Liver function tests Health Dictionary

Liver Function Tests: From 1 Different Sources


Tests of blood chemistry that can detect changes in the way the liver is making new substances and breaking down and/or excreting old ones.

The tests can also show whether liver cells are healthy or being damaged.

Health Source: BMA Medical Dictionary
Author: The British Medical Association

Liver

The liver is the largest gland in the body, serving numerous functions, chie?y involving various aspects of METABOLISM.

Form The liver is divided into four lobes, the greatest part being the right lobe, with a small left lobe, while the quadrate and caudate lobes are two small divisions on the back and undersurface. Around the middle of the undersurface, towards the back, a transverse ?ssure (the porta hepatis) is placed, by which the hepatic artery and portal vein carry blood into the liver, and the right and left hepatic ducts emerge, carrying o? the BILE formed in the liver to the GALL-BLADDER attached under the right lobe, where it is stored.

Position Occupying the right-hand upper part of the abdominal cavity, the liver is separated from the right lung by the DIAPHRAGM and the pleural membrane (see PLEURA). It rests on various abdominal organs, chie?y the right of the two KIDNEYS, the suprarenal gland (see ADRENAL GLANDS), the large INTESTINE, the DUODENUM and the STOMACH.

Vessels The blood supply di?ers from that of the rest of the body, in that the blood collected from the stomach and bowels into the PORTAL VEIN does not pass directly to the heart, but is ?rst distributed to the liver, where it breaks up into capillary vessels. As a result, some harmful substances are ?ltered from the bloodstream and destroyed, while various constituents of the food are stored in the liver for use in the body’s metabolic processes. The liver also receives the large hepatic artery from the coeliac axis. After circulating through capillaries, the blood from both sources is collected into the hepatic veins, which pass directly from the back surface of the liver into the inferior vena cava.

Minute structure The liver is enveloped in a capsule of ?brous tissue – Glisson’s capsule – from which strands run along the vessels and penetrate deep into the organ, binding it together. Subdivisions of the hepatic artery, portal vein, and bile duct lie alongside each other, ?nally forming the interlobular vessels,

which lie between the lobules of which the whole gland is built up. Each is about the size of a pin’s head and forms a complete secreting unit; the liver is built up of hundreds of thousands of such lobules. These contain small vessels, capillaries, or sinusoids, lined with stellate KUPFFER CELLS, which run into the centre of the lobule, where they empty into a small central vein. These lobular veins ultimately empty into the hepatic veins. Between these capillaries lie rows of large liver cells in which metabolic activity occurs. Fine bile capillaries collect the bile from the cells and discharge it into the bile ducts lying along the margins of the lobules. Liver cells are among the largest in the body, each containing one or two large round nuclei. The cells frequently contain droplets of fat or granules of GLYCOGEN – that is, animal starch.

Functions The liver is, in e?ect, a large chemical factory and the heat this produces contributes to the general warming of the body. The liver secretes bile, the chief constituents of which are the bile salts (sodium glycocholate and taurocholate), the bile pigments (BILIRUBIN and biliverdin), CHOLESTEROL, and LECITHIN. These bile salts are collected and formed in the liver and are eventually converted into the bile acids. The bile pigments are the iron-free and globin-free remnant of HAEMOGLOBIN, formed in the Kup?er cells of the liver. (They can also be formed in the spleen, lymph glands, bone marrow and connective tissues.) Bile therefore serves several purposes: it excretes pigment, the breakdown products of old red blood cells; the bile salts increase fat absorption and activate pancreatic lipase, thus aiding the digestion of fat; and bile is also necessary for the absorption of vitamins D and E.

The other important functions of the liver are as follows:

In the EMBRYO it forms red blood cells, while the adult liver stores vitamin B12, necessary for the proper functioning of the bone marrow in the manufacture of red cells.

It manufactures FIBRINOGEN, ALBUMINS and GLOBULIN from the blood.

It stores IRON and copper, necessary for the manufacture of red cells.

It produces HEPARIN, and – with the aid of vitamin K – PROTHROMBIN.

Its Kup?er cells form an important part of the RETICULO-ENDOTHELIAL SYSTEM, which breaks down red cells and probably manufactures ANTIBODIES.

Noxious products made in the intestine and absorbed into the blood are detoxicated in the liver.

It stores carbohydrate in the form of glycogen, maintaining a two-way process: glucose

glycogen.

CAROTENE, a plant pigment, is converted to vitamin A, and B vitamins are stored.

It splits up AMINO ACIDS and manufactures UREA and uric acids.

It plays an essential role in the storage and metabolism of FAT.... liver

Cod-liver Oil

Cod-liver oil is derived from the fresh liver of the cod (Gadus callarius). It is a rich source of vitamin D, used in the prevention and treatment of RICKETS, and of vitamin A. Human milk contains more than enough vitamin D for the breast-fed baby, provided the mother has a balanced diet with adequate exposure to sunlight, or is taking vitamin supplements during pregnancy and lactation if considered necessary. All baby foods in the UK contain added vitamins, and therefore supplementation is unnecessary until weaning begins, and the baby starts taking cow’s milk, which contains less vitamin D than human milk. (See APPENDIX 5: VITAMINS.)... cod-liver oil

Liver Fluke

Fasciola hepatica is a parasite infesting sheep and occasionally invading the bile ducts and liver of humans (see FASCIOLIASIS).... liver fluke

Liver Spots

A misnomer applied to the brown MACULES often seen on the backs of the hands of those chronically exposed to sunlight (see LENTIGO). They have no connection with any liver disorder.... liver spots

Vision Tests

Most vision tests examine a person’s sharpness of VISION (visual acuity) and often of the ?eld of vision (see VISION, FIELD OF). Refraction tests assess whether a person has an error that can be corrected with glasses such as ASTIGMATISM, HYPERMETROPIA or MYOPIA. Visual acuity is tested using a Snellen chart when the patient tries to read letters of di?ering standard sizes from 6 metres away. The optician will prescribe lenses to correct any defects detected by vision tests.... vision tests

Pregnancy Tests

There are several tests for pregnancy (see PREGNANCY AND LABOUR) in its early stages, and these can be done on blood or urine; some of the urine tests may be carried out at home. Most tests are based on the detection of HUMAN CHORIONIC GONADOTROPHIN (HCG) in the woman’s urine. They are nearly 100 per cent accurate and may show positive as early as 30 days after the ?rst day of the last normal period.

The haemagglutination inhibition test This, and the subsequent tests to be mentioned, are known as immunological tests. They are based upon the e?ect of the urine from a pregnant woman upon the interaction of red blood cells, which have been sensitised to human gonadotrophin, and anti-gonadotrophin serum. They have the great practical advantage of being performed in a test-tube or even on a slide. Because of their ease and speed of performance, a result can be obtained in two hours.

Enzyme-linked immunosorbent assay (ELISA) This is the basis of many of the pregnancy-testing kits obtainable from pharmacies. It is a highly sensitive antibody test and can detect very low concentrations of human chorionic gonadotrophin. Positive results show up as early as ten days after fertilisation – namely, four days before the ?rst missed period.

