Surviving John

As with any illness, the key to treatment is early diagnosis. However, this is often difficult because the flu-like symptoms often go ignored or misdiagnosed. Consequently, the diseases can be in advanced stages before they are discovered. The most common conditions that cause last stage liver disease include chronic viral hepatitis B and C, alcohol related liver disease, autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis, steatohepatitis and drug induced liver damage. In this article, we’ll explain the symptoms of liver disease and how you can take better care of this vital organ.

Alcohol abuse is the most common cause of end stage liver disease because the disease is rooted in addiction. Unless the patient makes lifestyle changes and gives up drinking, little can be done to improve their health. A fatty liver and alcoholic hepatitis are two of the most common conditions found with an alcoholic liver. Patients with acute alcoholic hepatitis often deteriorate during the first few weeks in hospital, with a mortality rate of 20-50%. With alcoholic cirrhosis, patients who abstain have a five-year survival rate of 60-70%, which falls to 40% in those who continue to drink.

Hepatitis is another common cause of liver damage. Most patients infected with hepatitis B and some with hepatitis C recover completely with no further liver damage. However, some will develop chronic hepatitis leading to cirrhosis and the end stage of liver disease. This is more common with hepatitis C. A liver transplant under these circumstances is difficult to manage because the new liver almost always becomes infected with these viruses. Ongoing treatment is usually necessary to keep the new liver healthy. Most cancers of the liver develop in other parts of the body and spread to the liver. Occasionally, cancer develops first in the liver. This is called primary cancer or hepatoma. When a primary liver cancer is identified early, a liver transplant will be performed. Primary cancer of the liver has the lowest long-term survival at about 50%-60%. However, long- term survival is less common in this case than with transplants for other conditions.

Sometimes the only hope for survival when a patient reaches the end stage of liver disease is a liver transplant. This is a very complicated process with no guarantees. There are really three operations involved. The first is the removal of the liver from the donor, the second is the removal of the diseased liver from the patient, and the third is the operation to insert and connect the new liver. The new liver is attached to the various blood vessels and bile ducts. Long-term treatment against rejection is always necessary.

You need to know that last stage liver disease does not mean the end of your life. The right medication, lifestyle changes and the possibility of a transplant can allow patients to live for years. As we’ve seen with alcohol related liver disease, abstaining from the behavior that caused the cirrhosis of the liver made a big difference. Additionally, corticosteroids have been shown to reduce the inflammation that characterizes liver disease. Among people with biliary cirrhosis, this drug replaces lost biliary acids, and side effects are rare. Your best friend while dealing with this disease is your doctor. Discuss your treatment options with him and decide together what your best chances are.