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Proper Manners When Interacting With Liver Disease Patients

Liver: Main Features and Functions

Structure
The liver of an adult typically weights about 1.5 kilograms and is about the size of two palms put together. It is by far the largest of all internal organs of the human body. Shielded by the right-side of the rib cage, the liver occupies the central part of the upper torso, from about one centimeter below the right nipple to two centimeters below the left nipple.
  • Liver cells
    The square-shaped cells of the liver are all attached to one another, constantly conveying cell information. All liver diseases begin with the destruction of liver cells, which leads to the collapse of the hepatic lobules. The progression of these diseases causes the fibrosis of liver cells, which, in turn, causes the confusion of blood vessels in the organ, thus disturbing the normal flows of blood into and out of the liver.
  • Hepatic portal veins
    Blood travels into organs via arteries and exits via veins. Aside from general arteries and veins, the liver also has portal veins that transport nutrients along with blood from the digestive tract into the liver. The food we eat is broken down and digested in the liver and intestines. The nutrients processed thus are then carried to the liver via portal veins. Hepatic portal veins, therefore, are indispensable to the functioning of the liver.
  • Bile
    The liver produces a special liquid known as bile, and a bile duct is a passageway via which this special liquid travels. The role of bile is to help the body discharge bilirubin, a type of toxin, as well as to facilitate the digestion of fat with bile acid.
Functions
The major role of the liver is to process the diverse compounds that are brought into it, from internal sources or sources external to the human body, so as to synthesize and provide the compounds the body needs. It could be said that the liver is like a combination of a power plant and a chemical processing facility, akin to a chemical industry cluster. In addition, the liver also stores blood and protects the immune system. As the liver handles such a variety of important bodily functions, any damage to it can lead to serious health problems.

Main Symptoms of Liver Diseases

Also known as “the silent organ,” the liver remains asymptomatic for long stretches of time even after it is afflicted with troubling conditions. Therefore, people with liver diseases often visit doctors too late. If you have any of the following symptoms or conditions, you may need to consult your doctor.

Sudden languor
Constant and seemingly groundless fatigue, coupled with a dull pain in the upper abdomen.
Loss of appetite
Inability to digest food and proneness to nausea/vomiting (with a sudden aversion to food rich in fats)—these symptoms can be particularly pronounced in the case of acute hepatitis.
Jaundice
Sudden sallowness of the skin and destruction of red blood cells indicate an accumulation of bilirubin inside the body. The liver is supposed to help the body discharge this toxin with the bile it produces. However, when the liver is damaged, it becomes unable to release bile acid, thus leading to a bilirubin build-up in the body, causing jaundice, first starting with the eyes. Acute jaundice may also be accompanied by itchy skin and rashes. This is because either bile acid has accumulated in the subcutaneous tissues or gallstones are blocking the bile ducts.
Unusual colors of urine and stool
In a healthy body, bile travels from the liver to the intestines via bile ducts, giving urine and stool their distinct colors. If the liver is damaged, and bile does not arrive at the intestines and kidneys as planned, urine may take on a dark brown color akin to that of Coca Cola. Stool, on the other hand, may turn either lighter or darker in color, sometimes almost black. The latter case, often accompanying the vomiting of blood, indicates damage to the veins of the esophagus.
Bleeding of the gums
Damage to the liver may also interfere with the organ’s ability to produce blood coagulants. Therefore, a liver disease patient may experience bleeding of the gums while brushing his/her teeth, frequent nosebleeds, and proneness to bruising at the slightest impact. This anomaly in blood flow may also cause damage to the veins in the abdomen and chest.
Skin irritations
Liver diseases may also cause palmar erythema (sudden reddening of the palms), rashes throughout the body (particularly on the chest, around the neck, and on the upper arms), and the darkening of facial skin. In this last case, the skin looks darker, not tanned. Capillaries may also become visible, and pimples and/or freckles and liver spots may present.

Types of Liver Disease

Jaundice
Jaundice is one of the most frequently noted symptoms and diseases of the liver, and is strongly correlated to the presence of a liver disease. However, liver disease is not the sole cause of jaundice. In rare cases, blood diseases may also lead to jaundice.
Portal hypertension
A liver disease may deform the anatomical structure of the liver and disrupt the flow of blood through the hepatic portal veins, thus raising the blood pressure in these veins and culminating in portal hypertension. Portal hypertension causes the spleen to enlarge and/or become excessively active, while also stimulating the collateral vessels in the digestive tract and stomach.
Hepatomegaly
In most cases of liver cirrhosis, the liver contracts in size and becomes hard to the touch. The appearance of hepatomegaly in a liver disease patient, therefore, may indicate liver cancer. However, hepatomegaly is also a noted symptom of metabolic and/or alcohol-induced liver diseases. In acute hepatitis, hepatomegaly may also appear to an extent, along with severe pain.
Hepatic encephalopathy
Hepatic encephalopathy can be caused by a variety of factors in patients suffering from fulminant hepatic failure, acutely deteriorating chronic hepatitis-B, and liver diseases of grade C on the Child-Pugh scale. In the past, this symptom presented in patients who had undergone shunt operations of the hepatic portal veins or other blood vessels to treat esophageal varices. Today, hepatic encephalopathy is reported with growing frequency in patients who have undergone transjugular intrahepatic portosystemic shunt (TIPS) operations.

General Course of Treatment for Chronic Liver Diseases

The causes and symptoms of chronic hepatitis and other liver diseases vary widely, but most patients are placed on a common course of treatment. As liver cancer is often accompanied by chronic liver conditions and diseases, liver cancer patients are also required to undergo treatments for these underlying conditions in addition to cancer therapy. The general course of liver disease treatment includes lifestyle management, dietary control, allopathy, and pharmacotherapy.

A question commonly raised by patients is to what extent they can and should be physically active. Patients of chronic liver diseases who do not exhibit pronounced or acute symptoms may continue to engage in daily activities at their usual level of rigor. And there are no special dietary requirements for chronic liver disease patients. If anything, these patients are required to eat a wide range of healthy foods in order to promote the regeneration of damaged liver cells and nourish their bodies. It is recommended that patients eat any healthy food they can digest well and enjoy. However, eating too much nourishing food, especially foods high in protein and fat, will only end up causing patients to gain weight.

As chronic liver diseases tend to deteriorate acutely and suddenly, patients may have difficulty eating as they become prone to nausea and vomiting. Candy, soft drinks, and fruit juices can be good sources of the sugar these patients need. They may be given intravenous injections of glucose and amino acids.

Alcohol has traditionally been strictly off limits to patients of chronic liver diseases. Patients are, of course, advised against excessive drinking (i.e., over 60 grams of alcohol or two-thirds of a bottle of soju). Drinking is especially known to expedite the deterioration of chronic hepatitis-C. Nevertheless, patients may still drink small amounts of alcohol every now and then (about 10 to 20 grams of alcohol at once, or 80 milliliters of soju or 500 milliliters of beer).

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