BENGALURU: There are more than 100 different liver diseases affecting both men and women of all ages. But some of them are very commonly seen amongst women and are widely undiagnosed. In recent years, India has witnessed a rise in liver disease amongst women owing to factors like increase in alcohol intake, underlying liver and autoimmune diseases — as well as specific medicine or drug-related issues. Some of the most commonly seen liver diseases are alcoholic liver disease, autoimmune hepatitis, viral hepatitis, non-alcoholic fatty liver disease (NAFLD), pregnancy-related liver disease, primary biliary cholangitis (PBC), benign liver tumors and cirrhosis.
The liver carries out more than 500 vital functions in our body which include production of bile, blood plasma, conversion of excess glucose, clearing the blood of drugs and other poisonous substances, regulating blood clotting and blood levels of amino acids, etc. Any anomalies or disturbances in the function can cause damage to the liver which can lead to liver damage or failure. Chronic fatigue, loss of appetite, weight loss, nausea, vomiting, jaundice, abdominal pain and swelling, itchy skin, dark urine colour, swelling in the ankles and legs and easy bruising are some of the symptoms indicating that you are more likely to have liver disease. Often liver disease during its initial stage shows no specific symptom however when the disease progresses and symptoms start showing.
Menopause and liver issues
Liver diseases are common in both men and women but certain liver diseases affect only women. Women when compared to men have less body water, stomach enzymes, much more likely to have toxicity from drugs. Lack of estrogen can have a negative effect on the liver. Thus, women after menopause are more likely to develop a fatty liver. Fatty liver in women can progress into cirrhosis more rapidly when compared to men. Women are also at the risk of gaining more weight after menopause because of hormonal changes. This can be life-threatening as fat can be accumulated in the liver cells which can lead to fibrosis, then cirrhosis and eventually cancer. According to research data by NCBI, women are 10 times more likely to have primary biliary cirrhosis (PBC) than men and four times as likely to have autoimmune hepatitis.
Certain liver diseases are commonly observed in women like pregnancy-related liver diseases such as ovarian hyperstimulation syndrome (OHSS), hyperemesis gravidarum (HG), Intrahepatic Cholestasis of Pregnancy (ICP), acute fatty liver of pregnancy (AFLP), HELLP syndrome. This may be attributed to the biological reasons.
Alcohol-related liver disease on the rise
Drugs and alcohol affect the liver earlier and more rapidly than men, and at a lower dose. Alcoholic hepatitis, an inflammation of the liver caused by drinking alcohol can develop in the course of weeks and months while some alcohol-related liver diseases like cirrhosis take years to develop. During the pandemic, there has been a sharp increase in the frequency of binge drinking episodes amongst women.
(The writer is consultant - hepatologist and liver transplant physician, Aster CMI Hospital)
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