Infection Prevention Month

According to the Centers for Disease Control and Prevention, one out of every 20 hospitalized patients will contract a healthcare-associated infection. The spread of these infections, however, can be controlled. There are several simple and cost-effective strategies that can help prevent infections, from the basic tenet of hand hygiene to the team-oriented approach of Comprehensive Unit-based Safety Programs.

Four infection prevention and process improvement experts weigh-in on the 10 best strategies for prevention of infections.

1. Hand Hygiene. According to the CDC, this is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Surgical team personnel should wash their arms and forearms before a procedure and put on sterile gloves, according to CDC guidelines for infection control. Steven J. Schweon, RN, MPH, infection prevention consultant and member of The Society for Healthcare Epidemiology of America, suggests the “clean in, clean out” approach, wherein hands and equipment are cleaned or disinfected on the way into the patient’s room and on the way out again.

2. Environmental hygiene. According to J. Hudson Garrett, PhD, MSN, MPH, FNP-BC, CSRN, VA-BC, senior director for clinical affairs at PDI, one of the most common sources of transmission of infection is environmental surfaces. Certain types of microbial bacteria are capable of surviving on environmental surfaces for months at a time, according to Mr. Garrett. When healthcare providers or patients touch these surfaces with their skin, the bacteria can be transmitted, causing infection. Thus, it is essential that the environment be kept clean and disinfected. Patients and their families are now the biggest advocates of medical safety, and Mr. Garrett suggests including them in infection prevention protocols, especially with respect to maintaining a clean and sanitary environment. It is also important to involve multidisciplinary environmental hygiene teams in meetings regarding adherence to infection prevention protocols. Irena L. Kenneley, PhD, APRN-BC, assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland and member of the Association for Professionals in Infection Control and Prevention, says that meeting with environmental services and sharing in-house surveillance data helps them relate housekeeping tasks with the spread of infection and helps ensure optimal environmental hygiene.

3. Screening and cohorting patients. Part of the preoperative health evaluation process should include consistent screening of patients, says Siew Lee Grand-Clément, a black belt in robust process improvement at the Joint Commission Center for Transforming Healthcare. These patients must then be treated prior to surgery or any other procedure. However, it is essential that patients who are suffering from the same disease or infection should be kept together in a designated area. “This is essential to ensure that cross infections do not happen,” says Dr. Kenneley. Infections can spread easily from one patient to another if they are being treated in the same area, with the same staff and shared patient care equipment. Some infectious agents are even airborne, says the CDC. Organizations must also evaluate whether the staff is adhering to specific protocols for specific infections, Dr. Kenneley says.

4. Vaccinations. The staff at a healthcare organization may sometimes be the cause of the spread of infections. They come into contact with patients with different types of diseases and may contract infections, according to the CDC. As a result, organizations must make sure that recommended vaccinations are being administered to their staff as recommended. “Keeping healthcare professionals healthy pays dividends,” says Mr. Schweon. It results in decreased transmission risk to co-workers and patients.

5. Surveillance. Through surveillance, organizations should gather data regarding infection patterns at their facility. They should also regularly assess current infection prevention protocols. Having a robust infection surveillance program helps organizations measure outcomes, assess processes of care and promote patient safety, says Mr. Schweon. Sharing the data that the infection surveillance program gathers is the next step. “Communicate, display and discuss all process and outcomes measures with all stakeholders,” says Dr. Kenneley.

6. Antibiotic stewardship. The misuse and overuse of antibiotics can put patients at a risk of contracting infections, according to the Association for Professionals in Infection Control and Epidemiology. Inappropriate antibiotic use may also result in patients becoming resistant to some drugs. If those patients contract an infection, it becomes harder to treat them and the risk of it spreading increases. Mr. Schweon suggests establishing a program to assist with appropriate antibiotic selection and dosing. This helps optimize patient outcomes and minimize adverse events like C. difficile infection and antibiotic toxicity, he says.

