• The liver is one of the body's vital organs that has a number of functions – detoxification, protein synthesis, and the production of chemicals that are necessary for digestion. • A human liver is reddish brown and has four unequal sized lobes; usually weighs about 3.5 pounds and is the largest gland in the human body. It is located just below the diaphragm in the body's right upper abdominal quadrant. • The liver plays a major role in the body's metabolic processes as well – glycogen storage, decomposition of red blood cells, some hormone production. • The liver produces bile – which is an alkaline compound that helps in digestion by changing fat (lipid) molecules to a more digestible format. The liver's detoxification and synthesis of micronutrients are vital – short term liver dialysis is possible, but a person cannot exist without a functioning liver
Chronic Liver Disease
With a number of functions -- including detoxification, protein synthesis, and the production of chemicals that are necessary for digestion -- the human liver is vital.
It is reddish brown and has four unequal sized lobes; usually weighs about 3.5 pounds and is the largest gland in the human body. It is located just below the diaphragm in the body's right upper abdominal quadrant.
The liver plays a major role in the body's metabolic processes as well -- glycogen storage, decomposition of red blood cells, some hormone production.
The liver produces bile -- which is an alkaline compound that helps in digestion by changing fat (lipid) molecules to a more digestible format.
The liver's detoxification and synthesis of micronutrients are vital -- short-term liver dialysis is possible, but a person cannot exist without a functioning liver (Virtual Liver, 2008).
Cirrhosis of the Liver
Cirrhosis is the result of chronic liver disease in which liver tissue is replaced by care tissue of fibrosis.
The most common causes of cirrhosis are alcoholism, hepatitis B and C, and fatty liver disease (Mayo Clinic, 2010).
Symptoms of Cirrhosis
Ascites -- Fluid retention in the abdominal cavity, one of the most common complications. Causes risk of infection and poor quality of life.
Jaundice -- yellowing of the skin, mucus membranes or the eyes caused by an overproduction of bilirubin in the blood due to partial liver shutdown.
Liver Encephalopathy -- confusion, altered levels of consciousness and psychotic episodes, even coma, as a result of liver failure and toxin buildup.
Abnormal Nerve Function -- nerve endings fire uncontrollably or are painful.
Portal Hypertension -- high blood pressure in the portal vein that delivers blood to the liver (Bacon and Bisceglie, 2000).
Causes of chronic liver disease
Hepatitis -- Hepatitis B and C. are infections of the liver that cause inflammation and cell death over time. Both shut down critical functions of the liver.
Drug Abuse/Chemical Exposure -- Drugs, chemicals and alcohol block the normal metabolism of protein, fats and carbohydrates and kill liver cells.
Bile Duct Obstruction -- starves the liver of needed blood, or causes back up of bile and infection
Autoimmune Disease -- results in inflammation and scaring of the liver.
Diabetes -- insulin imbalance causes breakdown and malfunction of liver function.
Malnutrition -- Without adequate food to digest and materials to detoxify, the liver function shuts down and eventually cells starve (Bacon and Bisceglie).
Diagnostic Testing-
Lab Tests -- There are a number of lab tests that are done to provide clinical data regarding cirrhosis:
AST and ALT tests show elevation in both chemicals.
Gamma-glutamyl transferase -- high in chronic liver disease
Billirubin -- elevates as cirrhosis progresses
Albumin -- levels fall as liver function declines
Globulins -- increased due to movement away from liver
Serum Sodium -- high because free water is unable to process correctly.
Fibrio Test -- uses six blood serum tests to generate a score that is correlated with the degree of liver damage; same prognostic value as a liver biopsy, but far less invasive.
Liver Biopsy -- A liver biopsy is done by inserting a hollow needle into the core of the liver and taking a small sample to be analyzed under a microscope. Usually this is done to see if there is cellular damage to the liver.
CAT Scan -- Computed Tomography is a medical imaging procedure in which a computer based "image" of the organ is created so that the physician has a three dimensional view of the organ in question.
Cholangiography
Ultrasound -- used routinely in the evaluation of cirrhosis; sound or elastic waves are bounced off tissues in a non-invasive procedure. This shows irregularities in shape and scaring (Dickerson, 2006).
Treatment Options
Nutritional Based -- Balanced diet including an excess of fresh vegetables; broccoli and green leafy vegetables especially; plenty of complex carbohydrates and avoid simple sugars; adequate protein but not excessive -- proteins should be from plant, rather than meat, sources. Replacement of certain fats and oils in cooking if the liver is unable to digest; restrict sodium.
Avoidance of Toxins or Substances - Abstain from alcohol, avoid exposure to toxic chemicals, avoid tobacco or other substances that may damage the liver (certain drugs and pharmaceuticals that are metabolized by the liver).
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