Liver disease, also called hepatic disease, refers to a number of diseases that may affect the liver and its function. The liver plays a role in the production of bile, blood-clotting factors and amino acids, and aids in the processing and storage of iron for red blood cell production. The liver also helps remove waste products from the blood and regulates levels of chemicals in the body.

Some of the diseases that affect the liver include infectious hepatitis, cirrhosis (scarring of the liver), liver failure, Gilbert’s syndrome, cancers, bile flow abnormalities and blood flow abnormalities. Some medications may also cause liver damage, including acetaminophen (Tylenol). Treatments for these conditions vary depending on the disease and its causes.

Symptoms of Liver Disease

Because there are so many different types of liver conditions, symptoms will vary. It is imperative that you do not ignore persistent symptoms and allow them to go unchecked.

• Nausea and vomiting


• Abdominal pain in the upper right part of the abdomen


• Swelling of the abdomen


• Dark urine


• Chronic, itchy skin


• Jaundice (yellowing of the skin due to high concentrations of the bile pigment bilirubin).


• Yellowish eyes


• Unexplained fatigue


• Weakness and weight loss

Risk Factors for Liver Disease

Many types of infectious liver disease begin with coming into contact with other people’s bodily fluids. Medical and healthcare professionals are at increased risk for hepatic disease.

• Any profession that exposes you to bodily fluids


• Blood transfusions before 1992


• Body piercings and tattoos


• Heavy alcohol use


• Shared needles from injected drugs


• Diabetes


• Obesity


• High level of triglycerides in the blood


• Unprotected sex


• Working with certain chemicals or toxins

Tests to Diagnose Liver Disease

Because the liver has so many functions, the term “liver disease” is very broad. There are hundreds of types of liver conditions but the most common testing methods to diagnose liver problems include the following.

• Imaging- Computed tomography (CT) scans, x-rays, magnetic resonance imaging (MRI) ultrasound, and magnetic resonance elastography are often used to help diagnose hepatic issues.


• Biopsy- Tissue samples from the liver can indicate disease.


• Blood testing- a simple blood sample can test for liver function, infectious hepatitis or inherited conditions.


• Genetic testing- Members of the same family can be tested for diseases that are genetic in origin.

Treatment for Liver Disease

Liver conditions can sometimes be treated with medications, surgery or even transplant, depending on the condition and severity.

Lifestyle Changes to Treat/Prevent Liver Disease

You can take precautions to prevent liver disease. Although some liver conditions are genetic, there are many conditions that can be prevented.

• Abstain from alcohol or drink in moderation- Women should have no more than one drink per day and men should have no more than two drinks per day.


• Stay current with vaccinations- Talk to your doctor about getting immunized for hepatitis A and B, especially if you are at risk for contracting the hepatitis virus.


• Avoid high-risk behaviors- a high level of risk accompanies the use of illicit drugs, unprotected sex, tattoos and body piercings. Know the risk when you engage in these choices.


• Avoid other people’s blood and body fluid- Hepatitis can be contracted when you come into contact with body fluids or when fluids have not been cleaned properly. Be aware of how hepatitis is spread. You can even contract the virus by sharing a razor or a toothbrush.


• Eat a healthy diet and maintain a healthy weight- Talk to your doctor about what weight is right for you, and use fresh fruits and vegetables and whole grains as the building blocks of your diet.


• Be conscientious about medication- Use medication only when necessary and do not mix alcohol and medication.

Colon cancer forms in the lining of the colon. Rectal cancer forms in the lining of the rectum, the last several inches of the large intestine terminating in the anus. Either of these cancers is called colorectal cancer.

In the United States, colon cancer is the second deadliest form of cancer when considering both men and women together. Each year about 150,000 people will be diagnosed with colon cancer, and 50,000 people will die from the disease, according to the American Cancer Society.

Though scientists are unsure of exactly what causes colon and colorectal cancer, some risk factors have been identified.

Risk Factors

• Being over age 50


• Polyps, growths inside the colon and rectum that may become cancerous


• A high-fat diet


• Family or personal history of colon cancer or polyps


• Ulcerative colitis, Crohn's Disease or other inflammatory bowel diseases involving the colon


• Sedentary lifestyle


• Diabetes


• Obesity


• Smoking


• Alcohol


• Radiation therapy for cancer

Many cases of colon or colorectal cancer have no symptoms or warning signs until the cancer has advanced. However there are some symptoms that may indicate colon cancer, but these symptoms can sometimes be confused for other conditions such as hemorrhoids. You should consult with your doctor if you experience any of these symptoms and are unsure of the cause.

