Do you know what your liver was doing last night? Seriously, your liver does a lot of things essential to health. What do you know about your liver? Do you actually have any idea what this vital organ is, and what it does for you? If you are reading this, you are about to find out. Functionally, the liver turns the nutrients in the foods you consume into the basic substances your body needs. An organ about the size of a football, found just under your rib cage, on the right, it also acts as a detoxifier, filtering out poisons from your bloodstream.

When your liver isn’t working well, it can affect your whole body. Different things can cause various liver conditions. Liver disease can be inherited or caused by a variety of factors, basically anything which results in damage to the liver. When most people think of liver damage, they tend think of alcohol use. Certainly, this is a common cause of liver problems, but, statistically, the most frequent is a viral infection. Not as often considered, obesity can also lead to damage to this organ, as can the use, or over-use, of certain drugs, both legal and illegal. The condition which results is called hepatitis.

Hepatitis is a term meaning there is inflammation of the liver. Obviously, excessive alcohol consumption causes liver disease (an entirely self-induced means of liver damage). Interestingly, scientists are not exactly certain what the specific mechanism for alcoholic liver disease is, and why drinking too much alcohol can damage it. One theory claims when our liver tries to break down alcohol, the resulting chemical reaction can damage its cells. This damage can lead to inflammation and scarring as the liver tries to repair itself. This concept is referred to as the oxidative stress theory. Another states that alcohol can damage our intestines, allowing toxins from our gut bacteria to get into the liver. These toxins, released from the gut, can lead to inflammation and scarring.

Alcohol is the most common drug used among adults in our society. Alcohol consumption is an integral, ingrained part of our culture. Think for a moment what a fundamental part of our society drinking alcohol is. Many business entities are dedicated entirely to the delivery and imbibing of alcohol (they are called bars). But, medically, alcohol is a toxic, deadly substance.

Alcoholism and chronic use of alcohol are associated with numerous medical, psychiatric, social, and family problems. Liver damage is just one of them. Alcohol consumption is a risk factor in twenty-five chronic diseases and conditions. It plays a significant role in certain cancers, psychiatric conditions, and numerous cardiovascular and digestive diseases. Additionally, excessive alcohol consumption can increase the risk of diabetes, stroke, and heart disease.

How many motor vehicle accidents can be traced back to the use of alcohol? Studies tell us alcohol is involved in more than 88,000 deaths per year. Approximately 14 million people in the United States meet the criteria for severe alcohol use disorders. Along with injuries that are unintentional, alcohol is significant in numerous intentional injuries due to increased aggression. Indeed, many research studies have linked alcohol use to physical violence.

Heavy drinking takes its toll on society in many ways. The costs resulting from alcoholism and excess consumption are staggering. The financial toll to our society results in an estimated $249 billion of expenditures each year, according to a report from the CDC. Obviously, there are the healthcare costs. The estimated annual cost to our criminal justice system is estimated at approximately $25 billion.

But the cost to society doesn’t stop there. Alcohol abuse and dependence claim an estimated 100,000 lives each year in the United States. Chronic alcohol abuse causes destruction of liver cells and this can result in scarring of the liver. The label applied to this scarring is cirrhosis. Cirrhosis is a permanent condition, and can often be the end result of chronic hepatitis.

Hepatitis and cirrhosis are on a continuum, meaning one a continuation of the other. Because of this, the symptoms may be very similar. Some forms of hepatitis develop very quickly, while, typically, cirrhosis develops, gradually, over time. Often, the progress toward liver failure is slow and gradual. There is no cure for cirrhosis, but removing the cause can slow the disease. If the damage is not too severe, the liver can heal itself over time. Alcohol causes liver cells to become inflamed and die because it is poisonous to all living cells.

As mentioned, a viral infection is most often the cause of hepatitis. The type of the disease is determined by the virus that causes it, those being labeled hepatitis A, B or hepatitis C. These each vary considerably in the causative agent as well as the manifestations of the disease. The first mentioned, hepatitis A, is generally the result of eating or drinking something tainted with fecal matter. There may no observable symptoms and it often goes away on its own within 6 months. Hepatitis A often resolves without any long-term harm.

On the other hand, hepatitis B is an infection which is transmitted from person to person. It is often transmitted through unprotected sex or intravenous drug use with a shared needle. It can also be caused by an accidental finger stick in the course of a medical procedure. When this form of hepatitis lasts more than six months, the incidence of subsequent problems increases noticeably, especially liver cancer.

Hepatitis C comes from infected blood or blood products. As with hepatis B, someone can get it from an infected needle if you’re a health-care worker, or IV drug use. Symptoms may not show up for many years. Although we don’t understand exactly why, as an age group, baby boomers are at high risk for hepatitis C.

What are the symptoms of liver disease? Early on, the sufferer may experience abdominal pains, diarrhea, fatigue, nausea, or vomiting. As the disease progresses, the symptoms become more serious, and more obvious. They can include bleeding in the gut, a tendency to bruise easily, worsening fatigue, yellowing of the skin (jaundice), itching, swelling of the legs and ankles, vomiting up blood, weakness, loss of appetite.

How does one keep your liver healthy? There are recommendations but these basically amount to the usual guidelines for overall health. Maintain a healthy weight and eat a balanced diet. Exercise regularly. Avoid toxins in your environment whenever possible. This includes the excessive consumption of the toxin which is alcohol, so pervasive in our society.

Regardless of whether your liver is infected with a virus, injured by alcohol or other chemicals, or being attacked by your own immune system, the danger is the same. If your liver is damaged sufficiently, it can no longer work to keep you alive. The liver helps turn food into energy for our cells. It is an essential organ for life. Be good to your liver and protect it. You need it.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.