July 24, 2010

Taking care of your liver

Sunday July 25, 2010

By Dr S.Y. CHONG

The liver is one of the body’s most important organs and needs to be protected at all times.

THE liver is the largest internal organ of the body. This vital organ is crucial to the smooth functioning of the human body.

It metabolises most of the nutrients that are absorbed by the intestine and detoxifies the blood by removing medications, alcohol and potentially harmful chemicals from the bloodstream – processing them chemically so that they can be expelled from the body by the digestive or urinary systems.

The liver also produces clotting factors and other proteins, stores certain vitamins, minerals (including iron) and sugars, regulates fat stores, and controls the production and excretion of cholesterol.

The liver is an amazing organ that can regenerate its cells within a few weeks. In fact, the liver can tolerate a fair amount of “abuse” and will only show signs of injury when the damage is very advanced.

Examples of liver disorders include hepatitis and cirrhosis. Hepatitis is inflammation of the liver and cirrhosis is scarring of the liver. These two conditions may progress to liver cancer if they are not monitored or treated properly.

As the saying goes, prevention is better than cure. Hence, here are some measures you can take to preserve liver health:

Eat right

Poor nutrition rarely causes liver disease but good nutrition in the form of a balanced diet will enable the liver to perform its many various functions efficiently, resulting in better overall health. It can also help liver cells damaged by hepatitis viruses to regenerate, forming new liver cells.

However, whilst it is important to take vitamins and minerals, please note that an excess of Vitamin A is toxic to the liver and should be taken in moderation.

Limit intake of calories

Excess calories in the form of carbohydrates can add to liver dysfunction and can cause fat deposits in the liver, contributing to fatty liver.

No more than 30% of a person’s total calories should come from fat because of the danger to the cardiovascular system. In order to estimate your daily calorie needs, you will need a minimum of 15 calories a day for each pound you weigh.

Watch the alcohol

Liquor, beer and wine are difficult for the liver to metabolise. The daily recommended alcohol intake is three units/drinks for men and two units/drinks for women.

As a general guide, one unit of alcohol translates to half a pint of ordinary strength beer, a small measure (25ml) of spirits or a standard measure (50ml) of fortified wine such as sherry or port.

Having three drinks or more per day should be avoided, as it may lead to alcoholic hepatitis and cirrhosis. People with liver disease should never drink alcohol at all. The same goes for individuals who are taking medication – mixing alcohol with painkillers or other types of medications can be dangerous to your liver.

In particular, the mixture of alcohol and acetaminophen (an ingredient in pain killers and cough medication) can cause sudden, severe hepatitis and even fatal liver failure. If you are not sure which medications to take in combination, please consult your doctor.

Beware ‘nutritional therapies’

Herbal treatments and alternative liver medicines should undergo rigorous scientific study before they can be recommended. “Natural” or diet treatments and herbal remedies can be quite dangerous. Plants of the Crotalaria, Senecio and Heliotopium families, as well as chaparral, mistletoe, skullcap, germander, comfrey, margosa oil, mate tea, Gordolobo yerba tea, pennyroyal, and Jin Blu Huan are all toxic to the liver.

Several scientific studies suggest that substances in milk thistle may protect the liver from harmful substances such as acetaminophen, which can cause liver damage. It is also believed that milk thistle has antioxidant and anti-inflammatory properties, and it may help the liver repair itself by growing new cells.

Stop smoking and stay away from toxic fumes and liquids

Fumes from paint thinners, bug sprays, and other aerosol sprays are picked up by the tiny blood vessels in your lungs and carried to your liver where they are detoxified and discharged in your bile.

The amount and concentration of those chemicals should be controlled to prevent liver damage. Make certain you have good ventilation, use a mask, cover your skin, and wash off any chemicals you get on your skin with soap and water as soon as possible.

Wash your hands

Hands should be washed with soap and water following bowel movements and before food preparation and consumption. This will help prevent the spread of hepatitis A.

Practise safe sex

Wear protection when having intercourse. Hepatitis B and C are transmitted through blood and body fluids. So use condoms and avoid sharing your personal items such as toothbrush, razor or manicure sets, especially if your partner is suffering from a liver disease.

Get vaccinated

Vaccination for hepatitis A and B is available. An immunisation programme for hepatitis B has been in place for all children and adults since 1989 to prevent hepatitis B infection. It is essential to vaccinate newborns for hepatitis B as infections in this group will result in 90% chronic infection. There is no vaccination available for hepatitis C.

In Malaysia, hepatitis B is the most common chronic liver infection, affecting over 1.1 million people. Whilst the majority of people who have acute hepatitis B will overcome the infection, the virus can linger in about 10% of patients for up to six months. Such patients are known as hepatitis B carriers or have chronic hepatitis B infection, depending on levels of virus in the blood and liver enzyme levels.

Chronic liver infection can lead to cirrhosis, where there are areas of scarring and liver cell regeneration within the liver. Cirrhosis can lead to liver cancer, which is often diagnosed too late as few symptoms appear until it has reached an advanced stage. Signs and symptoms of liver cancer include right upper abdominal pain, jaundice (yellowing of the skin), abdominal swelling, weight loss, fatigue, easy bruising or bleeding.

Apart from surgery, for which most liver cancer patients are ineligible due to the advanced stages of the disease at time of diagnosis, there is currently an oral treatment that has been found to be effective in targeting the liver cancer cells specifically and can be used in patients who are unsuitable for surgery.

Sorafenib is the only oral treatment available in Malaysia that is indicated for the treatment of advanced liver cancer. Currently there is a patient assistance programme for sorafenib, which provides drug assistance to patients who meet the eligibility criteria. More information on this programme can be obtained from the Malaysian Liver Foundation, tel: 03-78426101.

Keeping the liver healthy is essential to keeping your entire being healthy, so take good care of your liver, so that it can take care of you.

This article is contributed by Dr S.Y. Chong, medical advisor with Bayer Schering Pharma. This information is provided for educational purposes only and should not be taken in place of a consultation with your doctor. Bayer Schering Pharma disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

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