Liver disease: NHS Doctor talks about link with alcohol
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A healthy liver should contain little to no fat. However, it is estimated that up to one in every three people in the UK has early stages of non-alcoholic fatty liver disease (NAFLD), where there are small amounts of fat in the liver. Because symptoms are rare in these stages, the condition is often undiscovered until liver damage is extensive.
Muscle wasting is considered one of the “major complications” of end-stage liver disease.
Its incidence has been shown to increase as the condition advances, according to the World Journal of Gastroenterology.
The journal explained in 2015, that muscle wasting is defined as the progressive and generalised loss of muscle mass.
It added: “Muscle depletion is a common feature of chronic liver disease found in approximately 40 percent of patients with cirrhosis.
“Liver cirrhosis is a critical health problem associated with several complications, including skeletal muscle atrophy, which adversely affects the clinical outcomes of patients independent of their liver functions.
“However, the precise mechanism underlying liver cirrhosis-induced muscle atrophy has not been elucidated.”
Several mechanisms have been proposed to elucidate the role of muscles in liver cirrhosis.
One of the main causes of muscle wasting in cirrhosis is patients going into a catabolic phase overnight.
This stage of fasting occurs four to twelve hours after eating due to limited glycogen stores in the liver.
When the body goes into a catabolic state, it breaks down or loses overall mass, in both fat and muscle.
Impaired muscle protein synthesis is also believed to contribute to the progression of muscle wasting in liver disease.
Other potential causes may include nausea and early satiety caused by a build-up of ascites, or bowel dysmotility which contribute to poor nutrient intake in these patients.
Finally, maldigestion is another important component of reduced intestinal absorption in these patients.
According to the Cleveland Clinic, muscle wasting due to liver disease could cause one arm or leg to appear smaller than the other.
Equally, a person may experience weakness in one of the limbs, or numbness and tingling.
Generally, as muscle atrophy worsens, individuals find it increasingly difficult to swallow, speak, walk or keep balanced.
Unfortunately, symptoms can be slow to develop in liver disease, meaning they are often picked up in the later stages.
However, symptoms may also be absent even in the advanced stage of cirrhosis, as some people remain asymptomatic for years before their condition is discovered.
This is because the liver is still able to carry out its job in the early stages of cirrhosis, and function only starts to become impaired once liver damage is extensive.
The first symptoms patients may experience at this stage are fatigue, bleeding, easy bruising, and jaundice.
For many people, the condition is only picked up during tests or unrelated conditions.
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