The liver is the second largest organ and also the largest gland of the human body. It is classified as a part of the digestive system which carries out number of essential tasks comprising of detoxification, protein synthesis and production of chemicals that helps in digestion of food. It weighs an average of 1500g and is about a size of a football. It is located in the right upper abdomen just under the diaphragm and has a general shape of a prism or a wedge. It is completely protected by the rib-cage, thus it cannot be palpated externally. This triangular shaped gland consists of two lobes - a larger right lobe and a smaller left lobe. These lobes are separated by a band of tissue called as falciform ligament that keeps it anchored to the diaphragm.
Functions of Liver :
Liver is the largest gland in the human body and carries out more than 500 essential roles. Though it is difficult to give the precise number, enlisted below are the major functions of the liver:
- Bile Production: Liver secretes bile which consists of bile salts, cholesterol, bilirubin, electrolytes and water. This bile helps the small intestine to break down and absorb fats, cholesterol and vitamins.
- Fat Metabolism: Bile also breaks down the fats and makes it easier to digest.
- Protein Metabolism: Bile is essential for break down of proteins for digestion.
- Formation of Blood clot: Vitamin K is crucial for the synthesis of some proteins/coagulants that aids blood clotting. Bile, that is produced in the liver, is essential for absorption of Vitamin K. Thus, if the liver fails to develop enough Bile, then clotting factors cannot be produced.
- Filtration of Blood: The liver filters the blood coming from digestive tract and removes the compounds from the body, including hormones like estrogen and aldosterone. It also removes the compounds from outside of the body like alcohol and other drugs.
- Storage of Vitamins and Minerals: Liver functions as a store house of Vitamin A, D, E, K and B12. It also stores iron from hemoglobin in the form of ferritin and releases it to make new blood cells when required.
- Immunological Function: The liver contains high number of Kupffer cells that are involved in immune activity. These cells function to kill the disease-causing agents that may enter the liver through gut.
- Synthesis of Albumin: Liver also plays an important function of producing albumin, which is the most common protein in blood serum. It helps in transportation of fatty acid and steroids hormones to help maintain the correct pressure in the blood vessel and also preventing it from leaking.
Liver Disease and its types
A completely healthy liver function very efficiently. However, an organ as complex as the liver can also experience a wide range of problems and its ability to perform metabolic, detoxification and storage functions may get impaired. In such cases of a diseased or malfunctioning liver, the consequences can be dangerous or sometimes fatal. Following enlisted are the common types of Liver diseases that affect the liver and its function:
Alcoholic Liver Disease: Excessive consumption of alcohol over long period of time can cause significant liver damage. It is considered as the most common cause of cirrhosis across the globe.
- Hepatitis: It is defined as the infection of the liver usually caused by viruses like hepatitis A, B and C. It can have non-infectious causes too which may include chronic drinking, drugs, allergic reactions or obesity. In many cases, the liver can heal by itself but in severe cases, liver failure occurs.
- Cirrhosis: A chronic and long-term damage to the liver due to number of factors including toxins, alcohol and hepatitis lead to permanent scarring of the liver, called as Cirrhosis.
- Biliary Atresia: It is a condition that adversely affects a person’s bile ducts and bile flow when they’re an infant. If left untreated, the condition can cause liver scarring and affect liver tissue.
- Fatty Liver Disease: This usually occurs as a result of obesity or alcohol abuse. In fatty liver disease, vacuoles of fat build up in the liver cells. If it is not caused by alcohol abuse, the condition is called non-alcoholic fatty liver disease (NAFLD).
- Fascioliasis: This is caused by the parasitic invasion of a parasitic worm known as a liver fluke, which can lie dormant in the liver for months or even years. Fascioliasis is considered a tropical disease.
- Primary Sclerosing Cholangitis (PSC): It is a serious inflammatory disease of the bile ducts that results in their destruction. There is currently no cure, and the cause is currently unknown, although the condition is thought to be autoimmune.
