Alcohol related liver disease

Excess alcohol consumption can lead to a gradual scarring of the liver and eventually may lead to cirrhosis and abnormalities of liver function. It is a very common cause of liver disease in the UK and it usually progresses gradually over many years. The risk of developing alcohol-related liver damage is directly proportional to the amount of alcohol consumed but can also be exacerbated by other factors such as obesity and diabetes. Susceptibility to alcohol-related liver disease can also run in families.

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Fatty liver disease

Fatty liver disease is common liver disorder and is increasing in prevalence year by year. It can be associated with being overweight and is more common in patients who also have diabetes or high cholesterol. 

Only a proportion of patients with NAFLD will progress to advanced stages of liver disease, and simple tests are available to help determine who those patients are. There are no specific treatments yet for NAFLD, though lifestyle changes can have a beneficial impact on the condition and there are many new drugs in advanced stages of clinic trials.

Hepatitis B (HBV)

Chronic Hepatitis B affects several hundred million people worldwide and one of the most common causes of cirrhosis and primary liver cancer. 

Infection is often acquired in early childhood and usually manifests no symptoms. Screening for this condition is important if there is a family history of HBV or if the patient is from a part of the world with high rates of infection. Though there is no cure, very effective treatments exist to control the infection and prevent liver disease. Many other patients will only require monitoring of

Hepatitis C (HCV)

Chronic Hepatitis C is the most common transmissible cause of liver disease in the UK and is a very important cause of end stage liver disease and primary liver cancer. 

Infection can remain undetected for many years and is usually asymptomatic. Routes of transmission include through transfusion of infected blood products before discovery of the virus in 1991. There are now several new highly effective and well tolerated medicines available to cure hepatitis C infection.

Hepatocellular carcinoma (HCC)

This is a primary liver cell cancer that usually occurs only in the context of cirrhosis, though not always. Regular screening with blood tests and scans can pick up HCC at an early stage, making it more likely that curative treatment can be given.

Cirrhosis

Cirrhosis refers to extensive scarring of the liver and can occur after many years of liver disease. It can cause long-term irreversible damage to the liver. Any form of chronic liver injury can lead to cirrhosis but the most common causes are excess alcohol, chronic viral hepatitis, and non-alcohol fatty liver disease (NAFLD). n they occur.

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Portal hypertension

Blood flow through a cirrhotic liver is impeded causing backpressure in the veins that drain into it from the gut and spleen. This is termed portal hypertension and can lead to the development of dilated blood vessels in the gut called varices.

Varices may burst and cause severe or life-threatening internal bleeding. Treatment can be given to reduce the risk of this occurring. Screening for cirrhosis is safely performed with an endoscopic examination of the oesophagus and stomach.

Cholangiopathy

These are a group of diseases that primarily affect the bile ducts draining the liver. 

By impeding the free flow of bile, these diseases may cause progressive damage to the liver over time and can directly cause complications in the bile ducts themselves such as obstructive jaundice, bile infection, stones and bile duct cancer.

Abnormal Liver Function Tests (LFTs)

Liver function tests (LFTs) are frequently performed to detect early signs of liver injury or inflammation and to directly measure liver function. 

They may be performed in patients at risk of liver disease or sometimes as a part of a general screen in patients who are non-specifically unwell.  Transient derangements of LFTs can sometimes occur with general viral infections or as part of a reaction to a new medication. A patient with an LFT abnormality should be further investigated to exclude significant liver disease.

Liver transplantation

Liver transplantation involves the replacement of the whole of a patient’s liver with that from a donor. Most donations occur from people who have an acute terminal illness and who had expressed an intention to donate their organs after death, a process called cadaveric donation.

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Benign Liver Lesion

A liver lesion is a focal area of abnormality within the liver that looks different to the areas surrounding it. There are various possible types of liver lesion, many of them are benign and not of any significant health concern. Frequently, lesions in the liver are found by chance when a person has a scan of the abdomen, quite often for entirely unrelated reasons.

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Bile Duct

The bile ducts are a series of tubes connecting the liver to the small bowel that drains bile from the liver into the gut. They arise as small branches within the liver and progressively join up to form the main bile duct, into which the gallbladder, a sac containing bile situated on the under surface of the liver, also drains.

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