The information below is designed to help you with initial questions about liver disease. You can find more information in our publications or you can contact our helpline . If you are worried about or have a liver disease, please contact your doctor for advice.
Q: Seasonal flu
Q: Am I at increased risk from swine flu if my liver is damaged?
Q: I have liver disease, should I get the swine flu vaccine?
Q: I am over 65 with liver disease, should I be vaccinated?
Q: Should members of my household and carers be vaccinated?
Q: When will the vaccine be available and how do I get it?
Q: How can I protect myself and family against swine flu?
Q: What should I do if I have symptoms of swine flu?
Q: Are the medications for flu safe for people with liver disease?
Q: What does the liver do?
Q: I’ve just had a liver function test and been told the results are abnormal, what does this mean?
Q : I’ve been told I have a liver disease. What has caused it?
Q: My brother has been told he has cirrhosis. Does this mean he is an alcoholic?
Q: What are the symptoms of liver disease?
Q: How can liver disease affect quality of life?
Q: How common is liver disease?
Q: How much do you have to drink to get liver disease?
Q: If you stop drinking alcohol, can your liver disease get better?
Q: Someone I care about is putting their health at risk from alcohol. What can I do?
Q: I’ve been told to give up/cut down on alcohol, how can I do this?
Q: How can you get infected with hepatitis B and C?
Q: Can you get vaccinated against viral hepatitis?
Q: My GP wants to charge me for a hepatitis B vaccine, why?
Q: What treatments are available for hepatitis B and C?
Q: Should I see a specialist about my liver disease?
Q: How can I find out which hospital can best look after liver disease patients?
Q: I’ve been told I have end-stage liver failure, does this mean I’m going to die?
Q: Can prescription medicines, common pharmacy medicines, herbal remedies and illegal drugs affect my liver disease?
Q: I have liver disease, what can I do to keep myself well? Is there a special diet which would help my liver disease?
Q: What treatments are there for liver disease?
Q: Isn’t it true that the liver can regenerate and does this mean I can get better on my own?
Q: Can I travel after a transplant?
Q: I’ve been told I have gallstones and suffer pain. What are the possible complications?
Seasonal flu
Everyone with liver disease should keep up-to-date with their vaccines, including the annual vaccine against seasonal flu which becomes available in October. This vaccine does not protect against swine flu but will protect against seasonal flu, which is still likely to be circulating this winter and can be particularly dangerous for people with cirrhosis, chronic hepatitis, biliary atresia or those taking immunosuppresants for example, after a liver transplant.
We advise you to get both vaccines as soon as they become available. If you have symptoms of flu, stay at home and contact the Pandemic Flu Service or your GP for advice. Do not take over-the-counter flu remedies or painkillers like aspirin unless you have been told by a doctor they are safe for you.
This podcast features TV’s Dr Hilary Jones explaining the importance of the flu jab to people with liver disease and other conditions. Download podcast
If you have liver disease, you can get the jab for free from your GP. Both vaccines can be given at the same time. For more information on seasonal flu visit http://www.nhs.uk/conditions/Flu-jab/Pages/Introduction.aspx
Am I at increased risk from swine flu if my liver is damaged?
People with liver disease are at higher risk from serious complications from flu than other people, so it is important to take precautions against swine flu and indeed against seasonal flu. Although the new swine flu strain of flu does not appear to be a much more serious disease than seasonal flu, the number of people at risk is likely to be higher because less of the population have pre-existing immunity.
I have liver disease, should I get the swine flu vaccine?
People with chronic liver disease under the age of 65 will be in the first group to be offered the swine flu vaccine. This is based on advice from the Chief Medical Officer who has identified that people with suppressed immune systems and chronic diseases might be more at risk of complications from swine flu. Those in the top priority group include people with:
- Cirrhosis
- Biliary atresia
- Chronic hepatitis
- who are taking immunosuppressants (people who have had a transplant)
- people who are immunosuppressed due to their disease.
