How to Prevent Liver Disease

Introduction 

Liver disease is any condition that disrupts the function of the liver, usually in the form of scar tissue that results from prolonged inflammation. Inflammation can occur as a result of viral infection, obesity, or excessive alcohol consumption. The liver is a vital organ that functions as a detox centre for the blood. As blood from the digestive system is filtered through the liver, it can remove toxins, turn nutrients into needed chemicals for the body, or even metabolise medications for other ailments. 

However, once the liver is sufficiently scarred, blood flow is reduced, and its ability to perform its function is limited. This condition is often referred to as cirrhosis. Thankfully, when caught early, liver disease is very treatable. The liver is one of the only organs that can actually regenerate and heal itself, and a certain level of damage can be reversed with the right treatment regimen. However, the final stage of liver disease (liver failure) is much more difficult to treat and occurs when large portions of the organ become damaged beyond function. Getting medical attention at the first signs of liver disease can help avoid progression toward liver failure.  

There are three types of liver disease including alcohol-related liver disease (ARLD), non-alcoholic fatty liver disease (NAFLD), and infection-related liver disease. The first is caused by long-term heavy drinking, the second by obesity, and the third by an infection with hepatitis A, B, or C. They will be explored in more detail below. 

Signs & Symptoms 

Early forms of liver disease often do not show obvious symptoms, and swift diagnosis can be difficult. However, someone experiencing the early stages of liver disease may feel nausea, loss of appetite, fatigue, or diarrhoea. One of the key signs of early liver damage is red patches on the palms, or spider-like blood vessels appearing under the skin above the waist. 

As the condition progresses symptoms become clearer, including a yellowing of the skin or eyes (often called jaundice and associated with viral infection), abdominal pain, vomiting, itchy skin, swelling of the legs, dark urine, mental fog, and a tendency to bruise easily. Once the disease

has reached its final stage of liver failure, symptoms can include internal bleeding, kidney dysfunction, presence of fluid in the abdomen, and lung problems. The only treatment for end-stage liver failure is a liver transplant. 

Can You Reverse the Disease?

The good news is early-stage liver disease is reversible. Most organs, when damaged, replace the injured cells with scar tissue that no longer functions as part of the original organ. The liver, however, can replace its damaged parts with new cells. The reason liver scarring occurs in the first place is largely due to alcohol, viruses, and overused medications. This continuous harm prevents the liver from completing the regeneration of its cells, and scar tissue is formed instead. Stopping or limiting the use of damaging agents can provide time for the liver to heal completely and stay healthy. 

However, if the liver becomes sufficiently scarred, its organ function will be irreversibly altered. Although cirrhosis can be treated, it cannot be cured without a complete organ transplant. Therefore, catching the condition early and targeting its source is the only way to reverse or prevent further damage. 

Lifestyle Factors 

The following lifestyle factors have the greatest impact on increasing your risk of liver disease.  We will also look at what you can do to reduce your risk from today. 

• Nutrition: Nutrition and diet can have a significant effect on the likelihood of developing liver disease. The liver is a key organ in the process of digestion;when it is damaged, many foods can no longer be processed and toxins may build up in the blood. Some of the nutrients that may increase the risk of incurring liver damage are salt, added sugars, highly processed carbohydrates, and red meat protein. First, salt is responsible for fluid buildup and inflammation that can kick start the process of liver scarring. Next, added sugars and processed carbs will raise blood pressure and increase the buildup of fats in the liver. Finally, red meats, especially processed deli meats, are high in saturated fat and will slow liver function. Reducing the intake of these types of foods can help keep the liver healthy and prevent additional damage. 

The best way to decrease the risk of liver scarring is to eat the proper amount of protein, fruits, veggies, and fibre. First, proteins can actually aid in the process of repairing the liver and prevent fat buildup that occurs as a result of damage to liver cells. Second, according to a 2021 study, leafy greens and fruits high in antioxidants can actually protect liver cells from incurring damage. Third, studies have shown that consuming proper amounts of fibre can keep the liver functioning properly and help maintain its health. Overall, improving your diet can protect the liver from further damage, and speed up the regeneration process. 

• Physical Activity: Exercise goes hand in hand with diet in preventing liver disease. Obesity is the number one risk factor for non-alcoholic fatty liver disease (NAFLD) which is not treatable by medication. Exercising regularly and losing weight will reduce fat buildup around the liver and therefore improve its function. 

According to a 2018 study, the best way to induce weight loss and prevent NAFLD is to restrict calorie intake by following the diet recommendations outlined above, and by sustaining at least 150 minutes of cardio-related exercise per week. The best way to get started is simply by forming a healthy habit. Going for a walk everyday will get the body accustomed to increased movement, and eventually more vigorous exercise will become easier. Easing the body into the process of regular exercise before the onset of liver disease can help prevent the condition altogether. 

