The hardworking hero that’s too often overlooked
The start of the year sees us celebrating a very important, but often overlooked organ – the liver. Responsible for no less than 500 different functions around the body, we think it deserves more recognition!
With this in mind, we’ve spoken to our consultant gastroenterologist and hepatologist, Andy King. With advanced training in his field, Andy is a recognised leader in medical education and training.
As Dry January and Love Your Liver month are well underway, Andy shares everything you need to know about this vital organ. From the role it plays in our everyday health to what’s causing the rise of liver disease in the UK, and what we can do to maintain a healthy liver, no stone has been left unturned.
What is the liver and what role does it play in our everyday health?
The liver is a vital organ and is one of the largest in the body. It’s located in the upper right side of the abdomen, beneath the diaphragm.
It plays a crucial role in various physiological processes which are essential for maintaining overall health including:
- Digestion
- Detoxification
- Nutrient storage
- Regulating blood sugar and cholesterol levels
- Production of blood clotting factors
- Keeping our immune system healthy
- Managing metabolic processes
This is to name just a few.
Proper liver function is vital, and liver dysfunction can lead to serious health problems. When the liver stops working, almost everything else does too.
Are there any early warning signs of liver problems which can be easily overlooked?
One of the reasons why liver disease is difficult to diagnose is because it’s asymptomatic in its early stages. Even among those who are experiencing symptoms, they’re non-specific. For example, someone may be experiencing fatigue or loss of appetite which can be put down to a lot of other things.
In the advanced stages, the symptoms of liver disease can include jaundice (yellow eyes/skin), abdominal swelling, leg swelling, itching and bruising/bleeding.
Because there are no symptoms in the early stages, liver disease is typically picked up ‘by accident’ when a patient is being tested for something else. Another scenario where it can be diagnosed in its early stages is in patients who undergo regular screenings due to having high risk factors for the disease.
If you’re worried that you could have liver disease, don’t wait for symptoms to present themselves before getting checked. The main factors which put you at increased risk include obesity and drinking too much alcohol.
Liver disease is on the rise in the UK, what do you think could be contributing to this?
Increased alcohol consumption is a huge contributing factor. The rise in binge drinking, especially among younger adults is leading to more cases of alcohol-related liver damage.
Increasing rates of obesity, high-fat diets, processed foods and sedentary lifestyles are also key drivers. We’re seeing increased rates of obesity and non-alcoholic fatty Liver Disease (NAFLD), type 2 diabetes and metabolic syndrome. Insulin resistance in the latter two of these conditions can lead to fat build-up in the liver, contributing to the development of NAFLD and increasing the risk of liver complications.
A poor diet high in processed foods, sugar and unhealthy fats, combined with a lack of physical activity, can contribute to both obesity and fatty liver disease. The modern diet, often rich in refined carbohydrates and unhealthy fats, is a major factor in the rise of liver disease, particularly NAFLD.
What’s really worrying is that we’re also diagnosing people at younger ages, with more advanced stages of liver disease. This is no doubt fuelled by the high cost of living which means that fewer people can afford healthier foods.
What preventative measures can be taken to maintain a healthy liver?
Fortunately, there are lots of things we can do to protect the health of our liver.
Limit alcohol consumption
Excessive alcohol consumption is one of the leading causes of liver disease, including alcoholic liver disease (ALD) and cirrhosis. It’s important to follow the recommended guidelines for alcohol consumption, which is no more than 14 units per week for both men and women.
We also highly recommend having alcohol-free days to give your liver time to recover. Aim for at least three alcohol-free days every week.
Maintain a healthy weight
Being overweight or obese increases the risk of non-alcoholic fatty liver disease (NAFLD), which can progress to more serious conditions like cirrhosis or liver cancer. Achieving and maintaining a healthy weight through a balanced diet and regular physical activity is key to liver health.
Aim for at least 150 minutes of moderate exercise (e.g., brisk walking, cycling, swimming) each week. Regular physical activity helps prevent obesity and insulin resistance, which are linked to liver disease.
