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In a previous section, I referred to a number of liver conditions that are actually fairly rare – primary biliary cirrhosis (autoimmune), autoimmune hepatitis, Wilson’s Disease (hereditary). More information about these conditions and other more obscure liver issues can be found here or here.
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The only liver problems listed on the Mayo/CPMC pages that I’ll be discussing in any detail here are The Big Three: fatty liver, hemochromatosis and viral hepatitis. They’re the most common and the most insidious.
The bottom line is that anytime you replace enough healthy liver tissue with something else, you’re going to have problems. Certainly the overconsumption of alcohol can cause liver damage. Usually, but not always, the person drinking (and other people in their life), are aware of the drinker’s behavior and may expect liver problems to crop up. However, even “social drinking” can lead to serious problems for some people. Remember, everyone’s tolerances are different. Mostly what I want to do here, though, is focus on physical issues and causative factors that may not be so obvious.
Let’s start with NASH (non-alcoholic steatohepatitis, pronounced stee-at’-oh) and NAFLD (non-alcoholic fatty liver disease). For simplicity, let’s just say fatty liver. I’m sure you can deduce from those names that alcoholics are prone to developing fatty liver, but notice that these are both non-alcoholic conditions.
I always refer to this as a “growing” problem and I use that word with dual meaning – more and more people are developing fatty liver because more and more people are becoming and remaining seriously overweight and/or obese. A stunning 25% of adults in America have fatty liver and that percentage grows every year. Even more distressing, it’s estimated that 17% of our children have developed fatty liver from a lifetime of obesity. Children in their teens who have been overweight their entire lives are showing up at doctors’ offices with cirrhosis – that’s just crazy and so sad! I’m sure it does not occur to most parents that their child’s weight issues could lead to liver disease.
When you look at someone who’s carrying extra weight, whether they’re staring back at you from the mirror or standing in line with you at the bank, the fat you see on the outside of that person’s body is not the whole story. How do you know if you may be grossly overweight or obese? Besides that just-mentioned visual inspection, your BMI (Body Mass Index) should be in the 18-25 range (ideally 18-23). Here’s a simple online BMI calculator you can access.
Visible fat is not the whole story. Fat also accumulates inside the body cavity and in the liver itself. Fatty deposits in the liver cause inflammation (hepatitis), which leads to scarring (fibrosis). Over time, obesity can lead to cirrhosis because of fatty liver deposits. The good news is you can fix this! If you ever needed further motivation to get up off your (circle one – butt, tush, fanny, hiney, other uncomplimentary term) and eat better, get in shape and lose some weight, here you have it.
For some, even losing 10% of body weight can result in significant improvement. Remember that other serious contingencies can go hand-in-hand with obesity – high blood pressure and Type 2 Diabetes. There are other proven therapies that may be helpful for fatty liver besides weight loss, so check with your doctor. If you have a loved one in your life that fits the description of grossly overweight or obese, counsel them about this other rarely-mentioned complication of carrying extra weight. Remember, if you catch the damage to your liver at an early enough stage (up to Stage III, but better at Stage I or II), you can substantially reduce damage and allow the liver to heal. Once again – don’t forget the tendency of the liver to be quiet and non-complaining, even as fibrotic scar tissue is forming. ALWAYS check with your doctor before beginning any weight loss or exercise program.
Next time – hemochromatosis (hereditary iron overload).
Now get up out of your computer chair and go get some exercise!
Hollis Pickett, in partnership with Toni Donovan, runs a Redding area non-profit – Local Area Support For Hepatitis, also known as LASH. Hollis has been involved with hepatitis advocacy since 2002 and is a steering committee member with CalHEP Alliance. She has been the bookkeeper and office manager for the law firm of Carr, Kennedy, Peterson & Frost for the past 25 years. Toni has just completed a Masters in Public Health (MPH) and is currently employed by Planned Parenthood and Acaria Health (a specialty pharmacy). LASH provides community education and patient/caregiver support for those infected with chronic viral hepatitis. A support group meets once a month for patients and their families. LASH offers group presentations, individual counseling and clinical education for patients entering treatment. You can contact them via e-mail at email@example.com or call Toni (945-7853) or Hollis (524-5601).