Ultrasound The fetal sac can be detected by ULTRASOUND from ?ve weeks, and a fetal echo at around six or seven weeks (see also PRENATAL SCREENING OR DIAGNOSIS).... pregnancy tests

Pulmonary Function Tests

Tests to assess how the LUNGS are functioning. They range from simple spirometry (measuring breathing capacity) to sophisticated physiological assessments.

Static lung volumes and capacities can be measured: these include vital capacity – the maximum volume of air that can be exhaled slowly and completely after a maximum deep breath; forced vital capacity is a similar manoeuvre using maximal forceful exhalation and can be measured along with expiratory ?ow rates using simple spirometry; total lung capacity is the total volume of air in the chest after a deep breath in; functional residual capacity is the volume of air in the lungs at the end of a normal expiration, with all respiratory muscles relaxed.

Dynamic lung volumes and ?ow rates re?ect the state of the airways. The forced expiratory volume (FEV) is the amount of air forcefully exhaled during the ?rst second after a full breath – it normally accounts for over 75 per cent of the vital capacity. Maximal voluntary ventilation is calculated by asking the patient to breathe as deeply and quickly as possible for 12 seconds; this test can be used to check the internal consistency of other tests and the extent of co-operation by the patient, important when assessing possible neuromuscular weakness affecting respiration. There are several other more sophisticated tests which may not be necessary when assessing most patients. Measurement of arterial blood gases is also an important part of any assessment of lung function.... pulmonary function tests

Liver – Abscess

May follow inflammation of the liver from a number of causes, the most common being a manifestation of amoebic dysentery. Through blood infection it may appear on the surface of the liver or other organs.

Symptoms: pain under the right lower rib which may be referred to the right shoulder or under shoulder blades.

Treatment. Official treatment is aspiration or opening-up the abscess followed by drainage. Whether or not this is necessary, alternative anti-bacterials such as Myrrh, Goldenseal, Echinacea and Blue Flag may be used with good effect.

Alternatives. Teas: Milk Thistle. Grape leaves. 1 heaped teaspoon to each cup of water, thrice daily. Decoctions: Echinacea, Blue Flag, Goldenseal, Parsley root. One heaped teaspoon to each cup water gently simmered 20 minutes. Half a cup thrice daily.

Tablets/capsules: Blue Flag, Echinacea. Goldenseal. Wild Yam. Devil’s Claw.

Tinctures. Formula. Fringe Tree 3; Meadowsweet 2; Goldenseal 1. One to two 5ml teaspoons, thrice daily.

Practitioner. Ipecacuanha contains emetine which is specific for liver abscess; at the same time it is effective as an anti-amoebic-dysentery agent. Where dysentery is treated with Ipecacuanha liver abscess is rare. Tincture Ipecacuanha BP (1973). Dose: 0.25-1ml.

Diet. Fat-free. Dandelion coffee. Vitamins B6, C and K. Lecithin.

Treatment by or in liaison with a general medical practitioner. ... liver – abscess

Amoebic Liver Abscess (ala)

Abscess of the liver caused by Entamoeba histolytica and often containing socalled “anchovy sauce” fluid.... amoebic liver abscess (ala)

Blue Flag Tea For A Healthy Liver

Blue Flag tea has a long history in treating liver ailments: Native American tribes used to consume it for its hepatic properties. Blue Flag Tea description Blue flag is a perennial herb also known as the liver lily and the fleur-de-lis, native to North America. It has smooth spear-shaped leaves topped with a light bluish-purple flower. Blue flag plants grow in bunches and bloom during late June and early July. Blue Flag tea is the resulting beverage from brewing the abovementioned plant. Blue Flag Tea brewing To prepare Blue Flag tea, place 1 teaspoon of the dried roots in a cup of boiling water. Let it steep for 10 minutes. The tea can be consumed three times a day. Blue Flag Tea benefits Blue Flag has been successfully used to:
  • stimulate the liver and thus, it is helpful in the treatment of jaundice and hepatitis
  • fight impurities of the blood
  • fight against skin problems like acne and psoriasis
  • detoxify the body by increasing the production of bile, as well as frequency of urination
  • help treat indigestion
  • treat rheumatism
  • help in weight loss
Blue Flag tea can be an effective laxative, diuretic and as an emetic. It is also effective in reducing inflammation of the skin, decreasing the symptoms of skin infections. It is also good in treating burns, bruises and wounds. Blue Flag Tea side effects Until further studies are conducted, pregnant and nursing women should avoid intaking this type of tea. Blue Flag tea has proven its efficiency in dealing with severe liver-related diseases. Also, applied topically, it can treat skin problems, but not only.... blue flag tea for a healthy liver

Boldo Tea Is Benefic For The Liver

Boldo tea has a long medicinal history, according to recent archeological discoveries. It is a healthy choice for the liver, urinary tract and infections. Boldo Tea description Boldo is a tree found in the central region of Chile and near the Mediterranean. It is an evergreen shrub whose leaves are colored brown when dried and whose fruits are small green spheres. Apparently, boldo use dates back at least 10,000 years. Nowadays, people use this plant to aid digestion, cleanse the liver and increase bile production for gallbladder’s health. Boldo tea is the resulting beverage from brewing the abovementioned plant. Boldo Tea brewing To prepare Boldo tea:
  • Pour boiling water over 1 teaspoon of dried boldo leaves.
  • Let the mix infuse for about 10 to 15 minutes.
  • Drink it slowly.
Boldo tea can be drunk three times a day for short periods of time. Boldo Tea benefits Studies have shown that Boldo tea is efficient in:
  • treating urinary tract and bladder infections
  • helping in liver cleansing
  • helping alleviate heartburn
  • relieving discomfort in the gallbladder
  • helping treat mild stomach cramps
  • treating worm infections
  • helping in the treatment of cystitis
  • treating gonorrhea
Boldo Tea side effects Patients with severe liver or kidney disease or obstruction of the bile ducts are advised to avoid the use of Boldo tea. Pregnant and nursing women should not consume Boldo tea. Boldo tea is a medicinal beverage which proved its efficiency in dealing with liver cleansing and urinary tract infections. It is recommended to patients suffering from stomach cramps, but not only.... boldo tea is benefic for the liver