I am over 65 with liver disease, should I be vaccinated?
The current plan is to focus vaccination on people under the age of 65 first. The age restriction, to people under 65, is due to evidence that older people appear to have some natural immunity to the virus. People with liver disease over the age of 65 will be offered the vaccine after the under 65s, pregnant women and household contacts (see below).
Should members of my household and carers be vaccinated?
People who live in the same house as those with chronic liver disease or people who have had a transplant, or who care for them, will also be offered the vaccine. They have been identified as a priority for vaccination after people with chronic disease or immunosuppression, and pregnant women.
When will the vaccine be available and how do I get it?
The NHS has now received its first batches of the swine flu vaccine. They will start by offering it to patients in hospital and to healthcare professionals. The vaccine will arrive at GPs from 26th Oct and they will then start to offer the vaccine to those in the highest risk groups, including people with liver disease and their household members.
If your GP normally contacts you each winter to get your flu jab, you will also be contacted when the swine flu vaccine becomes available. If you have cirrhosis, chronic hepatitis, biliary atresia or are taking immunosuppresants and are not contacted by your GP, get in touch to find out when the vaccines are available and to make an appointment to get vaccinated.
You may be offered the swine flu vaccine at the same time as the seasonal flu vaccine, and it is safe for both vaccines to be given at the same appointment. GP surgeries are likely to be busy during this time and not everyone will be vaccinated in the first few days, so you may need to be patient. Do make sure though that you make and keep your appointments!
For more information visit http://www.nhs.uk/Conditions/Pandemic-flu/Pages/QA.aspx#vaccine
How can I protect myself and family against swine flu?
The advice given to the population as a whole applies equally to people with liver disease:
- protect yourself against infection by taking simple precautions such as hand-washing with soap or alcohol gel and cleaning surfaces;
- prepare in case you or a member of your family becomes ill by stocking up on essential supplies, and building a network of contacts with friends and neighbours who could help you if you become ill; and stay up to date by visiting www.nhs.uk or watching the news.
What should I do if I have symptoms of swine flu?
If you have liver disease and become ill with fever accompanied by a cough or sore throat, stay at home and contact the Pandemic Flu Service on 0800 1 513 100, www.pandemicflu.direct.gov.uk (or your GP) for advice. There are antiviral treatments against flu that can help speed up recovery, but they should be taken early in the illness. The same medication can sometimes protect against infection if you have a case in your household - again the Pandemic Flu Service or your GP can give you advice on whether this is necessary.
Flu-like symptoms can sometimes occur with some of the drugs used to treat liver disease. If you have flu-like symptoms whilst on treatment with interferons or if your liver symptoms get worse let your hospital specialist know so that he can advise your GP.
Are the medications for flu safe for people with liver disease?
The antiviral medicines prescribed for swine flu are safe for people with liver disease and do not interact with any normal medications for liver problems. But as with all medication, make sure your doctor knows about your liver disease, your current state of health and what other medicines you are taking so that they can make sure the treatment is safe for you. It is also important to check before taking any over-the-counter medicines for flu, as drugs like aspirin and ibuprofen can be dangerous for some people with liver disease.
What does the liver do?
The liver is the largest organ inside your body, and is essential to life, carrying out 500 different functions. It is the factory of the body, making proteins, blood clotting factors, and products to help with digestion and energy release. Your body uses it as a store of energy and iron. It also purifies the blood of bacteria, by-products of digestion, alcohol and drugs. Further information on the liver's functions .
I’ve just had a liver function test and been told the results are abnormal, what does this mean?
Liver function blood tests, referred to as LFTs, are often ordered by your GP to find out whether you have increased levels of certain enzymes that might indicate a problem with your liver. There are many reasons why you have abnormal results. There is no need to be alarmed, as it is quite common to have an abnormal LFT. Your doctor will probably order further tests to get a fuller picture of your liver health before reaching a conclusion. LFTs are a useful test but are not the only test your doctor will use or rely on to diagnose problems or give you a clean bill of health. You can find more details in our ‘ Liver disease tests explained’ booklet.
