- Dr. Niroshan Muwanwella
What is Liver Disease?
Liver disease is emerging as one of the toughest medical challenges of 21st century. Implications of the Liver Disease can be devastating, both to the suffering individual as well as those around them. With no definitive cure yet, prevention remains the best course of action.
Depending on the emergence of symptoms and the time duration of the illness, liver disease can be subdivided into acute liver disease and chronic liver disease. We are going to focus on chronic liver disease in this article.
Chronic liver disease can be simply defined as any liver disease which has lasted more than six months in duration. The causes of chronic liver disease can be numerous from viral hepatitis to alcoholic liver disease to certain autoimmune conditions to hereditary diseases and non-alcoholic fatty liver disease. Despite the health sectors around the globe employing various guidelines and protocols on managing the chronic liver disease, most of the disorders do not have a cure.
Chronic liver disease can have two stages, namely symptomatic and asymptomatic. The presence of symptoms may lead the patient to seek medical attention and the subsequent discovery of the liver disease. These can include jaundice (yellow discolouration of skin and eyes), bleeding due to depletion of blood clotting factors, confusion and coma due to a buildup of nitrogenous waste products in the bloodstream and fluid build up in the abdomen. However, asymptomatic stage of liver disease is one of the most important stages of liver disease not only because preventative measures can be implemented upon detection of this stage but also because significant liver cell damage can happen during this stage. Therefore detecting liver disease in the first instance, tight monitoring during the asymptomatic stage and implementation of measures to prevent/delay the progression to severe stages are of paramount importance.
Prevention of progression of the chronic liver disease can be managed with medications in only a handful of diseases such as chronic viral hepatitis and autoimmune hepatitis. In a majority of other causes, there are no medication interventions possible. One of these causes is NAFLD or non-alcoholic fatty liver disease. This has become one of the fastest emerging causes of chronic liver disease in the western world. More common among people with metabolic syndrome (at least three out of: obesity, elevated “bad” cholesterol, low “good” cholesterol, elevated blood pressure, elevated fasting glucose), this is simply defined as fatty infiltration of the liver. If not controlled, this can lead to inflammation of the liver and progression to cirrhosis.
Various interventions have been studied to reduce the rate of progression of NAFLD. Among them, the proven methods include lifestyle modifications, dietary modifications and exercise/weight loss. Various medications also have been trialled with inconsistent results.
In summary, chronic liver disease is fast becoming the pandemic of the 21st century. With most causes of the chronic liver disease having no cure, prevention is of paramount importance. As the consequences can be devastating, taking care of liver health has become one of the major health needs of today.
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