a gateway (both into and out of the liver), regulating the flow of both blood and bile.

What conditions and disorders affect the liver?

The liver performs numerous crucial functions essential for maintaining overall health and well- being. Dysfunction of the liver can lead to serious health problems and requires prompt medical attention.

Liver disorders and diseases are also referred to as hepatic conditions which are treated by specialist doctors referred to as hepatologists.

Some common liver diseases and conditions include:

– Hepatitis:Hepatitis denotes an inflamed liver, triggered by viral infections like hepatitis A, B, or C, excessive alcohol consumption, or autoimmune disorders. Hepatitis could either be acute or chronic depending on the type but some types like Hepatitis C can lead to permanent liver damage. You can protect yourself from viral Hepatitis infections by staying up to date on vaccinations for Hepatitis A and Hepatitis B.

- Non-Alcoholic Fatty Liver Disease (NAFLD):Accumulation of fat in the liver cells can lead to fatty liver disease. When the accumulation of fat is not due to alcohol consumption it is referred to as Non-Alcoholic Fatty Liver Disease (NAFLD). It can be attributed to factors such as obesity, insulin resistance and type 2 diabetes. If left untreated it can progress to a more severe form called nonalcoholic steatohepatitis (NASH) causing scarring and inflammation.

- Alcoholic Liver Disease (ALD):: Excessive alcohol consumption damages the liver and leads to a condition called Alcoholic Liver Disease (ALD). This disease causes inflammation and fatty deposits to build up in the liver, impacting its ability to function properly. If not properly treated, it can progress to more severe stages like alcoholic hepatitis, cirrhosis, and even liver cancer in some cases.

- Cirrhosis:Cirrhosis is an end stage liver disease characterized by scarring (fibrosis) of the liver caused by long-term liver damage, such as viral hepatitis infections like Hepatitis A or Hepatitis B, excessive alcohol consumption or fatty liver disease. It impairs liver function and can lead to liver failure.

- Liver Cancer:Liver cancer develops because of abnormal cell growth in the liver, usually caused by damage from cirrhosis. It can either be primary liver cancer (cancer originating in the liver) or spread from other organs (metastatic liver cancer). Individuals with cirrhosis, chronic infections like hepatitis B or Hepatitis C and certain genetic conditions have an increased potential risk of developing liver cancer.

- Liver Failure:Liver failure is attributed to a significant decline or loss of liver function. It can be acute or chronic. Acute liver failure develops rapidly while chronic liver failure develops gradually over time. Liver failure can be caused by several conditions including infections like viral hepatitis, drug overdose, autoimmune hepatitis, advanced cirrhosis and certain genetic conditions. Liver failure can be fatal and needs prompt medical attention. In some cases, patients with liver failure may also need liver transplants.

- Autoimmune Hepatitis:Autoimmune Hepatitis occurs when your immune system starts attacking your healthy liver cells.Autoimmune Hepatitis can cause chronic inflammation & liver damage and lead to jaundice in some cases.

- Hemochromatosis:Hemochromatosis is a genetic disorder characterized by excessive iron absorption and accumulation in the liver and the tissues in the body. With time, this excessive iron buildup can result in liver harm, cirrhosis, and potentially liver cancer.

- Wilson's Disease:This condition is a rare genetic disorder where copper levels build up in organs such as the liver and brain. This could potentially lead to liver damage or even cirrhosis if not managed effectively.

- Liver Abscess: It is a pus-filled cavity within the liver usually caused by a bacterial infection. It can result from conditions such as appendicitis, diverticulitis or infections.

- Drug-Induced Liver Injury:Certain medications or supplements can damage the liver even when they are taken religiously as per the instructions of your doctor. If a drug is known to cause liver damage then please talk to your doctor and get your liver health and function assessed by taking a Liver Function Test (LVT).

- Primary Sclerosing Cholangitis or PSC:It is a chronic inflammatory disease that affects the bile ducts both inside and outside the liver. It causes scarring and narrowing of the ducts eventually obstructing bile flow. It could potentially lead to liver damage, cirrhosis, and complications such as liver failure

- Primary Biliary Cholangitis or PBC:This autoimmune condition is marked by inflammation and destruction of the bile ducts in the liver. It can lead to bile buildup, liver scarring and eventually cirrhosis.

What are the symptoms of liver problems?