Bupleurum Tea: A Cure For The Liver

Bupleurum tea is largely known for its healing propertiesand its action against the growth and spreading of cancer cells. Bupleurum Tea description Bupleurum is a plant from the Apiaceae family, originating from Asia. The roots of Bupleurum are used in various healing mixtures throughout China and East Asia. Scientists have shown that this plant possesses anti-inflammatory constituents and may inhibit the growth of liver cancer cells. Both Japan and China medicinal industries use it in order to treat cancer and hepatitis. Bupleurum tea is the resulting beverage from brewing the abovementioned plant. Bupleurum Tea brewing Bupleurum tea can be prepared by combining dried and chopped bupleurum roots with hot water. After steeping the mixture for about 10 minutes, drink it slowly. Bupleurum herb can also be consumed as extracts and capsules. Buplerum Tea benefits Bupleurum tea has been successfully used to:
  • treat liver problems like hepatitis, cirrhosis and cancer
  • treat infections with fever
  • relieve chest congestion
  • treat indigestion
  • treat hemorrhoids
  • treat uterine and anal prolapse
  • treat diarrhea
  • help in overall efforts to treat HIV
Bupleurum Tea side effects Bupleurum tea is not recommended to pregnant and breastfeeding women. Bupleurum tea is a healthy beverage used efficiently to treat liver-related diseases. It has been also proven that this type of tea can fight free radicals, responsible for cancer cells growth, due to its content of antioxidants.... bupleurum tea: a cure for the liver

Halibut-liver Oil

The oil expressed from fresh, or suitably preserved, halibut liver. It is a particularly rich source of vitamin A (30,000 international units per gram), and also contains vitamin D (2,300– 2,500 units per gram). It is available in capsules as a means of providing the two vitamins. (See APPENDIX 5: VITAMINS.)... halibut-liver oil

Little Liver Pills

For bilious headache, inactive liver, constipation.

Ingredients: Aloin gr. 1/10. Ipom resin gr. 1/10. Capsic gr. 1/50. Podoph. resin. gr. 1/10. Jalapin gr. 1/10. Olearesin. Ginger. gr. 1/70.

Dose: One or two pills at bedtime or after dinner.

Historical interest only. ... little liver pills

Liver – Hepatitis A

The most common cause of inflammation of the liver from a virus known as Hepatitis A. May be caught by eating shellfish contaminated by sewage or polluted water. Distinct from alcohol and drugs. The virus is ingested in the mouth, grown in the intestines and passes out of the body on defecation.

Treatment. Same as for acute infectious hepatitis. ... liver – hepatitis a

Liver – Hepatitis C

Paul Bergner describes 4 cases of patients with chronic hepatitis C successfully treated. All were given Milk Thistle, and prescribed an alternative tea: equal parts, Burdock, Dandelion, Barberry, Liquorice, Cinnamon and Fennel. Chologogue action is important in chronic liver disease. Not used in acute inflammation. All patients felt better within 2 weeks, and had liver function tests at 3-monthly intervals, showing a gradual decline in elevated values until normal or almost so. All patients became symptom-free. (Medical Herbalism, Vol 6, No 4) ... liver – hepatitis c

Liver Disease In The Tropics

ACUTE LIVER DISEASE The hepatitis viruses (A– F) are of paramount importance. Hepatitis E (HEV) often produces acute hepatic failure in pregnant women; extensive epidemics – transmitted by contaminated drinking-water supplies – have been documented. HBV, especially in association with HDV, also causes acute liver failure in infected patients in several tropical countries: however, the major importance of HBV is that the infection leads to chronic liver disease (see below). Other hepatotoxic viruses include the EPSTEIN BARR VIRUS, CYTOMEGALOVIRUS (CMV), the ?avivirus causing YELLOW FEVER, Marburg/Ebola viruses, etc. Acute liver disease also occurs in the presence of several acute bacterial infections, including Salmonella typhi, brucellosis, leptospirosis, syphilis, etc. The complex type of jaundice associated with acute systemic bacterial infection – especially pneumococcal PNEUMONIA and pyomiositis – assumes a major importance in many tropical countries, especially those in Africa and in Papua New Guinea. Of protozoan infections, plasmodium falciparum malaria, LEISHMANIASIS, and TOXOPLASMOSIS should be considered. Ascaris lumbricoides (the roundworm) can produce obstruction to the biliary system. CHRONIC LIVER DISEASE Long-term disease is dominated by sequelae of HBV and HCV infections (often acquired during the neonatal period), both of which can cause chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (‘hepatoma’) – one of the world’s most common malignancies. Chronic liver disease is also caused by SCHISTOSOMIASIS (usually Schistosoma mansoni and S. japonicum), and acute and chronic alcohol ingestion. Furthermore, many local herbal remedies and also orthodox chemotherapeutic compounds (e.g. those used in tuberculosis and leprosy) can result in chronic liver disease. HAEMOSIDEROSIS is a major problem in southern Africa. Hepatocytes contain excessive iron – derived primarily from an excessive intake, often present in locally brewed beer; however, a genetic predisposition seems likely. Indian childhood cirrhosis – associated with an excess of copper – is a major problem in India and surrounding countries. Epidemiological evidence shows that much of the copper is derived from copper vessels used to store milk after weaning. Veno-occlusive disease was ?rst described in Jamaica and is caused by pyrrolyzidine alkaloids (present in bush-tea). Several HIV-associated ‘opportunistic’ infections can give rise to hepatic disease (see AIDS/HIV).

A localised (focal) form of liver disease in all tropical/subtropical countries results from invasive Entamoeba histolytica infection (amoebic liver ‘abscess’); serology and imaging techniques assist in diagnosis. Hydatidosis also causes localised liver disease; one or more cysts usually involve the right lobe of the liver. Serological tests and imaging techniques are of value in diagnosis. Whilst surgery formerly constituted the sole method of management, prolonged courses of albendazole and/or praziquantel have now been shown to be e?ective; however, surgical intervention is still required in some cases.

Hepato-biliary disease is also a problem in many tropical/subtropical countries. In southeast Asia, Clonorchis sinensis and Opisthorchis viverini infections cause chronic biliary-tract infection, complicated by adenocarcinoma of the biliary system. Praziquantel is e?ective chemotherapy before advanced disease ensues. Fasciola hepatica (the liver ?uke) is a further hepato-biliary helminthic infection; treatment is with bithionol or triclabendazole, praziquantel being relatively ine?ective.... liver disease in the tropics

Liver – Acute Yellow Atrophy

Necrosis. Fatal disease in which the substance of the liver is destroyed. Incidence is rare since the public has been alerted to the dangers of certain chemical toxins, fumes from synthetic glues, solvents, and poisonous fungi.

Symptoms: jaundice, delirium and convulsions.

As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.

Treatment for relief of symptoms only: same as for abscess of the liver.

Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy

Liver – Amoebic Hepatitis

Patients with amoebic dysentery may develop liver complications, usually by blood borne infection via the portal system. Small lesions coalesce to form abscesses capable of destroying liver cells.

Treatment: as for LIVER ABSCESS. ... liver – amoebic hepatitis

Liver Enlargement

From a number of causes ranging from persistent infections to chemical poisoning.

Formula. Fringe Tree bark 2ml; Black root 7ml; Echinacea 4ml; Distilled water to 4oz (120ml). Dose: teaspoon every two hours. (W.H. Black MD, Tecumseh, Oklahoma, USA)

Hypertrophy. Equal parts: tinctures Goldenseal and Fringe Tree. 15-60 drops in water before meals and at bedtime.

Diet. Low fat. Artichokes, Dandelion coffee, lecithin.

