Despite significant advances in our knowledge of how to diagnose and treat chronic liver disease, we are currently experiencing a global epidemic in cases. In Europe alone, 29 million people suffer from chronic liver disease, and this rapid upward trend is reproduced in England, where liver disease is one of the leading causes of premature mortality. Indeed, one in ten deaths of people in their 40s can be attributed to liver disease. The West Midlands area in particular has higher hospital admissions for fatty liver disease and alcoholic liver disease than the national average, as well as a higher mortality rate for alcohol-related disease.
The sad fact is that much of this is preventable, or at least easily treatable, since more than 90% of liver disease can be put down to alcohol, infection with hepatitis viruses (B and C), or obesity-related disease. The liver damage caused by any of these three agents can lead to fibrosis and cirrhosis, which dramatically increase the risk of developing liver cancer or dying from other causes, including cardiovascular disease. Once cirrhosis develops, treatment may well be limited to transplantation, which is not widely accessible globally and is hampered by a lack of available donor organs. However, if the liver damage is identified at an early stage, it is possible either to stop its progression or, in some cases, even reverse the damage.
One contributor to the huge increase in mortality from liver disease is a lack of awareness among the general public and within the scientific and medical communities of the scale of the problem and its causes. Similarly, the fact that the liver has a remarkable ability to regenerate itself in the early stages of damage, and that often patients have no symptoms until the damage is severe and difficult to treat, mean that treatment options may be limited once the patient arrives at their doctor’s clinic. Thus, one of the major ways in which we can maintain liver health and prevent disease is by education. We need to dispel the perception that alcohol is the only cause of liver damage and enlighten people to the consequences of obesity in relation to liver disease. Simple lifestyle changes can also have a dramatic effect on liver health.
Academics from the Centre for Liver Research at the University of Birmingham have developed a new free and interactive online educational resource to widen public and stakeholder awareness of the challenges of liver disease. This resource also includes input from leading clinical hepatologists and pathologists based at the Queen Elizabeth Hospital in Birmingham, who are able to provide examples of the specific causes of liver disease and highlight some of the groundbreaking clinical research taking place in Birmingham.
The course is offered through the FutureLearn online platform and covers everything from basic liver biology to the mechanisms underlying the global increase in liver disease. The activities also explain the influence that simple lifestyle changes can have on the livers of both healthy individuals and patients with existing liver disease. The course runs over the next three weeks, is designed to be undertaken at students’ leisure and should take no more than three hours a week to complete. More than 8,000 participants from diverse backgrounds have enrolled to date.
Dr Patricia Lalor
Senior Lecturer, Centre for Liver Research, University of Birmingham