1. Liver disease - are there warning signals?

Yes. You feel exhausted, drained. After getting up in the morning, you feel like going straight back to bed. Your eyes are glassy, and tiny red or blue blood vessels may appear under your eyes. Your stomach feels uncomfortably bloated. You feel hungry, but you don't feel like eating.

2. Can your liver hurt?

The liver normally suffers silently over a long period of time. If you feel that your liver is causing you pain, you should see a specialist at once. Your life is in danger.

3. What is good for your liver?

Take as little medication as possible. In particular, avoid taking pep pills in the morning and sleeping pills at night. Don't drink more than two or three cups of coffee daily. Drink plenty of fruit juice and mineral water instead. And remember - burnt food belongs in the garbage, not in your body.

4. Is heat good for the liver?

Yes, a hot-water bottle is a good home remedy to stimulate liver function and blood circulation. It's a good idea to cover the hot-water bottle with a wool blanket.

5. How can a tumour in the liver be identified?

Thanks to computer tomography and ultrasonography this is no longer a problem. Before diagnostics became so sophisticated, tumours could only be located when they were already 10 to 20 centimetres in size.

6. Do liver cells grow back?

Yes. For instance: parts of the liver can be taken from a healthy mother and be transferred, for example, to her sick child. Afterwards, both of them will have a fully functional organ because these liver cells grow back.

7. How exactly does cirrhosis of the liver develop?

Cirrhosis is the final stage of chronic liver disease. Over a period of many years functional hepatocytes are replaced by collagenous connective tissue. Since the liver has great resources, symptoms first appear when over 80 per cent of its cells are already inoperative.

8. Can the contraceptive pill cause damage to the liver?

300 - 3000 cases of liver damage in otherwise healthy women occur each year in Germany, if not caught early by the doctor. In order to keep this risk as low as possible, today's birth control pills contain much less oestrogen than before.

9. Can pollutants cause damage?

Yes. Heavy metals such as lead, cadmium and mercury can damage the liver's enzymes and thus interfere with its' metabolic functions. Among other chemicals Tetrachloromethane has been identified as being extremely toxic to the liver, leading to fatty liver and liver cell necrosis. Tetrachloromethane is used as a thinner in paint and lacquer and as as a fat-solvent in stain removers and machine cleaners.

10. When will science produce the first artifical liver?

Probably never! Given that the liver is such a unique and diverse organ, it is most unlikely that an artificial liver could replace it permanently, as is now possible in the case of the heart.

11. Can the liver be treated using blood treatment procedures similar to those used for kidney dialysis?

Yes, but only with restrictions and only in specialised liver intensive care units, for example those attached to liver transplant centres. This type of treatment cannot be offered to outpatients. Short treatments repeated over a period of weeks or months are of little help. Liver support machines, where the patient is continuously connected to a machine can be employed in cases of acute liver failure caused, for example, by poisoning. This applies to intensive care patients who are suffering from acute, life-threatening hepatic coma. However, this method of treatment is not suitable for patients suffering from chronic liver diseases (chronic viral hepatitis) or liver cancer. Due to the level of risk involved for the patient, this treatment can only justified in the case of hepatic coma.

12. My doctor noticed that I have a high liver count, but was unable to detect any liver disease. Is it possible to have an elevated liver count for no apparent reason?

Yes. A high liver count (for example elevated GOT, GPT or gamma-GT) is not always an indication of liver disease. The underlying cause is not always viral hepatitis, a tumor, an autoimmune disorder or alcohol abuse, and it doesnÕt automatically mean you have gallstones. In fact, gallstones often donÕt cause any problems, and if they do interfere with bile secretion it will be noticeable by symptoms such as colic and a change in stool color. In general, if your doctor has noticed that your liver count is elevated, you should have it checked every few months. In order to rule out the possibility of disease, more extensive tests are necessary. If these results are also negative, you can set your mind at rest. Nevertheless, regular check-ups are always worthwhile.

13. What is Nonalcoholic Steatohepatitis

Nonalcoholic steatohepatitis (NASH) is characterized by histopathological features of alcoholic hepatitis in patients drinking insignificant amounts of alcohol. Up to 20 per cent of patients with elevations of transaminases of unknown significance have been reported to have NASH. In about 80 per cent of cases NASH is associated with obesity and type 2 diabetes mellitus, especially in middle aged women. Hepatic steatosis, hyperinsulinemia, endotoxins, proinflammatory cytokines, oxidative stress and genetic factors are pathogenetically important. In its strict form NASH is characterized by steatosis, signs of
hepatocellular injury, necroinflammation and fibrosis. Most patients are asymptomatic or have mild, noncharacteristic right upper quadrant complaints. Transaminase values are below 100 U/l, alanine aminotransferase is higher than aspartate aminotransferase. In most patients long term prognosis is good, however, in some patients NASH is progressive and may lead to cirrhosis. Management includes careful weight reduction and treatment of diabetes. Therapy with ursodeoxycholic acid, vitamin E and insulin sensitizing agents has yielded promising initial results.
...further information (german)

Alcohol - the liver`s worst enemy

Alcohol is the liver`s worst enemy. As a matter of fact, alcohol abuse is the cause of two thirds of all chronic liver disease. Currently, nearly 3 million people in Germany are in need of liver treatment. The liver and alcohol - in the worst case a fatal affair. And the question that always crops up: How much alcohol can you consume without having to worry about liver damage?

The answer: women and men can tolerate different amounts of alcohol. A man with a healthy liver can consume about 60 grams of alcohol daily - this is equivalent to a bottle of wine (0,75 l) or 5 glasses of lager (1,5L) or four double liquors. A woman can consume about two-thirds of this. By the way, regular, excessive consumption of alcohol attacks the liver more intensely than having a binge now and again. A tip for all those who drink regularly: take a break! Stay away from alcohol entirely four to six weeks at least once a year, more often if possible. An otherwise healthy liver can fully recuperate during a period of strict abstinence and there is a good chance that a fatty liver will regress.