I’ve been told I have a liver disease. What has caused it?
There are many causes of liver disease. Drinking too much alcohol, usually over many years, is the single largest cause. There are also viruses that damage the liver; the most important are the blood-borne viruses hepatitis B and C. Some people lay down fat cells in their liver, often connected with being overweight or having diabetes. Other people carry genetic or develop autoimmune conditions that can lead to liver damage. It is also possible to suffer adverse reactions to medicines or drugs, resulting in liver failure. Cancer is both a cause and a consequence of liver disease. Finding the cause is important in designing the right treatment and stopping the progression of the disease. Further information on liver diseases .
My brother has been told he has cirrhosis. Does this mean he is an alcoholic?
No, there are many different causes of cirrhosis. Alcohol is only one of these. Cirrhosis may be caused by viruses, iron overload, copper overload, metabolic disease, fat and autoimmune conditions. Further information on Cirrhosis .
What are the symptoms of liver disease?
Liver disease is sometimes referred to as the ‘silent killer’ as there are often only vague symptoms until liver damage is quite severe. Early symptoms can include feeling generally unwell or tired, having poor appetite, weight loss, a tender abdomen, feeling itchy or vomiting. These are symptoms that are common in other medical conditions as well, however. Most people with liver disease only find out during tests for an unrelated illness or a medical check-up. When liver damage is quite severe, people can experience some of the following symptoms including yellow eyes and skin, called jaundice; bleeding problems; drowsiness and confusion; fever; swollen abdomen and legs; and tarry black stools or vomiting blood. If you have any of the symptoms consult your doctor.
How can liver disease affect quality of life?
Many people with liver disease will feel quite well and even severe symptoms may occur only in episodes that people recover from. However, the symptoms, side-effects of treatment and outlook of liver disease can really affect people with liver disease and their families, causing discomfort, pain, anxiety and depression. Your doctor and the medical team they work with can give you advice on how to manage the symptoms of your disease and direct you to other sources of help, like social services. Many people also find that talking with other people with liver disease can offer practical advice and support. Contact the British Liver Trust for your nearest support group .
How common is liver disease?
Liver disease is on the increase in the UK and is now the fifth largest cause of death. However, there are many more people living with liver disease and others who have a liver disease but are not aware of it. There are also a large number of people with a liver problem of some description, such as gallstones, and problems that resolve themselves over time without medical treatment. The British Liver Trust estimates that around 2 million people have a liver problem at any one time. Further information on liver disease in the UK
How much do you have to drink to get liver disease?
It varies from person to person, but by staying within safe guidelines and giving your liver at least two consecutive days alcohol-free each week, you are unlikely to get liver problems from alcohol. The Government’s guidelines are 2-3 units a day for women (around a glass of wine or pint of larger) and 3-4 units a day for men (a pint and a half of beer). If you are overweight, are using medicines or have viral hepatitis, your liver can be more vulnerable to alcohol. Learn about looking after your liver
If you stop drinking alcohol, can your liver disease get better?
In the early stages, yes if alcohol was the cause of your liver problem. However, once your liver becomes scarred, called cirrhosis , giving up alcohol won’t be enough to reverse the problem although it can help delay the progression. Alcohol puts a burden on the liver, so regardless of the cause of your liver disease; alcohol can make the problem more serious and speed up the damage. Further information on alcohol and liver disease
Someone I care about is putting their health at risk from alcohol. What can I do?
Finding out more information about alcohol and how they could be risking their health is a good first step. You may find you can discuss the problem with them, especially if they don’t realise how much they are drinking and what safe limits are. However, for many people only professional help really works. There are a number of organisations that help support partners and families of people with alcohol problems that you can find on our links page and our ‘ Alcohol and Liver disease ’ publication also contains useful information.