Warning Signs and Symptoms

• Abdominal pain or tenderness in the lower abdomen


• Bloody stool


• Diarrhea, constipation or other changes in bowel functions


• Narrower than normal stools


• Unexplained anemia


• Unexplained weight loss


• Bloating, fullness or cramps


• Vomiting

Colon Polyps

A colon polyp is a growth of extra tissue in the lining of the rectum or colon. While some can be cancerous, most are not. However, almost all colon cancer does begin as a polyp. Therefore, by removing polyps early, the chances of it growing into colon cancer are eliminated. People with a higher risk for developing polyps are anyone over age 50, those who have had polyps previously or those who have a family history of polyps or colon cancer. However you can still be at risk for polyps or colon cancer without having a family history of either condition. In fact, 80 percent of those who are diagnosed with colon cancer have no family history.

Polyps generally do not cause symptoms. If a patient does have symptoms, they can include blood in their underwear or on toilet paper after a bowel movement, blood in stool, or constipation or diarrhea that has lasted more than a week.

Polyps can be removed during a colonoscopy. If precancerous colon polyps are removed, the chance of the polyp turning into cancer is eliminated. Colon cancer is also highly treatable when discovered early. Depending on an individual's medical and family history, colonoscopies are typically recommended every one, three, five or 10 years.

Treatments and Procedures

The three primary treatment options available for colon cancer are surgery, chemotherapy and radiation. Treatment options for colon cancer depend on the stage of the cancer, whether the cancer has recurred and the patient's general health. The surgical option, a partial colectomy, is the main treatment and includes removing the affected portion of the colon. How much of the colon is removed and whether it is done in conjunction with other treatments will depend on the location of the cancer, how deep it has penetrated the wall of the bowel and if it has spread to the lymph nodes or other parts of the body.

In surgical treatment, the part of the colon that contains the cancer, as well as portions of healthy colon on either side, will be removed to ensure no cancer is left behind. Nearby lymph nodes will be removed and tested at the same time. Usually the doctor is able to reconnect the healthy portions of the colon, but if that is not possible the patient will have a temporary or permanent colostomy bag. A colostomy bag is a device that is worn on the skin discreetly under the clothing and is attached to the remaining bowel. Waste material travels into this bag which is then disposed of, and the bag is replaced as needed. Sometimes, a colostomy is done temporarily to give the bowel time to heal. It may become permanent if too much of the colon or the rectum has to be removed.

If the cancer is small, early stage and localized in a polyp, it is possible it may all be removed during a colonoscopy.

If the cancer is very advanced or the patient's health is extremely poor, surgery may be done simply to provide comfort. This is an operation that will relieve a blockage of the colon to improve symptoms. This will not cure cancer but may relieve pain and bleeding.

Chemotherapy can be used after surgery to destroy any remaining cancer cells, and may be recommended by the doctor if the cancer has spread beyond the lining of the colon. Chemotherapy can be used in conjunction with radiation. Radiation therapy uses powerful energy sources to kill any cancer cells that may remain after surgery or to shrink large tumors before an operation. This option is rarely used in the early stages of colon cancer.

Preventing Colon Cancer

Getting screened is the first step in preventing colon cancer. Several screening options are available, including colonoscopy and flexible sigmoidoscopy. Regular colonoscopies should begin at age 50 for people with an average risk for developing colon cancer. If you have a family history of polyps or colon cancer, many physicians may recommend getting your first colonoscopy at age 40 or even earlier depending on your history. Some recent studies indicate that African-Americans may need to start screening at age 45. More frequent and earlier screening is recommended if you are at high risk for colon cancer.

Lifestyle changes can also be made to reduce the risk of colon cancer:

• Add fruits, whole grains and vegetables to your diet


• Limit saturated fat


• Limit alcohol


• Eat a varied diet


• Quit smoking


• Stay active and maintain a healthy body weight

Diverticulosis is a condition when small pouches, called diverticula, form in the wall of the colon. This becomes more common as people get older. About half of people over the age of 60 have diverticulosis. A low-fiber diet can exert more pressure on the colon during bowel movements, which can cause these pouches to form. Diverticulosis does not cause any symptoms until they become inflamed or infected resulting in diverticulitis. These two conditions together are called diverticular disease.