7. Care coordination. Breakdown of communication in the surgical preparation, planning and postoperative care management among various care providers during the care transition process can lead to surgical site infections that could otherwise be avoided, says Ms. Grand-Clément. Often, the concept of “stopping the line” is not practiced, which is when care providers are doubtful if certain necessary infection prevention or surgical preparation activities have been completed by the previous care providers, and they halt the care transition process until the matter is resolved. Organizations must avoid situations where a certain process is overlooked by a department that assumes another department has already completed that it. “Activities must be timed and accountability should be specifically assigned,” she says. There needs to be coordination of care and communication within the surgical team as well. There is a risk of breaking the sterile field in the surgery room particularly around the portion of the surgical procedure when multiple, critical activities are taking place at the same time that require staff to multitask, she says. Care coordination goes a long way in preventing surgical site infections.

8. Following the evidence. Keeping abreast of the latest findings regarding the spread of infections and strategies for prevention is essential for a successful infection prevention program. “Infection preventionists must continually monitor the professional literature and attend educational conferences for the latest information with preventing infections,” says Mr. Schweon. However, it is also important to first look at the reality of your organization’s processes and perform your own gap assessment before adopting new practices. What is new in the infection prevention field may not necessarily be the best fit for your organization, says Ms. Grand-Clément.

9. Appreciating all the departments that support the infection prevention program. An organization’s culture may need to shift from thinking that only infection preventionists are accountable for infection prevention, because every patient encounter throughout the care continuum presents all healthcare workers with an infection prevention opportunity, says Ms. Grand-Clément. All caregivers are accountable, and to encourage infection prevention protocols, healthcare professionals should show appreciation for all the people who help keep infections at bay, from the people who prepare surgical instruments for the operating room to those preparing the food safely for patients, staff and visitors, says Mr. Schweon.

10. Comprehensive Unit-based Safety Programs. The Comprehensive Unit-based Safety Program is a structured strategic framework for patient safety improvement that integrates communication, teamwork and leadership, according to the Agency for Healthcare Research and Quality. Each unit should have its own infection prevention champions, with these individuals becoming an extension of the infection prevention and control department, adds Mr. Garrett. “The CUSP program has demonstrated time and time again how effective unit-based champions can be in influencing positive change and improving outcomes,” says Mr. Garrett.

Each of these strategies helps organizations keep the spread of infections at bay. When implemented, supported and carried out together, these 10 strategies are instrumental in ensuring the success of an infection prevention program at an organization.

QUOTE FOR FRIDAY:

“Create daily and terminal cleaning protocols and checklists for patient-care areas and equipment. Perform daily cleaning using a C. difficile sporicidal agent (EPA List K agent). Clean and disinfect the patient-care environment (including the immediate vicinity around a CDI patient and high touch surfaces) at least once a day, including the toilets.  Clean and disinfect all shared equipment prior to use by another patient.”

CDC Centers for disease control and prevention

 

HEALTH ACQUIRED INFECTIONS (HAIs)-Public Awareness.

The purpose of this article is to help broaden the public in knowing about HAIs including how their family or friend should be cared for when in a hospital with what they can do when visiting a loved one in a health facility for both the patient’s and visitor’s benefit.  

History of HAIs

Let us start with some history. In England in the 1830s, the term hospitalism was coined by Sir James Simpson to describe HAIs. In those days, it was believed that infection was spread because of inadequate ventilation and stagnant air. To prevent infection, windows were opened, and whenever possible care was taken to prevent overcrowding of hospital rooms. Little was known about microbes and their pathogenicity, and consequently little was done about personal hygiene. In Victorian society, the idea of one’s personal hygiene being connected to infection was taken personally and was met with great resistance.

Despite the efforts of medical personnel, many patients died of overwhelming sepsis following preventable infections. In the late 1860s after much persistence, Joseph Lister, a British surgeon, introduced the concept of antisepsis, which significantly decreased death from postoperative infection. After penicillin was introduced in 1941, postsurgical infection rates and deaths from postsurgical pneumonia were both dramatically decreased.

Today, modern medicine has brought a more thorough understanding of pathogens and the epidemiology of the diseases they cause. Unfortunately, in spite of the vast amounts of medical advances that have occurred over the years, the healthcare industry is still faced with the enormous task of preventing and reducing the risk of HAIs.

