THE LIVER REMINDS A PHOENIX BIRD : if at least 25% of the cells of an organ are alive, it will successfully recover due to regeneration. At the same time, the liver itself has no nerve endings and it never hurts. So, you can find out about the problems too late – on the way to the operating room. How to avoid a sad fate, we found out from experts: Doctor of Medical Sciences, gastroenterologist, hepatologist, member of the Scientific Society of Gastroenterologists of Russia and the European Association for the Study of Liver Diseases (EASL) Igor Bakulin, professor of the IPO of the First Moscow State Medical University named after I.I. I.M.Sechenov, President of the Foundation for the Support and Development of Evidence-Based Medicine Alexey Bueverov and Chief Physician of the Austrian Health Center Verba Mayr Natalia Edel.
How the liver works
The liver is the largest gland in the human body. It performs many different functions (for example, it is responsible for the synthesis of proteins and the production of substances necessary for digestion, produces bile), but chief among them is the purification of the blood from toxic substances and free radicals. If the organ is damaged, then the harmful elements are not “filtered”, remain in the bloodstream and “poison” the body. Hepatocytes – liver cells – are able to recover faster and better than other tissues of the body, but they are the ones that cause the greatest damage in diseases and various types of intoxication.
How to tell if your liver needs help
You can harm your liver for many years without feeling any discomfort: most diseases of this organ are asymptomatic. Symptoms such as yellowing of the skin and whites of the eyes, weight loss, and itchy skin usually appear late in the disease. The initial manifestations of liver dysfunctions – increased fatigue, apathy, poor appetite, nausea, deterioration of the skin condition (peeling, spider veins, dark circles under the eyes), sleep disturbances – if any, they are so nonspecific that they can be easily confused with overwork. Therefore, experts advise checking the condition of the liver by donating blood for biochemical analysis of certain indicators (the so-called hepatic profile) at least once a year – and in addition to a blood test, you can also undergo an ultrasound of the abdominal cavity.
One of the most common organ diseases is hepatitis. This is an inflammation of the liver associated with damage to its cells by viruses (infection with the most dangerous types, B and C, can become chronic and eventually lead to cirrhosis) or toxic substances (alcohol, drugs). The more often aggressive external factors affect the liver, the faster the liver cells are replaced by fibrous connective tissue, and the organ can no longer work at full strength.
How alcohol affects the liver
Passing through the digestive system, alcohol is absorbed into the bloodstream, and begins to break down when the blood passes through the liver. In the process of splitting alcohol molecules, the products of their decay are capable of disrupting the integrity of the membrane of liver cells, hepatocytes. If a person rarely drinks and does not have chronic diseases, the number of dead cells will be small and compensated by the liver itself. But regular consumption of alcohol or large quantities of it even for several days can cause fat to accumulate in the cells. Fatty liver disease (steatosis) is an early stage of so-called alcoholic liver disease. Almost everyone who drinks frequently has steatosis – but if a person stops drinking alcohol, the liver is usually fully restored by dividing intact hepatocytes.
The next stage is mild, moderate or severe alcoholic hepatitis. In the first two cases, the liver is still capable of recovery: the doctor prescribes drug therapy, limits physical activity, recommends adhering to a certain diet and drinking more fluids. This treatment usually takes up to four weeks. In severe hepatitis, the liver does not have time to recover due to the rapid development of serious complications, including kidney failure. Very often this disease turns into alcoholic cirrhosis – scarring instead of normal liver tissue, and these damage are irreversible. However, avoiding alcohol can prevent further damage. In this case, timely diagnosis and the choice of an appropriate treatment that ensures long-term remission are especially important.
How much alcohol is safe for the liver
According to the recommendations of the World Health Organization, the permissible dose for women should not exceed 20 g of pure alcohol per day. For men, this figure is doubled – they should consume no more than 40 g of pure alcohol, which corresponds to 100 ml of vodka, 400 ml of dry wine or 800 ml of beer. At the same time, the break between drinks should be at least two days, and drinks should be eaten with herbs, vegetables or fruits (oxidation of alcohol in the body causes an increased consumption of vitamins) and washed down with water or a soft drink to prevent dehydration.
Hepatologist Igor Bakulin draws attention to the fact that the recommendation of the European Association for the Study of Liver Diseases differs from the WHO recommendation and is that there is no safe dose of alcohol at all. In the human body there is not a single organ or system that would not be subjected to the destructive effects of alcohol. According to the doctor, talk that a glass of wine is good for the heart, and a glass of good vodka quickly relieves stress, are just excuses: alcohol does not have any effect that, if necessary, could not be achieved with the help of one or another drug. Another common myth is the division of alcohol into “bad” (“fired” vodka) and “good” (fifty-year-old cognac). Its damage to the liver is the same. The only difference is that the use of low-quality alcohol, in addition, is fraught with poisoning. And even buying high-quality expensive wine, a person does not protect himself from the development of liver diseases (alcoholic fatty disease, cirrhosis and even cancer).
Aleksey Bueverov notes that women are especially susceptible to the negative influence of strong drinks, even if they consume a small amount of alcohol. This is due, for example, to the fact that changes in hormone levels during the menstrual cycle can affect the breakdown of alcohol, or with the fact that the content of alcohol dehydrogenases and aldehyde dehydrogenases – enzymes that break down alcohol in the stomach and liver – are lower in women than in men. This means that with an equal amount of alcohol consumed, alcohol in a woman’s body will break down longer, and its level in the blood will be higher. At the same time, the risk of earning liver problems is higher.
What to do to keep the organ going
Drinking as little or as little alcohol as possible is important, but not the only component of liver health. It is also worth reducing your intake of foods high in sugar and fatty foods. A balanced diet is the best helper in maintaining liver function. It is believed that pumpkin dishes and natural mineral water are especially useful for her – they have a mild choleretic effect, prevent the crystallization of salts contained in bile, and improve intestinal motility. Doctor Natalia Edel advises to include mineral water in the diet for a couple of weeks, drinking half a glass three times a day 20-30 minutes before meals.
Another way to avoid malfunctioning of a vital organ is to add physical activity. This can be regular walks in the fresh air, swimming in the pool or working out in the gym. Any activity will do, the main thing is not to sit still. A sedentary lifestyle (especially if it is accompanied by overeating) leads to excess body weight – the main cause of non-alcoholic fatty liver disease: when fat accumulates in the body in excess, it begins to be deposited, including in the liver, destroying its cells.
Do hepatoprotectors help
Hepatoprotectors are medicines to improve liver function that must be prescribed by a doctor. As a rule, they are relevant as an adjunct to therapy that affects the cause of the disease, and are often used in the treatment of alcohol dependence. Hepatoprotective agents can have different mechanisms: to promote the restoration of cell membranes or to normalize impaired bile production. True, marketers often greatly exaggerate their effectiveness and there is a feeling that taking the drug can save the liver from destruction, even if you often drink or constantly overeat and move little. In practice, such means, although safe, do not always allow you to get the desired result.