All about Liver

#CrediTalk: Know All About The Liver From Dr. Sanjiv Saigal

We got in touch with Dr Sanjiv Saigal (Director, Transplant Hepatology, Medanta The Medicity) to help us inform you about the organ – Liver. Here’s everything you need to know about Liver, its functioning, diseases, treatment and prevention.

The Liver and its Functions

The liver is the largest organ of our body. It is one of the most exciting organs. We also call it the metabolic factory of the body. So whatever we eat goes through the liver. It is located on the right side of the abdomen, on the upper part. It is a beautiful organ. It is lovely, soft and pinkish in tinge. A normal liver would weigh something about 1000-1200gms.

The liver has several functions. You can broadly categorize them into three: Storage, Synthesis and Detoxification.

Storage

So whatever you eat gets converted into glucose, carbohydrates, fats and proteins. Then they are stored in the liver by various metabolic processes. These nutrients are immensely useful for us at the time of crisis, when we are not having adequate reserves for our bodies. Then these stores are needed to replenish our calories, proteins, and nutrition.

Synthesis

The liver synthesizes many important proteins. It synthesizes proteins that are needed for building strength, immunity, and protein needed for blood clotting. It also synthesizes the bile, which is extremely important and helps in the process of digestion.

Detoxification

Our body inhales various toxins day in and day out. It may be in foods that have adulteration with chemicals, drug toxins or other sources. The liver is the organ that detoxifies these elements so that they do not harm our body.

If the liver is not functioning well then we would have a lot of problems because of the toxic effects of drugs and chemicals which we are ingesting knowingly or unknowingly. That is the beauty of the liver. It maintains our body in a holistic state to keep us healthy, happy and lively all the time.

Watch Dr, Sanjiv Saigal, MBBS, MD- Medicine, DNB- Medicine, Director – Institute of Digestive and Hepatobiliary Sciences at Medanta – The Medicity, Gurgaon speaking about ABCs of Liver disease prevention

Diseases That Affect the Liver

There are two types of liver diseases which we encounter – an acute illness, which we normally call acute viral hepatitis. Another is chronic illnesses, where the liver is affected by a problem that continues for more than six months. Chronic leads to a state where the liver cannot function normally. The acute problems are transient, which is usually not a big issue but sometimes can be a concern. Commonly we see acute illnesses because of hepatitis B, hepatitis A or hepatitis E. Sometimes alternate medications can damage the liver in an acute phase.

Acute Liver Diseases

Acute means it is a short term problem (a few days to weeks, less than 6 months). Normally these illnesses would manifest as yellowness of eyes, fatigue, weight loss and fever. These illnesses improve with medication or control on viral infections. Your doctor just has to pick them up at the right time and treat them correctly. Rarely, acute illnesses can go on to cause liver failure. The bottom line is anybody who has an acute liver illness should go to a doctor.

Chronic Liver diseases

Chronic means the problem is going on and persisting for more than six months. After that, it is unlikely to improve if you don’t treat these problems.

One type of chronic liver disease is Liver Cirrhosis. It is the shrinkage of the liver. The liver becomes shrunk, small and nodular and may fail at some time in your life.

The conditions that lead to Chronic Liver Diseases in India are –

Viral hepatitis– Hepatitis B and hepatitis C

Over intake of alcohol- Alcohol is a huge killer. About 25% of patients who we see in our clinics today are affected by Liver cirrhosis because of their alcohol consumption.

Non-alcoholic metabolic disease– A non-alcoholic fatty liver disease is the one where alcohol is not the culprit. It is your lifestyle which leads to fatty liver. And that causes the liver to develop problems later on. Another group of problems is metabolic or inherited diseases like autoimmune problems, where the body damages your liver.

Also, read about: Can Only Alcoholics get Fatty Liver?

Signs and Symptoms to Call to the Doctor

A person develops certain signs and symptoms when they have chronic liver disease. Most importantly you start losing energy and feel fatigued. You will also have yellow eyes, swelling of feet, and weight gain. This weight gain may be the result of water accumulation in the tummy. You eventually also start losing concentration. Your alertness, vigilance and ability to make decisions go down.

