The liver is the largest internal organ of the human body and it is considered a silent worker with hundreds of functions. Unfortunately, early liver disease frequently has no obvious symptoms and many Filipinos are surprised when they are incidentally diagnosed with viral hepatitis, fatty liver, liver cirrhosis, or even liver cancer.
According to Dr. Edhel Tripon, Hepatologist and Vice President of the Hepatology Society of the Philippines, though there are many causes of liver disease in the Philippines, the top three causes of liver disease in Filipinos are the following:
1. Chronic Viral Hepatitis (B and C)
2. Fatty Liver (Metabolic Associated Fatty Liver Disease)
3. Alcoholic Liver Disease
All of the aforementioned causes of liver disease may cause long term liver inflammation and injury that can lead to cirrhosis of the liver (scarring of the liver). It is in patients with liver cirrhosis that tumors in the liver are more commonly found. "It is Hepatitis B, in particular, that remains to be a problem, with an estimated 10 million Filipinos carrying the virus, this is based on a UP NIH (University of the Philippines National Institutes of Health) study led by Dr. Janus Ong," shared Dr. Tripon. Hepatitis B is the most common cause of liver cirrhosis and liver cancer in Filipinos. Although less common in the Philippines, Hepatitis C prevalence is estimated to be about 400,000-600,000 in the Philippines. Both Hepatitis B and Hepatitis C have effective antivirals that can be used to prevent complications like cirrhosis and liver cancer.
How can we avoid and prevent liver disease ?
1. Practice a healthy diet
"Fatty liver is the fastest rising cause of liver cancer and cirrhosis worldwide," said Dr. Tripon. "These are found in patients who are overweight, diabetic, or hypertensive. So you can protect yourself from fatty liver by having a healthy diet."
Increasing the percentage of vegetables and fruits, cutting down on excess calories, avoiding flavored drinks, processed food, and fast food are simple ways to avoid getting excess liver fat.
Individuals who are overweight and have fatty liver are advised to lose about 5-10 % of their current body weight gradually.
2. Get regular exercise
A sedentary lifestyle is harmful to not just the liver but can also put you at risk of cardiovascular diseases, diabetes, and overall increase the risk of early death.
Doing regular physical activity can do much to prevent many types of complications in the body, including reducing liver fat as supported by this study. The same research has found that aerobic and resistance training can do much to prevent the progression of fatty liver. Thirty minutes of exercise 5-6 x a week at least through brisk walking, running, biking, or skipping rope at home is already beneficial, just do whatever you can to get moving. If you have other illnesses, it is advised to consult your doctor regarding the exercise best suited for you.
3. Avoiding alcohol intake and quitting smoking
There is no more safe level of alcohol drinking, and although previously thought that alcohol in small quantities are protective for cardiovascular disease, it has been shown that whatever questionable benefit there may be, this benefit is not gained in those who are overweight or obese. Alcohol intake can cause liver inflammation that may lead to long term liver damage. Smoking is also known to increase the rate of liver damage and cirrhosis, and is a well known carcinogen, so it is best to advise current smokers to quit the habit.
4. Get tested
Dr. Tripon shared that the majority of liver cancer cases are beyond cure at diagnosis, which is unfortunate because liver cancer is curable when diagnosed early.
Liver diseases, including cirrhosis and liver cancer, have no symptoms in their early stages. The diseases that lead to these conditions often go undiagnosed until patients have advanced complications. It is then advisable to include liver tests, including viral hepatitis screening in patients at risk for liver disease or those who have family history of liver disease.
The Medical City's Center for Liver Disease Management and Transplantation offers a way to detect liver diseases early. The FibroScan 502 Touch is a painless and non-invasive alternative to liver biopsy that uses ultrasound-based technology to check for fatty liver or scarring due to liver injury, and detects cirrhosis at its early stages.
5. Get vaccinated for Hepatitis B
Getting vaccinated is another preventive measure. Republic Act 10152 or the Mandatory Infants and Children Health Immunization Act of 2011 provides mandatory free hepatitis B vaccination to all infants. All children should receive the Hepatitis B vaccine in the first 24 hours of life and complete the rest of the vaccine series before they turn one.
"Liver cancer actually is the first vaccine-preventable cancer because the most common cause of liver cancer in the world and the Philippines is still hepatitis B," said Dr. Tripon. "So if you get protected against hepatitis B, you also protect yourself against liver cancer."
Patients who are already diagnosed with liver cirrhosis and liver cancer are best managed by specialists who have training and experience in managing these complex conditions. The Medical City Center for Liver Health and Transplantation (Liver Center) is one of the few institutions in the country that can offer liver tumor directed treatment including microwave ablation, transarterial chemoembolization (TACE) or radiation therapy (SIRT). In addition, the Liver Center has a team of doctors (hepatologists, surgeons, oncologists, intensivists) and paramedical professionals that work together with patients and their families in the surgical management of liver cirrhosis and cancer. These include complex liver surgeries and liver transplantation.
As the adage goes, prevention is better than cure. Do not wait for your liver to get irreparable damage. Being more mindful of your lifestyle and diet as early as possible can go a long way in maintaining a healthy liver. Keep yourself informed and include liver testing in your annual health checks to enjoy a long, liver-disease free life.
To learn more about the services and treatments offered at The Medical City, visit its website or reach out through its official Facebook page.
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