HCA Midwest Health - September 09, 2019

Over the past 10 years, there has been an alarming increase in liver disease, especially in younger people. Today the American Liver Foundation conservatively estimates that one out of 10 Americans is affected by liver disease.

Why? A potent cocktail of lifestyle, societal and health factors, experts say.

Chief among the culprits are the nationwide obesity epidemic, increased alcohol use among young adults and continued incidence of infections such as Hepatitis C. All of these can lead to cirrhosis (where scar tissue replaces normal liver tissue), which in turn can lead to liver cancer or liver failure.

Fortunately, according to expert, Brad Freilich, MD, board-certified gastroenterologist/hepatologist with HCA Midwest Health at Research Medical Center's Liver and Pancreas Institute, a healthy lifestyle can help safeguard this important organ. Let's break down the basics of liver disease and what we can do about it.

The liver - Your body's workhorse

At a whopping three-to-four pounds, the liver is the heaviest organ we have in our bodies and one of the biggest. That's understandable when you consider it performs roughly 500 different functions, such as processing nutrients, breaking down fats to help you digest food, fighting infection, and cleaning or filtering the blood. The liver is amazingly resilient and is, in fact, the only organ in the body that can regenerate itself. It has an incredible ability to "self-correct", but in cases of liver disease, important functions can be interrupted leading to a host of health problems.

Symptoms of liver disease

Known as a silent health threat, liver disease often shows no symptoms until it has wreaked havoc on the liver It is often discovered by "accident" says Dr. Freilich, during routine bloodwork such as a complete blood count or liver enzyme test. In fact, the majority of those who have underlying liver disease have no symptoms.

When symptoms do appear, the liver disease is advanced and symptoms are often not specific - fatigue, low energy, sometimes itchy skin. As liver disease advances, symptoms can include:

  • Yellowing or jaundice in the eyes and skin
  • Darker-colored urine
  • Stool that's pale or light in color
  • Gastrointestinal bleeding
  • Swelling in the legs and belly

Non-Alcoholic Fatty Liver Disease

The health impacts of chronic obesity are well-documented - heart disease, diabetes, high blood pressure, orthopedic problems, etc. Add to that increased cases of non-alcoholic fatty liver disease (NAFLD), currently the most common liver disease in the U.S. and around the world. In severe cases, characteristics of diseased livers caused by the inflammation and scarring from advanced NAFLD are identical to those of chronic alcohol overusers.

What you can do

The foundation for preventing and managing non-alcoholic fatty liver disease is losing excess weight, and eating the right foods. Shedding pounds is shown to help get liver enzyme levels back to normal. And experts say, what you eat can be as important as how much you eat.

"Our bodies are designed to deal with complex carbohydrates," Dr. Freilich explains. "They don't deal well with simple ones (the kind in sodas, baked goods, prepackaged sweets, etc.). Those create an inflammatory environment.

"The foundation for a healthy liver is to try keep the body in the right place, eating a diet mostly rich in complex carbohydrates, lean meats and healthy fats, and getting plenty of exercise."

If you have risk factors, such as obesity insulin resistance, and haven't already done so, Dr. Freilich encourages you to discuss testing with your physician.

"Patients with these related conditions should be screened for fatty liver disease," he says. "Because people have no symptoms and feel fine, they tend to not take it seriously. But over time, the disease leads to scarring or cirrhosis, which puts a person at higher risk of liver cancer and premature death."

Favorite streaming TV shows? Binge worthy. Alcohol? No way.

One of the liver's many jobs is to process alcohol, and it can only handle a certain amount. Too much alcohol can cause fatty liver inflammation, which leads to cirrhosis and sometimes liver cancer. Several recent studies are sounding the alarm on alcohol-related liver disease: Deaths linked to end-stage liver disease, with alcohol cited as a major cause, have been steadily climbing - up 65 percent from 2009 to 2016. The most impacted group? Adults 25 to 34 years of age. Alcohol is the second most common cause of cirrhosis behind fatty liver disease.

What you can do

Shaken or stirred, drink in moderation. For healthy adults, this means up to one drink a day for women and up to two a day for men. If you already have liver disease, however, there is not a safe amount of alcohol, Dr. Freilich says. Additional alcohol only continues to stress an already damaged liver, giving it no chance to heal itself.

While we're on the topic of drinking moderately, consider talking with your adolescents or teens about the risks of binge drinking. Binge drinking is defined by the Centers for Disease Control and Prevention (CDC) as five or more drinks in a two-hour period for a man, and four or more for a woman in a two-hour span. Some studies show binge drinking is more harmful to the liver than moderate daily drinking.

Liver Cancer

One of the scarier facts about the rise in liver disease is the related increase in liver cancer. Deaths from this disease doubled from 2009 to 2016 with the causes attributed to both alcohol- and non-alcohol-related liver disease.

What you can do

Some ways to reduce your risk of liver disease, including liver cancer, may sound basic, but are effective. Maintain a healthy weight, eating a well-balanced, nutritional diet and limit alcohol. Talk with your doctor about your risk factors and ways to incorporate healthy eating and exercise into your lifestyle.

Liver Expertise

HCA Midwest Health offers a comprehensive, multidisciplinary approach to liver disease and cancer treatment. The Liver and Pancreas Institute at Research Medical Center is a regional resource where medical specialists from hepatology, gastroenterology and other specialties collaborate to provide an individualized treatment plan. Sarah Cannon Cancer Institute at HCA Midwest Health provides comprehensive oncology care and access to the largest network of cancer specialists.

HCA Midwest Health also offers weight loss and metabolic health programs to help those struggling with obesity jump start weight loss and get on a healthy path.