Why is liver health important?
Of all the major health problems in the UK that threaten life, liver disease is rising the most rapidly.
Most forms of liver disease do not cause any symptoms until they are very advanced. Early diagnosis and treatment is the most important step in preventing complications such as liver cancer and liver failure.
What does the liver do?
The liver is a large organ that lies in the right side of the abdomen. It has many functions:
- It controls the body's metabolism.
- It filters out and excretes many of the waste chemicals produced in the body.
- It produces a large number of different proteins including those that help the blood to clot. It aids the digestive process.
- It stores many products that are vitally important to our day-to-day health.
What causes liver disease?
- Drinking alcohol in large quantities over a long time period can cause liver disease. But drinking is not the only risk factor. A wide variety of other conditions can cause liver disease:
- Cases of non-alcoholic fatty liver disease have been increasing rapidly in people on a typical 'western' diet. The liver is partially replaced by fat, which can cause inflammation and scarring and can lead ultimately to liver cirrhosis and its complications.
- Viral hepatitis, specifically hepatitis B and C, affects up to 1% of the British population but is greatly underdiagnosed. Long-term infection that is not diagnosed can damage the liver.
- Hereditary conditions such as iron overload (haemochromatosis) lead to liver damage and problems with other vital organs. These conditions do not cause symptoms until later in life and are often recognised after the damage has been done.
- Various medications and autoimmune conditions can also cause significant liver problems.
What are the symptoms of liver disease?
In its earliest stages liver disease often does not cause any symptoms. The majority of liver disease is identified incidentally, during screening blood tests or ultrasound scans.
Some people do get fatigue and discomfort in the abdomen. More advanced liver disease causes jaundice (yellowing of the skin and eyes), fluid accumulation in the abdomen and serious internal bleeding.
What tests can detect liver disease?
Three key types of test are used to investigate the health of the liver and to start diagnosing any problems:
- Blood tests.* These can be used to pick up early inflammation in the liver; they detect when liver cells are dying at a faster rate than normal. More advanced liver disease can be diagnosed by a rise in blood levels of bilirubin, the chemical that causes the body to turn yellow, and by a decrease in levels of some of the proteins made by the liver, such as albumin. Your consultant will also often require specific blood tests looking for certain causes of liver disease such as viral hepatitis.
- Imaging techniques. Ultrasound, CT and MRI scans can help with diagnosis. They can also be used to evaluate abnormal areas within the liver that could be cancer, or could become cancerous. These are usually done on The Physicians' Clinic site, and often on the same day as your appointment with the consultant, but this cannot be guaranteed.
- Fibroscan. It is very difficult to know from the above tests when the liver problems began. It is therefore important to find out how much fibrosis (scar tissue) is present in the liver. This used to require a liver biopsy but we now have a non-invasive test, the Fibroscan. This painless technique accurately determines the state of the liver and allows change to be monitored over time.
*Note: even in someone with significant liver disease, it is not uncommon for liver function blood tests to be entirely normal.
What treatments are available for liver disease?
All forms of liver disease are treatable if diagnosed sufficiently early. This means acting on blood test results or ultrasound abnormalities before symptoms develop.
Although in many cases a change of lifestyle remains one of the most important ways to manage liver damage, medications can prevent disease progression and often allow the liver to return to normal.
Liver health at The Physicians' Clinic
The Physicians' Clinic has consultants with a wealth of experience in diagnosing and managing all forms of liver disease. Your consultant will take time in clinic to discuss your issues with you and then advise on what investigations are recommended, all of which can be done at The Physicians' Clinic. The onward management plan will be tailored to you and may require a return visit to see the consultant.
Getting more information
If you have any questions concerning your procedure, please contact the gastroenterology/hepatology team at The Physicians' Clinic
The team is available Mon – Fri 0900-1700
Tel: 020 7034 8164
Fax: 020 7034 8140
￼￼￼￼If you experience problems:
- Contact your consultant directly by telephoning The Physicians' Clinic during office hours as above.
- Out of hours, please contact your gastroenterologist directly using the information supplied after your appointment.