WHAT IS LIVER AS AN ORGAN IN OUR BODY ? HOW DOES IT HELP US ? WHAT WE SHOULD DO TO PROTECT IT !

1. P. K. MITRAP. K. MITRA
EURODRUG LABORATORIESEURODRUG LABORATORIES
KNOW THYKNOW THY
LIVERLIVER
LOVE & CARELOVE & CARE

2. Do you really love your liver ?Do you really love your liver ?
How can you love your liverHow can you love your liver
without knowing it ?without knowing it ?
After knowing it how can you doAfter knowing it how can you do
injustice to it ?injustice to it ?

3. Hi... I'm Your Liver !Hi... I'm Your Liver !
Let me tell you what I do forLet me tell you what I do for
you…inyou…in 99 waysways

4. II store the ironstore the iron reserves youreserves you
need, as well as a lot ofneed, as well as a lot of
vitamins and other minerals.vitamins and other minerals.
Without me, you wouldn'tWithout me, you wouldn't
have the strength to carryhave the strength to carry
on!on!
1.
I am responsible for up to 500
separate functions, usually in
combination with other systems
and organs.

5. I makeI make bilebile to help digestto help digest
your food,your food, without me,without me,
you'd wasteyou'd waste away to nothingaway to nothing
& dump me& dump me with poisonswith poisons..
2.
The bile produced by me is collected
in bile canalliculi, which merge to
form bile ducts.

6. II detoxify poisonousdetoxify poisonous
chemicalschemicals you give me, andyou give me, and
that includes alcohol, beer,that includes alcohol, beer,
wine and drugswine and drugs (prescribed(prescribed
and OTC)and OTC) as well as illegalas well as illegal
substances.substances.
3
Without me, your "bad“
habits would kill you.

7. I storeI store energyenergy,,
Like a battery, byLike a battery, by
Stockpiling sugarStockpiling sugar
(carbohydrates,(carbohydrates,
glucose and fat)glucose and fat)
Until you need it.Until you need it.
44
Without me, the sugar level in your
blood could fall dramatically and you'd
go into a coma.go into a coma.

8. You cann’t start your day in theYou cann’t start your day in the
morning, if I am not on the job !morning, if I am not on the job !

9. II make the bloodmake the blood that gotthat got
your system going evenyour system going even
before you were born,before you were born,
without me, you wouldn'twithout me, you wouldn't
be here !be here !
55

10. II manufacture new proteinsmanufacture new proteins that yourthat your
body needs to stay healthy and grow.body needs to stay healthy and grow.
Without me, you wouldn't grow properly!Without me, you wouldn't grow properly!
6

11. II remove poisonsremove poisons from thefrom the
air, exhaust smoke andair, exhaust smoke and
chemicals you breathe.chemicals you breathe.
7
Without me, you'd be
poisoned by
pollutants!

12. II make clotting factorsmake clotting factors thatthat
stop the bleeding when youstop the bleeding when you
accidentally prick yourself.accidentally prick yourself.
8
Without me, you'd
bleed To death !

13. I helpI help defend youdefend you against the germs goingagainst the germs going
into your body all the time. I take thoseinto your body all the time. I take those
cold germs, flu bugs and other germs youcold germs, flu bugs and other germs you
encounter, and knock them dead - or atencounter, and knock them dead - or at
least weaken them.least weaken them.
9
Without me,Without me,
you'd be ayou'd be a
sitting ducksitting duck
for everyfor every
infectioninfection

14. I hope now you understandI hope now you understand
how much I love you……..how much I love you……..

15. Let us understand the most commonLet us understand the most common
diseases that affect me……diseases that affect me……

16. FATTY LIVER DISEASEFATTY LIVER DISEASE
What is it?What is it?
• Fatty liverFatty liver is the collection ofis the collection of excessiveexcessive
amounts of fat inside liver cellsamounts of fat inside liver cells, also called, also called
steatosis.steatosis.
• Mostly triglycerides & CholesterolsMostly triglycerides & Cholesterols
• Reversible condition.Reversible condition.

