World Liver Day is observed every year on April 19 to raise public awareness about liver diseases, which claim about 20 lakh lives annually worldwide. Liver diseases in India alone contributed to 18.3 per cent of the two million global liver disease-related deaths in 2015, implying how significant the burden of liver disease in India is, according to the United States National Institutes of Health (NIH). Since 1980, the contribution of cirrhosis and its complications, collectively called chronic liver diseases, as causes of morality in India has been increasing progressively. Liver diseases are a significant cause of premature death and disability in India.
The different types of liver diseases are acute hepatitis, alcoholic liver disease, chronic liver disease, drug-induced liver injury, hepatitis A, hepatitis B, hepatitis C, hepatitis E, hepatocellular carcinoma, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, Wilson's disease, and hemochromatosis, among others.
Hepatitis
Acute hepatitis refers to a wide variety of conditions characterised by acute inflammation of the hepatic parenchyma (the functional parts of an organ) or injury to hepatocytes resulting in the liver function becoming compromised or affected.
People suffering from acute hepatitis may experience symptoms such as fever, fatigue, loss of appetite, jaundice, nausea, vomiting, dark urine, and joint pain, among others. Hepatitis, which means inflammation of the liver, can be caused by the viruses Hepatitis A, B and C.
Hepatitis A can be prevented through frequent handwashing with soap and water after using the washroom, and before eating or preparing food. It is also important to take the Hepatitis A vaccine.
Hepatitis B can also be prevented by taking the Hepatitis B vaccine. People must avoid risk factors such as having intercourse with an infected person and sharing needles.
Hepatitis C can be prevented by avoiding behaviours that spread the disease, especially injecting drugs.
Alcoholic liver disease
Alcoholic liver disease is of three types: fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis. The build-up of fat inside the liver cells, which leads to an enlarged liver, is called fatty liver disease. This is the most common alcohol-induced liver disease, according to Johns Hopkins Medicine.
Alcoholic hepatitis results in the death of liver cells due to an acute inflammation of the liver, and is often followed by permanent scarring.
Alcoholic cirrhosis is a liver disease characterised by the destruction of normal liver tissue, and leaves scar tissue in place of the working liver tissue.
The heavy use of alcohol results in alcoholic liver disease. Therefore, the disease can be prevented by avoiding alcohol consumption.
Chronic liver disease
A progressive deterioration of liver functions for more than six months, which include synthesis of clotting factors, other proteins, detoxification of harmful metabolic products, and excretion of bile, is known as chronic liver disease. It is a continuous process of inflammation, destruction and regeneration of liver parenchyma, which leads to fibrosis cirrhosis.
Fibrosis and cirrhosis are the two types of chronic liver disease.
The growth of scar tissue in the liver due to infection, inflammation, or injury, that can prevent the liver from functioning properly, is known as fibrosis.
While fibrosis refers to any degree of scarring in the liver, cirrhosis is the most severe and extensive form of scarring, and is characterised by the incidence of higher complications of liver disease. In other words, fibrosis is the first stage of liver scarring, and cirrhosis is the final stage of chronic liver disease.
Chronic liver disease can be prevented by avoiding alcohol, getting hepatitis vaccination, avoiding non-steroidal anti-inflammatory drugs, taking iron supplementation when appropriate, and consuming a low-fat diet.
Hepatocellular carcinoma
Hepatocellular carcinoma, the most common type of liver cancer, occurs more often in men than women, and is most often diagnosed in people aged 50 years or above.
It is a primary tumour of the liver.
Long-term damage and scarring of the liver, or cirrhosis, may lead to hepatocellular carcinoma.
Childhood vaccination against hepatitis B, preventing and treating viral hepatitis when one contracts it, avoiding excess consumption of alcohol, screening for liver cancer in people with certain types of hemochromatosis or iron overload, and in people with hepatitis B or C or cirrhosis can prevent hepatocellular carcinoma.
Hepatitis E
An inflammation of the liver caused by infection with the Hepatitis E virus is called Hepatitis E. The disease is characterised by fever, reduced appetite, nausea, vomiting, abdominal pain, itching, skin rash, joint pain, jaundice, dark urine, pale stools, and a slightly enlarged, tender liver.
Non-alcoholic fatty liver and steatohepatitis
Non-alcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver, and is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. The main characteristic of NAFLD is that too much fat is stored in the liver cells.
According to the United States National Institutes of Health (NIH), non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) are types of NAFLD. If a person suffers from NASH, he or she has inflammation and liver damage, along with fat in the liver.
NAFLD and NASH can be prevented by consuming a healthy diet rich in fruits, vegetables, whole grains and healthy fats, maintaining a healthy weight, and exercising regularly.
Wilson's disease
Wilson's disease is a rare inherited disorder that causes copper to accumulate in the liver, brain and other vital organs, and is mostly diagnosed in people aged five to 35 years. In people suffering from Wilson's disease, copper is not eliminated properly and instead accumulates, possibly to a life-threatening level.
The symptoms of Wilson's disease include golden-brown eye discolouration or Kayser-Fleischer rings, build-up of fluid in the legs of abdomen, problems with speech, swallowing or physical coordination, uncontrolled movements, or muscle stiffness, according to Mayo Clinic.
Wilson's disease cannot be prevented because it is the result of an inherited genetic mutation.
Hemochromatosis
Hemochromatosis is a disorder in which the body absorbs too much iron from the food consumed by the human, causing excess iron to be stored in different organs, including the liver.
Hemochromatosis of different organs, including that of the liver, can be prevented by avoiding excess iron supplements and multivitamins containing iron, avoiding excess vitamin C supplements, and avoiding alcohol.
Autoimmune hepatitis
When the body's immune system attacks the liver leading to chronic inflammation and damage to liver cells, autoimmune hepatitis occurs.
Autoimmune hepatitis is of two types: type 1 and type 2. Type 1 autoimmune hepatitis is the most common type of autoimmune hepatitis, and can occur at any age, while type 2 autoimmune hepatitis mostly occurs in children and young people.
Autoimmune hepatitis cannot be prevented in most cases, according to NIH.
Primary biliary cholangitis
A chronic disease in which the small bile ducts in the liver become injured, are inflamed and eventually destroyed is known as primary biliary cholangitis. Bile builds up in the liver when there are no bile ducts, resulting in liver damage.
Primary biliary cholangitis can be prevented by quitting smoking, avoiding alcohol and illegal drugs, consuming a healthy, well-balanced diet, and exercising regularly.