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The liver is one of the most important organ in the human body. The dysfunction or failure of liver functioning can result in a multitude of symptoms and signs , some of which are very easily identifiable. Viral hepatitis as a major cause of liver inflammation and dysfunction. Let us learn more about these topics in this article.
Functions of the liver
Think of the liver as a factory that is functioning 24/7. It’s a factory that has a production line, waste disposal system and a very well run storage system.
The manufacturing component of the liver produces :
- Bile juice : which is critical in the digestion and absorption of fat in the small intestines. Bile also helps in the disposal of waste via our stool
- Albumin and blood plasma proteins : which are essential in preventing leakage of fluid out of our blood vessels and in ensuring that our blood can clot to prevent excessive bleeding.
- Immune components and cells : such as complement components and acute phase proteins which helps us get rid of external invading agents.
The liver also has excellent storage capabilities. It stores the excess glucose floating in our blood stream and pack them into glycogen within the liver, allowing our human body to utilise this energy when we need it.
It stores essential minerals and vitamins like vitamins A,D,E,K and B12 as well as iron and copper. All of these minerals and vitamins are vital to our bodily functions, including the formation of blood hemoglobin.
Perhaps the most important function of the liver is in its filtration and waste disposal capability. All the blood leaving the stomach and intestines passes through the liver, which removes toxins, byproducts, bacteria and other harmful substances, which include drugs that we consume.
Ammonia, which is produced from all organs in our body, is removed almost entirely by the liver. If allowed to accumulate, high levels of ammonia can be toxic to our brain, causing confusion, hallucinations and even coma.
Our red blood cells renews themselves every 3 months. Old and dying red blood cells are broken down and the yellowish bilirubin is removed via our liver as well.
When the liver fails, we will no longer be able to remove wastes and toxins. When these waste builds up, it poisons our organs from within and our body will shut down and stop functioning.
Our blood vessels becomes leaky with fluid accumulating in our skin and subcutaneous tissues, resulting in swollen face, swollen abdomen and swollen legs.
In severe cases, water accumulates in our lungs, causing the sensation of drowning. Our immune system will become severely weakened and we will be prone to all sorts of infection and we may start to bleed easily as our clotting function becomes impaired.
We will also start turning yellow because of the accumulation of bilirubin in our system. This is known as jaundice
What is Jaundice?
Jaundice occurs when high levels of yellowish bilirubin accumulate in our blood stream, turning the white of our eyes and our skin yellow. There are many causes of jaundice, which is a lecture by itself.
Jaundice can occur due to overproduction of bilirubin in our blood stream - such as when there is an overwhelming destruction of our red blood cells. Or it can occur due to the blockage of the bile duct by stones or cancers , resulting in bilirubin failing to be discharged in our stool. The bilirubin will then overflow back into our blood stream.
Viral Hepatitis and Jaundice
In the majority of cases, it is often due to the inflammation and infection of the liver, of which viral hepatitis is the top culprit. Hepatitis A,B,C and E are endemic in Singapore. Meaning they are around us all year round.
Inflammation of the liver by viral hepatitis can severely impair the liver’s ability to remove bilirubin. And therefore jaundice is one of the prominent signs of advanced viral hepatitis.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)