Andrew Watson of Goodmeasure Pharmacy, Rotherham looks at the causes of liver disease

The liver is often out of the limelight compared to other organs like the heart and lungs. But it is one of the body’s most vital and fascinating organs.

The liver has over 500 jobs, such as helping digest food, controlling cholesterol, and fighting infection. The main job most of us relate to the liver is removing waste and toxins from the body.

An interesting fact is that the liver is the only organ that can regenerate. If it gets damaged, it can repair itself – but only to a point.

In the UK, liver disease is on the rise, with one in five of us at risk of developing liver disease due to long-term damage. In 90 percent of cases, liver damage is preventable.

There is a stigma that liver damage is only caused by alcohol abuse, but this isn’t the case. Liver disease can be caused by lifestyle factors, but it can also be a result of genetics (haemochromatosis) or having an autoimmune disease.

These outdated views are putting patients at risk of not seeking medical help or not recognising symptoms of liver damage until it’s too late for treatment.

Some common symptoms of liver disease are:

• Feeling unwell or tired constantly
• Loss of appetite
• Nausea and vomiting
• Jaundice (yellow skin and eyes)
• Pain or swelling in the liver area
• Itchy skin
• Swelling in legs, ankles and feet
• Frequent nose bleeds and bruising easily
• Impotence or lack of libido
• Dark urine and pale stools
• Forgetfulness
• Personality changes

Here we look at the three main types of liver disease.

Alcohol-related liver disease

Alcohol is the biggest cause of liver disease in the UK. But you don’t have to be an alcoholic to develop it. A quarter of us regularly drink more than the recommended limit, 14 units a week, which increases the risk.

Alcohol is a toxin that is broken down by the liver. This process creates harmful chemicals that kill off liver cells, create a fatty liver and cause scarring which leads to cirrhosis.

The main way to reduce your risk is by reducing the amount of alcohol you drink. You should spread the recommended 14 units out over several days and aim for two or three alcohol-free days each week.

Be mindful of units: a pint of 4% ABV beer is 2.5 units, a bottle of 13% wine is 10 units, and a 25ml measure of 40% spirits is 1 unit.

Non-alcohol related liver disease

Being overweight or obese causes fat to build up in the liver, reducing its ability to function. A small percentage of people go on to develop liver failure or cancer. This risk increases if you have diabetes, high blood pressure or kidney disease.

A simple fatty liver can become cirrhotic if your lifestyle doesn’t change. There are easy steps to stop liver disease getting worse, such as losing weight or avoiding gaining weight, eating a balanced diet, and being more physically active. Everyone should aim to eat less sugar, saturated fats and refined carbs to protect their liver.

Viral hepatitis

Hepatitis means inflammation of the liver. It can be either acute or chronic and is usually caused by one of the hepatitis viruses A, B, C and E. These are rare in the UK, but can be passed on via contaminated food, water, or bodily fluids.

Some types of hepatitis can be treated with anti-viral medicines, and some can be prevented with a vaccination. However, long-term infection puts people at risk of permanent scarring to the liver – aka cirrhosis.

Life with liver damage

There’s no cure for cirrhosis. However, symptoms can be managed by adopting a healthier lifestyle to stop it getting worse.

If your liver is severely damaged and has stopped working, a liver transplant may be the only treatment option. A strict assessment must take place before anyone is put on the waiting list. Waiting time will depend on how urgently someone needs a transplant, but is on average 65 days for adults.

Liver transplants are generally very successful and most people are able to return to their normal activities within a year. Aftercare includes life-long immunosuppressants to stop the body attacking the new liver, regular check-ups, and keeping as healthy as possible. Most people live more than ten years after a liver transplant and many live for up to 20 years or more.