Liver disease

More than 25 million people in the United States suffer from liver disease, and more than 43,000 of those people die every year. The only remedy for advanced disease is a liver transplant. The liver, an essential organ, is locatedbehind the lower ribs on the right side of the chest. The largest organ in the body, it processes food and most medications. As the blood leaves the stomach and intestines, it passes through the liver, picking up and carrying nutrients throughout the body. The liver also cleanses the blood, discharges wasteproducts, maintains hormone balance, produces immune factors, stores iron, synthesizes blood clotting factors, and manufactures bile which is stored in the gallbladder and excreted into the intestines to aid digestion. Howard J. Worman, M.D. at Columbia University, lists more than 30 different liver diseases on a World Wide Web page entitled "Diseases of the Liver." Perhaps the most common and critical of these are viral hepatitis, cirrhosis,gallstones, alcohol-related disorders, and cancer.

Hepatitis, or "inflammation of the liver," is primarily caused by different strains of virus and affects more than five million Americans. Hepatitis A virus is a milder form which may last around six weeks. Hepatitis B and C, severe and often fatal, result in permanent liver damage--such as cancer and cirrhosis--in 50% of cases.

Cirrhosis, the seventh leading cause of death in the United States, can result from any injury or disease of the liver--including certain chemicalsand poisons, severe reaction to certain drugs, a build up of copper or iron,and obstruction in the bile duct. However, hepatitis, alcohol abuse, and other viruses cause more than half the cirrhosis fatalities. Cirrhosis developswhen damaged tissue forms scars, which obstruct blood flow, which, in turn, kills more cells. Symptoms can include enlarged liver and spleen, accumulationof fluid in the abdomen and body tissue, jaundice (yellowing of the skin and eyes), and vomiting large amounts of blood. Because the liver can nolonger purify the blood, toxins are carried to the brain causing anything from poor concentration to coma, brain swelling, and death. Certain types of cirrhosis can be treated but never reversed.

Gallstones develop when cholesterol and/or bile pigment crystalize creating "stones" which, when passing through the bile duct, cause extreme abdominal pain. If stones become lodged, bile backs up, spills into the blood stream, causing jaundice. Ultimately, cirrhosis can develop. Approximately 500,000 people undergo surgery each year to remove gall stones, and dissolving drugs have some success.

Alcoholic liver diseases include steatosis (fatty liver), acute and chronic hepatitis--both of which can be reversible if patients stop drinking--cancer, and cirrhosis. Alcoholic cirrhosis is the tenth leading cause of deathin the United States.

Liver cancer develops most often as a result of cancer spreading fromother organs. Little is known about primary liver cancers, except that it is often associated with other liver diseases. Although only about 1,000people die each year in the United States from primary liver cancer, the death rate is almost at epidemic proportions in Africa and the Orient. Researcher Brian Carr at the Starzel Transplant Institute at the University of Pittsburgh believes dietary carcinogens may be a culprit and, in particular, a moldcalled Aspergillus flavus, which grows on unrefrigerated cooked rice.

The incidence of liver disease is on the rise, perhaps because of increased use of medications and exposure to environmental chemicals. While liver diseases are still poorly understood, researchers believe almost half could be prevented through application of knowledge already available.

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