Supplements. Vitamin B6. ... liver enlargement

Blood-clotting Tests

Tests to screen for and diagnose bleeding disorders, usually resulting from deficiencies or abnormalities of blood coagulation factors or of platelets (see blood clotting). Tests are also used to monitor treatment with anticoagulant drugs.... blood-clotting tests

Liver, Diseases Of

The LIVER may be extensively diseased without any obviously serious symptoms, unless the circulation through it is impeded, the out?ow of BILE checked, or neighbouring organs implicated. JAUNDICE is a symptom of several liver disorders, and is discussed under its separate heading. ASCITES, which may be caused by interference with the circulation through the portal vein of the liver, as well as by other reasons, is also considered separately. The presence of gallstones is a complication of some diseases connected with the liver, and is treated under GALLBLADDER, DISEASES OF. For hydatid cyst of the liver, see TAENIASIS. Liver diseases in a tropical environment are dealt with later in this section.

In?ammation of the liver, or HEPATITIS, may occur as part of a generalised infection or may be a localised condition. Infectious hepatitis, which is the result of infection with a virus, is one of the most common forms. Many di?erent viruses can cause hepatitis, including that responsible for glandular fever (see MONONUCLEOSIS). Certain spirochaetes may also be the cause, particularly that responsible for LEPTOSPIROSIS, as can many drugs. Hepatitis may also occur if there is obstruction of the BILE DUCT, as by a gall-stone.

Cirrhosis of the liver A disorder caused by chronic damage to liver cells. The liver develops areas of ?brosis or scarring; in response, the remaining normal liver cells increase and form regeneration nodules. Those islands of normality, however, suffer from inadequate blood supply, thus adversely affecting liver function. Alcohol is the most common cause of cirrhosis in the United Kingdom and the USA, and the incidence of the disorder among women in the UK has recently risen sharply as a consequence of greater consumption of alcohol by young women in the latter decades of the 20th century. In Africa and many parts of Asia, infection with hepatitis B virus is a common cause. Certain drugs – for example, PARACETAMOL – may damage the liver if taken in excess. Unusual causes of cirrhosis include defects of the bile ducts, HAEMOCHROMATOSIS (raised iron absorption from the gut), CYSTIC FIBROSIS, cardiac cirrhosis (the result of heart failure causing circulatory congestion in the liver), and WILSON’S DISEASE (raised copper absorption).

Symptoms Some people with cirrhosis have no signs or symptoms and the disease may be diagnosed at a routine medical examination. Others may develop jaundice, OEDEMA (including ascites – ?uid in the abdomen), fever, confusion, HAEMATEMESIS (vomiting blood), loss of appetite and lethargy. On examination, cirrhotic patients often have an enlarged liver and/ or SPLEEN, and HYPERTENSION. Liver function tests, cholangiography (X-ray examination of the bile ducts) and biopsy of liver tissue will help to reach a diagnosis.

Treatment Nothing can be done to repair a cirrhosed organ, but the cause, if known, must be removed and further advance of the process thus prevented. In the case of the liver, a high-protein, high-carbohydrate, low-fat diet is given, supplemented by liver extract and vitamins B and K. The consumption of alcohol should be banned. In patients with liver failure and a poor prognosis, liver TRANSPLANTATION is worthwhile but only after careful consideration.

Abscess of the liver When an ABSCESS develops in the liver, it is usually a result of amoebic DYSENTERY, appearing sometimes late in the disease – even after the diarrhoea is cured (see below). It may also follow upon in?ammation of the liver due to other causes. In the case of an amoebic abscess, treatment consists of oral metronidazole.

Acute hepatic necrosis is a destructive and often fatal disease of the liver which is very rare. It may be due to chemical poisons, such as carbontetrachloride, chloroform, phosphorus and industrial solvents derived from benzene. It may also be the cause of death in cases of poisoning with fungi. Very occasionally, it may be a complication of acute infectious hepatitis.

Cancer of the liver is not uncommon, although it is rare for the disease to begin in the liver – the involvement of this organ being usually secondary to disease situated somewhere in the stomach or bowels. Cancer originating in the liver is more common in Asia and Africa. It usually arises in a ?brotic (or cirrhotic) liver and in carriers of the hepatitis B virus. There is great emaciation, which increases as the disease progresses. The liver is much enlarged, and its margin and surface are rough, being studded with hard cancer masses of varying size, which can often be felt through the abdominal wall. Pain may be present. Jaundice and oedema often appear.... liver, diseases of

Kidney Function Tests

Tests performed to investigate kidney disorders.

Urinalysis is a simple test in which a urine sample is examined under a microscope for blood cells, pus cells, and casts (cells and mucous material that accumulate in the tubules of the kidneys and pass into the urine).

Urine may be tested for substances, such as proteins, that leak into the urine when the kidneys are damaged.

Kidney function can be assessed by measuring the concentration in the blood of substances, such as urea and creatinine, that the kidneys normally excrete.

Kidney function may also be assessed by kidney imaging techniques.... kidney function tests

Liver Biopsy

A diagnostic test in which a small sample of tissue is removed from the liver, usually under local anaesthesia. The main function of this test is to diagnose liver diseases. (See also biopsy.)... liver biopsy

Tea For Liver

Liver problems appear as a sign of weakness shown by your organism after a prolonged consumption of alcohol, drugs or medicines. The main characteristic of these affections is that they are due to system intoxication and need to be repaired as quickly as possible. The liver is the organ responsible for our molecular exhaustion. All the toxins in our body go straight to the liver in order to clear the blood and detoxify the entire mechanism. When the liver is not functioning well, the main symptoms are: fatigue, stress, vascular malfunction and irradiated pain from the liver area to the entire body. Unsolved liver problems may lead to kidney failure and then to pulmonary edema or other respiratory disorder. How Tea for Liver Works A Tea for Liver is a natural supplement that can calm your localized pain and bring relief to those suffering from this affection. The main ingredients of these teas are based on a great amount of nourishing substances that can reconstruct the damaged liver cells or at least increase their action. However, these teas are not recommended for severe liver problems. If the pain is unbearable, a tea is most likely to calm it for a while and then lose its positive effect on your body. If that is the case, you should see a doctor immediately. Efficient Tea for Liver When choosing a Tea for Liver, you must keep in mind the fact that it must be safe and nourishing. You don’t need a tea that is rich in volatile oils or other substances that slow the liver cells’ action. If you are not sure about your abilities to choose the right tea, here are some suggestions: - Green Tea – has all the necessary ingredients to sustain life. Also, its action includes nourishing the coronary system and the arteries, in order to enhance the blood flow through your organs - Black Tea – more powerful than the Green Tea, the Black Tea is very effective, but more dangerous. If you’re also on your period or menopause, it’s best not to take it: it may cause abdominal acidity and discomfort. - Yerba Mate Tea – or the new green tea, how the specialists are calling it. Yerba Mate Tea can be used as a cure in order to rejuvenate the liver, but also as a treatment in cases of low blood pressure or digestive tract infections. Pay attention, though: more than 2 cups of Yerba Mate Tea per day may lead to a series of nervous system complications and even death! Teas you should avoid If you are suffering from liver problems, it’s best to avoid taking a tea with an elevated level of vitamins or acids. Although vitamins get directly to your blood and none of them reaches the liver, they have a tendency to enhance your body’s action towards other affected areas. In other words, they make your antibodies be more preoccupied with a random scratch than with your liver problems. A Tea for Liver needs to be specialized in internal affections and only attract antibodies to the most important damages. Tea for Liver contraindications When taken properly, any Tea for Liver is safe. However, high dosage may lead to a number of complications, such as diarrhea, nausea and even death. If you’re not very sure about starting a treatment based on one of these teas, talk to a specialist in order to gather more information. If there’s nothing that could interfere with your treatment, choose a Tea for Liver and enjoy its wonderful benefits responsibly!... tea for liver

