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The liver is the most important organ in our body. It is a key player in the body’s digestive system. Everything we eat or drink, including medicines, pass through the liver. If we didn’t have the liver, we would not have been able to process nutrients like carbohydrates, proteins, fats, vitamins and minerals from our food. Our body would not get rid of all the toxins and infections and our blood may probably never clot! The liver plays a vital role in maintaining the body’s metabolic balance. We can’t survive without the liver. It is an organ which can be easily damaged if we refuse to take good care of it.
As the liver performs different important functions, it is extremely vulnerable to a variety of metabolic, toxic, microbial, circulatory and cancerous assaults. Awareness about the liver’s functions and what all can cause liver diseases can help us take the road to great health.
Few commonly known diseases that can affect the liver are:
1. Viral Hepatitis is an infection of the liver that is caused by a group of viruses that have particular affinity for the liver. Out of these, Hepatitis A and E are caused by consuming contaminated food and water. Hepatitis B, C and D are acquired through blood, body fluids and unprotected sexual contact.
2. Alcoholic Hepatitis is inflammation or swelling of the liver due to ingestion of alcohol.
3. Cirrhosis or scarring of the liver is caused mostly due to alcohol intake, Hepatitis B and C viruses, bile duct disease or iron overload. The liver ceases to function normally due to irreversible damage. It progresses gradually and can lead to end stage liver disease and liver failure.
4. Drug induced damage is caused due to various medicines we take and chemicals we are exposed to. As the liver is the major detoxifying organ in the body, it is subject to an enormous variety of drugs and chemicals. We have to be always careful when consuming medicines. Even over the counter medications like paracetamol can cause fulminant liver failure. Never take medications beyond the recommended dosage.
5. Liver cancer can be caused by many factors including viral infections (Hepatitis B and C), chronic alcoholism, certain food contaminants, genetic factors and cirrhosis of the liver.

What are the symptoms of liver disease?
This depends on the onset and rapidity of progression of liver damage.
In case of acute liver damage (due to drugs, toxins, viral Hepatitis A, B and E), there may be fever with yellowish discolouration of the eyes, skin and urine. In most cases this may be self-limiting. In a small percentage, this may progress to liver failure and death.
In chronic liver damage (due to Hepatitis B, C or alcohol), the symptoms will be more gradual at the onset—Jaundice or yellowish discoloration of skin and eyes, swelling especially in the legs and feet due to low protein levels and reddish spider like discolorations (spider nevi) beneath the skin especially over the chest. Accumulation of fluid (ascites) in the abdomen giving it a protruded appearance and problems with clotting of blood, vomiting of blood or blood in stool will follow.
Altered senses with change in behavior, confusion, forgetfulness and other symptoms related to the brain, also known as hepatic encephalopathy, will surface leading to gradual worsening of kidney function.
Here are some tips for a healthy liver:
1. Diet and alcohol: A balanced diet with low fat content will be well suited to prevent fatty liver. Alcohol should be best avoided.
2. Exercise: It plays a role in controlling cholesterol and in the metabolism of fat thus indirectly protecting the liver.
3. Vaccination: Hepatitis B is preventable by vaccination. Vaccination done once in a lifetime protects against liver failure and cancer.
4. Hygienic food and drinking water: Hepatitis A and E are known to spread via the oral route. Think twice before having roadside delicacies. Your food and water should be safe.
5. Avoid self-medication: Various drugs, if taken indiscriminately, can damage the liver.
6. Regular check-ups: Once diagnosed with liver disease, be regular in follow-ups with the doctor. Reversible damage can become irreversible, if neglected.
If liver disease is diagnosed at an early stage, effective treatments are available to protect the liver and if the liver disease is very advanced, transplantation (change of the liver) is the answer.
The World Liver Day is observed every year on April 19 to create awareness among the people about the importance of liver and ways to prevent liver diseases. This World Liver Day, let’s strive not to abuse our liver, one of the most important organs that we have. Let’s treat it with the love and respect it deserves.
The department of Gastroenterology and Liver Diseases at the IMS and Sum Hospital, Bhubaneswar, wishes the people of Odisha to have a healthy liver as also a healthy and productive life. The Sum Hospital is the only of its kind in India where free screening and vaccination against Hepatitis B is provided on all week days round the year. The hospital also conducts programs in different parts of Odisha to create awareness and prevent liver diseases.

Dr. Manoj Kumar Sahu
Associate Professor and Head
Department of Gastreoenterology and Liver Diseases
Institute of Medical Sciences and Sum Hospital

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