HOW IMPORTANT IS THE LIVER?
The liver is a vital organ. Without it we would not be able to live. Apart from the brain, it is the most complex organ in the body.
It has a wide range of functions and acts very much like a factory. One of its mostamazing features is its regenerative power. Some 9/10ths of the liver can be cut away and provided the remaining 1/10th is healthy, the liver will grow back to its original size.
The liver is a processor
The food that we eat passes into the stomach via the oesophagus (gullet). The food is broken down by the action of the stomach and the small intestine.
The nutrients from the food are then absorbed into the blood via the vessels in the walls of the intestines. These drain to veins which lead into the portal vein which carries the blood into the liver. The nutrients are processed in many different ways in the liver. This processing of the food is known as metabolism. The final products made are used by the body for energy and growth.
The liver is a manufacturer
The liver produces a number of different substances which are vital in order for healthy growth and development. For example:
1. The liver cells produce substances which assist with the clotting of the blood, e.g.Prothrombin.
2. The liver cells make proteins which are carried in the blood. These have many functions. Albumin, for example, helps to control the distribution of fluid in all parts of the body and transports many substances to and from the liver and kidneys to other parts of the body.
The liver is a storage depot
The liver stores energy in the form of glycogen (sugar). It also stores a number of other substances, e.g. copper, iron and vitamins.
The liver is a controller
The liver plays an important part in controlling:
1. The correct level of many hormones within the body.
2. The blood sugar (glucose) levels. The liver stores glucose in the form of glycogen when there is too much glucose in the blood and releases it when the blood sugar level falls.
3. The amount of fluid the body retains and its distribution throughout the body.
4. The concentration of cholesterol which it converts into bile salts.
5. The action of many drugs
The liver is a filter
The liver removes many unwanted substances from the body. It plays an important role in controlling the harmful effects of some drugs and products of metabolism by changing them chemically before excreting them into the bile. Bilirubin (unconjugated or indirect) is produced when old red blood cells break down. The average life of a healthy red blood cell is 120 days.
This bilirubin is carried in the blood stream, attached to albuimin, to the liver where it is altered into a different form (conjugated or direct bilirubin) which is then:
1. Excreted in the bile.
2. Transferred into the bile which passes via the bile ducts into the intestine and appears as brown pigment in the stool. Bile is continuously produced by the liver cells mainly by the action of bile salts. It collects in and passes out through the network of bile ducts into the intestine. Bile salts play an important role in the digestion of fats.
The liver is a defender
The liver plays an important role in fighting many types of infection. It particularly protects the body against infection which arises in the gut. With so many different and complex functions, it is not surprising that more than 100 types of liver diseases have been identified in babies and children.
What are the signs and symptoms of childhood liver disease?
- Jaundice (yellowing of the skin and the whites of the eyes)
- Nausea, vomiting and/or loss of appetite
- Yellow urine
- Grey or pale coloured stools
- Change of sleep patterns
- Vomiting of blood or the passing of blood in the stools
- Tiredness or loss of stamina
- Abdominal swelling caused by: A large liver or A large spleen or Excess fluid in the abdomen (ascites)
- Itching
- Poor weight gain
-Abdominal pain
- Nausea, vomiting and/or loss of appetite
- Yellow urine
- Grey or pale coloured stools
- Change of sleep patterns
- Vomiting of blood or the passing of blood in the stools
- Tiredness or loss of stamina
- Abdominal swelling caused by: A large liver or A large spleen or Excess fluid in the abdomen (ascites)
- Itching
- Poor weight gain
-Abdominal pain
It is rare for all these signs and symptoms to be present in one child. Often only a fewof the symptoms and signs will be noticed.Also the degree of severity will greatly vary depending upon the cause. A previously undetected liver problem may be picked up during a routine medical check, e.g. 6 week baby check or school medical, or when the child is examined by the doctor for another reason. The doctor may find a previously unsuspected large liver or spleen.
SUSPECT STOOLS
In babies with liver disease the stools may be one of the colours below.
Do not worry about one or two stools that look unusual.
Don’t forget to look at the urine colour – in a new born baby it should be colourless.
Any baby with stools the colour below – whatever the age, should be investigated for liver disease.