Today HAIs are defined as nosocomial infections which are infections that are acquired in hospitals and other healthcare facilities (like a nursing home or subacute rehab facility). To be classified as a nosocomial infection the patient must have been admitted for reasons other than an infection. He or she must also have shown no signs of active or incubating infection upon admission.

On average, nosocomial patients stay in the hospital 2.5 times longer than patients without infection. An estimated 40 percent of nosocomial infections are caused by poor hand hygiene (WHO). Hospital staff can significantly reduce the number of cases with regular hand washing. They should also wear protective garments and gloves when working with patients.

Invasive procedures increase the risk of nosocomial infections. Noninvasive procedures are recommended when possible. Most nosocomial infections are due to bacteria. Since antibiotics are frequently used within hospitals, the types of bacteria and their resistance to antibiotics is different than bacteria outside of the hospital. Nosocomial infections can be serious and difficult to treat, especially if it’s a multi-resistant bacteria.

What put’s a person at risk?

Harmful microbes are all around us, and although infection poses a threat to everyone, certain people are more at risk of infection. For example, people in healthcare facilities are more at risk than those in the community simply because they are exposed to others who are infected with disease-causing organisms. These people are exposed to so many other peoples germs and bacteria as opposed to a private home simply puts you at potential for picking up them if not proper prevention is carried out by all that come in contact with you, starting simply with hand washing by the patient and those that see the patient (medical staff to visitors).

Even more at risk are special populations of patients, such as those with compromised immune systems, those who have undergone recent surgery, those with poor nutritional status, and those with open wounds. Patients undergoing certain medical procedures, such as intubations and central lines, are also at increased risk. Medical devices also carry a risk of infection. Urinary catheters, central lines, mechanical ventilation equipment, and surgical drains all put patients at risk for infection. Any foreign object in the body or any unnatural opening of the body (surgical wound or trauma wound) puts that individual at risk for local infection to that area and if left untreated goes to general infection (temp greater than 100.5 or 101 F).

Further, certain medications and various chemotherapies weaken patients’ immune systems, leaving patients more vulnerable to infection. The length of time spent in a healthcare facility also affects the risk of infection: The longer the stay, the longer that person is exposed to much more bacteria than at home putting greater risk of that patient’s chances of acquiring a HAI. Over 25 years ago and further back the doctors kept patients in the hospital longer than needed thinking this was the best care for the patient but now it’s get the patient out as soon as possible when the patient has reached clearance by MD’s to be discharged safely home and either the pt is back to normal or can safely heal at home exposed to less bacteria and germs since the hospital has so much more obviously due to population.

The most common method of transmission is by direct contact with an infectious microorganism. Sputum, blood, and feces are common vehicles for microbe transmission. Healthcare workers and patients spread microbes via droplets generated by talking, sneezing, or coughing. Small particles of evaporated droplets (droplet nuclei) and dust particles carry microorganisms and spread infection over long distances.

Infection can also be spread through inanimate objects known as fomites, such as improperly sterilized medical equipment that is used on more than one patient. Healthcare workers who move from patient to patient carry infectious organisms on their clothes, stethoscopes, and phones. Other modes of transmission include the spread of infectious agents through food and water or through vectors, such as mosquitoes, flies, and rats.

Though hospitals throughout America have this problem to face in all hospitals in America and elsewhere, these facilities have developed infection control people who continuously make policies/procedures in their facilities to prevent the spread of infection through all routes with the knowledge we know today as opposed to 25 years ago and further back regarding infection.

QUOTE FOR THURSDAY:

“The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program estimates that 42,220 new cases of liver and intrahepatic bile duct cancer will be diagnosed in the United States and some 30,200 people are expected to die of primary adult liver cancer in 2018. The five-year survival rate is just 17.7 percent. Having hepatitis B, hepatitis C, or cirrhosis are significant risk factors for adult primary liver cancer.

American Association For Cancer Research (AACR) Foundation

Month for LIver Cancer

liver awareness

liver awareness2

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer.

Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

  • Losing weight without trying
  • Loss of appetite
  • Upper abdominal pain
  • Nausea and vomiting
  • General weakness and fatigue
  • Abdominal swelling
  • Yellow discoloration of your skin and the whites of your eyes (jaundice)
  • White, chalky stools

It’s not clear what causes most cases of liver cancer. But in some cases, the cause is known. For instance, chronic infection with certain hepatitis viruses can cause liver cancer.

Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.

Factors that increase the risk of primary liver cancer include:

  • Chronic infection with HBV or HCV. Chronic infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.
  • Cirrhosis. This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.
  • Certain inherited liver diseases. Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson’s disease.
  • Diabetes. People with this blood sugar disorder have a greater risk of liver cancer than those who don’t have diabetes.
  • Nonalcoholic fatty liver disease. An accumulation of fat in the liver increases the risk of liver cancer.
  • Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops such as corn and peanuts can become contaminated with aflatoxins, which can end up in foods made of these products. In the United States, safety regulations limit aflatoxin contamination. Aflatoxin contamination is more common in certain parts of Africa and Asia.
  • Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.

MOST IMPORTANT is PREVENTION:

Reduce your risk of cirrhosis

Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce your risk of cirrhosis if you:

  • Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount you drink. For women, this means no more than one drink a day. For men, this means no more than two drinks a day.
  • Maintain a healthy weight. If your current weight is healthy, work to maintain it by choosing a healthy diet and exercising most days of the week. If you need to lose weight, reduce the number of calories you eat each day and increase the amount of exercise you do. Aim to lose weight slowly — 1 or 2 pounds (0.5 to 1 kilograms) each week.
  • Use caution with chemicals. Follow instructions on chemicals you use at home or at work.

Get vaccinated against hepatitis B

You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine, which provides more than 90 percent protection for both adults and children. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems.

Take measures to prevent hepatitis C

No vaccine for hepatitis C exists, but you can reduce your risk of infection.

  • Know the health status of any sexual partner. Don’t engage in unprotected sex unless you’re certain your partner isn’t infected with HBV, HCV or any other sexually transmitted infection. If you don’t know the health status of your partner, use a condom every time you have sexual intercourse.
  • Don’t use intravenous (IV) drugs, but if you do, use a clean needle. Reduce your risk of HCV by not injecting illegal drugs. But if that isn’t an option for you, make sure any needle you use is sterile, and don’t share it. Contaminated drug paraphernalia is a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
  • Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop refuse to answer your questions or don’t take your questions seriously, take that as a sign that the facility isn’t right for you.

Ask your doctor about liver cancer screening

For the general population, screening for liver cancer hasn’t been proved to reduce the risk of dying of liver cancer, so it isn’t generally recommended. The American Association for the Study of Liver Diseases recommends liver cancer screening for those thought to have a high risk, including people who have:

  • Hepatitis B and one or more of the following apply: are Asian or African, have liver cirrhosis, or have a family history of liver cancer
  • Hepatitis C infection and liver cirrhosis
  • Liver cirrhosis from other causes, such as an autoimmune disease, excessive alcohol use, nonalcoholic fatty liver disease and inherited hemochromatosis
  • Primary biliary cirrhosis

Discuss the pros and cons of screening with your doctor. Together you can decide whether screening is right for you based on your risk. Screening typically involves an ultrasound exam every six months.

Diagnosing liver cancer

Tests and procedures used to diagnose liver cancer include:

  • Blood tests. Blood tests may reveal liver function abnormalities.
  • Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI).
  • Removing a sample of liver tissue for testing. Your doctor may recommend removing a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer.

    During a liver biopsy, your doctor inserts a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.

Determining the extent of the liver cancer

Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of the cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans.

There are different methods of staging liver cancer. One method uses Roman numerals I through IV, and another uses letters A through D. Your doctor uses your cancer’s stage to determine your treatment options and your prognosis. Stage IV and stage D indicate the most advanced liver cancer with the worst prognosis.

Treatment

Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.

Surgery

Operations used to treat liver cancer include:

  • Surgery to remove the tumor. In certain situations, your doctor may recommend an operation to remove the liver cancer and a small portion of healthy liver tissue that surrounds it if your tumor is small and your liver function is good.

