Saturday 28th March 2020 • Promotional Content


Specialist clinics Healthcare Innovations 27 MEET THE EXPERT Know your liver


Liver disease is usually chronic and silent, developing over many years without overt symptoms. Those who have it are often unaware until severe liver damage has already occurred. However, if diagnosed early, liver damage can be treated and reversed


WHAT DOES THE LIVER DO? Te liver is a relatively large organ in the upper right part of the abdomen, just under the diaphragm. It’s made up of highly specialised cells that perform a range of crucial functions including: cleansing the body’s blood from internal and external


toxins,


manufacturing proteins such as clot- ting factors and key molecules for the immune system, making biochem- icals and bile to aid digestion and prevent jaundice, producing vitamins, storing energy and fat and acting as an energy warehouse for the body.


HOW DOES CHRONIC LIVER DISEASE PROGRESS & WHAT ARE THE CAUSES? Tere are many things that


UK Death Rate from Chronic Liver Disease is Increasing while other Causes are Falling


UK under 65 standard death rate for various disease (1970 = 100%)


UK circulation UK IHD UK stroke UK cancer UK chest UK liver UK luminal GI UK diabetes


UK blood


It’s unclear exactly how many people have cirrhosis as most people don’t know they have it until the condition is serious


commonest cause of death in the UK, but is the only one of the top five causes that’s rising, and rapidly at that.


can


irritate the liver chronically over time, including having a fatty liver (NAFLD), alcohol excess, viruses such as hepatitis B and C, disorders of the immune system, liver injury from some long-term medications or other external irritants, and some genetic and metabolic diseases. A significant minority of people with chronic liver irritation can develop inflammation of


the liver, which results in scar-


ring (or ‘fibrosis’). Over several years, even decades, unless diagnosed and the underlying cause treated, the fibrosis can progress. Te degree of fibrosis is graded from F0 (no fibrosis) to F4, which means extensive scar- ring throughout the liver. F4 fibrosis equates to cirrhosis. As liver fibrosis progresses from F0 to F4, people


usually experience no symptoms as there are no sensory nerve fibres in the liver tissue. Even when someone has developed cirrhosis (F4), they’ll usually have no symptoms initially, until the liver eventually starts to fail in its routine functions.


WHAT HAPPENS WHEN THE LIVER ISN’T WORKING? When


liver several function symptoms


deteriorates, can occur,


including jaundice, bruising, internal bleeding, swollen abdomen and legs due to fluid retention and low protein levels, confusion and even coma,


fatigue and serious infections due to a compromised immune system. Cirrhosis is also the main risk factor for primary liver cancer, i.e. arising within the liver itself, which carries a high fatality rate.


HOW COMMON IS LIVER DISEASE? It’s unclear exactly how many people have cirrhosis as most people don’t know they have it until the condition is serious. Annually now in the UK, more than 4,000 people die from cirrhosis and approximately 700 people need a liver transplant each year to survive. Liver disease is currently the fifth


CAN LIVER FIBROSIS BE DETECTED EARLY, BEFORE ANY SYMPTOMS? Yes, liver fibrosis can be detected at an early stage, but not accurately with routine blood tests or usual scans. Te classical way to establish the degree of liver fibrosis is by performing a liver biopsy, but more recently non-inva- sive techniques have been developed and validated. Foremost among these is the Fibroscan, a simple, repro- ducible, quick and safe procedure utilising ultrasound technology to allow a specialist to determine how much steatosis (fat) or fibrosis there is in someone’s liver. It’s often used as a screening test in those at risk of


to alcohol or fatty liver, and carried out as part of a liver health assess- ment. Furthermore, Fibroscan can be


Accreditations: Hepatology/ Gastroenterology/General Medicine. Areas of interest: abnormal liver Tests/ scans, abdominal pain, viral hepatitis, fatty liver disease, Fibroscan, diagnostic endoscopy, cirrhosis, autoimmune liver disease, primary liver cancer.


Professor Shahid A Khan, BSc Hons MB BS PhD FRCP SFHEA, is a Consultant Physician and Hepatologist at Imperial College Healthcare NHS Trust; and Professor of Practice (Hepatology) at Imperial College London. He’s lectured on liver disease nationally and internationally, including state of the art and invited presentations. He’s published extensively on liver disease in medical literature, including original research articles, reviews and book chapters. Professor Khan is an accredited Royal College of Physicians Educator and enjoys a large teaching role, at both undergraduate and postgraduate level. He has supervised several PhD/ MD studies in liver disease and is also director of admissions and inclusivity, as well as director of the Gastroenterology & Hepatology BSc Pathway at Imperial College London School of Medicine.


Private hospitals: • The London Clinic • The Lindo Wing, St Mary’s Hospital (Imperial Private Healthcare)


• BMI The Clementine Churchill Hospital


liver damage, such as secondary


repeated over time to assess if liver disease is progressing or responding to intervention.


CAN LIVER DISEASE BE TREATED AND LIVER DAMAGE BE REVERSED? Yes — liver fibrosis can be reversed if it’s diagnosed and its cause estab- lished and treated, before end stage liver failure develops. All the main causes of chronic liver disease are potentially treatable. If the cause of the liver fibrosis is treated, even established fibrosis can be reversed due to the liver’s remarkable powers of regeneration. Te key is diagnosing the issue and cause early.


Liver cirrhosis develops gradually through stages over several years, usually without symptoms


Medical Secretaries: Mrs Karen Baxter & Mrs Jeanette Brindley T: 020 7616 7719 E: livergroup@thelondonclinic.co.uk thelondonclinic.co.uk


5 change in SDR since 1970


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36