Amoebic Liver Abscess

Usually contracted in a tropical country during foreign travel. Likely to be associated with amoebic dysentery by the organism Entamoeba histolytica from contaminated drinking water or decaying foods (uncooked vegetables), foods exposed to flies. Onset of the disease may not be apparent until years after original infection. It presents with tenderness over the liver. On palpation, liver area is tender and the diaphragm elevated.

Symptoms. Fever, sweating, constitutional upset.

Differential diagnosis: diverticulitis, Crohn’s disease, salmonella, carcinoma, bacillary dysentery.

Alte rnative s:– Blue Flag, Boneset, Burdock, Chaparral, Echinacea, Elecampane, Elder flowers, Eucalyptus, Fringe Tree, Milk Thistle, Marshmallow, Queen’s Delight, Thyme (garden), Wild Indigo, Wild Yam, Yarrow, Yellow Dock.

Tea. Combine: equal parts, Yarrow, Burdock leaves, Marshmallow leaves. 2 teaspoons to each cup boiling water: infuse 10-15 minutes; 1 cup freely.

Decoction. Echinacea 2; Fringe Tree bark 1; Yellow Dock root 1. 2 teaspoons to 2 cups water gently simmered 20 minutes. Half a cup freely.

Formula: Combine: Echinacea 2; Fringe Tree bark 1; Boneset 1; Goldenseal quarter. Dose: Liquid Extracts: 2-4ml. Tinctures: 4-8ml. Powders: 500mg (two 00 capsules, or one-third teaspoon). In water, honey, or cup of Fenugreek tea.

Cold puree. Pass Garlic corm through food blender. Eat with a spoon as much as tolerated. Blend with adjutants: carrots, raisins, apple. ... amoebic liver abscess

Liver, Cirrhosis Of

See cirrhosis.... liver, cirrhosis of

Liver Imaging

Techniques that produce images of the liver, gallbladder, bile ducts, and blood vessels supplying the liver, to aid the detection of disease.

Ultrasound scanning, CT scanning, and MRI are commonly used.

Radionuclide scanning may reveal cysts and tumours and show bile excretion.

X–ray techniques include cholangiography, cholecystography, and ERCP (endoscopic retrograde cholangiopancreatography).

In these procedures, a contrast medium, which is opaque to X-rays, is introduced to show abnormalities in the biliary system.

Angiography reveals the blood vessels in the liver.... liver imaging

Lung Function Tests

See pulmonary function tests.... lung function tests

Personality Tests

Questionnaires designed to define various personality traits or types. Tests may be designed to detect psychiatric symptoms, underlying personality traits, how outgoing or reserved a person is, and predisposition to developing neurotic illness.... personality tests

Respiratory Function Tests

See pulmonary function tests.... respiratory function tests

Skin Tests

Procedures for determining the body’s reaction to various substances by injecting a small quantity of the substance under the skin or by applying it to the skin (usually on patches).

Patch tests are used in the diagnosis of contact allergic dermatitis.

They can also be used to test immunity to certain infectious diseases (such as in the tuberculin test).... skin tests

Cancer – Liver

A primary lesion in the liver is rare. Usually invasion of carcinoma from the pancreas, gall bladder, stomach or intestines. Enlargement is rapid.

Symptoms. Jaundice. Ascites (excess fluid in the abdomen). Tenderness and enlargement of right upper abdomen; hobnail to the touch.

Alternatives: for possible relief of symptoms:–

Dandelion juice (fresh): 4 drachms (14ml) every 4 hours.

Wormwood tea freely.

Tea. Equal parts: Agrimony, Gotu Kola, Milk Thistle. Mix. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup freely.

Decoction. Dandelion 2; Clivers 1; Liquorice 1; Blue Flag root half. Mix. 30g (1oz) to 500ml (1 pint) water gently simmered 20 minutes. Dose: half-1 cup 3 or more times daily.

Tablets/capsules. Blue Flag root, Goldenseal, Prickly Ash.

Formula. Dandelion 2; Milk Thistle 2; Fennel 1; Peppermint 1. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-2 teaspoons. 3 or more times daily.

Biostrath artichoke formula.

Practitioner. Dandelion juice (fresh) 4oz; Wahoo bark Liquid extract 10 drops. Violet leaves Liquid extract 10.5ml. Tincture Goldenseal 10 drops. Dose: 2 teaspoons in water thrice daily. To each dose add 10 drops Liquid extract Oats (avena). (W. Burns-Lingard MNIMH)

Vinchristine. Success has been reported following use of the Periwinkle plant (Vinca rosea).

Greater Celandine has been regarded of value.

Chinese Herbalism. See: CANCER: CHINESE PRESCRIPTION. Also: Pulverised t’ien chihuang (Hypericum japonicum) 1 liang, mixed with rock sugar, with boiled water, 3 times daily. Also of value for cirrhosis.

Epsom’s salt Baths (hot): to encourage elimination of impurities through the skin. Diet. Limit fats. Protein diet to increase bile flow.

Treatment by a general medical practitioner or hospital oncologist. CANCER – LYMPH VESSELS. See: HODGKIN’S DISEASE. ... cancer – liver

Liver – Acute Infectious Hepatitis

Inflammation of the liver from virus infection. As the commonest form of liver disorder, it is often without jaundice or marked liver symptoms apart from general malaise and abdominal discomfort, ‘Gippy tummy’, ‘chill on the liver’. For feverishness, add a diaphoretic.

Treatment. Bitter herbs keep the bile fluid and flowing.

Alternatives. Teas. Agrimony, Lemon Balm, Boldo, Bogbean, Centuary, Dandelion, Hyssop, Motherwort, Wormwood, Yarrow.

Maria Treben. Equal parts: Bedstraw, Agrimony, Woodruff. 2 teaspoons to cup boiling water.

Cold tea: 2 teaspoons Barberry bark to each cup cold water. Infuse overnight. Half-1 cup freely. Tablets/capsules: Blue Flag. Dandelion. Wild Yam. Liquorice.

Formula. Equal parts: Turkey Rhubarb, Dandelion, Meadowsweet. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). 3-4 times daily. Alfred Vogel. Dandelion, Devil’s Claw, Artichoke.