• Obesity: Obesity is a key risk factor for developing liver disease. Being overweight may lead to a condition termed “fatty liver”, which in turn causes inflammation and then scarring. Furthermore, other diseases associated with being overweight, such as diabetes, hypertension, and high cholesterol can also lead to liver damage. Combining the exercise and diet tips listed above can help decrease body mass, and vastly reduce the risk for developing liver disease. 

• Smoking: While smoking is associated with the ingestion of many different types of toxins that can cause liver cell injury and cirrhosis, it is also correlated with other damaging conditions including heart disease, diabetes, and metastatic cancers. According to recent studies, smoking is the number one cause of preventable disease, and discontinuing its practice is vital not only for reducing liver failure incidence, but also the occurrence of other conditions outlined above. Ending a smoking addiction is not easy, but it can be done. Here are some tips for quitting.

• Alcohol: Alcohol use is perhaps the number one risk factor for developing liver disease. When alcohol is digested by the liver, it produces highly toxic chemicals that kill liver cells. Over time, if alcohol consumption is limited, these cells can heal and resume function. Otherwise, if heavy drinking occurs regularly, scar tissue will form and eventually cause cirrhosis and liver death. Here are the NHS drinking guidelines, which can be used for maintaining healthy limits and checking current habits. 

Once liver cirrhosis has been diagnosed and has reached a certain stage, complete abstinence from drinking alcohol is recommended. While heavy drinking will lead to liver disease over time, single incidences of binge drinking can also cause severe liver inflammation often referred to as alcoholic hepatitis. This potentially life-threatening condition requires immediate and permanent cessation of alcohol consumption, otherwise irreversible liver injury will occur. 

• Sleep: Although research is still in its early stages, there is some evidence to suggest that losing sleep can lead to liver disease. This research rests on the fact that the liver is responsible for producing glucose and processing insulin. When deprived of sleep, subjects displayed much higher levels of glucose in the blood – often associated with a resistance to insulin that eventually becomes type II diabetes. It has long been known that metabolic diseases, like type II diabetes, are accompanied by the development of fatty liver and liver dysfunction. 

Although studies are still emerging on whether or not lack of sleep actually causes liver disease, having liver disease can certainly lead to a lack of sleep. Many patients with liver cirrhosis experience insomnia, daytime sleepiness, and an inability to sleep deeply. This symptom is often one of the first signs the liver has accumulated significant scarring and should be discussed with a doctor. 

• Mental health: Mental health is an important factor in the development of liver disease as it relates to addiction. The NHS estimates that over 70% of patients with alcohol-related liver disease have an alcohol dependency problem. For those looking for a way to quit or decrease their alcohol intake, here is a great resource. Furthermore, those who suffer from an alcohol addiction often experience addictions of other types like smoking or drug use. 

Hepatitis B and C are both severe forms of liver inflammation caused by viral infection passed via the blood. In the UK, both forms of virus are most commonly circulated through shared needles used for drug injection. These infections will cause liver scarring and likely cirrhosis if not treated. Drug addictions of any kind often develop due to mental health struggles and are not easy to overcome. Talking to a doctor or mental health professional is a great start, and here is a resource for seeking help.

• Wellness: Keeping your emotional health balanced is necessary for your physical health. A few simple tips for keeping well and avoiding stressors that may encourage the use of liver damaging agents, such as medications, smoking, or drinking, include: 

• Forming healthy habits – dedicate one hour a day to doing something you enjoy such as reading, cooking, or making art. Eventually the habit will form, and the hour will become a structured part of your routine. 
• Setting boundaries – do not be afraid to say no. Setting limits with your time, whether for work, family, or friends, is a great way to build self-confidence and remove stress from being spread too thin. 
• Get better sleep – a full night’s sleep improves physical and mental wellbeing. Here's a great resource for improving sleep habits. 

While all of these lifestyle factors have an impact on the risk of developing liver disease, the most important ones to change are alcohol consumption, obesity, and nutrition and exercise. Alcohol consumption will lead to liver damage - there is no way around it. Establishing healthy drinking habits or kicking it completely is the only way to completely protect the liver from damage. Next, obesity is associated with other conditions such as type II diabetes and heart disease. Both of these conditions, among others, will lead to non-alcoholic fatty liver disease and severely inhibit the organ’s function. Finally, improved nutrition and exercise can reduce fat around the liver, aid in its efficient function, and actually speed up the healing process of damaged cells. 

Liver disease does not have to be scary; it is completely avoidable and reversible if the right actions are taken proactively. 

Diagnostic Testing 

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