Consultant blames drinking, obesity and virus for dramatic rise in liver disease

By Claire Lomax, Telegraph & Argus, Bradford, England

Bradford faces an ‘explosion’ of people suffering from liver disease in the next ten years, a doctor has warned.

Heavy drinking, obesity and hepatitis B and C are behind a dramatic rise in the number of people in the district seeking treatment for liver disease.

Between 2001 and 2009 deaths from liver disease rose by 25 per cent and the numbers of patients waiting for a liver transplant are increasing rapidly.

There are currently eight adult patients in the Bradford district waiting for a new liver – up from three in July 2010.

Dr Sulleman Moreea, a consultant gastroenterologist at Bradford Teaching Hospitals NHS Foundation Trust, said while people were aware of the dangers of alcohol, more people needed to be aware of other causes of liver disease.

“There is a silent disease out there – hepatitis B and C,” he said. “When I started work in Bradford in 2004 I had 150 patients with hepatitis C on my books. Today I have 780 patients.

“If you don’t treat these patients they will develop cirrhosis of the liver. Every two months we are seeing a middle aged person dying from hepatitis C and we will be seeing more and more. We have people desperate for a new liver – some who have waited for three years.

“In the next ten years expect an explosion of patients with liver disease from hepatitis C.”

Thousands of people could already be infected with hepatitis and unaware they are carrying the virus, he believes.

The virus is 100 times more infectious than HIV, with no known cure, however, it can be controlled by drugs. Without treatment, it leads to cirrhosis of the liver and liver cancer.

The blood-borne viral infection is spread through sharing contaminated needles, non-sterilised equipment for tattooing, acupuncture or body piercing, from an infected mother to her baby at birth or through a blood transfusion in a country where blood is not screened.

To counteract the spread of this disease Dr Moreea set up a hepatitis C treatment programme in Bradford in 2005, which is now taking more and more referrals. A new drug has also recently been approved by NICE for use in the NHS which is effective in treating in hepatitis C patients, although it will cost between £18,000 and £22,000 per patient.

And a dietician is working in Bradford specifically to help obese patients with fatty liver disease.

“This is what we need to be investing in to prevent people from dying,” said Dr Moreea. “There are around 110 liver transplants carried out in Leeds per year for the whole of the north of England, so disproportionately Bradford has a bit of a problem.”

“You Have the Power to Donate Life – to become an organ and tissue donor Sign-up today!
Tell Your Loved Ones of Your Decision”

Australia, register at Australian Organ Donor Register

New Zealand, register at Organ Donation New Zealand

Canada - Ontario beadonor.ca
other Canadian provinces

South Africa, http://www.odf.org.za/

United States, donatelife.net

United Kingdom, register at NHS Organ Donor Register

Your generosity can save or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes and 18 people die each day waiting for an organ or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You.

One fifth of British 15-year-olds are drinking astonishing amounts of alcohol in a year

Click image for larger view

This frightening article highlights the dangers of drinking alcohol and the damage it can do to the liver, heart, brain, pancreas and other organs. Although this story doesn't mention alcohol's effects on the lungs, other researchers found that lowered glutathione levels due to alcohol can be as deadly to the lungs of alcohol abusers as alcohol itself can be to their livers and other organs. This story is about British teens, some as young as 11, but is probably true in North America and elsewhere.

By PROFESSOR ROGER WILLIAMS dailymail.co.uk

As Britain's schoolchildren enjoy the freedom of the long summer break, an alarming new government report has revealed just how much alcohol they are drinking.

According to Department of Health statistics, one in five young people between 11 and 15 drinks more than 600 units a year.

This amounts to an astonishing mountain of alcohol. Britain’s binge-drinking epidemic sees 200 under-18s admitted to hospital every week with drink-related injuries.

But it’s the long-term damage these young people are doing to their bodies that concerns me.

As someone who helped to establish the first liver transplant programme in this country back in 1969, and oversaw George Best’s liver transplant in 2002, I am horrified by the latest figures.

It would be worrying enough if they related to older teenagers, but in fact none of the 7,700 school pupils interviewed for the NHS Information Centre’s report was over 15.

Many were as young as 11. The immediate ill-effects may be nothing worse than a hangover but - however much we like to pretend otherwise - alcohol is a poison.

Teenagers do not reach full physical maturity until they are in their 20s, so they are pouring toxins into bodies which are still at a crucial stage of development.

There is also evidence that drinking a lot in a short space of time is worse for your health than more frequent drinking of smaller amounts.

Since young people are more likely to binge-drink, they are placing themselves at even greater risk.

Here are some of the ways in which alcohol affects our children.

Liver

In my clinic, I see a disturbing number of young people with severe alcoholic hepatitis - an acute inflammation of the liver, which can lead to jaundice, coma and even death.
Long-term, excessive drinking can also cause cirrhosis, in which the normal liver tissue is destroyed and replaced by scar tissue.

The incidence of cirrhosis in this country has increased tenfold in recent decades, with some patients who have been drinking since their early teens facing terminal liver disease in their 20s.

