Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Liver failure can be caused by a number of insults. Chemical
is the most preventable. We discussed overdose of paracetomol
(acetaminophen) but other medications (most of which have
been taken off the market) can also be the cause. Chemicals
in the workplace such as polyvinyl chloride can cause this as
well. And of course the most common chemical cause of liver
failure is the abuse of alcohol. I remind everyone that
alcohol abuse is rarely recognized by the abuser, who
generally does a great job of covering it up. As we will see,
it can cause a slow and painful death, lo aleinu.
Liver failure can come from infection such as with parasites
(amoebas, echinoccocus) and viruses. These viruses are called
hepatitis, and the B and C forms are the most likely to
progress to liver failure. They can only be spread by blood
and by human secretions. All blood is checked for these
before transfusion, but it is still safest to receive
transfusions from your own blood or someone you know. B has a
vaccine. It is now recommended for all people.
Liver failure can come from growths. While liver cancer is
unusual, metastasis or spread of other cancers to the liver
is common, especially those originating in the colon and the
ovarian kind.
Liver failure can also come from other causes that are less
well understood, but these are usually the people who will
benefit from a liver transplant which can be lifesaving. It
should be noted that the liver usually does well in trauma
with minimal intervention, especially in kids.
Liver failure produces dark emaciated people with large
collections of fluid in their abdomens. They have a tendency
to bleeding, especially in the esophagus -- the food pipe.
Often, the poisons that accumulate in the blood cause them to
be confused. It is a relatively slow and painful way to die.
One should do all possible to avoid this situation and
daven for those who have it.
How do you avoid it? Make sure the workplace is safe. Get
vaccines and wear gloves when dealing with sick people if you
have one in the house. Get checked for blood in the stool
yearly to avoid colon cancer, and eat a diet rich in fiber
and vegetables.
If you do not feed your children the Bamba diet, you should
know that the usual Israeli diet is much healthier than the
average Western diet. Women should see their physician yearly
as well to be screened for the cancers that affect them.
Alcohol use should be in moderation. In answer to a question
I'm sure I'll be asked: No, I do not eat liver. Write me in
care of the Yated.
A message from Glaxo, sponsor of this column. The new
Parkinson's guidelines are out, and Requip has been
recommended as first line in the battle against this
devastating disease. Side effects are minimal and dissipate
with continued use of the drug.
