Liver cells are damaged in liver diseases. This often shows up in the blood: as a sign of the damage or stress, liver values are constantly or frequently elevated. Although liver cells die at some point even in a healthy organ and are replaced by new cells, in liver disease this cell death can become too much in the long term, even for an organ such as the liver that is capable of regeneration. If liver disease lasts for many years, liver damage can develop, including cirrhosis. Vital functions such as metabolism, digestion and the immune system are often severely impaired in chronic liver disease.
Elevated liver values should not be underestimated
Millions of German citizens have liver disease without suspecting anything about their condition. There is a need for information about these connections, in some cases considerable, among the population, but also among many physicians. Liver disease is not a phenomenon of marginalized groups: it can affect anyone, even without an alcohol problem. Elevated liver values are not a trivial matter, but often the first indication of a disease. If these values are elevated, it is essential to rule out viral diseases such as hepatitis B and C in addition to alcohol. Obesity, diabetes, iron overload, immune system disorders, medications and toxins at work are also possible causes and should be questioned if in doubt.
What diseases are there?
Contrary to conventional wisdom, alcohol is far from being the only cause of liver disease. The different diseases can be divided as follows:
- Viral hepatitis (viral hepatitis).
- Toxic diseases
- Autoimmune diseases
- Metabolic diseases
1. viral inflammation of the liver (viral hepatitis).
The best known virus-related inflammations are hepatitis A, B and C. The routes of infection of these diseases are often confused.
- Hepatitis A is a travel disease transmitted primarily through contaminated food and smear infections. Because it always cures itself, it is considered the most harmless form of viral hepatitis. The course is problematic in the elderly, chronically ill and people with weak immune systems.
- Hepatitis B is contagious and can be transmitted through almost all body fluids (blood, saliva, tear fluid, vaginal secretions, semen). Sexual contacts, piercing, tattoos as well as contact with infected blood can lead to infection. Another risk is transmission of hepatitis B from mother to child during birth. In adults, acute infection with the hepatitis B virus heals in 95-98% of cases, so that only 2-5% of cases become chronic. In contrast, in people with weak immune systems (for example, young children, seniors, chronically ill), chronic courses occur much more often.
- Hepatitis C is hardly infectious in everyday contact. The risk of sexual infection is here in contrast to hepatitis B rather low. The risk of transmission depends on sexual behavior. Infection usually occurs through direct blood contact, for example through blood products, injuries, intravenous drug use, piercing, tattoos, acupuncture needles and poor hygiene during medical procedures. If infection occurs, hepatitis C is chronic in about 50-80% of cases if left untreated. Current hepatitis C therapy has severe side effects and does not work for every patient. However, due to improved drugs, hepatitis C is increasingly becoming a curable disease.
Hepatitis A or B can also be prevented by vaccination, but hepatitis C cannot.
2. toxic diseases
These include diseases caused by alcohol, fungal poisoning, environmental toxins and drugs. Over-the-counter medications, such as pain relievers and herbal preparations, can also affect the liver in individual cases.
3. autoimmune diseases
Autoimmune hepatitis or biliary tract diseases such as PBC or PSC – like metabolic diseases – are not contagious. Here, the body’s immune system turns against the body’s own tissues, such as the liver, due to a defect. Slow organ destruction can be the result. For a long time, such diseases were hardly known, but they are being diagnosed with increasing frequency.
4. metabolic diseases
These include mainly iron or copper storage disease and alpha-1 antitrypsin deficiency, which are caused by a genetic defect.Increasingly diagnosed is “non-alcoholic steatohepatitis” (NASH), which mainly affects overweight people and diabetics. Unlike the common fatty liver (which in itself is only a finding, but not a disease), NASH is a disease that must be taken seriously. As different as the causes and the course of chronic liver diseases are: In the late effects, these diseases are very similar. If the liver is overloaded by permanent inflammation, cell death occurs. The diseased liver becomes scarred and shrinks. The final stage is called cirrhosis. The consequences of cirrhosis can be serious: Watery belly (ascites), brain dysfunction (hepatic encephalopathy), bleeding from varicose veins in the stomach or esophagus (variceal bleeding), and in very unfavorable cases, liver cancer (hepatocellular carcinoma). Appropriate early therapies can often successfully prevent such a chronic course.
