Basic Know-How

Basic Know-How for Tackling Hepatitis

Tackling is an art in the game of football. Have you ever wondered if we can tackle Hepatitis? Yes we can. We can do it as smoothly as a skillful soccer player tackles the ball.

There are many prevalent myths on Hepatitis. People diagnosed with the disease are often seen to be alienated and isolated from the society. But living in the 21st century, it is a disgrace to the human kind to encourage such unscientific behaviors.

To know about Hepatitis, we need to start from the liver. So, before beginning the competition, enlighten yourself with few facts on the liver and Hepatitis.

Liver – Mystic, Magical, Magnanimous

No other organ is cursed more often than the liver, whenever different functions of our body are thrown out of gear. From hair fall, balding and skin rash to changes in appearance, body odor – liver is crucified more often than it should. Paradoxically, when the liver is really troubled, it often does not get recognized until very late and till advanced trouble has set in. Detection of liver disease often generates undue worry and panic. Unnecessary actions that frequently include hospitalization, intravenous fluid administration, restoring to faith based remedies confuse the situation further. For all practical purposes, liver is denied the scientific approach to either its welfare or ill health.

Liver is a savior

The liver had all along been considered to be a mysterious organ in popular imagination. Myths and gospels abound in nearly every culture and civilization about the role of the liver. This is partly because whenever the body is challenged by any external force, the liver comes into action first. Living organisms, called bacteria and viruses, are the cause of the commonest malady of our body – called infection. Many of these reach the liver before anywhere else. To get rid of these bad elements, the liver has got a rich and smart defense. The liver may be considered a fort where lie a strong regiment in different dresses. These are named differently – but their job is same.

Interestingly, this cantonment, called the liver, also carry out jobs that provide fuels to other organs – cooking, storing and distributing foods to different parts of the body. Carbohydrates (sugars of different types), fats (oily substances that are needed for digestion and action), proteins (providing strength and skeleton) are some of these substances that the liver makes and breaks depending on what the body wants. Thus, the liver is a chef that picks up the sentry’s dress, whenever the body is in distress. An important part of the job of the liver is to keep the ability of the blood to stop bleedings. It prepares some unique materials that function as boulders whenever bleeding starts from some part of the body. In view of this role as a professional disguiser (Bahurupee!) that the liver plays, it’s not unusual that the liver is thought of as guilty more often than it truly is.

What makes the liver unwell

The liver was long thought to be the seat of the soul – where the “atma” lies. There is often trouble in heaven too. This is most often caused by tiny creatures called viruses, which are so small that they cannot be seen by the usual microscopes. They have a pedigree tree of their own – that form an alphabet – “A” through to “E”. A & E are acquired most often by polluted water, transiently attack the liver, troubles and then leaves. On the other hand, “B” & “C” are the other group that comes through injections and blood and tend to stay – while the body tries to push them away. The body succeeds most often – but often fails in scavenging. This is called chronic hepatitis and can be bad unless taken care of. Apart from these, drugs – often used without prescription, alcohol and overweight can also cause liver injury. So, overall – liver gets troubled by a number of factors – some avoidable (overweight, excessive drinking, drugs) and some unavoidable (viruses).

How to recognize bad liver

The liver weeps when troubled and its reflected in some substances called enzymes. One such enzyme called SGPT is very well known and when elevated makes us cautious about incipient problems in the liver. It may, however, be kept in mind that elevated ALT may be innocuous and does not always indicate presence of disease in liver. Persistent SGPT elevation over a long period needs to be investigated. Elevation of bilirubin in serum underlies what is called jaundice in popular terms. Jaundice means that elimination of substances from the liver is defective because of liver cell injury. But, again serum bilirubin may be elevated lifelong without there being any disease in liver. This occurs in a condition called Gilbert’s syndrome which is not a disease and does not cause any harm. But the bilirubin remains higher than normal and causes anxiety. There is no need to undergo expensive and sophisticated tests to know the status of the liver. It does not add up to knowledge. On the contrary, it adds worry and depression.

Hepatitis B is the commonest cause of liver disease in India

Most people, who get exposed to the virus, recover and expel the virus. In a minority liver disease develops after decades of infection. Hepatitis B is a preventable cause of liver disease. In India, it is spread mainly through injections, often given without maintaining principles of sterility and cleanliness. Rural people are victimized more often by this disease than urban dwellers.

Hepatitis B is not transmitted by utensils

We often become paranoid and take unscientific steps of protection against the disease. Hepatitis B is never spread by casual contact, sneezing, coughing, sharing beds etc. Sharing towels, razors, toothbrushes etc. should be avoided.

Majority of HBV infected people lead a normal life

It is a fact that only 15% of HBV infected people develop liver disease. Marrying, childbearing, activities of daily life should be normal. Segregation, isolation of HBV infected people at workplace is unnecessary. They should have normal food intake.

HBV vaccine is safe and effective

The vaccine provides protection to more than 98% people. It is free from side effects. The target should be to vaccinate all children as early as possible after birth. Nothing is late and so even elder children need to get the vaccine. The vaccine is available free of cost at Government health set ups for children.

