The liver is a large self-repairing organ in our bodies. It is responsible for filtering blood before it passes through our bodies. The liver also helps to detoxify any toxins such as chemicals and medications. It also helps with the digestive tract by secreting bile into the intestines (Hoffman, 2019).
Liver cirrhosis is a chronic liver disease caused by scar tissue replacing healthy liver tissue. It is usually the final pathway of all liver disease. The liver is an organ that tries to repair itself, however each time it is injured scar tissue is formed. Liver damage can be done by excessive alcohol consumption, hepatitis, fatty liver disease, medication intake and much more. The fibrosis of the liver can eventually result to liver failure. A primary cause of liver cirrhosis is alcohol abuse. Alcohol “accounts for 20% to 50% of the prevalence of cirrhosis of the liver”.
Figure 1: Shows the number of deaths from alcoholic liver disease (Liver Disease in Canada, 2014)
Fig 2. Demonstrates the percentage of males and females categorized as heavy drinkers by age and gender (Canadian Community Health Survey, 2016)
“About 10 percent to 15 percent of people with alcoholism develop cirrhosis, but many survive it. Many are unaware that they have it, and about 30 percent to 40 percent of cirrhosis cases are discovered at autopsy (Anand 1999). The 5–year survival rate for people with cirrhosis who stop drinking is about 90 percent, compared with 70 percent of those who do not stop drinking” (Alcohol Research & Health, 2003)
Ultrasound is a diagnostic imaging tool that has been used to help diagnose cirrhosis. Ultrasound helps with detecting liver size, texture/tissue, nodularity, presence of lymph nodes and blood flow patterns even before the patient presents with any symptoms. With early diagnosis of liver cirrhosis, a treatment plan to decrease alcohol intake can be taken into effect.
Refraining from alcohol consumption improves the survival rate with cirrhosis. However, with more advanced stages of liver cirrhosis, abstinence of alcohol does not make much of a difference. Liver transplant is usually the only method in changing the prognosis of late stage alcohol induced liver cirrhosis. In Canada, a 6-month abstinence of alcohol is required for those requiring a liver transplant. Due to this requirement, only 10% of liver transplants are alcohol related cirrhosis patients. More recently, studies to challenge the 6-month sobriety rule have been taken into place. A 3-year pilot program has been issued to test whether a 6-month sobriety is effective in terms of a successful liver transplant. This program was put into effect after a man died two weeks after his diagnosis. His wife, Debra Selkirk had issued the claim which “argued that the six-month sober rule violates the right to life, liberty, and security of the person, essentially condemning hundreds of alcoholic patients to death for “no justifiable reason”. She also argued that the rule violates the Charter’s equality guarantee since other patients who have lifestyle-related diseases are not forced to change their habits before they can be eligible for a transplant.” (Wise Health Law, 2017)This pilot project hopes to decrease the number of Canadians who die from alcoholic liver disease annually.
Resources
Gerstenmaier, J. F., & Gibson, R. N. (2014). Ultrasound in chronic liver disease. Insights into Imaging, 5(4), 441–455. doi: 10.1007/s13244-014-0336-2
Hoffman, M. (2019, May 18). Liver (Anatomy): Picture, Function, Conditions, Tests, Treatments. Retrieved from https://www.webmd.com/digestive-disorders/picture-of-the-liver#1
The Epidemiology of Alcoholic Liver Disease. (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/arh27-3/209-219.htm
Statistics Canada. (2017, September 27). Health Fact Sheets Heavy drinking, 2016. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-625-x/2017001/article/54861-eng.htm
Welcome to the Canadian Liver Foundation (CLF)'s new website. (n.d.). Retrieved from https://www.liver.ca/
Wise Health Law. (2017, September 19). Pilot Project Makes Alcoholic Patients Eligible for Transplants. Retrieved from https://www.wisehealthlaw.ca/blog/hospitals/pilot-project-alcoholic-liver-transplants/