Liver Disease Overview

Liver Disease Overview

• Liver is the largest internal organ in the body, located below the diaphragm in the right upper abdominal quadrant.
• It's the largest gland, producing bile essential for fat digestion.
• Bile is stored in the gallbladder.
• The liver can regenerate itself from as little as 25% of its original size.
• Liver's functions include filtering and cleansing the blood, creating and breaking down sugar, proteins, and fats.

Liver Functions

• Filters and cleans the blood.
• Breaks down sugar, proteins, and fats.
• Stores vitamins A, D, E, K, and B12.
• Produces bile to aid fat digestion and absorption of fat-soluble vitamins.
• Stores minerals, like iron and copper.
• Removes metabolic products and toxins from the blood.
• Fights infections by capturing and digesting bacteria, fungi, parasites, and cellular debris.
• Produces essential proteins and hormones, including blood-clotting factors, albumin, transporter proteins, and thrombopoietin.
• Regulates glucose and cholesterol levels.
• Breaks down haemoglobin, cholesterol, protein, sex-steroids, and many drugs.

GDC Learning Outcomes

• Explain general and systemic diseases and their relevance to oral health.
• Describe relevant and appropriate physiology and its application to patient management.
• Describe the properties of relevant medicines and therapeutic agents and their application to patient management.

Liver Disease and the Hygienist/Therapist

• Understand liver disease's functions.
• Know how a diseased liver affects the body.
• Recognize the symptoms of liver disease.
• Understand how a dental treatment plan needs modification due to liver disease.

Causes of Liver Damage

• Alcohol
• Viral infections (Hepatitis A-E)
• Non-alcoholic fatty liver disease
• Body's immune system (e.g., primary biliary cirrhosis)
• Tumours (e.g., liver cancer)
• Cysts
• Haemochromatosis

Alcohol-Related Liver Disease

• The liver filters alcohol, breaking it down and removing it from the body.
• Liver cells die during this process.
• The liver needs time to regenerate and make new cells.
• Prolonged excessive alcohol intake hinders liver recovery.
• Can lead to serious and permanent damage.

Three Stages of Alcohol-Related Liver Disease

• Alcoholic fatty liver disease (usually no symptoms, reversible)
• Alcoholic hepatitis (inflammation of the liver; reversible early on)
• Cirrhosis (scarring of the liver; irreversible and prevents normal function).

Symptoms of Cirrhosis

• Often no symptoms until severe damage.
• Tiredness, weakness, nausea, and loss of appetite.
• Weight loss, palmar erythema, spider naevi, finger clubbing, and sialosis.
• Jaundice, itchy skin, dark urine, and tarry stools.
• Bleeding or bruising easily.
• Loss of libido.
• Swollen legs or abdomen (ascites).
• Gynaecomastia or testicular atrophy, oesophageal varices and encephalopathy
• Liver cancer

Treatment of Cirrhosis

• No cure to deal with symptoms and complications of cirrhosis.
• Stop drinking alcohol completely
• Healthy diet to address malnutrition, low protein and low salt diet, loss of weight and stop smoking.
• Medications (diuretics, beta-blockers, skin creams)
• Liver transplant.

Non-Alcoholic Fatty Liver Disease (NAFLD)

• Build-up of fat in the liver (not caused by alcohol).
• Usually related to obesity.
• Four stages, often symptom-free in the early stages.
• Inflammation, fibrosis, cirrhosis can occur.
• Symptoms of fibrosis: abdominal pain, tiredness, weight loss, weakness
• Symptoms of cirrhosis (see above).

Treatment of NAFLD

• Healthy lifestyle changes (lose weight, healthy diet, exercise, stop smoking and alcohol).
• Treat complications (diabetes, high cholesterol, hypertension).
• Liver transplant if cirrhosis develops.

Other Causes of Liver Damage

• Primary biliary cirrhosis (immune system attacks bile ducts)

• Tumors/cysts (Primary liver cancer, secondary liver cancer, liver cysts)

• Haemochromatosis (inherited iron overload damages liver, joints, pancreas and heart).

Key Takeaways:

• Liver is a vital organ with multiple functions.
• Various factors can damage the liver, including alcohol, viruses, and autoimmune issues.
• Liver damage can progress through different stages (fatty liver, hepatitis, cirrhosis) leading to serious long-term complications.
• Treatment usually focuses on addressing the underlying cause, modifying lifestyle choices and managing symptoms.

This quiz covers the essential functions and importance of the liver as the largest internal organ in the human body. Learn about its role in digestion, blood filtration, and its ability to regenerate. Discover how the liver contributes to overall health and homeostasis.