|In the News
Tylenol can be deadly, even when used as directed Over-the-counter flu remedies such as Nyquil or Theraflu are often used for relief of symptoms thought to be from the flu, but in actuality could turn out to be the symptoms of acute hepatitis. A choice that could trigger acute liver failure. In many cases acetaminophen is an excellent drug, but a person with acute or chronic liver diseases needs to avoid Tylenol and acetaminophen products altogether.
In a recent study of 72 patients with severe, life-threatening hepatitis, 12.5% of these patients had evidence of acetaminophen toxicity. An important finding in this study was that the acetaminophen toxicity occurred when the patients used the over-the-counter flu medicines in doses directed on the label. Acetaminophen overdose is a leading cause of liver failure and liver transplants. People with liver disease are frequently unaware that they are using acetaminophen-containing compounds, which could put them at risk for liver failure.
Acetaminophen is listed as an ingredient in at least 26 over-the-counter products, including Coricidin D, Triaminic, NyQuil, DayQuil, Dristan, Midol and Pamprin. Two of the most popular prescription compounds, Vicodin and Percocet, also contain acetaminophen. MedPage TodayOften overdoses occur by taking acetaminophen in addition to a cold remedy. Frequently people don't read the labels or are unaware of acetaminophen's potential for toxicity.
The Liver -- A Vital Organ
|Your liver is very
important to your health and one of the largest and most
essential organs in your body. Most people don't realize the vital
significance of the liver and the role it plays in maintaining
To help you understand one of the many
functions of the liver, imagine a 3-pound sponge tucked under
your ribs on the right. All circulating blood passes
through the liver. This virtual "sponge" acts as a big
filter cleaning the blood and removing toxins. It also
helps to metabolize various vitamins and medications in the
process. Nutrients from the food you ingest also pass
through the liver and are extracted for essential use by the
body's tissues. When the liver doesn't function
properly toxins, medications, vitamins, etc. can accumulate and
become very harmful. Furthermore, the body becomes
malnourished due to a lack of essential nutrients that would
have otherwise been extracted by a normally functioning liver.
Bile acids are produced by the liver
and can be stored in the
gallbladder or flow directly by way of bile ducts into the
intestinal tract. These bile acids then assist in the
absorption of nutrients. The complex process of blood
clotting is also a major function of the liver. Needless
to say, our survival and overall well being depends on a
normally functioning liver.
Cirrhosis is a chronic
liver disease that results from ongoing inflammation of the
liver. The body's attempt to correct this inflammation and
repair the liver, often results in scarring which seriously
disrupts the normal function of the liver. As cirrhosis develops, scar tissue grows
around normal liver cells and can block the flow of bile
through the ducts. This leads to a back up bile in the liver and
bloodstream and results in a yellowing of the skin, known as
cirrhosis progresses, the scar tissue also begins to impair the
normal flow of blood from the intestines through the liver,
resulting in increased pressure in the veins that supply this
area. This condition, called portal hypertension, can lead
to serious complications including fluid buildup in the abdomen
and bleeding from enlarged veins in the digestive tract.
Cirrhosis has various causes with the most common being the result of
drinking excessive alcohol over a long period of time.
Other common causes are the result of viral infections, such as
Hepatitis B and Hepatitis C. Undiagnosed hereditary
disorders can also lead to cirrhosis. The most common of
these is hemochromatosis which results in increased amounts of
iron being stored in the liver.
Cirrhosis is a very serious condition
and requires close monitoring by health care
professionals. It is essential that you follow their
- The key to treatment of cirrhosis is
to correct the underlying cause. This could involve
completely avoiding alcohol, obtaining treatment for viral
hepatitis, or an inherited disorder. It is also
important to eliminate certain substances from your diet or
environment that could be aggravating the condition. While
some diseases cannot be cured, appropriate treatment can
stabilize the condition and minimize symptoms and
- Serious complications of cirrhosis can occur, such as internal bleeding, (sudden onset of
black-tarry stools, or vomiting blood) which can be
life-threatening. Prompt diagnosis and management of
these complications is essential.
- Many medications,
vitamins, nutrients, alcohol and other toxins are filtered
through the liver and can further damage a diseased liver.
Always check with your health care provider before taking any
new medications, vitamins, dietary supplements or other
over-the-counter products such as herbal and "natural"
remedies. Often times, dosages of medications need to be
reduced in patients with chronic liver disease. A common over-the-counter product, Tylenol and all products containing acetaminophen, should be avoided in people with acute or chronic liver disease.
- Avoid all alcohol. This
is especially critical for those whose disease was caused by
nutrition is important in the management of cirrhosis. A
well-balanced diet including plenty of fruits, vegetables,
grains, and milk can allow for optimal function of liver
cells. While proteins are also very important in a
well-balanced diet, excessive protein intake should be
avoided, especially in patients with more advanced disease. Too
much protein can raise the amount of ammonia in the
bloodstream, possibly resulting in mental impairment.
- Limit the sodium in your diet
to help prevent your body from retaining extra fluid.
This will help you feel better and may prevent or delay
complications such as ascites (fluid build up in the abdomen)
and breathing difficulties (fluid build up in the lungs) and
lower extremity swelling. A helpful way to monitor one's
fluid status is to monitor daily body weight and to alert your
health care provider if there are sudden changes (ex: greater
than or equal to 2 pounds in a day, or 5 pounds in a week).
- Get vaccinations against Hepatitis
A and Hepatitis B. There is currently no vaccine against
the virus that causes hepatitis C.
- Make sure that the water you drink
and the food you eat are clean. Most cases of infection
with Hepatitis A result from poor cleanliness, especially in
restaurants and cafeterias.
- Patients with cirrhosis should avoid eating uncooked shellfish, which may carry
organisms that can cause hepatitis or other diseases. (See link to video
tutorial below for further precautions in avoiding
exposure to hepatitis.)
C" video tutorial from
Home Page. Locate the
button in the upper R hand column. This will take you to
an extensive list of available videos; scroll down to "Hepatitis C" and
follow the directions. Medline
Plus is a service of the National Library of Medicine and the National
Institute of Health.
|US National Library of Medicine & Nat'l Institute of Health
This site provides extensive information and links to the latest
news, overview of the basics, treatment, disease management,
nutrition, emotional coping, clinical trials, research, and
organizations for liver disease.
|Written by N Thompson, ARNP
in collaboration with M Thompson, MD, Internal Medicine, Last updated May 2006
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