I’ve been told to give up/cut down on alcohol, how can I do this?
There is support available, from your GP, specialist rehab services, or voluntary organisations like the AA. It is important to find the support you feel most comfortable with, so that you stand the best chance of success. For people drinking very large amounts of alcohol regularly, cutting down or giving up is very difficult and in some cases can result in side-effects, so it is usually best to seek advice and help to stop drinking. Information on organisations who can help .
You can find out more about alcohol and liver disease in our publication, ‘Alcohol and Liver disease’.
How can you get infected with hepatitis B and C?
Hepatitis B and C are infectious blood borne viruses which can cause severe liver damage. A tiny amount of blood getting into your bloodstream from an infected person can cause infection, for example through an open wound, cut or scratch. Some of the main routes of transmission are mother-to-baby (during birth); sharing needles and equipment for use in taking drugs, tattoos or piercing; unsafe sex; and from medical treatment in a country with poor hygiene standards. To protect yourself, don’t share personal equipment, use a condom and cover all cuts and wounds.
Can you get vaccinated against viral hepatitis?
There is a vaccine against hepatitis A , spread by infected food and water, which it is a good idea to have before travelling abroad outside Europe and the US. There is also a vaccine against hepatitis B which all people in high-risk groups should have. People in high-risk groups include those travelling to visit friends and family for long periods in areas where the infection is common, including South Asia, China and Africa. People receiving blood products, with kidney or liver problems or needing medical treatment abroad should be vaccinated. Some people are at risk because their job puts them in contact with other people’s body fluids. Other people at risk are those who change sexual partners frequently; inject drugs or men who have sex with men. Particularly for hepatitis B, it is important to complete the course and if you are having the vaccine before you travel, allow plenty of time to have the course and for it to take effect.
My GP wants to charge me for a hepatitis B vaccine, why?
The NHS only covers the cost of the vaccine for some people: those at risk as part of their day-to-day lives in the UK. It doesn’t cover it for travel purposes, unless you need it because of a medical reason, such as kidney or liver disease. It also doesn’t cover occupational health, vaccination because of your job. Your employer has a legal obligation to look at the risk of you being infected at work and arrange for you to have the vaccine if appropriate.
What treatments are available for hepatitis B and C?
There are a number of medicines to treat both diseases, many of which are quite new. They generally need to be taken over a period of several months. For hepatitis C, they may help you clear the infection. For hepatitis B, they can stop or delay the progression of the disease. The treatments have side-effects though and so wherever possible, preventing infection is the priority.
You can find out more about hepatitis B and hepatitis C in our online publications.
Should I see a specialist about my liver disease? Many people with liver disease benefit from specialist assessment and for a specialist to design a package of ongoing treatment. As a result, we recommend you speak to your GP to request a referral to a specialist, preferably a hepatologist or a gastroenterologist if a hepatologist is not available. After you have seen a consultant, your GP will probably monitor your day-to-day care with review by your consultant. Further information on liver specialists
How can I find out which hospital can best look after liver disease patients?
You have the right to choose which hospital your GP refers you to. Some hospitals have a specialist team dealing with liver patients. You can ask your GP or contact the British Liver Trust to find a hospital with a liver specialist near you. If you need to be assessed for a liver transplant, you will be referred to one of seven transplant centres across the UK .
I’ve been told I have end-stage liver failure, does this mean I’m going to die?
No, this means you have advanced disease, but many people live normal lives for many years even with end-stage liver failure. There are different ways of grading how serious your liver failure is, and you can find more information about this in our Cirrhosis publication. It is best to talk with your doctor about your condition, your treatment options and what you can expect.
Can prescription medicines, common pharmacy medicines, herbal remedies and illegal drugs affect my liver disease?
