Homeless Health: Liver Disease

All you need to know about liver disease

Your liver performs many vital functions in your body, including filtering out toxins from your bloodstream. This can make it vulnerable if it becomes overwhelmed by the toxins it processes, and it can stop working so well.

‘Liver disease’ refers to chronic conditions that can do progressive damage to your liver over time. Your liver has great regenerative powers, but constantly working overtime to restore itself takes its toll. Eventually, it can’t keep up.

Chronic liver disease moves through 4 stages:

1. Hepatitis: inflammation in your liver tissues. Inflammation itself is the liver’s attempt to get rid of toxins. But if toxins keep coming back, then the inflammation continues and can lead to scarring in the liver.
2. Fibrosis: this is when scarring of the liver leads to stiffening of tissues, and blood flow to the liver is reduced. This in turn reduces the liver’s access to oxygen and nutrients, and can stop it working so well. Some damage can still be reversed at this stage, if the liver’s cells are given a chance to regenerate.

Graphic showing a human torso with internal organs, highlighting the position of the liver

3. Cirrhosis: this is severe, permanent scarring in your liver, where fibrosis is no longer reversible. When your liver no longer has enough healthy cells, its tissues can no longer regenerate. You can still slow or stop the damage at this stage. Cirrhosis will begin to affect liver function, but your body will attempt to compensate for the loss, so you might not notice at first.
4. Liver failure: this is also called “decompensated cirrhosis” — your body can no longer compensate for the cell losses, and liver functions begin to break down, you begin to feel the effects throughout your body. Chronic liver failure is a gradual process, but it is eventually fatal without a liver transplant.

Whilst not everyone with liver disease will be get liver cancer, most people with liver cancer will have had liver disease. This is because the processes of inflammation and repair and scarring, can affect your cells and make them more likely to become cancerous.

Causes of liver disease

There are many types of liver disease, but here are a few of the most common:

Viral infections. Viral hepatitis infections that become chronic can cause hepatitis B and hepatitis C.
Alcohol-induced hepatitis. Heavy alcohol use can cause acute or chronic hepatitis. If it goes on long enough, it can cause cirrhosis and liver failure.
Toxic hepatitis. Chronic overexposure to toxins, such as industrial chemicals or drugs, can cause acute or chronic hepatitis.
Non-alcohol related fatty liver disease. Metabolic conditions associated with obesity, high blood sugar and high blood lipids can cause excess fat storage in your liver, which can cause inflammation.

More detail on the causes of liver disease can be found on the University Hospitals Sussex website.

What to do if you’re concerned about liver disease

Catching liver disease early is key – it this stage it may be reversed with a simple treatment or lifestyle changes. Some types of liver disease, whilst not curable, are manageable
Order a free test kit
Book an appointment with your GP, who can support you with a diagnosis, and with treatment and lifestyle changes to support you to better health.
If you’re in Brighton, CGL offer free liver scans on a drop-in basis

Order HepC test kit

NHS poster with link to order a HepC test kit to use at home. Link: https://hepctest.nhs.uk/

For professionals

Check out this presentation from Mags O’Sullivan and team at Arch’s 2023 Homeless Health conference. It contains information for frontline workers supporting clients with liver disease, as well as signposting to resources and services in Brighton and beyond.

Liver disease talk 2023

These resources were mentioned in the session, and are available here to download and view:

The alarming impact of liver disease in the UK (British Liver Trust)

Remeasuring the units

Homeless Health topics

Respiratory Health

Diabetes

Liver Disease / Hepatitis