The liver

In Australia, 40,000 deaths a year are due to liver disease. In coming years, more and more Australians will have liver disease from viral hepatitis, alcoholic and fatty liver disease. Liver cancer as a result of serious liver disease is now the most rapidly increasing of all cancers.

There are many ways to protect your liver but the best way to start caring for it is to eat a balanced diet, get some exercise and reduce alcohol intake. Diet includes fresh fruit and vegetables, drinking lots of water and reducing saturated fats such as in butter, meat and certain kinds of oils.

There are other simple ways such as getting vaccinated that help you look after your body’s engine room, the liver.

Keep your liver healthy
The increase in obesity and alcohol consumption is putting an enormous strain on the nation’s livers. Here are a few general tips to protect your liver:

• Eat a healthy and well-balanced low fat diet.
• Drink lots of water.
• Drink alcohol moderately. If you can’t cut back, talk to your doctor about getting some help to reduce your drinking.
• Stop smoking. Talk to your doctor or ring Quitline to get help to stop.
• Get vaccinated against hepatitis A and B.
• Talk to your doctor before mixing herbal supplements, prescription and non-prescription drugs.
• Be careful with certain herbal supplements that can be toxic to the liver such as kava, comfrey, chaparral, kombucha tea, pennyroyal and skullcap.
• Move: every activity in daily life adds up.

What is the liver?
The liver is one of the largest organs in your body – only your skin is bigger. Your liver is reddish-brown and, in an adult, about the size of a football, weighing between 1.25 and 1.6 kilograms.

The liver changes size and texture with disease: it can be enlarged due to inflammation or fat (steatosis), as a result of excessive drinking, obesity or diabetes.

The liver has a great ability to regenerate and heal itself by replacing or repairing injured cells. Depending on the damage, it can still function even when up to two-thirds of the tissue is diseased or removed. The remaining part can very quickly grow back to its original size and shape. When the liver is damaged from toxins or disease, the development of scar tissue (fibrosis) is the liver’s response to ongoing inflammation. As the liver heals and regenerates, this fibrosis or scarring can heal.

In a damaged liver with ongoing inflammation, scar tissue builds up and prevents repair, eventually leading to cirrhosis. The consequence of cirrhosis is that the liver can be prevented from doing its usual job. When your liver is not functioning properly, you can become yellow (jaundiced), bleed, become confused, swell as fluid accumulates and, in the most serious of cases, die.

What does the liver do?
The liver is a vital organ. All blood leaving the intestines passes through the liver before it reaches the heart and lungs. This lets the liver filter nutrients, food and other substances absorbed from the bowel. It is one of the tissues that regulate energy balance and metabolism (chemical balance) to provide nutrition for the trillions of cells in your whole body.

The liver controls the metabolic processes that keep you alive. It filters most things that you eat, breath or take into your bloodstream through your skin. A healthy liver performs a range of complicated functions, including processing most of the nutrients absorbed from your intestine, filtering and removing drugs, alcohol and other toxins from your bloodstream and making bile (a greenish fluid stored in your gallbladder) that helps digest fats.

The liver also produces substances to help your blood clot and certain other proteins. You don’t need to get cholesterol from any other source as your liver makes all the cholesterol your body needs.

Alcoholic liver disease, viral hepatitis and non-alcoholic hepatitis (NASH) are the most common causes of liver disease. These conditions can lead to either acute (short-term) or chronic (long-term) hepatitis, a liver problem that causes serious liver damage. If the liver disease is not treated, it can result in cirrhosis, liver failure and cancer.

Liver tests
Liver problems can be silent as you only get symptoms when you already have serious scarring in the liver. Therefore, the best way to find early liver disease is by blood tests, called liver function tests (LFTs). These tests measure the amount of certain chemicals released or produced by the liver to detect, evaluate and monitor the presence of damage or disease of liver cells. Your doctor may recommend liver tests if you have a high risk of liver disease, if you take medicine that can cause liver damage or if you have signs of liver disease.

The most reliable way to test the damage to your liver is with a liver biopsy. Inflammation and damage are diagnosed by examining liver tissue under the microscope. Liver tissue is obtained by a needle placed into the liver under ultrasound guidance. Currently, newer non-invasive techniques are being developed so that these sort of biopsies can be avoided in certain situations.