Symptoms of Diverticulitis

• Abdominal pain


• Fever


• Nausea


• Vomiting


• Chills


• Cramping or constipation

Complications from Diverticulitis

• Bleeding


• Colon obstruction


• Abscess


• Fistula (an abnormal connection between the colon and another part of the body)


• Perforation (puncture) through the bowel wall

Tests to Diagnose Diverticulitis

• CT scan


• Barium enema X-ray


• Checking your white blood cells for signs of infection

Because diverticulosis does not cause any symptoms, it is usually identified when a test is being performed for colon cancer screening not for evaluations of digestive symptoms. Diverticulitis may be difficult to diagnose because its symptoms are similar to other intestinal disorders such as irritable bowel syndrome (IBS) and stomach ulcers.

Treatment depends on the severity of your condition. Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Adding more fiber to your diet can reduce the amount of pressure on your colon and reduce symptoms from diverticular disease. You may also be put on a liquid diet to try and give your colon a rest. Severe cases of diverticulitis may require hospitalization to receive antibiotics intravenously. Occasionally surgery is necessary.

Surgical Treatments for Diverticulitis

• Primary bowel resection- during this procedure your surgeon removes the diseased part of your intestine and then reconnects the healthy segments of your colon


• Bowel resection with colostomy- this surgery may be necessary if you have so much inflammation in your colon that it is not possible to reconnect your colon. During a colostomy, your surgeon makes an opening, called a stoma, in the abdominal wall. The unaffected part of your colon is then connected to the stoma, and waste passes through the opening into a bag.

Helicobacter pylori (H. pylori) is a bacterium that causes inflammation of the stomach, chronic gastritis, and ulcers in the stomach or small intestine.

Most people with an H. pylori infection never experience symptoms. When symptoms do occur, it is usually because the bacterium has caused an ulcer to form.

Symptoms of H. pylori

• An ache or burning pain in your abdomen


• Nausea


• Vomiting


• Frequent burping


• Bloating


• Weight loss

This infection is usually acquired in childhood. H. pylori bacteria can be passed from person to person from direct contact with saliva, vomit or fecal matter. It can also be spread through contaminated food and water.

People with H. pylori infections may be more likely to develop cancer in the stomach, including mucosa-associated lymphoid tissue (MALT) lymphoma. The bacterium weakens the protective coating of the stomach and first part of the small intestine, allowing digestive juices to irritate the sensitive lining.

Tests to Diagnose H. pylori

• Blood test


• Breath test


• Stool test


• Upper endoscopy with biopsy

Treatments for H. pylori

H. pylori are usually treated with a combination of two antibiotics. Your doctor will also prescribe an acid suppression drug such as PPIs (proton pump inhibiters) or H2 (histamine-2) blockers to help the lining of your stomach heal. Once the bacteria are completely gone from the body, the chance of its return is low.

A peptic ulcer is a sore in the lining of the stomach or first part of the small intestine called the duodenum. When an individual has chronic peptic ulcers, it is known as peptic ulcer disease (PUD). A healthy digestive tract is coated with a layer of mucus that protects against acid deterioration. If the mucus decreases or the acid increases, an ulcer can result. Some ulcers may be associated with infection from a bacterium called Helicobacter Pylori (H. pylori).

H. pylori can live in the mucus layer and often causes no problems, but sometimes the bacterium can cause inflammation in the stomach lining and slowly produce an ulcer. H. pylori can be transmitted through food, water, and close human contact.

Another cause of PUD is long-term use of anti-inflammatory medicines like aspirin and ibuprofen. And contrary to popular belief, while stress and spicy foods can aggravate ulcers, they do not cause them. If untreated, peptic ulcers may get worse and cause more serious problems.

Symptoms of PUD

Burning stomach pain is the most common symptom of peptic ulcers and may come and go for a few days or weeks. Pain is more bothersome when the stomach is empty and usually recedes after the patient eats. The burning sensation may become worse at night and is almost always worse on an empty stomach. Sometimes, peptic ulcer disease has more severe symptoms.

• Nausea


• Vomiting of blood—Blood may appear red or black


• Unexplained weight loss


• Loss of appetite


• Dark blood in the stools or tar-like stools

Risk Factors for PUD

• Alcohol—Alcohol can wear away the mucus lining of the stomach and gut, and it also increases the amount of stomach acid that is produced.


• Smoking—Smoking can increase the risk of peptic ulcers for those who are infected with H. pylori.


• Long-term use of pain relievers and/or nonsteroidal anti-inflammatory drugs (NSAIDs).

Tests to Diagnose PUD

• H. pylori test- Doctors can test for the presence of H. pylori in the system by a blood sample, stool sample or a breath test. It can also be diagnosed by obtaining a sample of tissue during endoscopy.


