Diseases of the liver and gallbladder

The liver is the central metabolic organ of the human body.
Therefore, liver diseases often have far-reaching consequences, as limitations of liver function can affect the whole body. "Cardinal symptom" of liver disease is jaundice ( jaundice ), so the yellowing of the skin. This arises because the liver can no longer sufficiently convert and reduce the accumulating dye bilirubin and this deposits, for example, in the skin.
The following is a clear explanation of the major diseases of the liver and gallbladder.

Classification of diseases of the liver and gallbladder

You find the diseases of the liver and gallbladder divided into:

  1. Inflammation of the liver
  2. Structural diseases of the liver
  3. Diseases of the gallbladder
  4. Other diseases of the liver and gallbladder

Inflammation of the liver

Hepatitis C

The liver inflammations are divided into hepatitis A - E.
Hepatitis C is triggered by a specific virus, the hepatitis C virus (HCV). The virus is mainly transmitted by the blood, most often by drug addicts who reuse or divide needles. Sexual transmission of the virus plays a subordinate role. Acute hepatitis C remains asymptomatic in 75% of patients. However, the problem with hepatitis C is that in about 80% of cases, the acute infection leads to chronic hepatitis, which in turn can lead to cirrhosis and liver cancer. The course of a hepatitis C infection can be fatal. By moderene aggressive drugs, the virus can be combated and a cure is possible.

Hepatitis B

In turn, hepatitis B is triggered by the hepatitis B virus (HBV). It is the most common form of hepatitis. The hepatitis B virus is present in various body fluids of those affected and sexual transmission plays a much more important role than in hepatitis C. Also the transfer of mother to child during childbirth or during breastfeeding is possible and is the most common source of infection in developing countries. Compared to hepatitis C, hepatitis B is usually not chronic, and only 10% of those infected develop chronic hepatitis. Another major difference is that there is a vaccine against hepatitis B, which is given in Germany in early childhood as part of the "6-fold vaccine" and protects against infection.

Hepatitis A / D / E

Rarer and prognostically better liver inflammations are hepatitis A, D and E.
Hepatitis A is a typical motion sickness and is transmitted in holiday countries with low standards of hygiene, eg contaminated water. Typical symptoms include fever, diarrhea and vomiting.
Hepatitis D is caused by the hepatitis D virus. However, infection with this virus is only possible if the person already has hepatitis B! Therefore, overall, hepatitis D is very rare because most of the population can not develop the disease.
Hepatitis E is mainly transmitted in Germany via raw (wild) pork (eg Mett). It is important that the risk of infection increases significantly during pregnancy and the course of the disease in pregnant women is also less favorable! Therefore pregnant women should absolutely avoid meat.

Structural diseases of the liver

fatty liver

If excessive fat deposition occurs in the liver tissue, it is colloquially referred to as a fatty liver. As part of this restructuring of the liver, it can also cause inflammation, which are then referred to as steatohepatitis . The most common cause of obesity in the liver is excessive alcohol consumption, which is why one general alcoholic fatty liver ( alcoholic steatohepatitis, ASH ) differs from a non-alcoholic fatty liver ( non-alcoholic steatohepatitis, NASH ). Patients usually do not notice the disease until inflammation of the liver develops. The presence of fatty liver also greatly increases the risk of developing liver cirrhosis or liver cancer.

cirrhosis

Cirrhosis of the liver is a nodular remodeling of liver tissue that severely restricts liver function. The most common cause of liver cirrhosis is alcohol abuse (50%), followed by hepatitis C and B liver infections (25%). The disease has far-reaching consequences for the whole body, for example, varicose veins on the abdominal wall and in the esophagus, because the blood flow through the liver is limited. Liver cirrhosis develops liver cancer comparatively frequently over the years. There is no cure for tissue damage to the liver, patients can only be rescued with a liver transplant.

  • cirrhosis
  • Stages of cirrhosis

Liver cancer / HCC

Liver cancer is also known as hepatocellular carcinoma (HCC). Liver cancer often develops over the years from liver cirrhosis, or from a fatty liver. Chronic alcohol abuse and infections with hepatitis B or C are therefore the most important risk factors for the development of the tumor. If the tumor has not yet spread to other parts of the body, patients can be cured by partial liver removal or liver transplantation.
Furthermore, the liver is the place where metastases of other tumor diseases (eg lung / breast cancer) occur most frequently.

Wilson's disease

Wilson's disease is a congenital genetic metabolic disorder. The patients have a disturbance in the copper metabolism, which is why it comes to the deposition of copper, especially in the liver tissue and brain. The copper deposit causes tissue damage to the liver and patients often develop liver cirrhosis. The deposits in the brain can cause symptoms such as dementia and muscle twitching (tremor). By having a lifelong, low-copper diet and taking copper-binding medications, the disease is relatively well controlled, but in some cases, liver transplantation is needed.

liver fibrosis

Hepatic fibrosis is the displacement of healthy liver cells by connective tissue. The liver thus loses function. Overall, one can understand a liver fibrosis as a precursor to cirrhosis of the liver, because the nodular remodeling of the liver takes over. One speaks of liver cirrhosis. To determine the progression of connective tissue alteration, ultrasound examination or tissue sampling ( biopsy ) may help.

Diseases of the gallbladder

gallstones

Gallstones are deposits of certain components of bile in the gallbladder or bile ducts. Most of the cases (about 90%) are cholesterol stones. Cholesterol is excreted in the bile, but when blood cholesterol is too high, bile acid can no longer completely bind it and cholesterol stones fall out. The risk factors for gallstones include female gender, overweight and over 40 years of age. In patients with gallstones, one can first try not to dissolve the stones surgically, for example with shock wave therapy or certain medications. If this does not work, the gallbladder can be surgically removed.

cholecystitis

Gallstones block the bile ducts, usually resulting in gallbladder inflammation. It is usually the first symptom of gallstones that remain asymptomatic before. In 95% of cases, gallstones are the cause of gallbladder inflammation, but there are also "stone-less" inflammations. Symptoms of gallbladder inflammation are usually severe pain in the right upper abdomen, which can radiate to the shoulder, as well as nausea and vomiting. Jaundice can also develop. The treatment of gallbladder inflammation usually consists in the surgical removal of the gallbladder.

Diseases of the Gallbladder (December 2019).


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