Follow a balanced diet
- Eat nutrient-rich foods: focus on a balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats (e.g., from olive oil, nuts and avocados). This supports liver function and reduces the risk of fat build-up in the liver.
- Limit processed foods and sugars: avoid excess consumption of processed foods, refined carbohydrates and sugary drinks, which can contribute to weight gain and fatty liver.
- Drink plenty of water: staying hydrated helps the liver filter out toxins.
- Practice safe hygiene: avoid exposure to contaminated food or water that can lead to hepatitis A and other liver infections
Manage chronic health conditions
People with type 2 diabetes or insulin resistance are at higher risk of developing fatty liver disease. Maintaining normal blood sugar levels through diet, exercise and medication (if prescribed) is important.
High cholesterol and triglycerides can also contribute to fatty liver disease. Have your cholesterol levels checked regularly and take steps to keep it in a healthy range.
The year starts with Dry January and Love Your Liver awareness month. These are both great causes which encourage people to take steps towards enjoying better health. What are some of the benefits of reducing alcohol intake?
Chronic alcohol consumption is a leading cause of liver disease, including fatty liver disease, cirrhosis and alcoholic hepatitis. Reducing alcohol intake gives the liver time to recover and it reduces the strain on this vital organ.
When reducing your alcohol intake you also reduce your calorie intake which makes it easier to lose weight or maintain a healthy weight.
There are many other benefits of reducing our alcohol intake including lower blood pressure, reduced risk of heart disease and cancer, as well as improved immune function.
What should people do if they’re worried about the health of their liver?
The first thing to do is make an appointment with a doctor. They can evaluate your symptoms, review your medical history and discuss any risk factors you might have. Please be open and honest about your symptoms so your healthcare provider can give you the best possible care.
We can run some simple tests including blood tests and a FibroScan. This is like an ultrasound and can pick up any abnormalities in the liver immediately. This scan is available in most hospitals and can also be done privately.
If you’re at risk of liver disease due to factors like past intravenous drug use, unprotected sex or a history of blood transfusions before screening protocols were in place, your doctor may suggest testing for hepatitis B or C infections. Both conditions can cause long-term liver damage if untreated.
As with any disease, early detection is critical. When we pick up on it early, there are treatments and lifestyle changes we can prescribe. Liver disease is a progressive problem however and we want to stop it before it progresses to cirrhosis, which is irreversible.
Are there any new treatments or medications for chronic liver conditions such as hepatitis or cirrhosis?
We now have excellent treatment options for hepatitis B and C. Historically, treatment for hepatitis came with significant side effects. Direct- acting antiviral (DAA) medications have revolutionised hepatitis C treatment however, offering much more tolerable options. Furthermore, we can now cure hepatitis C in nearly 100% of patients.
Unfortunately, there’s no cure for hepatitis B at the moment, but antiviral medication can help reduce the viral load and lower the risk of complications like cirrhosis and liver cancer. As a result, we’re not seeing as many liver conditions caused by hepatitis these days.
The increased use of weight loss injections is also helping to reduce cases of liver disease because, in addition to promoting weight loss, they also help manage diabetes.
Are there any liver-related health issues you feel need more attention from the public?
The main thing is making people aware that risk factors for liver disease are common but symptoms don’t usually occur until it’s progressed to a late stage.
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are two conditions which deserve greater public awareness.. NAFLD is becoming one of the most common liver diseases globally, and NASH is expected to surpass hepatitis C as a leading cause of cirrhosis and liver transplantation in the coming years.
It’s also critical that we remember alcohol consumption remains a significant cause of liver disease worldwide. Binge drinking and heavy drinking is still widely accepted, even encouraged, among younger age groups and people often don’t recognise the severity of alcohol-related liver damage until it’s too late.
What advice would you give to someone recently diagnosed with a liver condition?
Learn about your condition so you can understand how to manage it properly. Speak to your healthcare provider about your diagnosis and ongoing treatment. There’s a high probability you’re going to have to make some lifestyle changes, for which support is available.
The British Liver Trust website is a brilliant source of help and information.
You can also get in touch to find out how we can help diagnose and/or manage your condition.
