Liver disease: NHS Doctor talks about link with alcohol
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Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease around the world, driven mainly by poor diet. Because the condition is void of symptoms in the initial stages some individuals go on to develop life-long complications. In the advanced stages, many of these patients report a debilitating itch known as pruritus, that worsens at certain times of the day.
According to several health bodies itching associated with liver disease tends to be concentrated in the soles of the feet and palms of the hands.
In 2015, a report published in the RPC Journals explained that patients with liver disease experience variations in the intensity of their itch throughout the day.
The worst itch, according to the report, may occur “in the late evening and early night-time”.
Scientific findings published in the journal Gastroenterology, suggest that keratinocyte cells at the surface of the skin may be responsible for the “devastating” itch associated with fatty liver disease.
“Cholestatic itch is a debilitating symptom that has a significant prevalence in patients with hepatobiliary diseases” explained the study authors.
The researchers continued: “The initial ideas were that it plays a role in how the skin is layered and in skin barrier function.”
However, the findings of the study suggested that the skin may act as a sensory organ in fatty liver disease.
Wolfgang Liedtke, Professor of Neurology from the Duke School of Medicine, added: “The skin cells themselves are sensory under certain conditions, specifically the outermost layer of cells, the keratinocytes.
The study showed that in patients with a specific type of liver disease called primary biliary cholangitis (PBC), patients are left with a surplus of lysophosphatidylcholine (LPC) and phosphorylated lipid, or fat circulating in the bloodstream.
The scientists then demonstrated that when injected into the skin, LPC evokes a debilitating itch.
It should be noted that in fatty liver disease, itching does not generate a rash or lesions on the surface of the skin.
Chronic itching, however, can lead to the development of visible irritation, redness or infections of the epidermis.
Unfortunately, treatment for itching associated with the condition remains an unmet medical need.
The gold standard for diagnosing non-alcoholic fatty liver disease is a liver biopsy and blood tests, but the latter does not always pick up the condition.
“The condition may also be spotted during an ultrasound scan of your tummy,” says the NHS.
Patients who experience a sudden onset of symptoms like abdominal swelling, spider veins or yellowing of the skin, are encouraged to see a GP.
Though there is currently no specific medication for NAFLD, making healthy lifestyle choices can help reverse the condition.
Research suggests losing weight is the single best thing a person can do to control or reverse their symptoms.
“Treatment also may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications,” explains the NHS.
The health body adds: “You may be advised to have regular appointments with your doctor to check your liver function and look for signs of any new problems.”
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