Antonius Musa, physician to Emperor Augustus Caesar records: “Wood Betony preserves the liver and bodies of men from infectious diseases”.

Preventative: Garlic. (Old Chinese)

Milk Thistle: good responses observed.

General. Bedrest until motions are normal. Enema with any one of above herb teas.

Diet. Fat-free. Fasting period from 1-3 days on fruit juices and herb teas only. Artichokes. Dandelion coffee. Lecithin.

See: COCKROACH, The.

Treatment by or in liaison with a general medical practitioner. ... liver – acute infectious hepatitis

Thyroid-function Tests

A group of blood tests used to evaluate the function of the thyroid gland and to detect or confirm any thyroid disorder. The thyroid hormones T3 and T4 are measured, as well as thyroid-stimulating hormone (TSH), the pituitary gland hormone that stimulates the thyroid gland.... thyroid-function tests

Tuberculin Tests

Skin tests used to determine whether or not a person has been exposed to the bacterium that causes tuberculosis. Tuberculin tests are carried out for diagnosis of tuberculosis, and before BCG vaccination. A small amount of tuberculin (purified protein from the bacteria) is injected into the skin. A few days later, the skin reaction, if any, is noted. A reaction indicates previous exposure.... tuberculin tests

Tuning Fork Tests

Hearing tests carried out to diagnose conductive deafness. In the Weber test, a vibrating tuning fork is held against the forehead. If there is conductive hearing loss, the sound seems louder in the affected ear. In the Rinne test, a vibrating tuning fork is held first near the ear, and then against the bone behind it. If it sounds louder when held against the bone, there is conductive hearing loss.... tuning fork tests

Urine Tests

See urinalysis.... urine tests

Acute Fatty Liver Of Pregnancy

a rare and life-threatening complication of pregnancy that usually presents in the third trimester with symptoms of nausea, vomiting, malaise, and abdominal pain. Liver function tests are abnormal and the features of *pre-eclampsia and often *HELLP syndrome are present. *Hepatic encephalopathy, *disseminated intravascular coagulation, and renal failure may develop, and the condition is associated with a high maternal and fetal mortality. Treatment involves a multidisciplinary approach, usually in an intensive care unit.... acute fatty liver of pregnancy

Liver – Hepatitis, Chronic

Term referring to hepatitis where the condition is the result of acute attacks of more than six months duration.

Causes: alcohol excess, drugs (Paracetamol prescribed for those who cannot tolerate aspirin), autoimmune disease, toxaemia, environmental poisons. Clinically latent forms are common from carbon monoxide poisoning. May lead to cirrhosis.

Symptoms. Jaundice, nausea and vomiting, inertia.

Treatment. Bile must be kept moving.

Alternatives:– Decoction. Formula. Milk Thistle 2; Yellow Dock 1; Boldo 1. 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily.

Formula. Barberry bark 1; German Chamomile 2. Dose: Liquid Extracts: 2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 750mg (three capsules or half a teaspoon) thrice daily.

Tablets/capsules. Blue Flag root. Goldenseal.

Astragalus. Popular liver tonic in Chinese medicine. A liver protective in chemotherapy.

Diet. Fat-free. Dandelion coffee. Artichokes. Lecithin.

Supplements. B-vitamins, B12, Zinc.

Treatment by or in liaison with a general medical practitioner. ... liver – hepatitis, chronic

Liver – Hepatitis B

Regarded as more serious than Hepatitis A. A main symptom is a flu-like illness followed by jaundice. Transmitted sexually, blood transfusion or by infected blood as from contaminated needles used by drug abusers. It is the first human virus to be identified with cancer in man. High mortality rate.

Symptoms: nausea and vomiting, fever, dark urine, loss of appetite, skin irritation, yellow discoloration of the skin and whites of eyes, weakness and fatigue.

Treatment. Internal. Silymarin (active principle of Milk Thistle) has been used with good responses. (R.L. Devault & W. Rosenbrook, (1973), Antibiotic Journal, 26;532)

Wormwood tea. 1-2 teaspoons herb to each cup boiling water in a covered vessel. Infuse 10-15 minutes: 1 cup thrice daily.

Formula. Equal parts: Balmony, Valerian, Wild Yam. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 1- 3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Astragalus. Popular liver protective used in Chinese medicine.

Phyllanthus amarus. Clinical trials on 78 carriers of the virus revealed that this plant effectively eliminated the virus from the body in 59 per cent of cases. Treatment consisted of 200mg dried powdered herb (whole plant minus the roots) in capsules, thrice daily for 30 days). (Thyagarajan, S.P., et al “Effect of Phyllanthus amarus on Chronic Carriers of Hepatitis B Virus.” The Lancet, Oct. 1988 2:764-766) External. Castor oil packs for two months.

Treatment by or in liaison with a general medical practitioner. ... liver – hepatitis b

Liver – Cirrhosis

A disease of the liver with hardened and fibrotic patches. Scar tissue obstructs the flow of blood through the liver, back pressure causing damage. As they wear out liver cells are not renewed.

Causes: damage from gall-stones, aftermath of infections, drugs; the commonest is alcohol. Usually made up of three factors: toxaemia (self-poisoning), poor nutrition, infective bacteria or virus.

Symptoms. Loss of appetite, dyspepsia, low grade fever, nosebleeds, lethargy, spidery blood vessels on face, muscular weakness, jaundice, loss of sex urge, redness of palms of hands, unable to lie on left side. Mechanical pressure may cause dropsy and ascites. Alcohol-induced cirrhosis correlates with low phospholipid levels.

Treatment. Bitter herbs are a daily necessity to keep the bile fluid and flowing. Among other agents, peripheral vaso-dilators are indicated. Regulate bowels.

Teas. Balmony, Milk Thistle, Boldo, Bogbean. Dandelion coffee. Barberry tea (cold water). Tablets/capsules. Calamus, Blue Flag, Wild Yam.

Formula. Wahoo 2; Wild Yam 1; Blue Flag root 1. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Milk Thistle (Silybum marianum). Based on its silymarin contents: 70-210mg, thrice daily.

Practitioner. For pain. Tincture Gelsemium: 5-10 drops in water when necessary.

Enema. Constipation may be severe for which warm water injection should be medicated with few drops Tincture Myrrh.

Diet. High protein, high starch, low fat. Reject alcohol. Accept: Dandelion coffee, artichokes, raw onion juice, turmeric as a table spice.

Lecithin. Soy-derived lecithin to antidote alcohol-induced cirrhosis. (Study: Bronx Veterans Affairs Medical Center & Mount Sinai Hospital School of Medicine, New York City)

Supplements. B-complex, B12, C (1g), K, Magnesium, Zinc.