17. FATTY LIVER - CAUSESFATTY LIVER - CAUSES
Fatty liver is commonly caused by AlcoholAlcohol oror
MetabolicMetabolic
Syndrome (Diabetes, Hypertension, Obesity and Dysli
demia), but can also be due to any one of many
causes.
1.1. NUTRITIONAL (MALNUTRITION/WEIGHT LOSS)NUTRITIONAL (MALNUTRITION/WEIGHT LOSS)
2.2. DRUGS & TOXINSDRUGS & TOXINS
3.3. VIRAL HEPATITISVIRAL HEPATITIS
4.4. AUTOIMMUNE LIVER DISEASEAUTOIMMUNE LIVER DISEASE

18. FATTY LIVER - CAUSESFATTY LIVER - CAUSES
• MetabolicMetabolic
AbetalipoproteinemiaAbetalipoproteinemia, G, Glycogen storage diseaseslycogen storage diseases, , Weber-Christian diseaseWeber-Christian disease, A, A
cute fatty liver of pregnancycute fatty liver of pregnancy, L, Lipodystrophyipodystrophy
• NutritionalNutritional
MalnutritionMalnutrition, T, Total parenteral nutritionotal parenteral nutrition, Severe , Severe weight lossweight loss, R, Refeedingefeeding
syndromesyndrome, J, Jejunoileal bypassejunoileal bypass, G, Gastric bypassastric bypass, Jejunal, Jejunal diverticulosisdiverticulosis
with with bacterial overgrowthbacterial overgrowth..
• Drugs and toxinsDrugs and toxins
AmiodaroneAmiodarone, M, Methotrexateethotrexate, D, Diltiazemiltiazem, Expired , Expired tetracyclinetetracycline, H, Highly activeighly active
antiretroviral therapyantiretroviral therapy, G, Glucocorticoidslucocorticoids, T, Tamoxifenamoxifen, Environmental , Environmental hepatotoxinshepatotoxins
Inflammtory bowel disease, HIV, hepatitis C and alpha 1-antitrypsin deficiencyInflammtory bowel disease, HIV, hepatitis C and alpha 1-antitrypsin deficiency

19. Alcoholic FattyAlcoholic Fatty
Liver orLiver or
AlcoholicAlcoholic
SteatosisSteatosis
causedcaused
By alcoholBy alcohol
abuseabuse
All body organs areAll body organs are
affected,affected,
with the liver and brainwith the liver and brain
suffering most seriously.suffering most seriously.
Alcoholic liver disease does not usually
cause any symptoms until the liver has
been extensively damaged. When this
happens, symptoms can include:
• NauseaNausea
• Weight lossWeight loss
• AnnorexiaAnnorexia
• Yellowing of the eyes and skin (Yellowing of the eyes and skin (jaundicejaundice))
• Swelling in the ankles and abdomenSwelling in the ankles and abdomen
• Confusion or drowsinessConfusion or drowsiness

20. Non-Alcoholic Fatty Liver DiseaseNon-Alcoholic Fatty Liver Disease
Affect people whoAffect people who
drink little or nodrink little or no
alcohol.alcohol.
Simple fatty liver (steatosis),Simple fatty liver (steatosis),
usually causes no liverusually causes no liver
damage but may lead to NASHdamage but may lead to NASH
Exact casue not knownExact casue not known
but Obesity & Insulinbut Obesity & Insulin
resistance lead toresistance lead to
progress of NAFLDprogress of NAFLD
Most patients have few or no symptoms,Most patients have few or no symptoms,
may complain of fatigue, malaise, andmay complain of fatigue, malaise, and
dull right-upper-quadrant abdominaldull right-upper-quadrant abdominal
discomfort.discomfort.

21. NonalcoholicNonalcoholic
steatohepatitis (NASH),steatohepatitis (NASH),
aa
more serious type.more serious type.
Caused by hepatitisCaused by hepatitis
infection, malnutrition,infection, malnutrition,
obesity, diabetesobesity, diabetes
mellitus,mellitus,
andand Reye's syndromeReye's syndrome ..
In some cases, this canIn some cases, this can
progress either toprogress either to
cirrhosis, which cancirrhosis, which can
produce progressive,produce progressive,
irreversible liver scarring,irreversible liver scarring,
or to liver cancer.or to liver cancer.
Fat in the liver, with inflammation
and damage, can occur in
children. Weight loss & weakness
may begin once the disease is
advanced or cirrhosis is present.
Reduce body weight, eat a
balanced diet, engage in physical
activity, and avoid alcohol and
unnecessary medications may
help in treatment as no specific
treatment available till date.

22. Reye's Syndrome:Reye's Syndrome:
A deadly disease, attack any child or adult without warning. A deadly disease, attack any child or adult without warning.
All body organs are affected, with theAll body organs are affected, with the
liver and brain suffering most seriously. liver and brain suffering most seriously.
Cause & cure remain unknown, research hasCause & cure remain unknown, research has
established a link between Reye's Syndromeestablished a link between Reye's Syndrome
And the use of aspirin and other salicylateAnd the use of aspirin and other salicylate
containing medications. containing medications.

