The Liver (2)

In the following chapter I am going to describe the most common liver diseases.

What is Hepatitis? It is an inflammation of the liver. The least harmful hepatitis is the self-limited form, but patients may also suffer from a form that could progress to fibrosis, cirrhosis or liver cancer. The most common pathogens that cause hepatitis are five viruses called Hep A, B, C, D and E.

People are infected with the B, C or D viruses as a result of parenteral contact with infected body fluids, contaminated blood in blood products or invasive medical procedures. Hepatitis B can also be transmitted from mother to newborn at birth, from family members to the child, and through sexual contacts. Hepatitis B and C may lead to chronic hepatitis and those two types are the most common causes of liver cirrhosis and liver cancer. Hepatitis A and E are usually caused by ingesting contaminated food or water.

Viruses are not the only reason for hepatitis, different infections can also cause hepatitis. Further, toxic substances such as alcohol and certain drugs, or autoimmune diseases and also Diabetes mellitus can cause hepatitis.

What is Liver Cirrhosis? As we already discussed, alcohol, viral hepatitis and also nonalcoholic fatty liver disease can cause liver cirrhosis. Liver cirrhosis develops slowly over a long period of time, usually several years. What is than exactly the problem? Cicatriced tissue replaces healthy tissue which makes the liver hard and lumpy . If this process continues, the liver starts fo fail. The cicatriced tissue tightens the portal vein and, as a result, it becomes difficult for the blood to flow into the liver. It backs up in the portal vein, gets into the spleen and causes several problems within the spleen. The only therapy for liver cirrhosis is a liver transplant.

What is a Fatty Liver Disease? Patients may develop a fatty liver disease on various ways. One is called Nonalcoholic Fatty Liver Disease (NAFLD). Even if a person who doesn’t drink any alcohol (or only moderate amounts) they can build up fat in the liver. Alcohol is converted by the liver into fat. Excessive alcohol consumption may cause the Alcoholic Liver Disease (ALD) since the fat from the alcohol conversion manifests in fatty liver disease. Rarely, women can also develop a fatty liver disease during pregnancy.

Some fat in the liver is normal. We talk about fatty liver disease, if the fat will exceed 5–10 % of the organ’s weight. What factors may support the development of ALD or NAFLD? For example, if the patients are overweight, suffering from diabetes, has high cholesterol, high triglyceride levels in their blood or has high blood pressure or the metabolic syndrome.

What is Hemochromatosis? This is a liver disease where too much iron builds up in your body. You absorb more iron than you need. Too much iron is toxic for the body. Usually the body has natural ways to discharge the extra iron, however, if one suffers from hemochromatosis, the body can’t. It stores the extra iron in body tissue, especially the liver, pancreas and heart. This extra iron can damage the body’s organs. Without treatment, it can cause even organ failure .

Two types of hemochromatosis can be distinguished: Primary hemochromatosis is an inherited disease while secondary hemochromatosis is usually the result of anemia, thalassemia, liver disease, or blood transfusions.

As a therapy blood and iron are removed from the body by blood-letting ; also patients can change their diet or take medicine.

What is Autoimmune Liver Disease? Autoimmune liver diseases occur when cells of the immune system attack the body’s own cells of the liver and the gall ducts. The reasons for these diseases are largely unknown. The three main categories of autoimmune liver diseases are:

autoimmune hepatitis (AIH) – a chronical inflammation of the liver cells that may occur at any age; primary biliary cirrhosis (PBC) – a chronical inflammation of the small bile ducts in the liver (mainly seen among women) primary sclerosing cholangitis (PSC) – it is also a chronic inflammation of the bile ducts, that mostly affects men. What about Liver Cancer? Worldwide, liver cancer is drastically increasing. In Germany, fatalities have almost doubled since the 1970s. This cancer is particularly treacherous , because it is often diagnosed too late. Only more advanced stage liver cancers cause obvious complaints like jaundice , nausea , weight loss and pain in the epigastric region. To avoid these late symptoms, early detection is especially important.

We differentiate between malignant and benign liver tumors. In the case of a malignant tumor more than half the time the tumor will have developed because of a hepatitis infection (B or C). In 40 % of the cases, alcohol and/or obesity are the reason for liver cancer. In less than 10 % the disease has another cause.

Malignant liver tumors can either be primary, meaning the liver cancer originated in the liver, or metastatic, where the cancer started in an organ other than the liver and metastasized.

The four main types of malignant liver cancer are:

Hepatocellular Carcinoma (the most prevalent form) Cholangiocarcinoma Metastatic Liver Tumors Pediatric Hepatoblastoma In benign liver tumors each cellular component of the liver can get the proliferation . Only four benign gutartig liver cancers have common clinical relevance:

hemangioma focal nodular hyperplasia hepatocellular adenoma hepatic cysts. Benign liver tumors are mostly asymptomatic. The affected population usually are young women, benign liver tumors are extremely frequent.

BIBLIOGRAPHY 1. Ryu M, Cho A: New Liver Anatomy – Portal Segmentation and the Drainage Vein. Springer Verlag, August 2009. 2. http://dict.leo.org 3. www.dict.cc 4. www.webster-dictionary.org

EXERCISE: 1. Late-stage chronic liver disease is called

a. Cirrhosis b. Liver cancer c. Fatty liver disease

2. What is the most common type of chronic viral hepatitis worldwide?

a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis D e. Hepatitis E

3. A woman has a considerably higher risk for developing liver cirrhosis than a man.

a. True b. False

You’ll find the answers on:

http://tinyurl.com/weiterbildung-englisch

Die Autorin: Carmen Lobitz mail@lobitz-seminare.de www.lobitz-seminare.de Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die u.a. Englischseminare für Health Professionals anbieten.

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Lösung für Exercise:

Answer: 1. a

Answer: 2. c

Answer: 3. a

The Liver (2)

What is Hepatitis?

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