Early Intervention and Health Promotion in the Management of Chronic Liver Disease

2018 ◽  
Vol 8 (1) ◽  
pp. 23-39
Author(s):  
Shaila Hussain
Keyword(s):  
Health Promotion ◽  
Liver Disease ◽  
Early Intervention ◽  
Chronic Liver Disease ◽  
Health Care Professionals ◽  
Health Belief ◽  
Chronic Liver ◽  
Health Concern ◽  
Lifestyle Modifications ◽  
The Uk

Liver disease is prevalent and a major public health concern. It has predominantly spread in the UK and worldwide, causing liver-related morbidity and mortality rates for the under 65s since 1970. This article aims to highlight the role of early intervention and health promotion in the management of chronic liver disease (CLD). The objective is to critically analyse an issue like CLD, and further employ principles, ethical theories to health promotion practice. Since 2015, there is no one single drug that treats NALFD, a dietary plan and lifestyle modifications can be added in management of the disease. Educating patients perhaps is a form of regimen, and a coping mechanism as set by the health belief model to understand the disease. Additional studies need to be formed to understand the exact contributions health care professionals are likely to make, and of those that are new clinicians.

scholarly journals Emergency Management of Acute on Chronic Liver Disease

2006 ◽  
Vol 5 (1) ◽  
pp. 3-7
Author(s):  
AJ Portal ◽  
Keyword(s):  
Liver Disease ◽  
Emergency Management ◽  
Chronic Liver Disease ◽  
Media Coverage ◽  
Recent Change ◽  
Chronic Liver ◽  
The Common ◽  
Complications Of Cirrhosis ◽  
The Uk ◽  
Licensing Laws

Chronic liver disease is becoming more common in the UK. There has been much media coverage due to recent change in licensing laws and celebrity figures suffering from cirrhosis. This review highlights the common complications of cirrhosis that frequently present to the acute physician, focussing on initial presentation and subsequent management, based on the current best available evidence.

Innovative strategies for reducing the burden of chronic liver disease

2020 ◽  
Vol 29 (Sup17) ◽  
pp. S4-S9
Author(s):  
Lynda Greenslade
Keyword(s):  
Health Economic ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Alcohol Consumption ◽  
Disease Prevention ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Innovative Strategies ◽  
The Uk

Alcohol consumption is increasing in the UK, bringing an increased incidence of cirrhosis, which in turn can lead to hepatic encephalopathy. This complication of cirrhosis can be devastating for patients and their families, and incurs a large health economic burden to the NHS. Cirrhosis is, of course, preventable. As disease prevention is at the heart of the NHS Long Term Plan, it can be used as the basis of a 10-year plan to avoid the complications of chronic liver disease

Detecting chronic liver disease: are liver function tests the solution?

2020 ◽  
Vol 81 (2) ◽  
pp. 1-8
Author(s):  
Prarthana Thiagarajan ◽  
Jane Chalmers ◽  
Indra N Guha ◽  
Martin W James
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Function Tests ◽  
Life Years ◽  
The Uk

By 2020, chronic liver disease will have eclipsed ischaemic heart disease as the leading cause of working life years lost in the UK. As mortality from chronic liver disease continues to rise, the landscape of aetiology has shifted from infectious to non-communicable causes. In parallel with the growing prevalence of obesity and type 2 diabetes, non-alcoholic fatty liver disease is estimated to affect 25% of the UK adult population. Simultaneously, escalating alcohol consumption has fuelled public health and economic concerns regarding its widespread impact on working-age adults. Given that chronic liver disease remains clinically silent until its advanced stages, there is an urgent unmet need to identify affected individuals earlier in the disease process, enabling targeted intervention strategies which may improve prognosis. Robust epidemiological data have shown that liver fibrosis is the strongest predictor of clinically meaningful outcomes, including decompensation, liver cancer and overall mortality. Detecting fibrosis among at-risk individuals, in a manner that is reproducible, non-invasive, safe and cost effective, has become a major challenge of our time. This article addresses the pitfalls of the standard panel of liver function tests, discusses other non-invasive biomarkers and reviews imaging technologies which may revolutionise community-based diagnosis and stratification of chronic liver disease.

