The digestive function
Bile secretion is a specific activity of
hepatocytes, which synthesizes
the components of bile.
Meet your liver.
Get to know your liver, by knowing its functions
LIVER DISORDERS
KEEP YOUR LIVER HEALTHY
Although it weighs on average only 1500 g, the liver is a real vital laboratory of the body, over one thousand chemical processes being performed at its level.
To better understand the functions of the liver, let's discover the structure of the liver together.
The liver is located in the upper right part of the abdomen, below the ribs
The liver is one of the organs that perform many functions in the human body. It detoxifies, synthesizes proteins and produces substances necessary for digestion. Among other things, the liver produces bile, an alkaline substance needed for the digestion of fats. The gallbladder, located just below the liver, is responsible for storing the bile until it is needed.
The liver regulates the level of most substances in the blood and excretes a bile product that helps eliminate metabolic products from the liver.
Blood that leaves the stomach and intestines passes through the liver.
The liver processes this blood and metabolizes nutrients and medicines in a form that is much easier for the rest of the body to use.
More than 500 vital functions in the liver have been identified.
Adapted from: Alexandru M, Descriptive and applied human anatomy and physiology; Medicala Publishing House 2016 and Grigorescu M, Treatise on Clinical Gastroenterology; Tehnica Publishing House 1996
The liver, unlike other organs, is able to regenerate after some liver damage or after a resection (surgical removal of a tissue or organ, partially or completely).
If the liver suffers repeated, long-term damage (chronic diseases), the changes become irreversible, interfering with its function. Being a very active organ, when it is sick, the whole body suffers.
Liver disease can be inherited or acquired as a result of exposure to chemicals or viruses.
Some liver diseases are temporary and heal on their own, while others can last for long periods of time and can lead to formidable (dreaded) complications.
ACUTE VIRAL HEPATITIS
Acute hepatitis is most commonly caused by hepatitis viruses (A, B, C, D, E).
Uncommon causes include other viruses with hepatic tropism (targeting) (e.g. infectious mononucleosis, yellow fever, cytomegalovirus); there are also medicines that can cause hepatitis (statins, tuberculostatics, some antibiotics, paracetamol abuse, etc.)
It is the most common form of acute hepatitis and is diffuse inflammation of the liver caused by specific hepatotropic viruses (hepatitis A, B, C, D, E).
Some forms of acute viral hepatitis may be subclinical (patients have vague, nonspecific symptoms - mild fatigue, lack of appetite) or acute hepatitis may be manifested by: marked physical asthenia, nausea, vomiting, lack of food, upper abdominal discomfort, jaundice (yellowing of the skin), sometimes itchy skin, hyperchromic urine, discolored stools.
The treatment is supportive (helpful) of liver function and vital functions.
The consumption of alcoholic beverages is prohibited and the administration of essential phospholipids may be recommended as a complementary non-conventional treatment, which must accompany the therapy addressed to acute viral hepatitis.
Source: Liver and its diseases: tips for patients by Adina Purcareanu - Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4
DRUG-INDUCED HEPATITIS
Excessive use of medicines and drug combinations increase the frequency of toxic effects. The liver is an organ susceptible to the harmful effects of medicines because it is involved in their metabolism and inactivation.
In general, the medicines used have low toxicity and do not cause liver damage through their own action, but some of their metabolites (substances resulting from the various transformations that drugs undergo in the body) can be highly reactive if they exceed the inactivation mechanisms.
Drug-induced hepatitis is a condition of the liver caused by the administration of certain medicines, plants or certain chemicals to patients with pre-existing liver disease or not, manifested by jaundice (yellowing of the skin and mucous membranes), pruritus (itching of the skin), fatigue, lack of appetite in mild cases.
The most common forms of drug-induced hepatitis are those described with isoniazid (antituberculosis), methotrexate (administered in rheumatoid arthritis), some antihypertensives (calcium channel blockers), acetaminophen (paracetamol), statins (atorvastatin, simvastatin, etc.) (antifungal), some antibiotics (amoxicillin / clavulanic acid), oral contraceptives.
The administration of essential phospholipids together with statin therapy reduces the incidence of hepatic adverse reactions by decreasing the activity of ALAT (liver enzyme whose values are increased in liver disease) and reducing platelet aggregation (which is increased in the administration of statins).
Essential phospholipids can be given to patients with toxic drug-induced hepatitis to speed up liver cell regeneration and improve detoxification.
It is also recommended to associate it in patients with chronic statin treatment, to prevent drug-induced hepatitis and the effects on lipid metabolism.
Source: Liver and its diseases: tips for patients by Adina Purcareanu – Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4 www.livertox.nih.gov
ALCOHOLIC LIVER DISEASE
Regular consumption of alcoholic beverages can lead to alcoholic liver disease, which includes three diseases: alcoholic steatosis, alcoholic hepatitis, alcoholic cirrhosis.
Alcoholic steatosis is a condition that can range from asymptomatic (no clinical symptoms) to the presence of symptoms such as nausea, vomiting, upper abdominal pain, which is perfectly reversible when you stop drinking alcohol for 6 months.
