Hepatitis: The Liver Killer

CAUSES

Hepatitis means inflamation of the liver. In my earlier blog, Transplanted , I discussed the cause of my hepatitis. The condition that caused my liver to require replacement is called NASH for Non-Alcohol Stearic Hepatitis. NASH is rather uncommon, but a more common cause is alcoholism itself. Alcohol can inflame the liver. Livers really do not like alcohol.

Viruses may also cause hepatitis. There are 5 types of viral hepatitis: A, B, C, D, and E. Hepatitis A and E are contracted from contaminated food or drink; hepatitis B and C cause infection through contact with contaminated blood often through needle sharing; hepatitis D infects only those who already have hepatitis B. Hepatitis B often is transmitted sexually. Infected mothers may transmit the virus during pregnancy, however.

There are vaccines to prevent hepatitis A, B, or D.

There are other, less common, causes of hepatitis. These would include parasitic, bacterial, genetic, injury-induced, blood-deprived (also called shock hepatitis), ischemic (low oxygen- induced), autoimmune, and neonatal (resulting from childhood diseases).

(visit Wikepedia at https://en.wikipedia.org/wiki/Hepatitis for an excellent article on the causes of hepatitis)

CIRRHOSIS

Hepatitis causes scarring to occur in the liver. This scarring is called cirrhosis.

FIGURE 1: Healthy Liver Compared To Cirrhotic Liver

Cirrhosis is the main stage resulting in the demise of the liver. Cirrhosis may lead to liver cancer or it may be asymptomatic. Liver enlargement usually accompanies cirrhosis (c.f. Figure 1). In any event, cirrhotic livers do not function well.

ENLARGEMENT

Enlarged livers present other difficulties. The portal vein can become partially occluded (i.e. portal vein thrombosis) because of the growing lobes of the liver pressing against it.

Technically portal "vein" is a misnomer; veins generally are defined as blood vessels that return blood to the heart. The portal vein returns blood from the intestine to capillaries in the liver. Detoxifying blood carrying products of digestion is the major function of the liver. Seventy-five percent of the blood supply to the liver is through the portal vein; the hepatic artery accounts for the other 25%.

The neighboring spleen may become enlarged as well. Spleen involvement may cause precipitous drops in platelet levels.

FIGURE 2: Platelets Making A Blood Clot

Without sufficient platelets, blood clots form quite slowly. Bruising may occur from only a gentle touch.

In Figure 2, the red blood cells, depicted as red, disk-shaped objects, are bound together by platelets, the grayish elements, thereby forming the blood clot.

SIGNS

Patients with dying livers may display a variety of signs: loss of appetite, weight loss, accumulation of abdominal fluid (i.e. ascites), diarrhea, nausea, vomiting, weakness or fatigue, and confusion (i.e. hepatic encephalopathy),.

Any one of these signs is not sufficient to diagnose liver disease, but a combination of them strongly suggest that the liver is failing. The only known way to clinch the diagnosis is through liver biopsy.

CONCLUSION

When my liver became sick, I realized how important the liver is to general health. Most of us might rate the brain and heart as the most important organs in the body. Without a healthy liver, however, these organs would perish as well. The liver is the "wind beneath their wings".