The liver has remarkable regenerative abilities. It can repair and regenerate damaged tissue to a certain extent. Despite its vital role, the liver is known to suffer silently, meaning it doesn't exhibit symptoms of damage until later stages. However, recognizing these potential warning signs can improve outcomes by helping with early diagnosis and timely interventions.

Here's an overview of some common liver disorder symptoms:

- Constant fatigue

- Loss of Appetite and unexplained weight loss

- swelling, discomfort or abdominal pain especially below your rib cage in the upper right abdominal area

- Jaundice caused by the excess Bilirubin build up in your blood. Yellow eyes or yellowing of your skin could indicate jaundice.

- Nausea and Vomiting (especially after eating food)

- Pale or clay coloured stools (caused by reduced bile flow)

- Darker than usual urine caused by excess bilirubin excretion

- Itchy skin (particularly at night): could be brought on by bile buildup in your skin

- Swelling in the abdomen (ascites) or swelling in the legs (edema) brought on by fluid retention.

- Tremors or shaking

- Weakness and loss of balance

- Mental confusion or Encephalopathy

- Low blood pressure or low BP

- Easy bruising or prolonged bleeding: could be caused by impaired clotting factor production

- Palmar erythema or reddening of the palms

- Spider Angiomas: Small, spider-like blood vessels visible on the skin (especially in the upper body)

- Tiny red dots on your skin (petechiae) and nail clubbing: They could indicate advanced liver disease so please consult a doctor immediately if you notice them.

The aforementioned list is not exhaustive and the specific signs of liver damage or liver problems symptoms people experience may vary depending on the underlying liver disease and its severity. If you experience any one or more of these symptoms then consult your doctor right away for prompt diagnosis and appropriate treatment.

How do you test for liver disease?

Liver diseases are diagnosed through a combination of medical history, physical examination, laboratory tests, imaging studies, and sometimes liver biopsy. Here's an overview of the diagnostic methods commonly used:

Liver Function Tests (LFTs):These blood tests measure levels of enzymes and proteins that are produced or secreted by the liver. Common markers include:

• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transferase (GGT)
• Bilirubin
• Albumin
• Prothrombin time (PT)

Abnormal levels of these markers may indicate liver damage or dysfunction.

Common Imaging tests: Ultrasounds, CT scans, or MRIs provide visual insights into the liver's size, shape, and potential abnormalities like fatty deposits or scarring.

Transient Elastography (FibroScan):This specialized non-invasive imaging test is used to measure the liver stiffness and screen for fibrosis (scarring) and cirrhosis.

Liver biopsy:Sample tissues may be procured from the liver using a needle in certain cases for microscopic and laboratory analysis.This can help diagnose liver diseases that are difficult to distinguish based on imaging or blood tests, such as autoimmune hepatitis, primary biliary cholangitis, or liver fibrosis.

Alcohol Screening: Given that excessive alcohol consumption can cause liver damage, healthcare providers may choose to conduct alcohol screening tests to assess alcohol consumption patterns and check for potential liver damage.

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Frequently Asked Questions

1. What are the first signs and symptoms of liver disease?

Ans - Unfortunately, many liver diseases often progress silently, with symptoms manifesting only in later stages when the damage is significant. Early signs of liver disease may include constant fatigue or weakness, upper right abdominal pain and discomfort, reduced appetite and yellow eyes or skin, indicating jaundice. However, the symptoms may vary from individual to individual depending on their medical history, type of liver disease and its severity.

2. What are the causes of liver disease?

Ans - Liver disease can be caused by various factors including viral infections (such as hepatitis), excessive alcohol consumption, fatty liver disease (associated with insulin resistance, obesity & Type 2 Diabetes) autoimmune conditions, genetic disorders and certain medications.

3. Is liver disease curable?

Ans - The outcome of liver disease depends on its cause and severity. Some forms of liver disease, such as acute hepatitis, may resolve on their own or with treatment. However, chronic liver disease may require ongoing management, and in some cases, liver transplantation may be necessary. Please consult your doctor right away if you experience any symptoms or notice signs of liver damage. Early diagnosis and prompt medical interventions can improve outcomes drastically.

4. What diseases can develop in the liver?

Ans - Viral Hepatitis, fatty liver disease, cirrhosis, liver cancer, hemochromatosis, Wilson's disease, primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are some of the common liver diseases and disorders.