The liver is one of the most critical among the large organs of the human body. It has over 500 known functions discovered till date. It produces bile which carries waste, it breaks down fats in the small intestine; it filters toxins from the blood, converts excess glucose into glycogen for storage, and improves immunity by resisting infection. There are several liver conditions that affect both children and adults. For the purpose of this article, we will focus on liver conditions in children.
There are innumerable liver conditions which will be described briefly below. They show a wide range of symptoms some of which are common across conditions. It’s important to be aware of them so that timely medical help can be provided, failing which, there can be long-term consequences, or death even in some cases.
Jaundice: Marked by high levels of bilirubin in the body due to inflammation, abnormalities of the liver cells or blockage of the bile ducts. It can also occur due to excessive breakdown of large numbers of red blood cells, which is common in newborns. Jaundice is the first and sometimes the only sign of liver disease.
Cholestasis: In this condition, the bile flow is obstructed either inside or outside the liver. This can be caused by any of the following: hepatitis, bile duct narrowing, bile duct cancer, drug effects, primary biliary cirrhosis, hormonal changes during pregnancy, pancreatic cancer, a stone in the bile duct and inflammation of the pancreas.
Portal hypertension: The portal vein brings blood to the liver from the intestine and spleen. When there is increased blood-pressure in these blood-vessels or resistance to blood-flow in the liver, the condition is called portal hypertension. This causes the growth of new blood-vessels called collaterals. The collaterals bypass the liver and connect the blood-flow from the intestine to general circulation. As a result, impurities which were supposed to get filtered by the liver now enter the general circulation.
Esophageal varices: The collaterals described in the previous condition continue to have high blood-pressure in them. These vessels can extend all the way down to the esophagus and stomach. The excess blood pressure causes the vessels to dilate and eventually rupture. So there is a large amount of blood lost due to vomiting of blood as well as blood flowing through the gastrointestinal tract. This manifests as bloody stools.
Ascites: An obstruction of the hepatic vein causes a condition called Ascites. In this, fluid starts leaking from the surface of the liver and the intestines into the abdominal cavity. Eventually, this leads to a distended abdominal cavity which manifests as abdominal pain, abdominal swelling, discomfort and shortness of breath.
Hepatic Encephalopathy: Also called Liver encephalopathy, portal-systemic encephalopathy and hepatic coma. In this condition, the liver is not able to filter the toxins out of the blood, as a result, they start accumulating in the body. This eventually causes damage to the nervous system and brain function.
Liver Failure: When the liver becomes sick or damaged due to different reasons, the liver function starts deteriorating. It then progresses through various stages such as inflammation, fibrosis, cirrhosis, end-stage liver disease, liver cancer and eventually liver failure. Liver transplantation is the only solution, failing which, it can result in death of the patient. The causes for liver failure are many: certain viruses, medication, toxins in the blood, immune system problems, inherited metabolic disorders, low blood-flow to the liver due to heart failure, chronic hepatitis C and diseases of the bile ducts.
AIAT Deficiency: The liver synthesizes a protein called alpha-1 antitrypsin (A1AT) that blocks the action of proteins that cause inflammation or breakdown of proteins in the body. This is released by the liver into the bloodstream. Due to different reasons, in some people the liver may stop release of this substance, creating a deficiency of the same. Usually a genetic condition
Alagille-Watson Syndrome: This is a condition that manifests as liver, heart, eye and skeletal abnormalities. In the liver, it causes cholestasis described above, jaundice and too few bile ducts.
Biliary Atresia: This condition is found in newborn children. In this condition, bile ducts in the liver get blocked. Since the bile is unable to leave the liver, the liver gets damaged which in turn affects many vital body functions. The condition can be chronic and progressive.
Choledochal Cysts: A congenital condition. The bile duct which transports bile from the liver to gall bladder and small intestine may develop a swelling. Then, bile starts backing up into the liver. This can cause various issues with liver function, and inflammation of the pancreas (pancreatitis).
Cirrhosis: This is marked by damage to the liver resulting in decreased blood-flow through the liver. Gradually, this results in death of liver tissue. Nutrients, toxins, drugs and hormones are no longer processed by the liver. Further, proteins and some other substances are no longer produced by the liver, either completely or in reduced quantities.
Fatty Liver Disease: Fatty liver disease and steatohepatitis are conditions in which fat starts depositing in the liver. These affect the ability of the liver to remove toxins from the blood.
Hepatitis: This is an inflammation of the liver caused by a virus. It results in damage and destruction of liver cells. The condition is contagious and further, not everyone displays symptoms.
Hemochromatosis: Also called iron overload disease, this is a genetic condition. The body absorbs too much iron from the food. This excess iron is not excreted out and instead starts accumulating all over the body, including the liver and pancreas. Over time, it starts damaging the internal organs and lead to liver disease, liver cancer, liver failure, heart disease and diabetes.
Wilson disease: In this condition that is hereditary, the body absorbs excess copper from the food. The excess copper is retained in the liver leading to liver damage. The damaged liver will release the copper into the bloodstream eventually. This in turn causes damage to the kidneys, eyes, brain, eventually causing liver failure and death.
Primary Sclerosing Cholangitis: In this condition, the bile duct starts narrowing down progressively, eventually blocking out the duct completely. This blocks the bile flow leading to various complications in the liver and body.
If your child is showing any of the signs or symptoms listed above, rush to a reputed hospital. Such hospitals have a dedicated liver department. Specialists there will diagnose your child’s condition precisely and put him/her on the best course of treatment for quick recovery and rehabilitation.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
