BENGALURU: Liver is the largest metabolically active visceral organ in the body handling storage of glycogen, breaking down toxins and extraneous substances (drugs), hormone and clotting factor production, immunological barrier and conditioning and excretion of unwanted materials. All the food and substances ingested by mouth have to go through the liver and are modified/ metabolised in the liver. As it is in constant contact with items/antigens coming through the gut, it acts as an important modulator and activator of our immune system. This helps in developing a mature immune system and plays an important role in reducing allergies in childhood.
In addition, the liver has a large functional reserve and is able to function adequately even 70-80 per cent of it is removed. Because of the diverse functions and a large reserve, initial symptoms of an unhealthy liver are nonspecific and may not be easily apparent. On the other hand, advanced liver diseases are easy to identify with jaundice, ascites (water in the abdomen), swollen feet, blood in stools/vomiting and altered sensorium.
Some signs and symptoms that may point to an unhealthy liver:
Poor appetite: Not feeling hungry, unable to complete the meal and aversion to food
Fatigue/tiredness: Common but a very nonspecific symptom. Unexplained fatigue can be because of liver disease and has to be evaluated
Myalgia (Muscle pains), loss of muscle mass: Skeletal muscle acts as a liver sparer performing some of the functions of the liver. Liver damage also results in the breakdown of muscle mass and reprocessing into glucose.
Pruritis / Itching: Some kinds of liver disease present with itching for a long time before manifesting other signs of liver dysfunction.
Jaundice, fluid in abdomen (ascites), bleeding gums: Blood in stools/vomitus, and altered sensorium are seen in advanced liver disease. Jaundice can also occur as part of acute liver inflammation.
Identifying these signs early and getting help from gastroenterologist/hepatologist will help prevent irreversible liver damage.
The author is a gastroenterologist at SPARSH Super Speciality Hospital.