Protecting the Liver,
the Silent Organ that Keeps the Body Going
Dr. Do Young-seok, Professor of Gastroenterology at Daejeon Eulji Medical Center

The liver is called a 'silent organ' because there are no symptoms until it is 70~80% destroyed. Also, even when there is a problem with the liver, it does not significantly disrupt its functions. So when the patient finally visits a doctor after experiencing certain health issues, it will be too late.
In time for the Liver Day (October 20), we sat down with Dr. Do Young-seok, Professor of Gastroenterology at Daejeon Eulji Medical Center, for information on liver disease.

Q1. What kind of role does the liver play in the body?

The liver is the largest organ in the body, weighing around 1,200 to 1,500g. You could say it is the ‘chemical factory’ of the body because it processes various substances introduced into the body or produced by the body, such as hormones, and synthesizes and supplies important materials. Not only that, but it is also involved in △ the immune system, △ detoxification of drugs, alcohol, and other toxic substances, and △ bile production.

Q2. How do the symptoms of liver disease manifest?

There are various symptoms such as fatigue, general prostration, reduced appetite, nausea, vomiting, indigestion, abdominal discomfort, abdominal pain, and so on, but there are no liver-specific symptoms. That is, the symptoms that manifest when you experience indigestion from eating too fast are similar to the symptoms of reduced liver function, making it difficult to suspect liver disease right away. But if you frequently experience symptoms of indigestion, even without eating too much or too quickly, then there is a chance that your liver isn’t functioning properly. Sometimes, it may be accompanied by eye fatigue, poor vision, and numb limbs. In most cases, however, it is asymptomatic, so if you drink heavily or have a severe case of abdominal obesity, I advise that you undergo a blood test and abdominal ultrasound to check for liver disease.

Q3. What is the relationship between the liver and fatigue?

Fatigue is one of the most common symptoms of liver disease. Especially in the case of acute hepatitis, severe fatigue is experienced relatively quickly. However, fatigue has diverse causes, so when you feel unusually tired, you should think about what the cause might be. If it has been caused by a change in your day-to-day life or overwork, then you should get plenty of rest. If fatigue persists or worsens, despite making various efforts to ease it, then it is best to consult a doctor.

Q4. What is the main cause of chronic liver disease?

They are hepatitis and alcohol. What you must be particularly wary of are hepatitis B and C, which are associated with more than 60% of liver cancer cases. Liver cirrhosis and liver cancer caused by viral infections occur mostly in people in their 60s and 70s. To keep your liver healthy, it is best to refrain from drinking. Liver damage caused by excessive alcohol intake initially leads to fatty liver disease, and it can eventually progress into alcoholic hepatitis and cirrhosis. If prolonged, the liver will not recover to its normal state, even if the person stops drinking.
Some people with chronic hepatitis B patients do not see the doctor regularly. In many cases, by the time you realize your body is not normal, it will have progressed into liver cirrhosis or liver cancer. So it is safest to see the doctor regularly even if you aren’t experiencing any symptoms.

Q5. We often hear the ‘liver indicators are high/low.’ What is meant by that?

That is referring to the indicators of the liver conditions, which can be assessed based on a blood test. Indicators include AST(GOT), ALT(GPT), γ-GT, ALP, bilirubin, albumin, and proteins. Usually when a doctor says the ‘liver indicators are high,’ it means that the AST and ALT enzyme levels are higher than normal, which necessitates an analysis of the cause. Having said that, just because the liver indicators are within the normal range, it does not mean that your liver is completely healthy because there are cases where the levels are normal even though the liver is in a bad shape.

Q6. What do the letters following the word, hepatitis, mean?

First of all, hepatitis refers to an inflammation of the liver tissue. It can lead to symptoms such as severe fatigue, reduced appetite, discomfort in the upper abdomen, nausea and so on, but there are also patients who do not experience any particular symptoms and patients who experience jaundice or ascites. When recovery is not made within 3 to 4 months and the condition persists for 6 months or longer, it is called chronic hepatitis.
The alphabetic letters next to the word, hepatitis, indicate different types of the virus. There are five known hepatitis viruses, which are types A, B, C, D, and E. In the past, the most prevalent type was hepatitis B, followed by hepatitis C and hepatitis A, but there has been a marked decrease in hepatitis B patients, whereas hepatitis A has been on the rise. Hepatitis caused by hepatitis D or E, on the other hand, is very rare.

Q7. Aren’t there liver diseases that are not caused by alcohol?

It is absolutely normal to have some fat in the liver. However, if fat accounts for 5 to 10% of the weight of the liver, it is diagnosed as fatty liver disease (FLD). FLD is divided into alcoholic and non-alcoholic, and the latter is caused by excess nutrient intake. Consuming excess calories leads to fat buildup in the liver, which occurs because the liver is unable to process and break down fat properly. FLD often accompanies obesity, diabetes, or hyperlipidemia, and most FLD patients develop the disease due to abdominal obesity and are overweight in their middle years of life. There has been a surge in FLD patients, evidencing that there is a serious problem with liver health.

Q8. Is it impossible to fully recover from cirrhosis?

Once cirrhosis begins, it is difficult to restore the liver tissue back to normal. However, when appropriate treatment is provided early on according to the cause of the problem, fibrosis can be mitigated and recovery can be made in some cases. What is most important above anything else is to begin appropriate treatment as soon as possible to prevent further liver damage as much as possible and not let it progress into a serious condition. This is because a severe case of cirrhosis may eventually lead to a need for liver transplantation.

Q9. Any tips on how to keep the liver healthy?

The best thing you can do to protect your liver is to quit drinking or reduce your alcohol intake and maintain a good nutritional status. When a person with a liver disease abstains from drinking, the chances of complications and liver cancer can be lowered.
Also, do not take medications carelessly. Even painkillers can cause toxic hepatitis if they are taken over a long period of time or in doses above what is recommended. Other than that, fatty foods and overeating can lead to fatty liver disease (FLD), so it is advised that you eat vegetables and other foods that are rich in vitamins and proteins. If you work too much, it can also cause a burden on the liver, so I recommend that you get sufficient rest and exercise.
Hepatitis B and C, which are viral diseases, can be contracted easily in day-to-day life. In the case of adults, they are mainly transmitted by direct blood contact, so you must be careful when it comes to getting a tattoo or piercing. Hepatitis A, which is primarily transmitted by the fecal-oral route, is becoming increasingly prevalent, and the best way to avoid it is vaccination. Those with underlying liver diseases are at a greater risk of hepatic failure, so I advise those with a liver disease to get vaccinated.

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