    Whether this is an option for you also depends on the location of your cancer within the liver, how well your liver functions and your overall health.

  • Liver transplant surgery. During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery is only an option for a small percentage of people with early-stage liver cancer.

Localized treatments

Localized treatments for liver cancer are those that are administered directly to the cancer cells or the area surrounding the cancer cells. Localized treatment options for liver cancer include:

  • Heating cancer cells. In a procedure called radiofrequency ablation, electric current is used to heat and destroy cancer cells. Using an ultrasound or CT scan as a guide, your surgeon inserts one or more thin needles into small incisions in your abdomen. When the needles reach the tumor, they’re heated with an electric current, destroying the cancer cells.
  • Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.
  • Injecting alcohol into the tumor. During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol causes the tumor cells to die.
  • Injecting chemotherapy drugs into the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver.
  • Placing beads filled with radiation in the liver. Tiny spheres that contain radiation may be placed directly in the liver where they can deliver radiation directly to the tumor.

Radiation therapy

This treatment uses high-powered energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the liver, while sparing the surrounding healthy tissue.

During external beam radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body.

A specialized type of radiation therapy, called stereotactic radiosurgery, involves focusing many beams of radiation simultaneously at one point in your body.

Targeted drug therapy

Targeted drugs work by interfering with specific abnormalities within a tumor. They have been shown to slow or stop advanced hepatocellular carcinoma from progressing for a few months longer than with no treatment.

More studies are needed to understand how targeted therapies, such as the drug sorafenib (Nexavar), may be used to control advanced liver cancer.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.

What you can do in being preparred to see your doctor:

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, as well as any vitamins or supplements, that you’re taking.
  • Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

 

QUOTE FOR WEDNESDAY:

“Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common form of liver disease in children and has more than doubled over the past 20 years.  About 100 million individuals are estimated to have NAFLD.”

The American Liver Foundation

Part II Liver and Disease (Non-Alcoholic Fatty Liver Disease-NAFLD)

A      healthy liver

              A. HEALTHY LIVER  

  B      liver diease 1      

                B. DISEASED LIVER

TREATMENT There are no medical treatments yet for NAFLD. Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages.

