Causes of Liver Disease ( SILENT KILLER IN SIERRA LEONE) by Sierra Liver Foundation
What are the causes of liver disease (alcohol and cirrhosis)? http://www.medicinenet.com/liver_disease/page6.htm
The liver can be damaged in a variety of ways.
- Cells can become inflamed, for example, hepatitis.
- Bile flow can be obstructed, for example, cholestasis).
- Cholesterol ortriglycerides can accumulate, for example, steatosis).
- Blood flow to the liver may be compromised.
- Liver tissue can be damaged by chemicals and minerals, or infiltrated by abnormal cells, like cancer cells.
Alcohol
abuse is the most common cause of liver disease in North America.
Alcohol is directly toxic to liver cells and can cause liver
inflammation, referred to as alcoholic hepatitis. In chronic alcohol abuse, fat accumulation occurs in liver cells affecting their ability to function.
Cirrhosis
Cirrhosis
is a late-stage of liver disease. Scarring of the liver and loss of
functioning liver cells cause the liver to fail. Significant amounts of
liver cells need to be damaged before the hole organ fails to function.
What are the causes of liver disease (drug-induced liver disease)?
Liver
cells may become temporarily inflamed or permanently damaged by
exposure to medications or drugs. Some medications or drugs require an
overdose to cause liver injury while others may cause the damage even
when taken in the appropriately prescribed dosage.
Taking excess amounts of acetaminophen (Tylenol,
Panadol) can cause liver failure. This is the reason that warning
labels exist on many over-the-counter medications that contain
acetaminophen and why prescription narcotic-acetaminophen combination medications (for example, Vicodin, Lortab,
Norco, Tylenol #3) limit the numbers of tablets to be taken in a day.
For patients with underlying liver disease or those who abuse alcohol,
that daily limit is lower and acetaminophen may be contra-indicated in
those individuals.
Statin medications are commonly prescribed to
control elevated blood levels of cholesterol. Even when taken in the
appropriately prescribed dose, liver inflammation may occur. This
inflammation can be detected by blood tests that measure liver enzymes.
Stopping the medication usually results in return of the liver function
to normal.
Niacin
is another medication used to control elevated blood levels of
cholesterol, but liver inflammation for this medication is related to
the dose taken. Similarly, patients with underlying liver disease may be
at higher risk of developing liver disease due to medications such as
niacin. Recent studies have found that niacin may not be as effective as
previously thought in controlling high cholesterol.
Patients who take niacin may want to see their health care professional
to determine if other treatment options may be appropriate.
There
are numerous other medications that may cause liver inflammation, most
of which will resolve when the medication is stopped. These include
antibiotics such as nitrofurantoin (Macrodantin, Furadantin, Macrobid), amoxicillin and clavulanic acid (Augmentin, Augmentin XR), tetracycline (Sumycin), and isoniazid (INH, Nydrazid, Laniazid). Methotrexate (Rheumatrex, Trexall),
a drug used to treat autoimmune disorders and cancers, has a variety of
side effects including liver inflammation that can lead to cirrhosis. Disulfiram (Antabuse) is used to treat alcoholics and can cause liver inflammation.
Some herbal remedies and excessive amounts of vitamins can cause hepatitis, cirrhosis and liver failure. Examples include vitamin A, kava kava, ma-huang, and comfrey.
Many mushrooms are poisonous to the liver and eating unidentified mushrooms gathered in the wild can be lethal
What are the causes of liver disease (hepatitis and others)?
The term "hepatitis" means inflammation, and liver cells can become inflamed because of infection.
Hepatitis A is a viral infection that is spread primarily through the fecal-oral route when small amounts of infected fecal matter are inadvertently ingested. Hepatitis A causes an acute inflammation of the liver which generally resolves spontaneously. The hepatitis A vaccine can prevent this infection. Thorough hand washing, especially when preparing food is the best way to prevent the spread of hepatitis A. This is especially important for workers who work in the food and restaurant industries.
Hepatitis B is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and sexual contact) and can cause an acute infection, but can also progress to cause chronic inflammation (chronic hepatitis) that can lead to cirrhosis and liver cancer. The hepatitis B vaccine can prevent this infection.
Hepatitis C causes chronic hepatitis. An infected individual may not recall any acute illness. Hepatitis C is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and some forms of sexual contact). Chronic hepatitis C may lead to cirrhosis and liver cancer. At present, there is no vaccine against this virus. There is a recommendation to test all people born between 1945 and 1965 for Hepatitis C antibody to identify people who do not know that they have contracted the disease. Newer medications are now available to treat and potentially cure Hepatitis C.
Hepatitis D is a virus that requires concomitant infection with hepatitis B to survive, and is spread via body fluid exposure (needles from drug abusers, contaminated blood, and sexual contact).
Hepatitis E is a virus that is spread via exposure to contaminated food and water.
Other viruses
Other viruses can also cause liver inflammation or hepatitis as part of the cluster of symptoms. Viral infections with infectious mononucleosis (Epstein Barr virus), adenovirus, and cytomegalovirus can inflame the liver. Non-viral infections such as toxoplasmosis and Rocky Mountain spotted fever are less common causes.
Non-alcoholic fatty liver disease
NASH or non-alcoholic steatohepatitis (also referred to as "fatty liver") describes the accumulation of fat within the liver that can cause inflammation of the liver and a gradual decrease in liver function.
Hemochromatosis
Hemachromatosis (iron overload) is a metabolic disorder that leads to abnormally elevated iron stores in the body. The excess iron may accumulate in the tissues of the liver, pancreas, and heart and can lead to inflammation, cirrhosis, liver cancer, and liver failure. Hemachromatosis is an inherited disease.
Wilson's disease
Wilson's disease is another inherited disease that affects the body's ability to metabolize copper. Wilson's disease may lead to cirrhosis and liver failure.
Gilbert's disease
In Gilbert's disease, there is an abnormality in bilirubin metabolism in the liver. It is a common disease that affects up to 7% of the North American population. There are no symptoms and it is usually diagnosed incidentally when an elevated bilirubin level is found on routine blood tests. Gilbert's disease is a benign condition and requires no treatment
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