- Liver Cancer: It is the sixth most common form of cancer and the second most frequent cause of cancer death. The most common types of liver cancer are hepatocellular carcinoma and cholangiocarcinoma. The leading causes are alcohol and hepatitis.
- Hemochromatosis: This condition causes an excess of iron to accumulate in the body. Too much iron can damage the liver.
Signs and Symptoms of Liver Disease
At early stage the liver disease may have minimal or no symptoms but as its progresses, characteristic signs develop. Some of the common symptoms of liver diseases are:
Skin and eyes that appear yellowish (jaundice)
Pain and swelling in abdomen
Swelling in the legs and ankles
- Skin Itching
- Urine color become dark
- Bloody or Pale/Tar colored stool
- Chronic fatigue
- Vomiting or Nausea
- Appetite Loss
- Tendency to bruise easily
Causes of Liver Disease
Though alcohol is one of the most common cause for liver disease, there are several other factors that are responsible for causing liver disease. Following are the leading causes of most of the liver diseases:
- Genetics : An abnormal gene inherited from either of the parents can cause various substances to build up in the liver and may result in liver damage. Genetic liver diseases include:
- Wilson's disease
- Hyperoxaluria and oxalosis
- Alpha-1 antitrypsin deficiency
- Alcohol : Excessive consumption of alcohol interrupts the normal liver function which may lead to a chemical imbalance. The continuous detoxification of alcohol may alter or destroy liver cell and results in deposit of fat (fatty liver) and more seriously, either inflammation (alcoholic hepatitis) and/or permanent scarring (cirrhosis). Liver cancer can also result from alcohol induced liver disease.
- Infection : Parasites and viruses can infect the liver by causing inflammation which reduce liver function. These viruses can be spread through blood or semen, contaminated food or water, or close contact with an infected person. The most common type of liver infection is caused by hepatitis virus, and the depending on the virus, the liver infection is classified as:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Abnormal Immune System : Diseases in which the immune system attacks certain parts of the body (autoimmune) can affect the liver. Examples of autoimmune liver diseases include:
- Autoimmune hepatitis
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Obesity : Fatty liver is also one of the leading causes of liver disease which is linked to obesity. Though fatty liver disease is being seen in non – obese people as well. Diabetic people have more chance of developing this type of liver disease.
It is important to find the exact cause and extent of liver damage so as to get the appropriate line of treatment. Some of the common diagnostic test for liver diseases are as follows
- Blood tests: A battery of blood tests called liver function tests (LFT) can be used to diagnose liver disease.
- Imaging tests: An ultrasound, CT scan and MRI can show the damage in the liver.
- Biopsy: Removing a tissue sample (biopsy) from liver helps to diagnose the liver disease and to look for signs of liver damage.
Treatment of Liver Disease
Treatment for liver disease depends on the diagnosis. Some liver problems can be treated with lifestyle modifications, such as losing weight or stopping alcohol intake. Careful monitoring of liver function is required for medical program. Other liver problems may be treated with medications or may require surgery. Treatment for liver disease that results in liver failure may ultimately require a liver transplant.
Liver Prevention : Guidelines to reduce your risk
To prevent liver disease :
- Drink alcohol in moderation: Limit the intake of alcohol to minimize the risk of liver damage.
- Avoid risky behavior: Avoid using illicit intravenous drugs, and don't share needles used to inject drugs. Use a condom during sex. If choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.
- Maintain a healthy weight: Obesity can cause nonalcoholic fatty liver disease.
- Get vaccinated: It you are already infected or at the increased risk of getting hepatitis virus, consult with the doctor about getting the hepatitis A and hepatitis B vaccines.
- Use medications wisely: Take prescription and non-prescription drugs only in recommended doses as per the suggestion of doctor. Don't mix medications and alcohol.
- Avoid contact with other people's body fluids: Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.
- Take care with aerosol sprays: Make sure that the room is ventilated, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals.
- Protect your skin: Wear gloves, long sleeves, a hat and a mask when using insecticides and other toxic chemicals.
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