Gastroenterology

2019 ◽  
Author(s):  
Ricky Sinharay
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Hospital Admissions ◽  
Medical Profession ◽  
Therapeutic Endoscopy ◽  
Chronic Liver ◽  
Molecular Events ◽  
Related Liver Disease ◽  
The Uk ◽  
And Function

Gastroenterology and hepatology encompass a vast array of organs that have diverse structure and function and are affected by a multitude of disease processes. Diseases of the digestive tract are a major cause of morbidity and mortality in the United Kingdom (UK) and worldwide. There have been great advances in our understanding, diagnosis, and management of gastrointestinal (GI) disease, and knowledge continues to develop at a great pace. Understanding the physiology and cellular and molecular events that drive pathological processes, as well as the devel­opment of sophisticated endoscopic and radiological tests, have trans­formed diagnostic capability. Therapeutic endoscopy has progressed to replace surgical management of common GI emergencies such as upper GI tract bleeding and decompressing biliary tract obstruction. However, as ever, there is still much work to be done. For example, the advances in biologic immunotherapy in inflammatory bowel disease has greatly im­proved patients’ quality of life and a reduction in the need for surgery, though the overall impact of these medications on the natural history of the disease is debatable at present. Hepatology is a greatly misunderstood specialty. The physiological changes that occur as cirrhosis and portal hypertension develop are the key to understanding all manifestations of a decompensating liver. Recently, there has been a significant increase in the prevalence of chronic liver disease in the UK, and as a result, hospital admissions have increased. Liver disease is the only major cause of death still increasing year on year, and twice as many people now die from liver disease than in 1991. The 2013 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) of patients with alcohol- related liver disease (ARLD) found that less than half the number of patients who died from ARLD received ‘good care’, and avoidable deaths were identified. Allied to this, the enquiry shed light on a cultural pessimism regarding outcomes and prognosis of chronic liver disease and, in particular, ARLD from both the public and the medical profession as a whole. There is now a concerted drive towards improving awareness of chronic liver disease, and initial simple supportive treatments can greatly improve sur­vival, more so than previously thought.

scholarly journals Comparative analysis of indices of the metabolic syndrome in patients with and without non-alcoholic fatty liver disease at a teaching hospital in Nnewi, South-East, Nigeria

2019 ◽  
Vol 10 (2) ◽  
pp. 40-45
Author(s):  
Nneka S. Chukwurah ◽  
Uchenna C. Okonkwo ◽  
Anele E. Ihekwaba
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Chronic Liver Disease ◽  
Fatty Liver Disease ◽  
Chronic Liver ◽  
Health Concern ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Alcoholic Fatty Liver Disease

Background: Non-Alcoholic fatty liver disease (NAFLD) has become a worldwide health concern with increase in the global incidence of obesity and it is now considered the hepatic component of the metabolic syndrome. Aims and Objective: The study’s aim was to compare the indices of the metabolic syndrome in compensated chronic liver disease patients with and without NAFLD at NAUTH, Nnewi. Materials and Methods: A total of 136 consecutive patients with compensated chronic liver disease were recruited into the study. A structured questionnaire was administered to obtain relevant socio-demographic data. NAFLD was diagnosed based on clinical, biochemical, ultrasonographic and in a few histological features. The Adult Treatment Panel III criteria were used to identify patients with the metabolic syndrome. Results: Of the 136 participants recruited into the study, 52 (38.2%) fulfilled 2 or more diagnostic criteria for NAFLD with a male: female ratio of 1:1.36. The mean (SD) age of persons with NAFLD was 45.12 (±8.07) years compared to 47.49(±11.79) years for persons without NAFLD. The difference was not statistically significant (p=0.2). Body mass index (BMI), central obesity (waist circumference), fasting blood sugar, blood pressure, total cholesterol and triglycerides were significantly higher in the NAFLD group (p= <0.05) respectively. Conclusion: Indices of the metabolic syndrome were more prevalent in persons with NAFLD. It is recommended that patients with NAFLD be screened for metabolic syndrome and appropriate therapy instituted to decrease the risk of both hepatic and cardiovascular complications.

