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Very topical post Christmas with a lot of people thinking they may have over done it a bit with both food and drink!

The liver is the body’s largest solid organ weighing in at about 3lbs, 1.34Kg or about a bag and a third of Sugar to put it into a visual context. It’s sort of triangular in shape with a long straight lower edge and curved up in the top corner – Google it and you’ll see what I mean. It’s a complex organ ( aren’t they all! ) divided into 2 lobes left and right, with each lobe further divided into 8 segments and with each segment further divided into 1000 small lobes called lobules.

I like to think of it as the body’s bouncer! Often it’s the first to identify potential threats to the body that have come via the digestive tract and through the blood, part of what’s termed first pass metabolism. The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines to help break down food substances. The liver also makes proteins that are important for blood clotting and other functions such as storing vitamins and minerals and energy in the form of glycogen – all to be released when the body needs it.

But, as with any part of the body things can go wrong. Some of these can be beyond our control such as infections, although lifestyle can play a part here too. Hepatitis is inflammation of the liver, usually caused by viruses like hepatitis A, B, and C. Hepatitis can have non-infectious causes too, including heavy drinking, drugs, allergic reactions, or obesity. Long-term damage to the liver from any cause can lead to permanent scarring which is called cirrhosis. The liver then becomes unable to function well and eventually may fail and of course there is liver cancer and the most common type hepatocellular carcinoma, almost always occurs after cirrhosis is present.

But there is a new kid on the block – Non Alcoholic Fatty Liver Disease or the catchy NAFLD for short. Actually it’s not that new but dates back to the first case in the 1950’s but it is becoming more prevalent as our society becomes more over weight with up to 1 in 3 people showing early signs. You might have been to your GP recently for routine bloods only to be called back as your liver function tests are a bit up. Secondary tests and an ultrasound scan later confirm your liver is ‘a bit fatty’. What does this mean? A healthy liver should contain little or no fat and so is usually a consequence of being overweight/ obese. Other risk factors include type 2 diabetes, high blood pressure, high cholesterol, are over the age of 50 and smoking. Generally it won’t cause any trouble and is reversible with lifestyle changes but as you can imagine a proportion of these will go on to develop cirrhosis and beyond.

So as Christmas has passed and it’s time to look to the New Year and set new goals, spare a thought – look after your liver as it’s been looking after you!

E-mail me at jasonjones@doctors.org.uk

Dr Jones

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