Love Your Liver for Longer Life

Eager Mini-Med students ready for Saturday class

I regret to report that I am not qualified to summarize the recent Mini-Med School  session on the skin. To do that, I’d need at least six years of medical school (rather than my current 18 weeks) and a library of forensic photos of skin lesions (I prefer more nonrepresentational art). The lecture focused on what can happen to the skin as we age, occasionally using our face as a canvas for spots, growths, tags and other unpleasant additions to once-youthful skin. The morphology is far too complex for this blogger’s brain but let me summarize in two succinct points:1. Aways wear sunblock (sun is the major factor in aging skin) 2. Pay attention to anything on your skin that changes with time or worries you and see your doctor about it (skin cancers can and do sneak up without warning).

On to a body part that’s more digestible (sorry) - the liver.  Christopher Bowlus, MD and professor of gastroenterology and hepatology, introduced his lecture by saying he’d talk about “digestive issues after the age of 50 ... which, actually, is most of them.” Ah, yet another portend of the aging process.

A Hernia Where?
The malady of GERD (Gastroesophageal Reflux Disease ) came up first (please notice the paltry pun here) and drew rapt attention as GERD is fairly common - and mostly just annoying, but can grow to be a dangerous condition leading to cancer of the esophagus. GERD develops when acid from the stomach moves up and into the esophagus because the esophageal sphincter no longer prevents this action. A hiatal hernia can be the cause. The sphincter opens and closes to keep acid from traveling up (much like another such muscle keeps other matter from traveling down at will). This acid causes burning, pressure, discomfort and can get bad enough to feel like a heart attack, reports Dr. Bowlus. “I sent my own dad to the emergency with heartburn.”

A hiatal hernia  is not uncommon and can be diagnosed with an endoscopy. Treatments range from taking over-the-counter acid suppressants like Zantac or Prilosec, or simple Tums or Mylanta. However, when such band aids don’t work it’s important to look more closely at what’s happening. If the lining of the esophagus has changed and has the look of the structure of the stomach, this could indicate a precancerous or cancerous condition.

GERD happens to men more than to women and predominantly to white men. There’s a rise in esophageal cancers that’s being traced to this nation’s obesity epidemic. Risk factors include being a white male over the age of 50 and overweight.  (There were lots of sideways glances from women to their male partners during this lecture.)

Baby Boomers Face Increased Risk
Dr. Bowlus also talked about liver health and disease - he says he considers the liver the most fascinating organ in the body. Go figure. Liver disease is the 10th leading cause of death among men and the 12th in women. A scary characteristic about the disease is that symptoms often don’t appear until it is, literally, too late. The risk rises significantly between the ages of 45 and 54. Most common causes are alcohol, chronic hepatitis, the use of certain medications and the growing incidence of fatty liver disease. 

A safe level of alcohol (4 ounce servings) for most women is 1 drink a day and for men, it’s about 2 per day, according to many studies.  The Doc clearly announced that no, you may not save up your drinks and enjoy them all over the weekend.  Studies show about 20% of alcoholics will develop liver disease such as hepatitus, and many other diseases are associated with alcohol consumption.

Hepatitis B is a chronic infection that, in Asia and Africa are transmitted at birth, is the leading cause of death in Asia and greatly impacts immigrants to the U.S. from those countries.

Hepatitis C is more prevalent in the U.S., and traced to sharing needles, getting tattoos and, prior to1992, blood transfusions. Baby boomers beware! According to a recent study our generation is at pretty high risk. Dr. John Ward of the Centers for Disease Control calls it “a silent epidemic.” The recent CDC report predicts that one of every 3 baby boomers “is living with hepatitis C infection.”

The Big, Bad ‘C’

Colon cancer topped off the Doctor’s list of gastroenterological threats. The 3rd most common cause of death in men and 2nd in women, the occurrence dramatically increases after the age of 50. Risk factors include smoking, alcohol use, obesity and family medical history. Stool-based screening tests that we are advised to get annually after the 50th birthday may reveal small amounts of blood. Since cancers bleed, this would be an indication a closer look is needed. Unfortunately, a closer look most often means a colonoscopy or a similarly “uncomfortable” procedure.

Being exceptionally bright mini-medical students we all could extrapolate what “uncomfortable” actually means. I am stunned that, in the digital era, in a time when CERN physicists are dabbling with atoms traveling faster than the speed of light and neuro-imaging scientists are essentially able to ‘read’ a mind, our scientific genius can’t devise a less “uncomfortable” procedure to examine the colon. Nonetheless, very recent studies in the New England Journal of Medicine affirms the procedure is highly effective and critical to saving lives.

Week four of UCD’s Mini Medical School, orchestrated by the Department of Internal medicine and Dr. Michael McCloud, takes a close look at medications (I think we take too many) and the heart (we all need just one in good working order).

COMMENTS
From Mollie:

One of the networks was telling the children of the elderly when they should take away their parents cars.I think that should be up to Motor V. They also were talking  about how many accidents the elderly have. I thought why don't you look at sixteen year olds and how many accidents THEY have... This is one reason we need to fight ageism unless we want

some one else telling us what to do.

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