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What is Liver?
Liver is the largest solid organ in the body located beneath the rib cage in the right upper abdomen. It weighs between 3 and 3.5 pounds.
What are The Functions of Liver?
Liver helps in removing waste products and foreign substances from the blood, regulates blood sugar levels, and creates essential nutrients.
Here are some of its most important functions:
1. Albumin Production: Albumin is a protein that keeps fluids in the blood from leaking into surrounding tissue. It also carries hormones, vitamins, and enzymes through the body.
2. Bile Production: Bile is a fluid that is important for the digestion and absorption of fats in the small intestine.
3. Filters Blood: All the blood leaving the stomach and intestines passes through the liver, which removes toxins, byproducts, and other harmful substances.
4. Regulates Amino Acids: The production of proteins depends on amino acids. The liver makes sure amino acid levels in the blood remain optimal.
5. Regulates Blood Clotting: Blood clotting coagulants are created using vitamin K, which can only be absorbed with the help of bile, a fluid the liver produces.
6. Resists Infections: As part of the filtering process, the liver also removes bacteria from the blood.
7. Stores Vitamins and Minerals: The liver stores significant amounts of vitamins A, D, E, K, and B12, as well as iron and copper.
8. Processes Glucose: The liver removes excess glucose (sugar) from the blood and stores it as glycogen. When needed, it can convert glycogen back into glucose.
What is Liver Disease?
Liver diseases refer to chronic conditions that cause progressive damage to the liver over time. Viral infections, toxic poisoning, and certain metabolic conditions are among the common causes of chronic liver disease.
What are The Causes of Liver Disease?
Following are the causes of liver disease:
1. Viral infections: Viral infections that become chronic can cause chronic hepatitis, including hepatitis B and hepatitis C.
2. Alcohol-induced hepatitis: Heavy alcohol use can cause acute or chronic hepatitis. If it goes on long enough, it can cause cirrhosis and liver failure.
3. Toxic hepatitis: Over exposure to toxins, such as industrial chemicals or drugs, can cause acute or chronic hepatitis.
4. Non-alcohol related fatty liver disease: Metabolic conditions associated with obesity, high blood sugar and high blood lipids can cause excess fat storage in liver, which can cause inflammation (non-alcohol related steatohepatitis).
5. Biliary stasis: Congenital (present at birth) conditions that obstruct the flow of bile through bile ducts can cause bile to build up and injure liver, including biliary atresia and cystic fibrosis. Non-congenital causes include biliary stricture and gallstones.
6. Autoimmune Diseases: Autoimmune conditions can cause chronic inflammation and scarring in liver or bile ducts, including autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis.
7. Inherited metabolic disorders: Disorders that cause toxic products to build up in blood such as glycogen storage disease (GSD), Wilson disease, hemochromatosis and Gaucher disease — can cause chronic liver damage.
8. Cardiovascular diseases: Conditions that affect blood flow to and from liver — including Budd-Chiari syndrome, ischemia, arterial diseases, and right-sided heart failure — can cause chronic liver damage.
What are The Symptoms of Liver Disease?
First signs and symptoms of Liver Disease
Chronic liver disease often won’t cause symptoms in the early stages. But sometimes it begins with an episode of acute hepatitis. A person might have the following symptoms for a short period while the immune system works to defeat the infection.
1. Fever
2. Stomachache
3. Nausea
Later stage signs and symptoms of Liver Disease
1. Jaundice
2. Dark colored urine
3. Light colored stool
4. Weight loss and muscle loss
5. Musty smelling breath
6. Itchy skin with no visible rash (Pruritus)
7. Mild brain impairment
As liver disease advances, it can affect the blood flow and hormones. A person may see signs and symptoms in skin and nails, such as:
1. Spoon nails
2. Terry’s nails
3. Nail clubbing
4. Spider angiomas
5. Tiny red dots on the skin (petechiae)
6. Small yellow bumps of fat deposits on the skin or eyelids
7. Easy bleeding and bruising
8. Red palms of the hands
9. What Tests are Done to Diagnose Liver Disease?
10. Liver Function Test
It is a group of tests that are performed together to detect, evaluate, and monitor liver disease or damage. The panel usually consists of several tests that are run at the same time on a blood sample. These include:
1. Alanine Aminotransferase (ALT)
An enzyme found mainly in liver tissue and to a lesser extent in the heart, kidney and skeletal muscle. Its measurement is clinically useful in the diagnosis of liver and biliary disease.
2. Aspartate Aminotransferase (AST)
An enzyme found in several parts of the body, including the heart, liver, and muscles. Since AST levels aren't as specific for liver damage as ALT, it's usually measured together with ALT to check for liver problems. When the liver is damaged, AST can be released into the blood stream. A high result on an AST test might indicate a problem with the liver or muscles.
3. Gamma Glutamyl Transpeptidase (GGTP)
An enzyme that is found in many organs throughout the body, with the highest concentrations found in the liver. GGT is elevated in the blood in most diseases that cause damage to the liver or bile ducts.
4. Bilirubin, Total
It is used to detect an increased level of bilirubin in the blood. It helps to determine the cause of jaundice and diagnose conditions such as liver disease, haemolytic anaemia, and blockage of the bile ducts.
5. Bilirubin, Direct
It measures a form of bilirubin that is conjugated (combined with another compound) in the liver; It is only increased in the case of liver disease.
6. Alkaline Phosphatase (ALP)
An enzyme related to the bile ducts but also produced by the bones, intestines, and during pregnancy by the placenta (after birth). High levels of ALP may indicate liver inflammation, blockage of the bile ducts, or bone disease.
7. Albumin
Albumin is the main protein made by the liver. This test measures the level of albumin in the blood. A low result indicates that the liver isn’t functioning properly.
8. Total Protein
The total protein test measures the total amount of protein in the blood and specifically looks for the amount of albumin and globulin. It also measures the ratio of albumin to globulin in the blood known as the A/G ratio.
Total Protein is useful in evaluating patients for nutritional status, liver disease, protein losing renal and gastrointestinal diseases.
9. Ammonia Test
Ammonia Test is used to detect an elevated level of ammonia in the blood that may be caused by severe liver disease, kidney failure, or certain rare genetic disorders.
10. Ceruloplasmin Test
Ceruloplasmin is the major copper-carrying protein in the blood, and also plays a role in iron metabolism. Ceruloplasmin testing is used to help diagnose Wilson disease, an autosomal recessive disorder. Low levels may also occur in Menkes syndrome which is a genetic defect in copper metabolism.
11. Bile Acids, Total
Increases in serum bile acids may be a marker for acute hepatitis, chronic hepatitis, liver sclerosis, liver cancer, and intrahepatic cholestasis of pregnancy.
12. NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score
It is a non-invasive scoring system based on several laboratory tests that help to estimate the amount of scarring in the liver.
