Preventing liver disease
Congenital liver diseases can’t be prevented since they’re present from birth.
All that can be done is to treat symptoms as they arise. But much can be done to prevent liver disease that’s the result of a viral infection, alcohol and/or drug abuse, and diet choices.
Here are some steps you can take to support your liver in doing its job, and to prevent liver disease:
Maintain a healthy weight
Fat accumulation in the liver as a result of an unhealthy diet can cause serious liver damage. This is known as non-alcoholic fatty liver disease (NAFLD) and often affects people who are overweight or obese. Weight loss is recommended, as are regular exercise and a healthy, low-fat, carbohydrate-controlled diet.
Maintain excellent hygiene
Good hygiene habits will go a long way to preventing hepatitis A, as the virus is spread by coming into contact with infected faeces. It’s essential to wash your hands after going to the toilet, and after changing a baby’s nappy. You also need to wash your hands before working with food. And remember to boil your drinking water if you’re not sure that it’s clean.
If you haven’t been vaccinated against hepatitis but have been exposed to it, your doctor can give you preventive passive vaccine. This is done through an injection of donated blood that contains immunoglobulins or antibodies to the hepatitis A and B viruses. It’s not needed if you’ve already been infected with the virus.
More importantly, a preventive active vaccine against hepatitis A is available, and is often used as a preventative mechanism for staff in day-care centres or health settings. The vaccine is recommended if you’re travelling to a country where there’s a high prevalence of hepatitis A (your travel clinic will tell you if you need it).
In South Africa, vaccination against hepatitis B has been part of the routine childhood immunisation programme since 1995. The vaccine is given to children at the ages of 6, 10 and 14 weeks, along with the oral polio vaccine and the DPT (diphtheria, pertussis, tetanus) vaccine. The other vaccines don’t interfere with the hepatitis B vaccine, and there’s no increased risk of side effects when they’re given at the same time.
Up until 1995, hepatitis B vaccine was only given to people in high-risk groups, particularly healthcare workers. Children and adults born before 1995 will probably not have been vaccinated against hepatitis B. Currently, however, there’s move afoot to introduce a birth-dose hepatitis B vaccine.
It’s advisable for people who are sexually active to be vaccinated against hepatitis B. If you’re a known hepatitis B carrier, all family and household members need to be vaccinated against the virus.
In older children and adults, the vaccine is given in three doses, usually over a period of six months. It’s important that the three doses of vaccine be given with at least one month spacing between them, in order for good immunity to be achieved.
No vaccine for hepatitis C has been developed as yet.
Avoid medicine overdose
Paracetamol is the most frequently used over-the-counter painkiller, and paracetamol overdose is the most common cause of liver failure and chronic liver damage that requires liver transplantation in developed countries.
It’s essential to stick to the recommended dosages for this medication, and not to take any medication without consulting your doctor. Medication and alcohol should never be mixed.
Drink moderately and avoid drug use
Inflammation in the liver can be caused by heavy drinking over a long period of time. If left untreated, scarring can occur, leading to liver cirrhosis.
The ability to process alcohol differs from person to person. In South Africa, the recommended amount is no more than one drink (12g of alcohol) per day for women, and no more than two drinks per day for men.
Illegal drugs such as heroin, cocaine and inhalants can cause severe liver injury and should be avoided at all costs.
To detox, or not
Will it help to go on a “detox diet”? The simple answer is “no”. It may sound like a great concept but, unfortunately, many of the claims made by detox-diet promoters are exaggerated, and not based on scientific evidence.
While some detox diets recommend healthy habits like eating more fruit and vegetables for a period of time, it’s best to just follow a balanced diet and active lifestyle.
Supplements containing essential phospholipids (which make up the protective membrane around cells) may have protective and restorative properties for your liver, among other proven health benefits. Ask your pharmacist or doctor if you’re unsure whether these supplements could benefit you.
Prevention is the best medicine. Follow a healthy lifestyle, vaccinate yourself against hepatitis A and B and protect your liver in this way.
What is liver disease
Reviewed by Dr Mark Sonderup, B Pharm, MB ChB, FCP (SA). Senior Specialist, Division of Hepatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital. March 2018.