The Liver
The Liver is located in the upper right portion of the abdomen. It is the largest solid organ in the body. The liver plays a vital role in many bodily functions from protein and bile production to blood clotting and cholesterol, glucose, and iron metabolism. The liver also prevents shortages of nutrients by storing vitamins, minerals, and sugars. The liver is also responsible for helping our bodies fight infection by removing bacteria from the bloodstream.
Liver Disease: A broad term used to define any disturbance of liver function that causes illness. Usually, more than 75% of liver tissue needs to be affected before decrease in function occurs. Alcohol abuse is the most common cause of liver disease in North America. Treatment is specific to the type of liver disease the person has. Liver transplantation is the final option for patients whose liver has failed.
Cirrhosis: A type of liver disease that describes permanent scarring of the liver. Normal liver cells are replaced with scar tissue that is incapable of performing any liver function. Treatment may consist of medications to control the amount of protein absorbed in the diet. Low sodium diet and water pills may also be required to minimize water retention. In patients with ascites (fluid collection in the abdominal area), the excess fluid may have to be occasionally removed with a needle known as a paracentesis.
Hepatitis: Inflammation of the liver cells. This can happen from the presence of an infection.
Hepatitis A: Viral infection that is spread through fecal-oral route. Hepatitis A causes an acute inflammation of the liver which generally resolves spontaneously. Thorough hand washing is the best preventative measure for this type of liver disease. Hepatitis A vaccine can prevent this infection. Treatment mostly consists of supportive care to maintain hydration while the body’s immune system fights and resolves the infection.
Hepatitis B: Spread by exposure of body fluids often from needles from drug abusers, contaminated blood, and sexual contact. Hepatitis B can lead to cirrhosis and liver cancer. Hepatitis B vaccine can prevent this infection. Treatment consists of antiviral medications.
Hepatitis C: Is the cause of chronic hepatitis. The infected individual may not even recall any acute illness. It is spread by the exposure to body fluids. There is no vaccine for this virus. The disease may also lead to cirrhosis and liver cancer. Treatment also consists of antiviral medications.
The Gallbladder
The gallbladder is a sac located underneath the liver. It stores and concentrates bile produced by the liver. Bile aids in the digestion of fats and is released from the gallbladder into the small intestine in response to food. The pancreatic duct joins the common bile duct at the small intestine adding enzymes to aid in digestion.
Cholecystitis: Inflammation of the gallbladder. In most cases, cholecystitis is caused by gallstones that block the tube leading out of your gallbladder. This results in a buildup of bile that can cause inflammation. Other causes of cholecystitis include bile duct problems and tumors. If left untreated, cholecystitis can lead to serious complications, such as a gallbladder that becomes enlarged or that ruptures. Once diagnosed, cholecystitis requires a hospital stay. Treatment for cholecystitis often eventually includes gallbladder removal.
Cholelithiasis: Cholelithiasis refers to the formation of gallstones in the gallbladder. Gallstones can vary in size and shape from as small as a grain of sand to as large as a golf ball. The gallbladder may contain a single large stone or many smaller ones. Pseudoliths, sometimes referred to as sludge, are thick secretions that may be present within the gallbladder, either alone or in conjunction with fully formed gallstones. Low fiber and high cholesterol diets have been found to increase the risk of gallstone formation.
Treatment: Gallstones can sometimes be dissolved by oral ursodeoxycholic acid, but it may be necessary for the patient to take this medication for up to two years. Gallstones may recur, however, once the drug is stopped. Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) following endoscopic retrograde cholangiopancreatography (ERCP). Gallstones can be broken up using a procedure called extracorporeal shock wave lithotripsy (often simply called “lithotripsy”), which is a method of concentrating ultrasonic shock waves onto the stones to break them into tiny pieces. They are then passed safely in the feces. However, this form of treatment is suitable only when there are a small number of gallstones. Complete removal of the gallbladder or cholecystectomy is another treatment option.
The Pancreas
The pancreas is a large gland behind the stomach and close to the first part of the small intestine. It secretes digestive juices into the small intestine through a tube called the pancreatic duct. The pancreas also releases the hormones insulin and glucagon into the bloodstream.
Pancreatitis: Pancreatitis is the inflammation of the pancreas. It is caused when digestive enzymes start digesting the actual pancreas itself. It may be a acute or chronic disease. Acute pancreatitis occurs rapidly and is usually resolved in a few days after being treated. Treatment consists of intravenous fluids for hydration, antibiotics, and medications to relieve abdominal pain. Chronic pancreatitis does not heal or improve. Over time it worsens and leads to permanent damage. A major cause of this is from alcohol abuse. Other causes are cystic fibrosis, high calcium and fat levels in the blood, medications, and autoimmune disorders. Treatment for chronic pancreatitis often involves hospital admission, intravenous fluids, pain medications, nutritional support, oral pancreatic enzymes, and the cessation of alcohol and smoking.
Pancreatic Cancer: Pancreatic cancer is the fourth and fifth most common cancer in men and women. Pancreatic ductal adenocarcinoma accounts for 90% of cancers of the pancreas. Pancreatic cancer is very life threatening and often difficult to diagnose in the early stages making it a very deadly disease. Of pancreatic cancers, 60% develop in the pancreatic head and 40% develop in the body and tail. Symptoms at first may be very vague and unnoticeable. Possible treatments include surgery, radiation, chemotherapy, and targeted therapy that uses substances that attack the cancer cells without harming the normal cells.
References
Pancreatitis. (2014, March 3). Retrieved March 9, 2014, from MedlinePlus website: http://www.nlm.nih.gov/medlineplus/pancreatitis.html
Stevens, T. (2014). Pancreatic neoplasms. Retrieved March 8, 2014, from Cleveland Clinic website: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/pancreatic-neoplasms
Treatment of gallstone and gallbladder disease. (2014). Retrieved March 9, 2014, from The Society for Surgery of the Alimentary Tract website: http://www.ssat.com/cgi-bin/chole7.cgi
Wedro, B. (2014). Liver disease facts. Retrieved March 9, 2014, from MedicineNet.com website: http://www.medicinenet.com/liver_disease/article.htm