Treatment by or in liaison with a general medical practitioner or gastro-enterologist. ... liver – cirrhosis

Fatty Liver

see nonalcoholic fatty liver disease; acute fatty liver of pregnancy.... fatty liver

Hobnail Liver

the liver of a patient with *cirrhosis, which has a knobbly appearance caused by regenerating nodules separated by bands of fibrous tissue.... hobnail liver

Renal Function Tests

tests for assessing the function of the kidneys. These include measurements of the specific gravity of urine, creatinine *clearance time, and blood urea levels; intravenous urography; and renal angiography.... renal function tests

Stycar Tests

Standard Tests for Young Children and Retardates: tests to detect visual problems in children between the ages of six months and five years. They consist of a series of standardized balls, toys, or letters. The tests were developed by the paediatrician Mary Sheridan.... stycar tests

Synacthen Tests

tests used to assess the ability of the adrenal cortex to produce cortisol. Serum cortisol is measured before and then 30 minutes (or 5 hours) after an intramuscular injection of 250 ?g (or 1 mg) tetracosactide (Synacthen), an analogue of *ACTH. The adrenal glands are considered to be inadequate if there is a low baseline concentration of cortisol or the rise is less than a certain predefined amount.... synacthen tests

Liver – Congestion

Non-inflammatory simple passive congestion is usually secondary to congestive heart failure, injury, or other disorders.

Symptoms: headache, vomiting of bile, depression, furred tongue, poor appetite, lethargy, sometimes diarrhoea. Upper right abdomen tender to touch due to enlargement, pale complexion.

BHP (1983) recommends: Fringe Tree, Wahoo, Goldenseal, Blue Flag, Butternut bark, Boldo, Black root. Treatment. Treat the underlying cause, i.e. heart or chest troubles. Bitter herbs.

Alternatives:– Teas. Balmony, Bogbean, Centuary. 1 heaped teaspoon to each cup boiling water infused 15 minutes. Half-1 cup 3 or more times daily.

Decoction. Dandelion and Burdock roots. Mix. One teaspoon to large cup water simmered gently 20 minutes. Cup 2-3 times daily.

Tablets/capsules. Blue Flag, Goldenseal, Wild Yam.

Formula. Dandelion 2; Wahoo 1; Meadowsweet 1; Cinnamon 1. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Alfred Vogel recommends: Barberry bark, Centuary, Boldo, St John’s Wort, St Mary’s Thistle, Sarsaparilla.

Epsom salt baths (hot) to promote elimination of impurities through the skin.

Diet. Fat-free. Dandelion coffee. Artichokes. Lecithin. ... liver – congestion

Liver – Fatty

Destruction of normal liver cells and their replacement by fat.

Causes: obesity; environmental chemicals, toxins from fevers (influenza, etc).

Alternatives. Teas. Boldo, Clivers, Motherwort, Chaparral. One heaped teaspoon to each cup boiling water infused 15 minutes. 1 cup freely.

Tablets/capsules. Seaweed and Sarsaparilla.

Formula. Fringe Tree 2; Clivers 1; Bladderwrack (fucus) 1. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 1-2 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Cider Vinegar. 2-3 teaspoons to glass water. Drink freely.

Evening Primrose oil. 4 × 500mg capsules daily.

Diet. Fat-free. Dandelion coffee. Artichokes.

Supplementation. Vitamin B6. C. K. Zinc. Kelp. ... liver – fatty

Liver – Injuries

As bleeding cannot be ruled out, no time should be lost seeking hospital treatment.

An immediate surgical repair may be necessary. However, there are ways in which healing can be speeded and body defences sustained. The following promote healing: Fringe Tree being most relevant. To prevent infection it should be combined with Echinacea (anti-microbial).

Alternatives. Teas. Comfrey, Horsetail, Marigold, St John’s Wort, Plantain.

Decoction. Equal parts: Fringe Tree bark; Echinacea root. 1 heaped teaspoon to each large cup water simmered gently 20 minutes. Half-1 cup or as much as tolerated, every 2 hours.

Tinctures. Equal parts: Milk Thistle, Echinacea root. 20-60 drops in water every 2 hours.

Castor oil packs. Applied over liver area. ... liver – injuries

Blood Tests

Analysis of a sample of blood to give information on its cells and proteins and any of the chemicals, antigens, antibodies, and gases that it carries. Such tests can be used to check on the health of major organs, as well as on respiratory function, hormonal balance, the immune system, and metabolism. Blood tests may look at numbers, shape, size, and appearance of blood cells and assess the function of clotting factors. The most important tests are blood count and blood group tests if transfusion is needed. Biochemical tests measure chemicals in the blood (see acid–base balance; kidney function tests; liver function tests). Microbiological tests (see immunoassay) look for microorganisms that are in the blood, as

in septicaemia. Microbiology also looks for antibodies in the blood, which may confirm immunity to an infection. blood transfusion The infusion of large volumes of blood or blood products directly into the bloodstream to remedy severe blood loss or to correct chronic anaemia. In an exchange transfusion, nearly all of the recipient’s blood is replaced by donor blood. Before a transfusion, a sample of the recipient’s blood is taken to identify the blood groups, and it is matched with suitable donor blood. The donor blood is transfused into an arm vein through a plastic cannula. Usually, each unit (about 500 ml) of blood is given over 1–4 hours; in an emergency, 500 ml may be given in a couple of minutes. The blood pressure, temperature, and pulse are monitored during the procedure.

If mismatched blood is accidentally introduced into the circulation, antibodies in the recipient’s blood may cause donor cells to burst, leading to shock or kidney failure. Less severe reactions can produce fever, chills, or a rash. Reactions can also occur as a result of an allergy to transfused blood components. All

blood used for transfusion is carefully screened for a number of infectious agents, including HIV (the AIDS virus) and hepatitis B and hepatitis C.

In elderly or severely anaemic patients, transfusion can overload the circulation, leading to heart failure.

In patients with chronic anaemia who need regular transfusion over many years, excess iron may accumulate (haemosiderosis) and damage organs such as the heart, liver, and pancreas.

Treatment with desferrioxamine to remove excess iron may be needed.... blood tests

Hearing Tests

Tests carried out to assess hearing. Hearing tests are performed as part of a routine assessment of child development and when hearing impairment is suspected. The tests are sometimes included in a general medical examination. Hearing tests may also be used to identify the cause of tinnitus or dizziness.

An audiometer (an electrical instrument) is used to test an individual’s ability to hear sounds at different frequencies and volumes. The lowest level at which a person can hear and repeat words (the speech reception threshold) is tested, as is the ability to hear words clearly (speech discrimination). The type of hearing loss (see deafness) is determined by holding a tuning fork to different parts of the ear.... hearing tests

Intelligence Tests

Tests designed to provide an estimate of a person’s mental abilities. The most widely used are Wechsler tests of which there are 2 basic types: the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Intelligence Scale for Children (WISC). Each is divided into verbal (concerned with language skills) and performance sections, including measures of constructional ability and visual-spatial and perceptual ability (interpretation of shapes). Other tests include the Stanford–Binet test, which is used mainly as a measure of scholastic ability.

