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Liver diseases: Silent but deadly

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The liver is the largest, solid organ in the body and is responsible for numerous, critical functions. In the event that it becomes diseased, it poses significant damage and sometimes death, as it is the gateway to the body.

According to Dr. Abdulfatai Olokoba, a consultant gastroenterologist at the University of Ilorin Teaching Hospital, Ilorin, Kwara State, “diseases of the liver account for tremendous morbidity and mortality. In a study at University College Hospital (UCH), Ibadan, Oyo State, which covered a 14-year period, liver diseases accounted for 12.1 per cent of 4568 deaths in the medical wards; the third commonest cause of death after cardiovascular diseases and infections.”

He attributes the increase in population, poor sanitation, high mobility of dwellers due to uncertain and temporary accommodations, high risk behaviours, poverty, socio-cultural practices, among others, to factors that make Nigeria a high risk area for liver diseases.

He adds that most times, liver diseases are asymptomatic and may progress to complications before diagnosis.

Medical researchers have also stated that viral hepatitis, liver cirrhosis and primary hepatocellular (liver) cancer (PLC) comprise the major causes of morbidity and mortality from liver diseases in Nigeria and in a paper: Liver diseases of importance in Nigeria, delivered at the biennial scientific conference of West African Association of Gastroenterologist (WASOG), it was pointed out that with liver cancer, “the presenting symptoms are usually abdominal pain accompanied by weight loss, weakness, loss of appetite and abdominal swelling and are commonly present for less than six weeks before presentation and patients frequently die within four months of the on-set of symptoms. The disease thus runs a very fulminate course and does not usually respond in more than a very few cases, to sophisticated f0rms of treatment. A diagnosis of PLC is synonymous with a death sentence.”

With the significant role the liver plays, it is important we take good care of our liver and this can be achieved by taking the following steps:

Cut back on alcohol
Alcohol consumption has been globally linked to a number of diseases and deaths and accidents. Unfortunately, for heavy alcohol drinkers, their livers carry the burden and suffer for their addiction. The liver filters alcohol out of the blood and is metabolised and used to generate fat. For those who regularly drink more than the recommended guidelines, their liver quickly becomes fatty and the liver cells become bloated and unable to work properly.

The Institute of Human Virology, University of Maryland, United States, points out that alcoholic liver disease involves an acute or chronic inflammation of the liver induced by alcohol abuse and alcoholic hepatitis usually occurs after years of excessive drinking. They add that the longer the duration of alcohol use and the greater the consumption of alcohol, the greater the probability of developing liver disease.

A study on the Aetiological Significance of Alcohol in Liver Cirrhosis on the Jos Plateau published in the West African Journal of Medicine showed that alcohol was found to be the cause of liver cirrhosis in 80 per cent of the patents studied.

With alcohol consumption, changes start within the liver as inflammation (hepatitis) and progress to fatty liver and cirrhosis. Cirrhosis (scarring of the liver cells) is the final phase of alcoholic liver disease and symptoms may not be present until the disease is relatively advanced and where scarring occurs, the liver will start to lose function.

Serious complications are associated with advanced disease such as alcoholic encephalopathy (damage to brain tissue) and portal hypertension (high blood pressure within the liver).

Beware of self medication
Self-medication is never advised and herbal treatments and supplements should not be taken without first consulting with your doctor. This is because some medications require the liver to work extra hard to metabolise them and some can damage the liver. Also, some herbal supplements can actually be toxic to the liver.

Get vaccinated
The Society for Gastroenterology and Hepatology in Nigeria (SOGHIN) revealed that the World Health Organisation (WHO) has estimated that about 20 million Nigerians are infected with hepatitis B and about five million die of the consequences. For hepatitis A and B, vaccinations are available and Dr. Olokoba states that hepatitis B vaccine is protective in more than 90 per cent of normal individuals. There are many studies which show a consistent and specific causal association between Hepatitis B virus infection and PLC. To protect your liver from these diseases, get vaccinated.

Maintain personal and environmental hygiene
While sharing may be a good virtue, we should be careful not to cross the line with sharing personal items that have a potential for the exchange of bodily fluids. Hepatitis B is transmitted by exchange of bodily fluid (saliva, sweat, semen, urine, vaginal fluid) with an infected person. Hepatitis C is transmitted through blood contact and sadly, people infected with hepatitis C often show no symptoms, though long-term effects can include liver damage and cancer. Unsterilised equipment and needles from drug use, tattoos and body piercings, acupunctures and so forth are some of the ways it is transmitted.

Hepatitis A is transmitted through contaminated food or drink owing to poor personal and environmental hygiene. Dr. Olokoba says though it is very rarely transmitted through blood transfusion and does not lead to chronic liver disease, it may occur in epidemics. It can be controlled by provision of clean water, proper disposal of sewage and improved personal hygiene.

Be careful what you eat
The liver is the gateway of the body and it stores, activates and transports vitamins and minerals. 85 to 90 per cent of blood from digestive tract passes through the liver first. So, diet and the liver are inextricably linked. Consuming too many preservatives, additives, food colours, and artificial sweeteners stresses the liver, just as a diet in excessive protein does. Foods rich in fibre, vitamins, fruits, whole grains and nuts are great for the liver.

Avoid obesity
Obesity has been fingered as a risk factor for a number of diseases and liver disease is not excluded. Although alcohol can cause a build-up of fat in the liver, experts have stated that it is possible for someone who consumes a little of alcohol or doesn’t drink at all to have fatty liver, a disease known as Non-Alcoholic Fatty Liver Disease (NAFLD). Although anyone can get it, overweight or obese people have a higher risk and fatty liver can lead to cirrhosis, liver cancer or liver failure.

Be sexually responsible
For sexually active people, responsibility or the lack of it can make a difference in one contracting a life-threatening disease or not. Diseases such as hepatitis B can be transmitted sexually, and presently, it is more infectious than HIV/AIDS, deadly and has no cure. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.

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