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Liver Disease & Hepatitis

The liver is one of the largest solid organs of the body. It is located in the upper right part of the abdomen. Most of the organ lies under cover of the rib cage.

Liver function
It is not just the liver’s size but also its functions that makes it so important.

Its major functions include processing the food that passes through the gut and converting it into energy that can be utilized by the body.

It is also a powerful detoxification center that handles many chemicals, alcohol, poisons and toxins as well as drugs and clears the blood.

The liver also makes bile and stores it in a small pouch like organ called the gall bladder. This bile helps in digestion especially fats.

Causes of liver disease
Liver diseases may vary in causation.

They may be of short duration, acute liver disease, or long term, chronic liver disease. An acute liver disease may also convert into a chronic liver disease over time.

Some liver diseases are caused by infective viruses like Hepatitis virus (A, B and C).

Liver diseases also result from taking in some drugs or alcohol over long term. Sometimes the diseased liver over long term becomes shrunken and scarred.

Such a condition is called cirrhosis. Like other organs liver can also be afflicted with cancers.

Types of liver disease
Alcohol related liver disease is one of the commonest toxin induced liver disease worldwide. In normal cases the liver breaks down alcohol in the body.

If there is too much intake over a long period of time the liver fails to perform its functions leading to a condition called Alcoholic Liver disease.

Alcohol-related liver disease may be of three types – fatty liver disease, alcoholic hepatitis and finally alcoholic cirrhosis.

The alcohol related liver disease begins as fatty deposits on the liver followed by inflammatory changes and finally irreversible tissue scarring or cirrhosis.

The hepatitis phase leads to swelling of the liver and damage. At the initial phases of alcohol liver disease if alcohol is discontinued the changes may be reversed.

Liver disease may also be Non-Alcoholic called Non Alcoholic Fatty Liver Disease. This results in fat deposits on the liver and is seen in obese, diabetic and individuals with high blood cholesterol. It can affect 2-5% of the general population.

Liver disease is thus a wide ranging term that includes all conditions that cause imbalance or disturbance of the functions of the liver.

Liver disease is also called hepatic disease. Since it is a large organ, nearly two thirds of the liver has to be affected for the symptoms of hepatic disease to show in most individuals.

If there is very high blood pressure in the portal vein the condition is termed portal hypertension. This can lead to cirrhosis, enlarged abdomen with fluid (ascitis), bleeding, enlarged spleen, and sometimes jaundice. Bleeding may occur in the esophagus or via rectum.Portal hypertension is often a result of liver cirrhosis that results from chronic liver disease.

Portal hypertension may also sometimes lead to a condition called hepatic encephalopathy where the brain is affected and the person may go into coma. This is usually accompanied by liver failure.

(Dr. Ananya Mandal)


Hepatitis is a disease that includes any type of inflammation of the liver, the result of a complex process that occurs when the liver suffers an injury. Doctors call the inflammation that lasts less than six months acute hepatitis and inflammation that lasts longer than six months chronic hepatitis. While there are many causes of liver inflammation, clinicians divide them into two main categories: viral hepatitis and non-infectious hepatitis.

Viral Hepatitis
When most people think of hepatitis, they’re usually thinking about viral hepatitis. There are five viruses that commonly infect the liver, named using letters of the alphabet — A through E. What makes viral hepatitis confusing is that each one of these viruses causes a slightly different type of disease and has a different way of spreading. Some of these viral infections can result in acute, chronic or both forms of hepatitis. Since these viruses spread from person to person, doctors also call this type of hepatitis infectious hepatitis.

Non-Infectious Hepatitis
Not all causes of hepatitis are infectious. Chemicals such as alcohol or medications can be harmful to the liver and can cause inflammation. In addition, other health problems like genetic and metabolic disorders, immune-related injury and obesity, can damage the liver and lead to inflammation. Since these types of hepatitis cannot spread from one person to another, clinicians call it non-infectious hepatitis.

Testing for Hepatitis
The many causes of hepatitis create many ways to test for the disease. One basic test is to feel for an enlarged liver, known as hepatomegaly. Your doctor will do this test during clinical examination; if he finds an enlarged liver, they will look for causes and may order a blood test.

