Chronic Liver Disease
Chronic liver disease -also known as CLD- is a deterioration of the liver and its functions.
Usually, it deteriorates for a period of over six months.
As a progressive and continuous process of inflammation and disruption, CLD is a common condition that often results in:
- Regeneration of liver parenchyma
- Disruption of functioning
- Nodule formation
- Vascular reorganisation
There are numerous causes for CLD, such as:
- Alcohol abuse (prolonged)
- Continuous infection
- Autoimmune disease
- Genetic and metabolic issues
The Numerous Causes:
Alcoholic Liver Disease, also known as ALD, is one of the most common forms of chronic liver disease and is perhaps the most widely known.
Alcoholic liver disease incorporates an array of separate diseases, including:
- Fatty liver (with or without hepatitis)
- Alcohol hepatitis
This is the most common cause of CLD.
Alcoholic liver disease is directly linked to alcohol abuse, where alcohol abuse stops the function of the liver.
Heavy and abusive drinking causes scarring and cirrhosis, the final and irreversible stage of liver disease from alcohol abuse.
Your chances of alcoholic liver disease increase the longer you have been drinking and the more you drink.
You do not have to get constantly drunk to suffer from this disease, just drinking for a prolonged period of time is enough to cause it.
The group most at risk is the ages of between 40 to 50, where mostly men are at risk.
The symptoms can range from a loss of energy and appetite to stomach pain and sickness.
Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-alcoholic fatty liver disease is associated with obesity, diabetes and a plethora of other conditions such as Mellitus.
This condition leads to fibrosis of the liver.
Non-alcoholic fatty liver disease is a build-up of fat in the liver, commonly seen in people who are overweight.
This can lead to diabetes and high blood pressure, but if you already suffer from diabetes, NAFLD can rapidly increase your risk of developing cardiac conditions.
However, unlike alcoholic liver disease, NAFLD is reversible as you can prevent it from worsening and reduce the amount of fat in your liver.
A lack of treatment over several years can result in non-alcoholic steatohepatitis, which can lead to liver failure or liver cancer.
You are at risk from NAFLD if you:
- Are overweight or classed as obese
- Have type 2 diabetes or a condition that affects your body’s insulin
- Suffer from an overactive thyroid
- Have high blood pressure or high cholesterol
- Are over the age of 40/50 and smoke
Chronic Viral Hepatitis
Hepatitis B, C and D viruses can cause life-long and chronic infections.
Viral hepatitis causes liver inflammation, a swelling of the liver that will damage this vital organ.
These types of hepatitis can spread through contact with another person’s infected blood, and occasionally through bodily fluids.
This is commonly spread through the sharing of needles or sex that is unprotected.
This can lead to cirrhosis and liver cancer.
Liver disease can be genetic, inherited from other members of your family.
Genetic liver diseases include Wilson’s disease, hemochromatosis and alpha-1 antitrypsin deficiency.
Wilson’s disease is a rare inherited disease, commonly diagnosed between the ages of 5 to 35.
This causes copper to develop in your vital organs such as your brain and liver.
This disease is progressive and can cause liver disease, which can be fatal to individuals if left untreated.
There are not always noticeable or negative symptoms of liver disease, but if you do get signs, they will look like this:
- Jaundice (yellowing of the skin and eyes)
- Swelling and pain in your abdomen
- Swollen legs
- Swollen ankles and feet
- Itchy skin
- Dark urine and pale stool
- Chronic fatigue
- Sickness and vomiting
- Loss of appetite
- Tendency to bruise quite easily
What’s the Difference Between Cirrhosis and Fibrosis?
Fibrosis is the growth of scar tissue, and this is usually associated with inflammation and infection.
Cirrhosis of the liver leads to the coughing up of blood, hair loss and jaundice.
The most common cause of cirrhosis is alcohol abuse and hepatitis.
The scar tissue replaces the normal liver tissue, progressively stopping the flow of blood through the liver.
This vital organ can then no longer process nutrients effectively, and therefore not produce what it is meant to such as proteins.
Fibrosis can be reversed (to a certain extent) if it is identified early enough.
Cirrhosis is severe and serious scarring of the liver, also known as stage 4 and the final stage of fibrosis.
If you are suffering from cirrhosis, you will lose weight and muscle mass, becoming both tired and weak.
You may notice red patches on your palms and evident blood vessels on your skin above waist level.
This can be diagnosed through blood tests, liver biopsy, and scans such as CTs, MRIs and ultrasounds.
The Beijing Classification
The Beijing Classification (BC) was designed for systematic and reproducible documentation of fibrosis, specifically regression versus progression.
Cirrhosis is considered to be the end stage of liver disease, for over the past 200 years.
The BC was designed to assess biopsy specimens from patients with chronic viral hepatitis, including fibrosis.
The BC is used to sub-classify the varying degrees of cirrhosis:
- Predominantly Progressive: ‘Progressive’ is defined as more than 50% fibroseptal stoma in the LBx. This shows loosely aggregated collagen fibres, including both light and dark staining fibres. These are markedly inflammatory cells.
- Indeterminate: This is defined as an uncertainty between progressive and regressive scarring.
- Predominately Regressive: This is defined as less than 50%, or the majority of fibroseptal stoma in the LBx, showing thin and dense stroma. There is dark straining on the trichrome.
Is Liver Disease a Large Issue?
The data profile of liver disease compared with age shows that:
- Liver disease is mostly found in individuals from the ages of 25 to 59.
- The younger population seem more at risk that the older cohorts.
From 2017 – 2019:
- 17,161 men under the age of 75 died from liver disease
- 10,132 women under the age of 75 died from liver disease
As of 2020, there were around 27,900 men and 28,500 women in England with liver disease.
In 2020-2021, the hospital admission rate due to liver disease for males was 156.4 per 100,00.
This was around 41,091 accounts of hospitalisation.
The hospital admission rate due to liver disease for females was 94.4 per 100,000 people, representing almost 26,347 accounts.
In 2020, the number of people under 75 that died from liver disease was:
- 3,785 women
- 6,342 men
It has been noted that the admission rates for alcoholic liver disease are getting worse.
- 16,280 men were hospitalised with alcoholic liver disease
- 8,260 women were hospitalised with alcoholic liver disease
For NAFLD, across a 3-year period from 2017 to 2020, there were over 7,738 people hospitalised.
For persons under the age of 75, over 717 people died from NAFLD across this 3-year period, which is also said to be increasing.
Further statistics indicate that:
- A significant portion of those with liver disease live in the most deprived areas in England.
- 8% of adults with liver disease are classified as overweight or obese.
- The amount of liver disease accounts has increased from 32,799 in 2010 to 41,091 in 2020.
Getting Help Today
Chronic liver disease can have a devastating impact on quality of life, whether it is caused by excessive alcohol consumption or otherwise.
If you suspect you may be suffering from chronic liver disease, the best thing to do is to reach out for help.
Our support line in ready to provide advice 24 hours a day, 7 days a week.
For advice on how to cut down your alcohol intake before it does permanent damage to your liver, we’re here for you.