  • See a doctor who specializes in the liver regularly
  • Talk to your doctor about ways to improve your liver health
  • Lose weight, if you are overweight or obese
  • Lower your cholesterol and triglycerides
  • Control your diabetes
  • Avoid alcohol
  • PREVENTION There are ways to prevent NAFLD:
  • Maintain a healthy weight
  • Eat a healthy diet
  • Exercise regularly
  • Limit alcohol intak
  • Only take medicines that you need and follow dosing recommendations. The more severe form of NAFLD is called non-alcoholic steatohepatitis (NASH). NASH causes the liver to swell and become damaged. NASH tends to develop in people who are overweight or obese, or have diabetes, high cholesterol or high triglycerides. NASH can occur in many.
  •  Causes: NASH:NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.
  • Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
  • Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur. NASH is one of the leading causes of cirrhosis in the United States.  Up to 25% of adults with NASH may have cirrhosis.  Know people have NASH even if they do not have one risk factor can get the disease.
  • Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans.
    • Nonalcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage.
    • NASH occurs in people who drink little or no alcohol and affects 2 to 5 percent of Americans, especially people who are middle-aged and overweight or obese.
    • NASH can occur in children.
    • People who have NASH may feel well and may not know that they have a liver disease.
    • NASH can lead to cirrhosis, a condition in which the liver is permanently damaged and cannot work properly.
    • Fatigue can occur at any stage of NASH.
    • Weight loss and weakness may begin once the disease is advanced or cirrhosis is present.
    • NASH may be suspected if blood tests show high levels of liver enzymes or if scans show fatty liver.
    • NASH is diagnosed by examining a small piece of the liver taken through a needle, a procedure called biopsy.
    • People who have NASH should reduce their weight, eat a balanced diet, engage in physical activity, and avoid alcohol and unnecessary medications.
    • No specific therapies for NASH exist. Experimental therapies being studied include antioxidants and antidiabetes medications.
    • Other Pointers in knowing about the types of liver diseases:
  • Most liver diseases are managed and not cured. The exception is for gallstone disease and some viral infections like Hepatitis A and infectious mononucleosis. All forms of liver disease has the ability to progress to cirrhosis and cause liver failure. Complications associated with cirrhosis and liver failure include an increased risk of bleeding and infection, malnutrition and weight loss, and decreased cognitive function.
  • Depending on the type of cause for liver disease, determines how it is treated. Hep A requires supportive care from others to maintain hydration while the body’s immune system continues to fight off infections. Other diseases may require long-term care to control and minimize consequences of a particular disease. With cirrhosis and end-stage liver disease patients, they are often given medications to control the amount of protein absorbed in the diet. For other cirrhosis patients, they may not be able to metabolize waste products which raises their blood ammonia levels. To help them function, they need to take water pills (diuretics) and start a low sodium diet to minimize water retention. Only when all other options have failed is liver transplantation an option.
  • Symptoms of liver disease range depending on the exact cause for the limited liver function. The general symptoms include a weakness or fatigue, weight loss, nausea, vomiting, fever and a yellow discoloration. If these symptoms are experienced without an explanation, it may be time to consult a medical professional. The time for education is before something like this happens. The survival rate is much higher for the individuals that seek medical attention early on through the act of having the knowledge to make the right decision. By the way the yellow discoloration is what we call Jaundice.
  • Some of the other viruses that cause liver disease are viral infections like Mononucleosis, Adenovirus and Cytomegalovirus. There are also non-viral infections like toxoplasmosis and Rocky Mountain Spotted fever that could lead to liver disease but they are less common.
  • There are other conditions like Hemachromatosis (iron overload), which is a metabolic disorder that leads to abnormally elevated amounts of iron that is stored in the body. It is an inherited disease. Wilson’s disease is another inherited disease but it affects the body’s ability to metabolize copper. Gilbert’s Disease is an abnormality in bilirubin metabolism in the liver and affects up to 7% of the North American population.
  • Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur. NASH is one of the leading causes of cirrhosis in adults in the United States. Up to 25% of adults with NASH may have cirrhosis. Know people have NASH even if they do not have one risk factor.
  • Due to alcohol abuse acting as the most common cause of liver disease, it is recommended that alcohol consumption is in moderation. It may help minimize the risk of alcohol-related liver disease. Hepatitis B and C contraction can be decreased by minimizing the risk of exposure to another person’s bodily fluids. There is a vaccination available for Hepatitis A and B. There is screening available for Hepatitis C at most clinics or doctors offices. Fatty liver disease is preventable by the promotion of a healthy lifestyle. Those lifestyle choices include a well-balanced diet, weight control, avoiding excess alcohol consumption and routine exercise.

QUOTE FOR TUESDAY:

“Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).”

American Liver Foundation

The Liver and NAFLD (Non-Alcoholic Fatty Liver Disease).

liver awareness2

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and in some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Nonalcoholic fatty liver disease is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.

Nonalcoholic fatty liver disease is common and, for most people, causes no signs and symptoms and no complications.

But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis.

At its most severe, nonalcoholic fatty liver disease can progress to liver failure.

Much of the American Liver Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

Much of the Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

But the Foundation is also tapping into the heightened awareness during Liver Awareness Month to draw attention to the alarming increase in the incidence of Non-Alcoholic Fatty Liver Disease (NAFLD), which, staggeringly, affects up to 25 percent of people in the United States.

As its name suggests, NAFLD is the buildup of extra fat in the liver that isn’t caused by alcohol. It’s normal for the liver to contain some fat. But if more than 5 to 10 percent of the liver’s weight is fat, then it is called a “fatty liver.”

Most often, NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Sedentary behavior is another major contributing factor to the onset of NAFLD.

For these reasons, concern continues to grow as one in 10 children—that’s seven million children in the United States—is estimated to have fatty livers.

NALFD can become even more serious. It can progress to Non-Alcoholic Steatohepatitis (NASH), which means that along with the fat, there is inflammation and damage to the liver. A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.