Hepatitis G infection: role in cryptogenic chronic liver disease and primary liver cell cancer in the UK

1998 ◽  
Vol 5 (3) ◽  
pp. 165-169 ◽  
Author(s):  
R. C. Hollingsworth ◽  
E. J. Minton ◽  
C. Fraser‐Moodie ◽  
E. Metivier ◽  
P. M. Rizzi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Liver Cell ◽  
Cell Cancer ◽  
Chronic Liver ◽  
Hepatitis G ◽  
Cryptogenic Chronic Liver Disease ◽  
The Uk

scholarly journals Engagement with community liver disease management across the UK: a cross-sectional survey

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0085
Author(s):  
Helen Jarvis ◽  
Jonathan Worsfold ◽  
Vanessa Hebditch ◽  
Stephen Ryder
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Disease Management ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Health Board ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Authorities ◽  
The Uk

BackgroundLiver disease is an increasing cause of premature mortality in the UK. Its management in primary care is not well understood. It is unclear what role commissioning bodies are playing in liver disease in the UK.AimThe aim of this study was to assess the level of engagement with community chronic liver disease management amongst CCGs and health authorities across the UK.Design & settingA cross-sectional survey to all UK CCGs and health authorities.MethodSurvey questions were developed by the British Liver Trust, in collaboration with topic experts, and evaluated structures in place relating to liver disease management at commissioning/health board level.ResultsThere were 159 responses representing 99% UK coverage of CCGs/health boards. 20% reported an individual responsible for liver disease within their organisation with 40% and 29% reporting having pathways in place to respond to abnormal liver blood tests and liver disease more generally respectively. All those reporting use of pathways reported using national guidelines to guide content. 25% made use of transient elastography (Fibroscan) and 16% of direct serum fibrosis markers (eg, ELF score) which are both part of current NICE guidelines. There was marked regional variation in all areas of engagement surveyed, with Wales having exceptionally high levels of engagement in all areas in contrast to the other nations.ConclusionThe results of this survey should be used as a catalyst to highlight necessary regional improvements to the primary care management of chronic liver disease across the UK.

scholarly journals The Gut–Liver Axis in Chronic Liver Disease: A Macrophage Perspective

Cells ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 2959
Author(s):  
Kevin De Muynck ◽  
Bart Vanderborght ◽  
Hans Van Vlierberghe ◽  
Lindsey Devisscher
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Intestinal Barrier ◽  
Chronic Liver ◽  
Health Concern ◽  
Low Grade ◽  
Intestinal Dysbiosis ◽  
Health And Disease ◽  
Intestinal Macrophage ◽  
End Stage

Chronic liver disease (CLD) is a growing health concern which accounts for two million deaths per year. Obesity, alcohol overconsumption, and progressive cholestasis are commonly characterized by persistent low-grade inflammation and advancing fibrosis, which form the basis for development of end-stage liver disease complications, including hepatocellular carcinoma. CLD pathophysiology extends to the intestinal tract and is characterized by intestinal dysbiosis, bile acid dysregulation, and gut barrier disruption. In addition, macrophages are key players in CLD progression and intestinal barrier breakdown. Emerging studies are unveiling macrophage heterogeneity and driving factors of their plasticity in health and disease. To date, in-depth investigation of how gut–liver axis disruption impacts the hepatic and intestinal macrophage pool in CLD pathogenesis is scarce. In this review, we give an overview of the role of intestinal and hepatic macrophages in homeostasis and gut–liver axis disruption in progressive stages of CLD.

Genetic predictors of spontaneous viral elimination or chronic liver disease in hepatitis C infection

2001 ◽  
Vol 120 (5) ◽  
pp. A7-A7
Author(s):  
S ROSS ◽  
S MASCHERETTI ◽  
H HINRICHSEN ◽  
P BUGGISCH ◽  
U FOELSCH ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Hepatitis C Infection ◽  
Genetic Predictors
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