Cirrhosis of liver: Myths and facts

Actor Amitabh Bachchans recent disclosure that he suffers from liver cirrhosis had an unlikely effect....

Actor Amitabh Bachchans recent disclosure that he suffers from liver cirrhosis had an unlikely effect: a keen interest generated in the disease among the public. Doctors only hope this will result in greater awareness about the disease and dispel the myths surrounding it.

Bachchan who does not consume alcohol said he had contracted the disease from blood transfusion after his near fatal accident while shooting for Coolie in 1982. He had also added that cirrhosis is usually a condition arising from excessive drinking.

This is where the myths kick in. One of the common misconceptions is that most liver diseases are alcohol related, said Dr S K Acharya,Head of Gastroenterology,All India Institute of Medical Sciences (AIIMS),Delhi. We constantly get patients who cannot understand how they could suffer from liver disease when they are teetotalers. When celebrities contract such ailments,people show interest in them. Otherwise,we need mass awareness campaign to make the public aware of the risk factors and the available treatment.

Liver the functions

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Liver performs hundreds of vital functions. Without it,one cannot digest food and absorb nutrients,get rid of toxic substances from the body or even stay alive.

The liver produces bile,an alkaline compound which aids in digestion and currently,there is no way to compensate for the absence of liver function.

Prevalence of liver diseases

According to conservative estimates,liver diseases affect more than one

of every 10 Indians. The increase in

incidence in the country could be attributed obesity and diabetes epidemic in the country,said Dr Neelam Mohan,hepatologist,Sir Gangaram Hospital,Delhi.

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In India,the bulk of cirrhosis cases are caused by fatty liver,Hepatitis B and C infections apart from alcohol intake.

Fatty liver and cirrhosis

Aptly named,fatty liver is the build-up of excess fat in the liver. Technically,when fat accounts for over 10 per cent of the livers weight,the condition is called fatty liver. This is commonly associated with persons suffering from obesity and can lead to inflammation, said Mohan.

Over time,inflammation can cause liver tissues to harden. In extreme cases,this can lead to cirrhosis.

what is Cirrhosis

Cirrhosis is a chronic disease in which normal liver cells and tissue are destroyed and replaced by fibrotic scar tissue and regenerative nodules.

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Cirrhosis impairs the livers ability to control infections and process nutrients,hormones and drugs,leading to progressive loss of liver function. There has been no definitive treatment available to repair damaged liver cells and tissues. In the long run,a severely affected liver will culminate in liver failure.

Unlike the US and UK,where alcohol is a major cause of cirrhosis,in India,most of the cases are owing to fatty liver and viral Hepatitis, said Dr Mohan.

A hospital-based study conducted in 2007 with a sample size of 730 patients,established that nearly 70 per cent patients diagnosed with Non-Alcoholic Fatty Liver Diseases (NAFLD) were obese. The study further found that the prevalence of NAFLD in adult population is nearly 19 per cent.

In conclusion,the authors maintained that the prevalence of NAFLD was directly related to the increasing incidence of central obesity which was increasing the burden of chronic liver disease.

Symptoms

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Fatty liver and viral hepatitis have minimal symptoms,which can take years before being diagnosed as was the case with Bachchan.

It takes 15 to 20 years for a hepatitis C infection to develop into cirrhosis, said Dr SL Broor,Senior Consultant,Gastrointestinal and Liver Diseases,Indraprastha Apollo Hospital,Delhi. Usually these diseases are picked up during preventive health checks or when the patients are tested prior to other medical procedures.

Hepatitis induced cirrhosis damages the liver silently. In advanced stages,the patient experiences fatigue,weight loss,abdominal discomfort,weakness and confusion.

Diagnosis and risk factors

Obesity,diabetes,high triglycerides,alcohol abuse,rapid weight loss and malnutrition may also cause fatty liver. Some people,however,develop fatty liver even if they have none of these conditions,in which case it is termed idiopathic.

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There are also cases like Bachchans in which liver disease develops from an infection contracted during a blood transfusion.

Experts maintain that many of those who underwent surgeries in the 80s and early 90s did contract Hepatitis C.

The blood screening for Hepatitis C began only in the late 90s, said Broor. Hepatitis induced cirrhosis takes years to be diagnosed because there are no symptoms.

Cirrhosis,though a chronic condition,can,however,be effectively managed with drugs and it is not correct to assume that transplant is the only cure for it. Not every cirrhosis patient is a candidate for liver transplant, said Broor.