Gastroenterology and Hepatology: Look after your liver

Liver disease

Chief Medical Officer Professor Dame Sally Davies highlighted a 20 per cent rise in liver disease deaths in under-65s since 2000. She calls for urgent action to discourage harmful lifestyles.

While most of Europe has seen rates fall, high levels of drinking and obesity in England are worsening a major preventable disease. Three of the major causes of liver disease - obesity, alcohol abuse and undiagnosed hepatitis infection - are all preventable and must be tackled to stop the rising number of premature deaths from liver disease.

Alcohol

Alcohol-related incidents make up six per cent of callouts for the London Amulance Service. In 2011/12 they handled 66,254 emergency incidents because somebody had too much to drink - that is 181 patients every single day.

Alcohol misuse is a major cause of illness, injury and death. As well as short-term damage, like sprains, cuts and a hangover, alcohol can also cause long-term problems like liver and heart disease and dementia.

Men should drink no more than 21 units a week and women 14 units. Try to have two alcohol free days a week to give your liver a rest as well.

1 unit = ½ pint beer = pub measure spirits = small glass wine

How you can have a safe night out*

  1. Eat before drinking: food soaks up alcohol, slowing it down on its way into the bloodstream. It will provide more energy, and lessen the effects the next day.
  2. Drink lighter beers: stronger continental beers are popular, but make for a messy night and a bigger hangover. The difference between a pint of 5% lager, and a 3.5% or 4% one is one unit.
  3. Set a drinks limit: plan what to drink in an evening and stick to it.
  4. Have a strategic soft drink: this keeps the body hydrated, and will lessen the effects the next day.
  5. Avoid drinking in rounds: this can often mean drinking at a faster pace set by another one of the group.
  6. Be your own person: nobody should feel as though they should have to drink something if they don’t want to, and real friends should respect each others' wishes.
  7. Keep track of what you’ve had: it is hard to say ‘That’s my limit tonight’ if you don’t know how much you’ve had.
  8. Use more mixers: diluting a drink with another mixer will make it last longer, and lessen the effects.
  9. Drink smaller drinks: A large glass of wine in most bars is equivalent to a third of a bottle!
  10. Plan your journey home: Don’t leave it to chance—think about how you’re going to get home, and who with, before you go out. Make arrangements before you start drinking, and make sure you don’t get left to walk home alone.

*Source: Department of Health and Home Office: ‘Know your limits’ campaign

Obesity

Staying a healthy weight improves health and reduces the risk of diseases associated with being overweight or obese, such as coronary heart disease, Type 2 diabetes, liver disease, osteoarthritis and some cancers.

The first step is to Check you BMI online

General advice*

  • Check your weight or waist measurement every now and then, or keep track of the ‘fit’ of your clothes, to make sure you are not gaining weight.
  • Discuss any concerns about your (or your family’s) diet, activity levels or weight with a GP or practice nurse, health visitor, school nurse or pharmacist.
  • Adults: Use a weight loss programme (such as a commercial or self-help group, book or website) only if it is based on a balanced diet, encourages regular exercise, and expects weight loss of no more than 0.5–1 kg per week. People with certain medical conditions – such as Type 2 diabetes, heart failure or uncontrolled hypertension or angina – should check with their GP or hospital specialist before starting a weight loss programme.

How to have a healthy balanced diet

  • Base meals on starchy foods such as potatoes, bread, rice and pasta, choosing wholegrain where possible.
  • Eat plenty of fibre-rich foods – such as oats, beans, peas, lentils, grains, seeds, fruit and vegetables, as well as wholegrain bread, brown rice and pasta.
  • Eat at least five portions of fruit and vegetables a day in place of foods higher in fat and calories.
  • Eat a low-fat diet, and avoid increasing your fat and/or calorie intake.
  • Eat as little as possible of: fried foods; drinks and confectionery high in added sugars; and other food and drinks high in fat and sugar, such as some take-away and fast foods.
  • Eat breakfast.
  • Watch the portion size of meals and snacks, and how often you are eating.
  • Avoid taking in too many calories in the form of alcohol.
  • Children and young people: should have regular meals in a pleasant, sociable environment with no distractions (such as television); parents and carers should join them as often as possible.

How to keep physically active

  • Make activities you enjoy – such as walking, cycling, swimming, aerobics or gardening – part of your everyday life. Small everyday changes can make a difference.
  • At work, take the stairs instead of the lift, or go for a walk at lunchtime.
  • Avoid sitting too long in front of the television, computer or playing video games.
  • For children:
  • gradually reduce the time they are sitting in front of a screen
  • encourage games that involve running around, such as skipping, dancing or ball games
  • be more active as a family, by walking or cycling to school, going to the park, or swimming

*Source: ww.NICE.org.uk

Obesity on NHS Choices

Useful links

 

Endoscope

Gastroenterology
Hillingdon Hospital
Telephone: 01895 279778