• Endoscopy- an endoscopy is a test that uses a hollow tube with a lens attached. The scope can view the throat, stomach and small intestine and detect an ulcer.


• Biopsy- if an ulcer is found, a small tissue sample will be removed and examined


• X-ray- Swallowing barium (a white liquid) before the x-ray helps doctors see details of the esophagus, stomach, and small intestine as well as view the ulcer

Treatments for PUD

Depending on the cause of the peptic ulcer, treatments will vary.

• Antibiotics—antibiotics can kill the bacterium H. pylori in the digestive system. A two-week treatment should be sufficient, and then antacid medication may be prescribed to control stomach acid.


• Proton pump inhibitors—these medications reduce stomach acid by blocking the action of cells that produce acid. Examples of brand-name proton pump inhibitors are Prilosec, Prevacid, Aciphex, Nexium and Protonix.


• H2 blockers—these medications reduce stomach acid, reduce pain and bring healing. Brand-name products are Zantac, Pepcid, Tagamet, and Axid.


• Antacids—these medications neutralize stomach acid. Side effects can include constipation or diarrhea. Antacids relieve symptoms but do not always produce healing.

If medication does not heal a peptic ulcer, this may be an indication of another issue.

• An infection other than H. pylori


• Zollinger-Ellison syndrome—extreme overproduction of gastric acid


• Stomach cancer


• Crohn’s disease

Lifestyle Changes to Treat PUD

Along with medication, these lifestyle changes may be helpful in assisting to control the pain of peptic ulcer disease.

• Wise diet choices—eating plenty of fresh fruits, vegetables and whole grains may promote healing. Processed foods, fried foods and junk food will make it harder to heal.


• Change your pain reliever—because PUD can be aggravated by using certain pain relievers, talk to your doctor about a different option.


• Stop smoking—Smoking can affect the mucus lining of the stomach and produce more stomach acid.


• Avoid alcohol—Alcohol can wear away the mucus layer of the stomach and intestine.


• Manage stress—Use exercise, mediation, relaxation techniques and recreation to reduce stress and reduce stomach acid production.

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes inflammation in the lining of the rectum and colon. Ulcers form where inflammation has injured the cells that usually line the colon, which then may bleed and create pus. This inflammation also causes the colon to empty frequently, producing diarrhea. Ulcerative colitis can be debilitating and sometimes lead to life-threatening complications.

Ulcerative colitis can be difficult to diagnose because symptoms such as abdominal pain and diarrhea are often seen in other intestinal disorders. About half the people diagnosed with ulcerative colitis have mild symptoms. Others may suffer frequent fever, bloody diarrhea, nausea and severe abdominal cramps. It may also cause problems such as arthritis, inflammation of the eye, liver disease and osteoporosis. It is not known why these problems occur outside the colon, but scientists think it may be the result of inflammation triggered by the immune system. Some of these problems go away when the ulcerative colitis is treated.

Symptoms of UC can also vary depending on the severity of inflammation and where it occurs. Doctors classify ulcerative colitis according to its location.

Classifications of Ulcerative Colitis and Their Symptoms

• Ulcerative proctitis: Inflammation is confined to the area closest to the anus (rectum). For some people rectal bleeding may be the only sign of the disease. Others may have rectal pain and a feeling of urgency (tenesmus). This form tends to be the mildest.


• Proctosigmoiditis: Involves the rectum and the lower end of the colon, known as the sigmoid colon. Bloody diarrhea, abdominal cramps and pain.


• Left-sided colitis: Inflammation extends from the rectum up through the sigmoid and descending colon, which are located in the upper left part of the abdomen. Bloody diarrhea, abdominal cramping and pain on the left side and unintentional weight loss.


• Pancolitis: Affects more than the left colon and often the entire colon. Bloody diarrhea that may be severe, abdominal cramps and pain, fatigue and significant weight loss


• Fulminant colitis: A rare, life-threatening form of colitis affects the entire colon and causes severe pain, profuse diarrhea and, sometimes, dehydration and shock. People with this condition are a risk of serious complications, including colon rupture and toxic megacolon, a condition that causes the colon to rapidly expand.

Causes of Ulcerative Colitis

The cause of ulcerative colitis is unknown. Researchers believed that stress was a possible cause, but they no longer believe that this is a viable explanantion. However, stress can aggravate symptoms. There are now two possibilities for the cause of ulcerative colitis.

• Immune system: some scientists believe that a virus or bacterium may trigger ulcerative colitis. The digestive tract becomes inflamed when the immune system tries to fight off the invading pathogen. It is also possible that inflammation may stem from an autoimmune reaction.


