LiveWorld Transcripts

Houston Chronicle presents

Dr. Woods
"Ask the Doctor": Liver Disease

January 25, 2000

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Garindan: Is all liver disease associated with excessive alcohol use? Does alcohol consumption have any effects on someone with liver disease?

Dr Woods: Unfortunately, the most common cause of liver disease in the United States is the excessive use of alcohol. Women are particularly prone to develop liver disease from alcohol. In fact, even with what most individuals might think is just social drinking, this may be a sufficient enough quantity of alcohol in a young woman to cause moderate to severe liver injury. Most of the effects of alcohol on the liver can be reversed if the individual stops consuming alcohol before the damage becomes permanent. Alcohol is especially toxic to the liver if there is any degree of underlying liver disease. For example, patients who have chronic liver disease from Hepatitis C will accelerate the development of cirrhosis of the liver if they consumer alcohol. In a non-drinking person it may take as long as 20 to 30 years for cirrhosis to develop in a patient with Hepatitis C. If that same patient consumes alcohol, the time frame may be reduced to 10 to 15 years.

Charisma: What are 'liver spots'?

Dr Woods: Most liver spots are related to abnormalities that happen in the small blood vessels on the arms or usually the chest where nests of blood vessels develop and cause so-called 'liver spots'. I have never found a satisfactory answer to why these spots develop. But they are classic signs of liver disease. Interestingly, if a patient undergoes a liver transplant, the spots rapidly disappear.

Ilamae25: Does spherocytosis anemia eventually effect the liver?

Dr Woods: There are a variety of blood disorders where a patient will rapidly break down their blood cells, and oftentimes these patients will develop gallstones as the result of excess breaking down of red blood cells. In most cases, there is no real problem with the liver, but rather just the development of gallstones as the result of the disease. However, because in the past many of these patients had to receive frequent blood transfusions, a number of patients may have become infected with the Hepatitis C virus and so, while the disease itself had no direct affect on the liver, the fact that the patient required multiple blood transfusions may have resulted in the development of liver disease.

Genius88: What are the chances you can die from liver disease and hepatitis?

Dr Woods: That's quite an open ended question! If one has chronic viral hepatitis, it is likely that the patient will go on to develop cirrhosis of the liver and will be at risk of dying without a liver transplant. For some types of hepatitis, like Hepatitis A, it would be extremely rare for someone to die of that infection. The exceptions would be the very young or the very old. Hepatitis B can present itself as either a very acute illness, with a significant risk that the patient could develop liver failure and require an emergency liver transplant or face death; or the patient may recover; or, in a third option, the patient would develop chronic liver disease that I've just mentioned. Other forms of hepatitis, either in reaction to drugs or toxins like alcohol, can be fully reversible or, in rare cases, could lead to acute liver failure and the need for liver transplant. So, in summary, a person's risk of dying of liver disease from hepatitis depends largely on their age, underlying health, and the type of hepatitis.

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