Examining the reasons behind a rise in deaths from liver disease

Published on Monday 9 January 2012 09:48

CHRISTMAS may be over but many people will still be left with lingering feelings of regret about exactly how much they ate or drank over the festive period.

Alcohol is such an accepted part of British society today it is so easy for drinkers to lose track of how many units they have consumed, but when does a social or domestic habit start causing harm?

According to figures from NHS Northamptonshire, the total number of people in the county who died from chronic liver disease including cirrhosis more than doubled between 1993 and 2009.

A total of 11 men and 16 women died in 1993 but, by 2009, these statistics had risen to 49 men and 29 women.

And according to LAPE (Local Alcohol Profiles for England) a total of 170 men and 71 women died between 2007 and 2009 due to causes specifically linked to alcohol.

According to Dr Udi Shmueli, consultant gastroenterologist at Northampton General Hospital, he has dealt with a steadily increasing number of liver disease cases, including younger people and those who have been heavily drinking since they were young.

He explained that drinkers can be unaware of the damage they are doing to their livers until they are faced with a symptom such as bleeding from veins in the gullet, swelling of the abdomen or jaundice, which indicates that severe damage has been done.

He said: “If someone has cirrhosis, irreversible scarring and damage to the liver from alcohol, if they continue to drink there is a 50 per cent chance they will be dead in two years.

“If they stop drinking there is a good chance they will have a normal life expectancy.

“Even when there is irreversible damage, there can be enough liver function to give people a normal life expectancy if they stop damaging it.”

If the liver cannot repair itself and the damage has gone too far then a liver transplant may be necessary, a procedure which can involve a waiting time of several months.

The liver’s primary function is to detoxify the blood, breaking down any potential toxins. Its job is also to break down any proteins that could cause someone to feel ill.

Dr Udi said: “People who have cirrhosis might feel tired or confused as the liver would detoxify the blood. It also makes bile, another toxin which, if it isn’t cleared, can make you feel unwell.

“It also helps the blood to clear so, if your liver fails, your blood won’t clot.”

“Part of the worrying thing about liver damage is you can’t often tell it is happening,” said Dr Udi. “But people should be able to count their units. Suppliers don’t always put units on bottles, just the percentage of alcohol.

“But what 12 per cent means is 12 units in a litre of wine and a bottle is three quarters of a litre.”

He continued: “People know when they are alcoholics because they simply can’t stop. But often in outpatient clinics we see perfectly normal people who come because they are unwell in one form or another and you find alcohol is the problem.

“Occasionally we get people with cirrhosis established liver problems who don’t go around getting drunk but who might go out at lunchtime and have a couple of glasses of wine. But if you have had a couple of glasses at lunch and you have one in the evening or a pint of beer, then you have had three glasses. maybe you might have a couple more and you can end up having 10 units in one day, then at the weekend you might have a bit more, but 10 units a day would be 70 units a week.

“We see very nice people and very affable people, probably employed and perhaps in a high earning occupation, but they socialise and have too many drinks on a regular basis.”

Much of Dr Udi’s work is in dealing with the serious health effects of alcohol abuse.

He said that bleeding in the gullet is one of the most unpleasant conditions he has to deal with.

He said: “People know what varicose veins look like, well when there is cirrhosis you can get these in the gullet, but it is not as terrible here as it is in the north of the country and from what our junior doctors tell me we don’t get as many big bleeds as in Leicester.”

Another commonly seen problem is chronic pancreatitis which, according to Dr Udi, can cause serious pain from the abdomen through to the back. yet there is little that medical professionals can do to help with this condition.

Alcohol is also directly linked to dementia, stroke and cancer of the oesophagus.

“People pickle themselves,” Dr Udi said.

“We have lots of people who abuse their body in one way or another with drugs, alcohol or both, we have always had them and we are getting more and more. I think people need to have an idea of what they are drinking.”

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