Liver Functions and Disease: What You Need to Know

The liver is the largest solid organ in the human body and performs numerous vital functions. It plays a central role in the metabolism of carbohydrates, proteins, and fats. Additionally, the liver is crucial for detoxifying harmful substances from food, medications, and environmental toxins. It also plays a key role in blood coagulation, as it is the primary site for producing clotting factors.

The Increasing Burden of Liver Disease Globally

The global burden of liver disease has been rising, especially with the westernization of lifestyle and diet. In India alone, liver disease accounts for nearly two million deaths annually and is responsible for 4% of all deaths. A recent study predicts that by 2040, the incidence of liver disease might double the current rates, reaching 30.5%. With changes in diet and lifestyle, the prevalence of overweight and obesity is increasing, leading to a surge in fatty liver disease.

Hepatitis: Causes and Types

Hepatitis, as the name implies, is the inflammation or injury of the liver, essentially indicating liver damage. It can be caused by infectious agents like viruses or non-infectious causes such as chemicals, drugs, alcohol, autoimmune diseases, and certain rare genetic disorders.

Viruses causing hepatitis are named from Hepatitis A to E, most of which are blood-borne infections. **Hepatitis B** is widespread in many developing nations, particularly in Asian and African countries. India has intermediate endemicity for Hepatitis B, with chronic (lifelong) infection affecting 40 million people and resulting in more than 120,000 deaths annually due to its complications.

Metabolic Associated Fatty Liver Disease (MAFLD)

With advancements in research, the term non-alcoholic fatty liver disease (NAFLD) has been replaced with Metabolic Associated Fatty Liver Disease (MAFLD) to better reflect the disease's nature and aid in public understanding and prevention. MAFLD is more common among middle-aged individuals (40-60 years old), although there has been a recent increase among adolescents. Fatty liver does not produce any symptoms in its early stages and is usually diagnosed through a screening ultrasound scan.

The Alarming Rise of Metabolic Associated Fatty Liver Disease

Metabolic associated fatty liver disease is one of the globally increasing and highly alarming liver problems. Previously, non-alcoholic fatty liver was a major health issue in developed nations. However, in recent years, even developing countries like India have seen a rise in steatohepatitis due to the obesity epidemic. The impact of fatty liver does not stop there; fatty liver-related liver cancer and the need for liver transplantation are also on the rise.

Lifestyle Changes and Their Impact on Liver Health

The major reason behind the increasing liver disease is the change in lifestyle, food habits, and sedentary work patterns. Fatty liver is considered the liver manifestation of metabolic syndrome. Hepatitis becomes commonly identified among individuals with underlying diabetes (high blood sugar levels), high blood cholesterol levels, obesity (Body Mass Index BMI >30), sedentary lifestyles, and excessive junk food consumption. Recently proposed risk factors include high blood pressure, pre-diabetes, and high Hs-CRP levels in the blood. Additionally, alcohol consumption remains a significant risk factor resulting in hepatitis.

Symptoms of Hepatitis

The most common symptoms of hepatitis include extreme fatigue, abdominal pain, body pain (myalgia), fever, nausea, and gastrointestinal disturbances. In severe cases, it can result in dark urine, yellowish discoloration of the eyes, leg swelling, abdominal tightness or discomfort, bleeding tendencies like bleeding gums or nose, sleep disturbances, and even coma.

Diagnosis of Hepatitis

Detection of hepatitis is primarily based on blood tests such as liver function tests and ultrasound scans of the abdomen. Advanced scans like fibroscan and magnetic resonance elastography are also useful in identifying and treating hepatitis. The advantage of fibroscan is that it provides an accurate measure of fat fraction in the liver and the degree of liver damage. Other screening tests to identify the cause of hepatitis include fasting blood sugar levels, HbA1c levels, blood cholesterol levels, triglyceride levels, and HOMA insulin levels.

Treatment of Hepatitis

The treatment of hepatitis focuses on lifestyle modification, weight reduction, healthy dietary habits, and good diabetic control. A healthy balanced diet with low fat and sugar intake, and avoiding excessive sweets, foods rich in bad cholesterol, and junk food will improve liver health. Regular walking and aerobic exercises 3 to 4 times a week, along with weight reduction for obese or overweight individuals, play a major role in reversing fatty liver to normal.

The Importance of Screening and Prevention

It is highly advisable for individuals with the aforementioned risk factors to get tested for their liver health with basic blood tests and liver scans. Only a minor proportion of patients might require medication, as most cases of hepatitis are manageable with modification of risk elements. Prevention is better than cure; simple screening for hepatitis can avoid major liver health problems in the future.

Key Steps Towards Hepatitis Prevention

1. Healthy Diet: Avoid junk food, excess sugars, and soft drinks.
2. Avoid Alcohol and Substance Abuse: Refrain from consuming alcohol and other harmful substances.
3. Daily Physical Activity: Engage in 30 to 45 minutes of brisk walking daily.
4. Regular Checkups and Screening: Regularly monitor liver health through blood tests and scans.
5. Vaccination: Ensure vaccinations are up to date to prevent liver infections.

Our prime role currently is to make people understand and accept the concern regarding hepatitis evolving into a major burning health issue. The key message is to focus on prevention rather than treatment alone. This goal can be accomplished with steps like screening, identification of risk factors, correcting them, maintaining a healthy diet and lifestyle, and spreading this message beyond horizons.

Your liver health matters! Prevent hepatitis at any cost!