23. Causes of NAFLD/NASH:Causes of NAFLD/NASH:
Unclear but researchers believe the contributing factors are:Unclear but researchers believe the contributing factors are:
• Obesity / Hypertension / Abnormal cholesterol levelsObesity / Hypertension / Abnormal cholesterol levels
• Insulin Resistance / DiabetesInsulin Resistance / Diabetes
• The fat may come from other parts of the body, or the liver mayThe fat may come from other parts of the body, or the liver may
absorbabsorb anan increasedincreased amount of fat from the intestine.amount of fat from the intestine.
• Another possible explanation is that the liver loses its ability toAnother possible explanation is that the liver loses its ability to
change fat into a form that can be eliminated.change fat into a form that can be eliminated.

24. What are the symptoms ?What are the symptoms ?
Fatty liver usually produces no symptoms butFatty liver usually produces no symptoms but
few patients may show the following symptoms:few patients may show the following symptoms:
• JaundiceJaundice
• Right-side abdominal painRight-side abdominal pain
• Abdominal swellingAbdominal swelling
• Fever.Fever.
• AnnorexiaAnnorexia
• FatigueFatigue
• Swollen LegsSwollen Legs

25. At more advanced stage, liverAt more advanced stage, liver
becomesbecomes cirrhotic:cirrhotic:
• Cirrhosis refers to scarring ofCirrhosis refers to scarring of
the liver. It replaces healthythe liver. It replaces healthy
tissue, cannot do what healthytissue, cannot do what healthy
liver tissue does.liver tissue does.
• Scar tissue also blocks theScar tissue also blocks the
normal flow of blood throughnormal flow of blood through
the liver, can be life-the liver, can be life-
threatening.threatening.

26. A fatty liver is enlarged and has a greasy, pale yellow look.A fatty liver is enlarged and has a greasy, pale yellow look.

27. NAFLD / NASH: Diagnosis ?NAFLD / NASH: Diagnosis ?
• The liver may be tender when the abdomen isThe liver may be tender when the abdomen is
pressed.pressed.
• Blood tests - for liver function (Enzymes)Blood tests - for liver function (Enzymes)
• Ultrasound or abdominal CT scan.Ultrasound or abdominal CT scan.
• Liver Biopsy (Grading of Steatosis)Liver Biopsy (Grading of Steatosis)
• Fibro-ScanFibro-Scan
• TSH Estimation (NASH-Marker)TSH Estimation (NASH-Marker)

28. NAFLD/NASH – Treatment ?NAFLD/NASH – Treatment ?
• Treatment for fatty liver is aimed at eliminating or treatingTreatment for fatty liver is aimed at eliminating or treating
the cause of the condition.the cause of the condition.
• In some cases, fatty liver is reversible if caught early in itsIn some cases, fatty liver is reversible if caught early in its
development.development.
• Pregnancy-related fatty liver is treated by delivering thePregnancy-related fatty liver is treated by delivering the
baby, if viable.baby, if viable.
• In severe cases, the patient may eventually require a liverIn severe cases, the patient may eventually require a liver
transplant.transplant.
• Drugs like: UDCA, Pentoxifylline, Vitamin-E, Statins,Drugs like: UDCA, Pentoxifylline, Vitamin-E, Statins,
Metformin, Pioglitazone, Metadoxine may help immensely.Metformin, Pioglitazone, Metadoxine may help immensely.
• Nutritional counselling, Weight reduction also helpNutritional counselling, Weight reduction also help

29. AbnormalityAbnormality 2005 %2005 % 2006 %2006 %
Fatty liver 17.52 24.12
Liver cyst 9.99 11.66
Renal cyst 7.04 7.77
Renal calculi 10.90 11.48
GB calculi 9.63 9.54
Prostatomegaly 4.39 6.18
ovarian cyst 4.58 4.77
uterine myoma 1.87 3.45
Total scan done 1661 1132
CholescintigraphyCholescintigraphy Statistics PGH – CT ScanStatistics PGH – CT Scan

30. Abnormality 2005 % 2006 %
Fatty liver 9.82 18.82
Liver cyst 1.33 2.52
Renal cyst 1.60 3.45
Renal calculi 2.21 3.39
GB calculi 3.54 5.52
Prostatomegaly 1.48 2.83
ovarian cyst 5.10 8.58
uterine myoma 2.25 3.79
Total scan done 2627 3566
CholescintigraphyCholescintigraphy Statistics PGH – USGStatistics PGH – USG

