The liver is one of the most important parts of the human body and is located in the right upper part of the abdomen. Over 500 functions of the body are carried out by the liver. Sadly, however, people tend to neglect the health of their liver.

Bile is produced in the liver, which helps to break down fats in food and remove some waste material. It also helps in regulating blood levels of ammonia. Many proteins are manufactured in the liver. It also produces cholesterol which is useful for many metabolic functions of the body. The liver contains an abundant quantity of enzymes that help regulate proteins, lipids, and carbohydrates.

Clotting of blood occurs due to the clotting factors produced in the liver. It also helps in the manufacturing of haemoglobin (a component of blood that helps supply oxygen to various body parts, via the bloodstream). Many toxic substances, bacteria, and metabolic products of drugs are removed by the liver. It also handles the clearing of alcohol. There are several other useful functions.

But unfortunately, many people are ignorant of the importance of good functioning of the liver. A glaring example is alcohol abuse. Those who drink regularly tend to put a burden on the liver. It can handle the consumed alcohol up to a limit and then, when the burden starts getting persistent or more, it starts getting damaged. Initially, there is inflammation, which is reversible, if one stops drinking. But if that continues, irreversible damage occurs to the liver, resulting in liver failure.

The liver is also vulnerable to being damaged by infections. Notably among those are viral infections caused by hepatitis viruses, A, B.C. D or E (viral hepatitis). Poor food hygiene, sex with an infected person, transfusion of infected blood, and injection by a contaminated needle, are the sources of infection. Other viruses like Cytomegalovirus and Epstein–Barr virus can also damage the liver. Enterococci, staphylococci, streptococci, and Salmonella Typhi are some of the bacteria that affect the liver. The liver can also be affected by protozoal infections like amoeba.

Many drugs affect the liver adversely. Very commonly used painkillers tend to damage the liver. Antibiotics like amoxicillin and clauvulanic acid, erythromycin, rifampicin, pyrazinamide, lipid-lowering drugs, some antifungal drugs, immune suppressant drugs, etc., are some of those.

White sugar, excess salt, trans fats, ready to eat fast foods, are also not healthy for the liver. People working in any industry involving chemicals are vulnerable to liver damage due to hepatotoxic chemicals. Carbon tetrachloride, vinyl chloride, and polychlorinated biphenyls are some common chemicals affecting the liver.

Greater awareness about the importance of the liver and substances that can inflict damage to it can help reduce liver damage and failure on the whole. A healthy lifestyle that includes a healthy balanced diet, regular exercise, relaxation, avoidance of addictive substances like alcohol, tobacco, etc., and disciplined sex, all help to keep the body, as well as the liver healthy.

These measures also help boost the immunity of the body, which in turn protects against being sick with infections that can affect the liver. Those working in industries that involve chemicals that are potentially toxic to the liver should be cautious and use protective measures to minimise exposure.

One should also be aware of the features of early liver disease. Reduced appetite, with no other explanation for it, is one of the earliest symptoms. It may be associated with nausea and or vomiting. Yellow discoloration of the eyes and urine is a clear sign that the liver is affected, either by infection or damage by some toxins.

An inflamed or swollen liver can be confirmed by an abdominal ultrasound, and one feels heaviness and or pain in the right upper part of the abdomen. Liver function tests are a battery of blood tests, which reveal the type and extent of derangement of liver function. Treatment depends on the underlying cause and its duration and severity.

Dr Rachna Pande is a specialist in internal medicine.