In liver diseases liver cells are damaged. Often this is also evident in the blood: As a sign of injury or strain, liver values are constantly or frequently elevated. Although liver cells eventually die off in a healthy organ and are replaced by new cells, in the case of liver disease this cell death can become too much even for a regenerative organ such as the liver. If a liver disease takes many years, it can cause liver damage or even cirrhosis. Vital functions such as metabolism, digestion and the immune system are often severely limited in chronic liver disease.
Elevated liver values should not be underestimated
Millions of Germans are suffering from liver disease without any idea of their illness. There is a considerable need for information among the population about these relationships, but also with many doctors. Liver diseases are not a phenomenon of marginal groups: they can hit anyone, even without any alcohol problem.
Elevated liver values are no triviality, but often a first indication of a disease. When these levels are elevated, one should exclude viral diseases such as hepatitis B and C in addition to alcohol. Overweight, diabetes, iron overload, immune system disorders, medications and toxins in the workplace are also possible causes and should be questioned in case of doubt.
Which diseases are there?
Contrary to popular belief, alcohol is far from the sole cause of liver disease. The different diseases can be subdivided as follows:
- Viral Lebeerenztündung (viral hepatitis)
- Toxic diseases
- Autoimmune diseases
- Metabolic diseases
1. Viral liver inflammation (viral hepatitis)
The most common virus-induced inflammations are hepatitis A, B and C. The routes of infection are often confused.
- Hepatitis A is a motion sickness that is mainly transmitted by contaminated food and smear infections. Because it always heals on its own, it is considered the most harmless form of viral hepatitis. The problem is the course in old people, the chronically ill and people with weak immune systems.
- Hepatitis B is contagious and can be transmitted via almost all body fluids (blood, saliva, tears, vaginal secretions, semen). Sexual contacts, piercing, tattoos as well as contact with infected blood can lead to contagion. Another risk is the transmission of hepatitis B from mother to child at birth. In adults, the acute infection with the hepatitis B virus heals in 95-98% of cases, so that only 2-5% of cases are chronic. In people with a weak immune system (for example, infants, the elderly, the chronically ill), on the other hand, it is much more likely that chronic processes develop.
- Hepatitis C is hardly infectious in everyday use. The risk of sexual infection here is rather low in contrast to hepatitis B. The risk of transmission depends on the sexual behavior. The infection usually comes through direct blood contact, for example, through blood products, injuries, intravenous drug use, piercing, tattoos, acupuncture needles and poor hygiene during medical procedures. If it comes to infection, hepatitis C is untreated in about 50-80% of cases chronic. Today's hepatitis C therapy has strong side effects and does not work in every patient. However, with improved medication, hepatitis C is increasingly becoming a curable disease.
A hepatitis A or B can also be avoided by vaccination, hepatitis C is not.
2. Toxic diseases
These include diseases caused by alcohol, fungal poisoning, environmental toxins and medicines. Even over-the-counter medications such as painkillers and herbal supplements can in some cases burden the liver.
3. Autoimmune diseases
Autoimmune hepatitis or bile duct disease such as PBC or PSC are - just like metabolic diseases - not contagious. The immune system of the body turns here due to a defect against the body's own tissue such as the liver. A slow organ destruction can be the result. For a long time, such diseases were hardly known, but are being diagnosed more and more often.
4. Metabolic diseases
These include, in particular, the iron or copper storage disease and alpha-1-antitrypsin deficiency, which are due to a genetic defect. "Non-alcoholic steatohepatitis" (NASH), which primarily affects overweight and diabetics, is increasingly being diagnosed. Unlike ordinary fatty liver (which in itself is just a finding, but not a disease), NASH is a serious disease. As different as the causes and the course of chronic liver diseases are: In the long-term consequences, these diseases are very similar.
If the liver is overloaded by permanent inflammation, cell death occurs. The diseased liver is scarring and shrinking. The end stage is called cirrhosis. The consequences of cirrhosis can be serious: water belly (ascites), disorders of brain performance (hepatic encephalopathy), bleeding from varicose veins in the stomach or esophagus (variceal bleeding), in very unfavorable cases liver cancer (hepatocellular carcinoma). Appropriate early therapies can often successfully prevent such a chronic course.