In most intelligence tests, scoring is based on mental age (MA) in relation to chronological age (CA). The intelligence quotient (IQ) is MA divided by CA, multiplied by 100. The tests are devised to ensure that 3 in 4 people have an IQ between 80 and 120. They are standardized so that the score indicates the same relative ability at different age levels.

Intelligence tests may be used to assess school or job aptitude. However, they have been criticized for their alleged bias regarding gender and race.... intelligence tests

Liver Cancer

A cancerous tumour in the liver. The tumour may be primary (originating within the liver) or secondary (having spread from elsewhere, often the stomach, pancreas, or large intestine). There are 2 main types of primary tumour: a hepatoma, which develops in the liver cells, and a cholangiocarcinoma, which arises from cells lining the bile ducts.The most common symptoms of any liver cancer are loss of appetite, weight loss, lethargy, and sometimes pain in the upper right abdomen.

The later stages of the disease are marked by jaundice and ascites (excess fluid in the abdomen).

Tumours are often detected by ultrasound scanning, and diagnosis may be confirmed by liver biopsy.

A hepatoma can sometimes be cured by complete removal.

In other cases, anticancer drugs can help to slow the progress of the disease.

It is usually not possible to cure secondary liver cancer, but anticancer drugs or, in some cases, removal of a solitary metastasis may be advised.... liver cancer

Liver Disease, Alcoholic

Damage to the liver caused by excessive alcohol consumption.

The longer consumption goes on, the more severe the damage.

The initial effect is the formation of fat globules between liver cells, a condition called fatty liver.

This is followed by alcoholic hepatitis, and damage then progresses to cirrhosis.

Alcohol-related liver disease increases the risk of developing liver cancer.

Liver function tests show a characteristic pattern of abnormalities, and liver biopsy may be needed to assess the severity of damage.

There is no particular treatment, but abstinence from alcohol prevents further damage.

Treatment for alcohol dependence may be required.... liver disease, alcoholic

Liver, Disorders Of

The liver is a common site of disease. The most significant liver conditions include alcohol-related disorders (see liver disease, alcoholic), hepatitis, and liver cancer. Disorders can also result from infection. Certain viruses cause hepatitis (see hepatitis, viral). Bacteria may spread up the biliary system to the liver, causing cholangitis or liver abscess. Parasitic diseases affecting the liver include schistosomiasis, liver fluke, and hydatid disease. Certain metabolic disorders, such as haemochromatosis and Wilson’s disease, may involve the liver. Other types of liver disorder include Budd–Chiari syndrome, in which the veins draining the liver become blocked. Occasionally, defects of liver structure are present at birth. Such defects principally affect the bile ducts; one example is biliary atresia, in which the bile ducts are absent. Because the liver breaks down drugs and toxins, damage to liver cells can also be caused through overdose or drug allergy. (See also jaundice; liver failure; portal hypertension.)... liver, disorders of

Liver Failure

Severe impairment of liver function that develops suddenly or at the final stages of a chronic liver disease. Because the liver breaks down toxins in the blood, liver failure causes the levels of the toxins to rise, affecting the functioning of other organs, particularly the brain. Liver failure may be acute or chronic. Symptoms of acute liver failure develop rapidly and include impaired memory, agitation, and confusion, followed by drowsiness. The functioning of other organs may become impaired, and the condition may lead to coma and death. Features of chronic liver failure develop much more gradually and include jaundice, itching, easy bruising and bleeding, a swollen abdomen due to accumulated fluid, red palms and, in males, gynaecomastia (enlarged breasts) and shrunken testes. Chronic liver failure may suddenly deteriorate into acute liver failure.

Acute liver failure requires urgent hospital care.

Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.

Consumption of alcohol should cease in all cases.

The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.

For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure

Liver Transplant

Replacement of a diseased liver with a healthy liver removed from a donor. Liver transplants are most successful in the treatment of advanced liver cirrhosis in people with chronic active hepatitis or primary biliary cirrhosis. People who have primary liver cancer are rarely considered for transplantation because there is a high risk that the tumour will recur.During this procedure, the liver, gallbladder, and portions of the connected blood and bile vessels are removed.

The donor organs and vessels are connected to the recipient’s vessels.

After the transplant, the recipient is monitored in an intensive care unit for a few days and remains in hospital for up to 4 weeks.... liver transplant

Tests, Medical

Tests may be performed to investigate the cause of symptoms and establish a diagnosis, to monitor the course of a disease, or to assess response to treatment. A medical testing programme carried out on apparently healthy people to find disease at an early stage is known as screening.

The accuracy of a test is based on its sensitivity (ability to correctly identify diseased subjects), specificity (ability to correctly identify healthy subjects), and predictive value.

The predictive value is determined by a mathematical formula that involves the number of accurate test results and the total number of tests performed.

The best tests have both high specificity and high sensitivity, and therefore high predictive value.... tests, medical

Bolam And Bolitho Tests

where clinical *negligence is claimed, tests used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors. The 1957 case of Bolam v Friern Hospital Management Committee established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. In 1997 this standard of care test was amended by the case of Bolitho v City and Hackney Health Authority, which requires the doctor’s behaviour to satisfy the judgment not only of responsible medical opinion but also of a court’s own independent logical analysis.... bolam and bolitho tests

Dexamethasone Suppression Tests

(DSTs) tests based on the principle that appropriate doses of *dexamethasone can suppress the output of cortisol from the adrenal glands in the normal state and that this ability is reduced or lost in *Cushing’s syndrome. In the overnight DST 1 mg of dexamethasone is administered at midnight and the serum cortisol level is measured at 9.00 am the next morning. Failure to suppress cortisol output may indicate Cushing’s syndrome but also occurs in patients with obesity and depressive illness. In the low-dose DST (0.5 mg dexamethasone every 6 hours for 48 hours), cortisol suppression occurs in patients with obesity and depression but not in those with Cushing’s syndrome. In the high-dose DST (2 mg dexamethasone every 6 hours for 48 hours), cortisol is suppressed in patients with Cushing’s disease (in which excess amounts of ACTH are secreted by the pituitary gland) but not in those with Cushing’s syndrome due to other causes. Although the low- and high-dose tests are unreliable, all three tests should be performed to aid the diagnosis of Cushing’s syndrome.... dexamethasone suppression tests

Nonalcoholic Fatty Liver Disease

(NAFLD) a spectrum of conditions affecting the liver in the absence of excessive alcohol consumption. NAFLD is a common cause of referral for patients with abnormal liver function tests. Fatty liver is excessive fat accumulation in the liver seen as an area of brightness within the liver on ultrasound examination. Fatty liver does not lead to irreversible liver damage in the majority of cases. Nonalcoholic steatohepatitis (NASH) is inflammation of the liver associated with accumulation of fat. It is often linked to insulin resistance, diabetes, hypertension, obesity, and *metabolic syndrome. Treatment involves dietary modification, regular physical exercise, weight reduction, and management of underlying conditions (e.g. diabetes, hypertension, and hiperlipidaemia). NASH may predispose to *cirrhosis and may ultimately require liver transplantation.... nonalcoholic fatty liver disease



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