Some blood tests look for levels of enzymes and other proteins that may be disturbed when there is liver damage. Other blood tests will look for evidence of specific viruses, levels of toxins such as alcohol or Tylenol or even markers of genetic diseases such as iron or alpha-1 anti-trypsin.

Usually, the diagnosis of hepatitis is made using a combination of tests. More advanced tests might include using imaging technology such as ultrasound, computerized axial tomography (CT) scans or magnetic resonance imaging (MRI).

A liver biopsy, where a doctor removes a small piece of the liver and sends it to a laboratory for further testing, may be necessary if a clear cause of the inflammation cannot be identified or if the doctors need to clarify how much of the liver is involved.

Living with Hepatitis
While some types of hepatitis resolve quickly, other types last for decades and will need to be managed closely by your physician. Living with any type of hepatitis requires having regular medical appointments and following your medical treatment plan.

In addition to medications, your treatment plan may include modifying your lifestyle, such as restricting alcohol and maintaining a healthful body weight, which helps prevent the disease from getting worse. Other lifestyle changes may be necessary to prevent spreading the disease, if infectious, to others.

Finally, seek out others who live with hepatitis. Many support groups exist to help educate and assist people and their families. With a little education and support, people with hepatitis can live full and complete lives

How many types of hepatitis are there?
There are five main types of hepatitis that are caused by a virus, A, B, C, D, and E – plus types X and G.

  • Hepatitis A– this is caused by eating infected food or water. The food or water is infected with a virus called HAV (Hepatitis A Virus). Anal-oral contact during sex can also be a cause. Nearly everyone who develops Hepatitis A makes a full recovery – it does not lead to chronic disease.
  • Hepatitis B– this is an STD (sexually transmitted disease). It is caused by the virus HBV (Hepatitis B Virus) and is spread by contact with infected blood, semen, and some other body fluids. You get Hepatitis B by:
    • Unprotected sexual intercourse with an infected person (unprotected sex means without using a condom) Using a syringe that was previously used by an infected person (most commonly happens with drug addicts and people who inject steroids).
    • Having your skin perforated with unsterilized needles, as might be the case when getting a tattoo, or being accidentally pricked. People who work in health care risk becoming infected by accident in this way.
    • Sharing personal items, such as a toothbrush or razor, with an infected person.
    • A baby can become infected through his mother’s milk if she is infected.
    • Being bitten by someone who is infected.

The liver of a person infected with Hepatitis B swells. The patient can suffer serious liver damage due to infection, resulting in cancer. For some patients the hepatitis becomes chronic (very long-term or lifelong). Donated blood is always tested for Hepatitis B.

  • Hepatitis C– Hepatitis C is usually spread through direct contact with the blood of a person who has the disease. It is caused by the virus HCV (Hepatitis C Virus). The liver can swell and become damaged. In hepatitis C, unlike hepatitis B, liver cancer risk is only increased in people with cirrhosis and only 20% of hep C patients get cirrhosis. Feces is never a route of transmission in hepatitis C. Donated blood is also tested for Hepatitis C.

Misuse of anesthesia can result in the transmission of hepatitis B and hepatitis C viruses, researchers reported in the journal Gastroenterology. The cause of infection tends to be from anesthesia contamination, and not endoscopy contamination. Experts say that more effort is needed to better educate the healthcare community about the importance of strict sterile techniques when using any type of anesthesia.

  • Hepatitis D – only a person who is already infected with Hepatitis B can become infected with Hepatitis D. It is caused by the virus HDV (Hepatitis D Virus). Infection is through contact with infected blood, unprotected sex, and perforation of the skin with infected needles. The liver of a person with Hepatitis D swells.
  • Hepatitis E – a person can become infected by drinking water that contains HEV (Hepatitis E Virus). The liver swells but there are no long-term consequence. Infection is also possible through anal-oral sex.
  • Hepatitis X – if hepatitis cannot be attributed to the viruses of hepatitis A, B, C, D, or E, it is called Hepatitis X. In other words, hepatitis of an unknown virus.
  • Hepatitis G – this is a type of hepatitis caused by the Hepatitis G virus (HGV). Usually there are no symptoms. When there are symptoms they are very mild.

What are the signs and symptoms of hepatitis?
Many people with Hepatitis experience either mild symptoms or none at all. Remember that an infected person’s feces are always infectious to other people. When symptoms appear, they usually do so about 15 to 180 days after the person has become infected.