• Hereditary: you’re more likely to develop ulcerative colitis if you have a parent or sibling with this disease. However, most people who have ulcerative colitis do not have a family history of ulcerative colitis.

Risk Factors of Ulcerative Colitis

• Age: While this disease can occur at any age, ulcerative colitis usually begins before the age of 30.


• Race or ethnicity: Although whites have the highest risk of the disease, it can occur in any race.


• Family history: You’re at a higher risk if you have a close relative, such as a parent, sibling or child with the disease.


• Isotretinoin use: Isotretinoin, formerly sold under the brand name Accutane, is a medication sometimes used to treat scarring cystic acne or acne that does not respond to other treatments. While there have been some connections between isotretinoin and ulcerative colitis, the reports are conflicting as to whether isotretinoin actually causes ulcerative colitis.

Complications of Ulcerative Colitis

• Severe bleeding


• Severe dehydration


• Liver disease (rare)


• Inflammation of your skin, joints and eyes


• An increased risk of colon cancer


• A rapidly swelling colon (toxic megacolon)

Tests to Diagnose Ulcerative Colitis

• Blood tests


• Colonoscopy


• Flexible sigmoidoscopy


• Barium enema


• CT scan

Treatments for Ulcerative Colitis

There is no known cure for UC, but therapies are available that may dramatically reduce the signs and symptoms of UC and even bring about a long-term remission. This is either achieved through medications or surgery.

Medications

• Anti-inflammatory drugs
  
  
  
  • Sulfasalazine (Azulfidine)
  
  
  • Mesalamine (Asacol, Lialda)
  
  
  • Balsalazide (Colazal)
  
  
  • Olsalazine (Dipentum)
  
  
  • Corticosteroids
  
  
  
  


• Immune system suppressors
  
  
  
  • Azathioprine (Azasan, Imuran)
  
  
  • Mercaptopurine (Purinethol)
  
  
  • Cyclosporine (Gengraf, Neoral, Sandimmune)
  
  
  • Infliximab (Remicade)
  
  
  • Adalimumab (Humira)
  
  
  
  


• Other medications
  
  
  
  • Antibiotics
  
  
  • Anti-diarrheals
  
  
  • Pain relievers
  
  
  
  

Surgery

If diet and lifestyle changes, medications or other treatments do not relieve your symptoms, your doctor may recommend surgery. Surgery can often eliminate ulcerative colitis, but that usually means removing your entire colon and rectum.

Lifestyle Changes to Treat Ulcerative Colitis

You can make dietary and lifestyle changes to help alleviate symptoms and lengthen time between flare-ups.

While there is no evidence that says certain foods cause ulcerative colitis, there are certain foods that can aggravate your symptoms. Limiting dairy products and avoiding problem foods may help improve your symptoms. Problems foods can vary for each person, but you should also avoid “gassy” foods such as beans, cabbage and broccoli, raw fruits and fruits, popcorn, caffeine and carbonated beverages. Experiment with fiber. For some, adding more high-fiber foods can help with bowel issues; however, if you have an inflammatory bowel disease fiber may worsen your symptoms. Try eating five or six meals instead of two or three large ones and drink plenty of fluids, preferably water.

Avoiding stress is also a good way to alleviate your symptoms. Stress can aggravate your symptoms, so learning to better manage stress can help. Exercise, biofeedback, regular relaxation and breathing exercises are all ways you can manage stress.

Esophagitis is a general term for any inflammation, irritation or swelling of the esophagus, which is the tube that leads from the back of the mouth to the stomach. It is frequently caused by a backflow of stomach acid to the esophagus. This is commonly called heartburn or GERD (gastroesophageal reflux disease). Irritation may cause the tissues to become inflamed and occasionally form ulcers, and patients may have difficulty swallowing and have a burning sensation in the esophagus. Other symptoms include painful swallowing, heartburn or oral lesions. A stricture occurs when the inflamed area heals with a scar that narrows the esophagus, resulting in causing problems with swallowing. People who have frequent heartburn, vomit excessively, have had surgery or radiation to the chest or take medications like aspirin, ibuprofen and potassium are at a higher risk of developing strictures.

Benign esophageal stricture is a narrowing of the esophagus that can cause swallowing difficulties. It can be caused by gastroesophageal reflux (GER), certain medications, long-term use of a nasogastric tube that runs from the nose to the stomach, swallowing corrosive substances or a bacterial or viral infection. Symptoms can include difficult or painful swallowing, unintentional weight loss or food regurgitation.