31. Fatty liver % detection vs no of check-up 2006Fatty liver % detection vs no of check-up 2006
Modality
2005
total check-up
2005
%
2006- total
check-up
2006
%
Ct Scan 1661 17.52 1132 24.12
Ultrasound 2627 9.82 3566 18.82

32. I KNOW STILL SOME PEOPLEI KNOW STILL SOME PEOPLE
DON’T LOVE ME ……DON’T LOVE ME ……

33. Let me tell you some easy waysLet me tell you some easy ways
to love me, ….. your liverto love me, ….. your liver

34. • Don't drown me in beer, alcohol orDon't drown me in beer, alcohol or
wine !wine !
• Even one drink is too much for someEven one drink is too much for some
people and could scar me for life.people and could scar me for life.
• Watch those drugs!Watch those drugs!
All drugs are chemicals, and when youAll drugs are chemicals, and when you
mix them up without a doctor's advicemix them up without a doctor's advice
you could create something poisonousyou could create something poisonous

35. • I scar easily due to repeatedI scar easily due to repeated
alcohol / drug abuse.. and thosealcohol / drug abuse.. and those
scars, called "cirrhosis" arescars, called "cirrhosis" are
permanent.permanent.
• TTaking unnecessary medicine isaking unnecessary medicine is
a bad habita bad habit. All those chemicals. All those chemicals
can really hurt me (liver).can really hurt me (liver).
• Sedentary life style or metabolicSedentary life style or metabolic
syndrome damage me most …syndrome damage me most …
please take careplease take care

36. Be careful withBe careful with aerosol spraysaerosol sprays !!
Remember, I have to detoxify what you breathe in, too. SoRemember, I have to detoxify what you breathe in, too. So
when you are cleaning with aerosol cleaners, make sure thewhen you are cleaning with aerosol cleaners, make sure the
room is ventilated, or wear a mask.room is ventilated, or wear a mask.
That goes double for bugThat goes double for bug
sprays, mildew sprays,sprays, mildew sprays,
Paint sprays and all thosePaint sprays and all those
Other chemical spraysOther chemical sprays
you use. Be careful whatyou use. Be careful what
you breathe!you breathe!

37. Watch what gets on your skin!Watch what gets on your skin! Those insecticides you put onThose insecticides you put on
trees and shrubs not only kill bugs they can get to me righttrees and shrubs not only kill bugs they can get to me right
through your skin and destroy my cells, toothrough your skin and destroy my cells, too. Remember. Remember
they're all chemicalsthey're all chemicals. Cover your skin with gloves, long. Cover your skin with gloves, long
sleeves, a hat and mask every time insecticides are in thesleeves, a hat and mask every time insecticides are in the
air or if you're handling them.air or if you're handling them.

38. Don't eat too muchDon't eat too much fattyfatty
foodfood !!
I make the cholesterol yourI make the cholesterol your
body needs,body needs, and I try to makeand I try to make
the right amount.the right amount.
Give me a break.Give me a break. Eat a good,Eat a good,
well balanced nourishing diet.well balanced nourishing diet.
If you eat the right stuff forIf you eat the right stuff for
me, I'll really do my stuff forme, I'll really do my stuff for
you!you!

39. WARNING:WARNING:
I can't and won't tell you I'm inI can't and won't tell you I'm in
trouble until I'm almost at thetrouble until I'm almost at the
end of my rope... and yours.end of my rope... and yours.
Remember:Remember: I am a nonI am a non
complainer.complainer.
Overloading me with drugs, alcoholOverloading me with drugs, alcohol
and other junk can destroy me !and other junk can destroy me !
This may be the only warning youThis may be the only warning you
will ever getwill ever get..

40. Take My Advice, Please!Take My Advice, Please!
• Check me out with your doctor regularly.Check me out with your doctor regularly.
• Blood screening tests can identify some trouble.Blood screening tests can identify some trouble.
If I'm soft and smooth, that's good. If
I'm hard and bumpy, that could mean
a trouble, take needful actions.
If your doctor suspects trouble, USG
and CT scans can look into it.
My life, and yours, depends on how
you treat me and love me.

41. Now you know how much I care forNow you know how much I care for you.you.
Please treatPlease treat meme with tender loving care.with tender loving care.
I am your silent partner in all vitalI am your silent partner in all vital
Actions of life and …. Love youActions of life and …. Love you

42. THANK YOUTHANK YOU