Yes. Most drugs (whether prescription, legal or illegal) are processed and broken down by the liver. In people with liver disease where the liver is already under strain, the extra work in breaking down drugs can be dangerous. Make sure all the health professionals (such as your GP, dentist and pharmacist) know about your liver disease before you are given or buy medicines from them. Even common tablets such as aspirin can be dangerous to people with liver problems. Herbal remedies and illegal drugs are a particular risk, as they are not regulated and can contain impurities that cause liver damage. If in doubt, speak to your liver specialist before taking any medicines or drugs.
I have liver disease, what can I do to keep myself well? Is there a special diet which would help my liver disease?
There are many things you can do to look after yourself. No specific foods are of benefit you should however try to have a diet that is well balanced with protein, carbohydrate and plenty of fresh vegetables. Some patients with fatty liver disease will need special dietary advice. You may find it helpful to undertake gentle exercise, without getting yourself over-tired. Alcohol should be avoided as it places an increased burden on your liver and smoking places a burden on your body and can accelerate some conditions. It is also essential to check that any prescription or over-the-counter medicines are safe to take with your liver disease. Plan things that increase your sense of wellbeing, such as a massage, aromatherapy, time with friends, music or relaxation time, but avoid stress and becoming exhausted. You can find out more in our Diet and liver disease publication.
What treatments are there for liver disease?
There are many different liver diseases, and the treatment that is right for you depends on the type of liver disease, its cause and how much damage it has done. You may find our specific publications on the different liver diseases useful.
For advanced liver disease, there are a number of treatments aimed at reducing the impact of the symptoms. For example, you might be given diuretics for portal hypertension, lactulose for hepatic encephalopathy and regular drains for ascites. You may be offered surgery such as liver resection for liver cancer. You may be assessed for a liver transplant. There are also a range of lifestyle measures that can help some people, including changes to diet. Your liver specialist will design a package of treatment that is right for you. For more information, see our Cirrhosis publication.
Isn’t it true that the liver can regenerate and does this mean I can get better on my own?
Your body can replace old liver cells, called hepatocytes, with new ones. This means that your liver can recover from minor stresses and strains. However, over time damage can cause fibrous scar tissue. This changes the structure of the liver and cannot be repaired. This is why it is so important to spot liver problems before the damage builds up and becomes irreversible.
Can I travel after a transplant?
Having a liver transplant is a major operation and the transplant together with anti-rejection medicines will have a lifelong impact on you. As a result, there are a whole range of things you’ll need to consider when travelling, such as how to avoid infection, vaccines, sunscreen, being close to medical help and travel insurance. You’ll be advised not to travel long distances away from your transplant centre in the early weeks. After this, speak to your transplant centre about what precautions you should take. You can find out more in our publication Life after liver transplant .
I’ve been told I have gallstones and suffer pain. What are the possible complications?
Gallstones can cause a condition called a cholangitis attack and also less severe pain and discomfort . Cholangitis is an inflammation of the bile duct system that is usually related to a bacterial infection that can be caused by gallstones blocking the ducts. The main symptom is severe abdominal pain and tenderness, in the ‘upper right quadrant’ area, although pain can be felt in the chest, upper back or right shoulder. Other symptoms include nausea and vomiting, belching, pale stools and dark urine. You may also have a fever, jaundice, feel lethargic and itchy. An attack of acute cholangitis can make you feel very unwell, so most people will consult a doctor or go to hospital fast. Doctors can treat with antibiotics and painkillers, and schedule an operation to remove the gallbladder to stop the attack happening again. Further information on Gallstones
Got a question not answered here?
You can email our team or call our helpline on 0800 652 7330 for general information or to request hard copies of our publications.
If you are worried about or have a liver disease, speak to your doctor for advice. They can refer you to a liver specialist (hepatologist) for more specialist advice if this is necessary. If you would like more information on which hospitals have specialist liver services, please contact the British liver Trust.
Last updated on: 20 October 2009 |
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