Heart

Drinking affects the rate at which the heart beats and the high levels of alcohol in the blood associated with binge drinking can create an irregular rhythm which causes sudden cardiac arrest.

In later life, those who drink at an early age also face the danger of raised blood pressure and heart disease.

Brain

Apart from the impaired judgment which makes intoxicated youngsters more likely to have casual sex - with all its attendant consequences - getting drunk also causes long-term damage to the brain.

Just at the age when they should be at their sharpest, teenage drinkers may be impairing their reaction times, memory and attention span.

One study by the Institute of Child Health suggested that teenage drinkers are 30 per cent more likely to leave school with no qualifications.

They were also 40 per cent more likely to use illegal drugs and suffer mental health problems.

Pancreas

This organ is crucial to digestion. By their late 20s, those who drink heavily at an early age may develop painful pancreatitis, which can cause permanent loss of function. They also have an increased risk of diabetes.

Cancers

Drinking to excess is associated with a higher incidence of common cancers of the mouth, oesophagus, stomach, breast, colon and pancreas.

Physical and emotional development

Excessive drinking during puberty may upset the critical hormonal balance necessary for normal development of organs, muscles, bones and the reproductive system.

Alcohol abuse also exacerbates conditions such as depression and stress, with suicide a major cause of death in 15- to 34-year-olds in the UK today.

“You Have the Power to Save Lives – Register to be an organ and tissue donor & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

In the United States, be sure to find out how to register in your state at ShareYourLife.org or Download Donor Cards from OrganDonor.Gov

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help 75 to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

We regard transplanted organs as a gift, not as a medical right

This father should think again before demanding a new liver for his alcoholic son

Anjana Ahuja TimesOnline

One can imagine the surprise of the barman who went to serve Gareth Anderson. The 19-year-old wandered in to a Belfast pub last week, and asked for a drink. Nothing wrong with that, except that Anderson was clad in hospital gown and slippers, accessorised with intravenous drip needles in his arm. Sensibly, the barman refused to serve him, and rang the Ulster Hospital opposite.

Had the barman known the reason for Mr Anderson’s hospitalization, he might have been less measured: the teenager is awaiting a liver transplant, precipitated by a blowout weekend fuelled by 30 cans of lager. The young alcoholic is now in a London hospital, which has refused a transplant unless he stays dry for six months (as is requested of all potential liver recipients whose condition is drink related). Mr Anderson’s father, meanwhile, is planning legal action to overturn the six-month ruling.

There is much to rue in this story, not least an alcohol-worshipping culture that is now corroding the health of ever-younger drinkers. It is regrettable that donated livers are in such short supply; if they were not, Mr Anderson could have received a new organ and resumed his normal life (minus the booze, we hope).

But it is his father’s determination to resort to law that strikes me: surely his protective paternal instincts could have been deployed much earlier, including handcuffing his son to the hospital bed (he would surely find any judge sympathetic).

Brian Anderson admits that his son is an alcoholic. Alcoholism doesn’t happen overnight. According to a petition set up in Gareth’s name, he has been drinking from an early age. So what was Mr Anderson Sr doing when his son took the first steps on the lager-lined road to the emergency ward?

It may seem harsh that doctors will not make an exception, given that Gareth is critically ill. Their stance would also seem perverse in the face of research published in the British Medical Journal in 2004 that looked at liver transplantation for people who had drunk themselves into ill health. The authors wrote: “The length of abstinence before transplantation does not reliably predict abstinence afterwards, so no justification exists for a fixed arbitrary period ... death may be the price of proving abstinence.”

So it may be in Mr Anderson’s case. And there has been wide discussion of whether it is wise or justified to make moral judgments when deciding whom to treat. Doctors advise against rationing on moral grounds.

This is why we give chemotherapy to the woman who smokes 40 a day, and stomach-stapling to the man addicted to doughnuts. It would be an unkind and unjust society that did otherwise.

But organ donation is trickier. A liver that goes to Mr Anderson is a liver that is denied to somebody else. If he is seeking lager (beer) from the comfort of his hospital bed, can we be confident that he will spurn it when discharged? Here is the nub: we regard organs as a gift, not a medical right. These precious, limited resources flow not from drug companies or government coffers, but from the untimely misfortune of others (including, in China, from executed prisoners, it seems). That is why we resist the idea that they should be traded for money, like so many bags of sugar or barrels of oil.

So we ask that those who want them demonstrate that they are worthy of such largesse. In Mr Anderson’s case, it is six months on the wagon. The six-month rule is as much about making liver transplants for alcoholics socially palatable as it is about the chances of relapse.

Youth is not a compelling reason why Mr Anderson should jump the queue: he might be more deserving than a 60-year-old unreformed soak, but, hand on heart, I do not see why he should usurp, say, a 30-year-old father who has shunned the bottle for six months because it is his only chance to watch his children grow up.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

In the United States, be sure to find out how to register in your state at ShareYourLife.org or Download Donor Cards from OrganDonor.Gov

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes and 18 people die each day waiting for an organ transplant.