Its evolution can be favourable, with the healing of liver inflammation or it can evolve towards fibrosis of the liver tissue with the appearance of cirrhosis.
The treatment is a supportive (helpful) of liver function, as well as the treatment of the cause and complications of alcoholic hepatitis.
Alcoholic cirrhosis is a chronic, irreversible disease caused by liver fibrosis.
The treatment of cirrhosis is in fact the treatment of all its complications, and to support liver function, the administration of multivitamins, essential phospholipids, silymarin is recommended.
Source: Liver and its diseases: tips for patients by Adina Purcareanu – Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4
STEATOSIS AND NON-ALCOHOLIC STEATOHEPATITIS (NASH)
Steatosis and Non-Alcoholic Steatohepatitis (NASH) - Fatty liver
Non-alcoholic steatosis, as well as non-alcoholic steatohepatitis (a form of liver damage that includes inflammation that is not caused by alcoholic beverages) is liver damage that can occur in patients who do not consume alcoholic beverages but are overweight or obese, have type II diabetes, dyslipidemia, some may have ischemic heart disease, essential hypertension.
Represents a common disorder in the metabolic syndrome that includes the above conditions. It can occur at any age and in both sexes, but most commonly occurs in middle-aged women (40-60 years old).
It is a condition that requires careful periodic monitoring because although liver damage can be completely asymptomatic and most patients have a good prognosis, nonalcoholic steatohepatitis can progress to cirrhosis or even liver cancer.
Although most patients are asymptomatic, some may experience fatigue, altered general condition, or discomfort in the right hypochondrium (on the right side, below the ribs).
Hepatomegaly (enlargement of the liver) occurs in three quarters of patients.
For diagnosis, the intake of alcoholic beverages should be low (<20 g / day). Blood tests should rule out the presence of hepatitis B or C.
Therapeutic behaviour in these patients should include the treatment of risk factors (diabetes, high blood pressure, dyslipidemia), weight loss recommendation, and diet low in animal fats.
The administration of essential phospholipids, vitamin E, silymarin is recommended, other therapeutic methods currently being researched.
Source: Liver and its diseases: tips for patients by Adina Purcareanu - Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4
CHRONIC HEPATITIS
Chronic hepatitis is a condition of the liver that must meet the time criterion (last more than 6 months). The most common causes are hepatitis B, C and D viruses.
The clinical characteristics are variable, from completely asymptomatic chronic hepatitis (without clinical manifestations) detected by chance, to symptoms such as altered general condition, anorexia, fatigue, sometimes sub-febrile state and a vague sensation of abdominal discomfort. Jaundice is usually absent.
These can be associated with joint and muscle pain, kidney, vascular, neuronal damage, etc.
The most common laboratory change is an increase in transaminases (ALT> AST levels), although they may be within normal limits.
Bilirubin is usually normal. When transaminases are elevated, it is mandatory to determine B and C viruses, although this would be useful as a screening method in the population because chronic liver damage can also exist with normal transaminases.
Source: Liver and its diseases: tips for patients by Adina Purcareanu - Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4
LIVER CIRRHOSIS
Liver cirrhosis is a severe disease characterized by a large process of fibrosis and major liver structural changes (regeneration nodules), most often caused by viral infections (B or C) and alcohol consumption.
Patients with cirrhosis may be asymptomatic or have multiple complications.
Source: Liver and its diseases: tips for patients by Adina Purcareanu - Bucharest Media Med Publicis, 2016, ISBN 978-606-8463-38-4
WHAT SHOULD YOU EAT TO HAVE A HEALTHY LIVER?
The Mediterranean diet is recommended, rich in monounsaturated fatty acids and Omega 3, which you can take from extra virgin olive oil, unroasted and unsalted oleaginous fruits, fish: such as salmon, fresh mackerel, sardines, tuna and herring.
Priority is given to fresh, raw or baked fruits and vegetables. Another healthy choice are whole grains, without sugar: whole rice, quinoa, buckwheat, etc.
Fruits and vegetables that have a hepatoprotective effect:
WHAT ARE THE SIGNS THAT SHOW THAT THE LIVER IS SUFFERING?
WHAT ARE THE ESSENTIAL TESTS FOR FINDING LIVER DISEASE?
Transaminases are tests that are part of the usual test group.
But there are other tests that are indicated by the doctor to diagnose more serious conditions.
In the case of modified transaminases, other additional tests are required to find out the exact cause.
What does Bilirubin Indicate?
It increases in the presence of various liver problems.
Acute hepatitis, chronic hepatitis, cirrhosis, liver tumors, toxic drug-induced hepatitis and, of course, excessive alcohol consumption lead to increased bilirubin levels.
Abdominal ultrasound can detect "fatty liver". This is a painless, non-invasive examination and should be done every year.
This ultrasound allows the examination of the organs that are in the abdominal cavity (liver, pancreas, spleen, gallbladder, kidneys).
There is also a set of 3 tests that show the degree of fibrosis of the liver: FIBROSCAN, FIBROTEST, HEPATIC PUNCTURE OR BIOPSY
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