These are early signs and can lead you towards a liver coma. It is one of the most dangerous diseases. Another important manifestation is bleeding. Rupture of veins in food pipe leads to blood in vomiting or blood in the stool. As liver cirrhosis progresses, a person can have kidney dysfunction, liver cancer and other issues also.

The doctor may indicate a liver transplant depending upon your condition. The doctor will suggest a liver transplant if they realize that this liver is not going to function well.

Please note that not all cirrhosis patients need a liver transplant. The monitoring by doctor and stage of liver condition are factors that determine whether transplantation is needed or not.

Also, read about: Who needs a Liver Transplant?

Prevention of Liver Diseases

I feel that prevention is better than cure. A fit liver means a fit body and a fit person

We can summarise the preventive aspects as:

Avoiding alcohol

If you avoid alcohol, you are going to have huge benefits. About 1/5th of liver diseases in our country are because of alcohol. These diseases can be prevented by simply avoiding alcohol.

Balanced diet

A balanced diet is fundamental to any person who wants a healthy body, especially good health of the liver. You don’t need to go to a highly qualified dietician or big books to know how to eat better.

A diet good in vegetables and proteins will do you good. Vegetable proteins are better than animal proteins. If you have to, you should choose fish, egg and chicken, but avoid red meat. Also, you should avoid saturated oil and boiled foods. There is a huge misconception in our country that boiled food keeps the liver healthy. It’s not true. Some bit of oil and ghee is needed for good health.

Care

Care for hepatitis B and hepatitis C is essential. You should get regular checkups done and lead a good lifestyle.

Diabetes

You may think about how diabetes is linked to the liver. Diabetes and hypertension are the main causes of fatty liver disease in our country. This is known as non-alcoholic fatty liver disease.

If a person has unmoderated diabetes, high blood pressure, and high cholesterol, they can get steatosis. In this disease, fat gets accumulated in the liver. Whenever the fat content of the liver is more than 5% than the weight of the liver, it’s called fatty liver. This non-alcoholic fatty liver can turn into liver cirrhosis.

Both in the West and our country, non-alcoholic fatty liver disease is the 2nd to 3rd cause of liver transplant. In the USA, non-alcoholic fatty liver disease is the commonest cause of liver transplant. But you can prevent fatty liver disease by actually controlling diabetes, blood pressure and cholesterol. You should exercise and avoid weight gain. This applies to children as well. Don’t let your children be couch potatoes, make them go to the park because fatty liver disease is also there in children.

Exercise

There may be 100 reasons to not exercise but 1 or 2 motivations to do it. If you move your body a little bit, it has amazing results. Anything is better than nothing. The ideal is 30-40 min of brisk walking every day at least 5 days a week. Jogging or sweating is not a must. Any form of exercise is good. Anything that is making your body move is better than nothing.

Another aspect of prevention is getting a vaccination. You must get vaccinated against hepatitis B, which is available in our country. Vaccination of hepatitis C is not yet available globally. Every newborn in the country is vaccinated. Three doses of vaccination can give about 99.5% protection against hepatitis B. Even adults at any age can get vaccinated. These suggestions can make a huge impact on how to prevent liver diseases.

Check out all the article in #CrediTalk series here.

About The Doctor

Dr Sanjiv SaigalDr Sanjiv Saigal is a trained and well experienced Hepatologist and Director of Institute of Digestive and Hepatobiliary Sciences at  Medanta -The Medicity, Gurgaon. He has a rich experience of 26 years in this field.

He has completed his DNB in Gastroenterology from National Board of Examinations in 1996, and DM in Gastroenterology from GB Pant University of Agriculture & Technology in 1998. He is a member of Indian medical association (IMA) and Indian society of gastroenterology.

For a priority appointment or more information, contact us at +91 8010994994 or book an appointment with Dr. Sanjiv Saigal here –

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