China and Taiwan are amongst more than 120 countries that have been using the vaccine to their children. The results are rewarding and HBV infection pool is coming down.

HBV Infection is treatable

It has been an excellent journey since an injection was available around 20 years back for treatment. Now, there are many drugs – some oral – that give good results for treatment of Hepatitis B. Hence, there is no reason to be pessimistic when somebody needs to be treated for HBV. Many more drugs are being developed. However one needs to be cool and hopeful.

Normal Childbearing is possible

A common problem is to find women who are found to be HBV positive while screening before childbirth. They are very depressed and they need to be reassured that the child will be normal. Some precautions are necessary at childbirth. The child needs to be given some injections. It is a crime to advocate termination of pregnancy under these circumstances.

HBV and HIV are miles apart

They are often clubbed together – but there are more differences between them than similarities. The only closeness between the two is in the fact that they are often brothers in the same boat. But they look different and also behave in different fashion. Most importantly, in Hepatitis B – most infected people never develop disease. Unfortunately, there is a popular belief amongst awareness activists that unless you frighten people about a health condition – people don’t follow instructions. This is improper and generates mere living fossils out of people who otherwise carry normal life all through. We need to keep in mind that physical well being can be measured and taken care of by drugs. But, emotional trauma resulting from exaggerated representation of scientific information remains hidden and manifest as masked depression. Science should be brought to people in a flower vase, not as a thriller or horror movie.

What can damage your liver?

Damage to the liver may result from alcohol, hepatitis viruses, poor diet and toxins (from substances such as paracetamol, tobacco and marijuana), as well as some genetic defects and autoimmune disorders.

A  poor diet, unhealthy weight, lack of exercise, high cholesterol, diabetes and heart disease can put you at risk of developing non-alcoholic fatty liver disease. 

Alcohol and the liver

With the exception of the brain, the liver is the most complex organ in the body. Few of its functions include:
  • filtering toxins from the blood
  • aiding digestion of food
  • regulating blood sugar and cholesterol levels
  • helping to fight against infection and disease
The liver is very resilient and is capable of regenerating itself. Each time your liver filters alcohol, some of the liver cells die. The liver can develop new cells, but prolonged alcohol misuse over many years can reduce your liver’s ability to regenerate, resulting in serious damage to the liver.

Effects of alcoholism and alcohol abuse

Alcoholism and alcohol abuse can affect all aspects of your life. Regular use of alcohol can cause serious health complications, affecting virtually every organ in your body, including your brain. Alcoholism and alcohol abuse can also have an impact on your family, friends and the people you work with.

Despite the potentially lethal damage that heavy drinking does to the body—including cancer, heart problems, and liver disease—the social consequences can be just as devastating.  Children are especially sensitive and can suffer long-lasting emotional trauma when a parent or caretaker is an alcoholic or heavy drinker.

Alcohol-related liver disease (ARLD)

ARLD refers to liver damage caused by alcohol abuse. It covers a range of conditions and associated symptoms.

ARLD does not usually cause any symptoms until the liver has been severely damaged. When this happens, symptoms can include:
  • feeling sick
  • weight loss
  • loss of appetite
  • yellowing of the eyes and skin (jaundice)
  • swelling in the ankles and tummy
  • confusion or drowsiness
  • vomiting blood or passing blood in your stools

Stages of alcohol-related liver disease

There are three main stages of ARLD, although there is often an overlap between each stage. These stages are explained below.

Alcoholic fatty liver disease

Drinking a large amount of alcohol, even for only a few days, can lead to a build-up of fats in the liver. This is called alcoholic fatty liver disease, and it's the first stage of ARLD. Fatty liver disease rarely causes any symptoms, but it is an important warning sign that you are drinking at a level harmful to your health.

Alcoholic hepatitis

Alcoholic hepatitis (not related to infectious hepatitis) is often the second, more serious stage of ARLD. It occurs when alcohol misuse over a longer period causes the tissues of the liver to become inflamed. Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time.

The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently.

Unfortunately, some people will only find out they have liver damage for the first time when their condition reaches this stage.

Cirrhosis

Cirrhosis is the final stage of alcohol-related liver disease, which occurs when the liver becomes significantly scarred. Cirrhosis is generally not reversible, but stopping drinking alcohol immediately can prevent further damage and significantly increase your life expectancy.

Complications

Death rates linked to ARLD have risen considerably over the last few decades and alcohol is now one of the most common causes of death in many parts of the world, along with smoking and high blood pressure. Life-threatening complications of ARLD can develop. These include internal (variceal) bleeding, a build-up of toxins in the brain (encephalopathy), fluid accumulation in the abdomen (ascites) with associated kidney failure and also liver cancer. So, OPT FOR AN ALCOHOL FREE LIFE.

Physical Fitness:

Exercising regularly and eating a healthy diet are the most effective ways to achieve and maintain a healthy weight, immune system and liver. In fact, there is evidence to suggest that exercise itself (with or without weight loss) can prevent and reverse fatty liver  disease. Brisk walking helped control some features of nonalcoholic fatty liver disease.

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