Tuesday, 25 March 2014

‘Scandal’ of liver disease inaction

 



Liver Alcohol, obesity and viral infection are the main causes of liver disease

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The lack of action to tackle liver disease in the UK is "scandalous" according to a group of MPs.

In a report, the all-party Parliamentary Hepatology Group says deaths from liver disease in England have risen 40% between 2001-2012.

It argues continuing complacency is leading to a "shameful waste of lives".

Liver disease accounts for the fifth highest number of deaths in the UK, but is the only one of the major killers that does not have a national strategy.

David Amess MP, who co-chairs the Parliamentary Hepatology Group said if the rise in liver disease continues to be ignored then "before long every one of us will know somebody with cirrhosis, end stage liver disease or liver cancer."

The main causes of liver disease - alcohol misuse, obesity and viral hepatitis - are all preventable.

Chart showing rise in hospital admissions from liver diesease

The MPs took evidence from liver specialists, patients, charities and Public Health England for their inquiry.

Many patients don't find out they have liver disease until it is too late to reverse the damage.
Two patient stories
Dave Norris, from Forest Gate in north-east London said he was devastated to learn last year that he needed a liver transplant.

Mr Norris, 58, said he had always been overweight but never realised that it might permanently damage his liver.

"I was completely shocked when I was told I had non-alcoholic fatty liver disease. I had Type 2 diabetes and weighed 100 kilos (nearly 16 stone) but thought you had to be much fatter than that to do such damage to the liver."

Mr Norris had a liver transplant in November 2013. He is now back at work and says he is taking better care of his health and watching his weight.

Liver disease

  • The average age of death from liver disease is 59 and falling
  • Deaths rose by 40% in England between 2001-2012, from 7,841 to 10,948
  • In the past decade there has been a five-fold increase in cirrhosis among people aged 35-55
  • Deaths from liver disease are rising in the UK, but falling in most other European countries.
  • One in five people in the UK is at risk of serious liver damage
  • Source: All-Party Parliamentary Hepatology Group Inquiry/Public Health England/British Liver Trust

Chris Wilde, a retired dentist from Devon nearly died eight years ago as a result of decades of drink-related liver damage.

He suffered massive internal bleeding due to liver malfunction and was told that unless he gave up alcohol he would die.

Mr Wilde, 65, said: "I considered myself a social drinker but now realise I was dependent on alcohol. I had two cans of lager and maybe half a bottle of wine each day, which was similar to my friends. But it was scarring my liver."

He gave up alcohol and hopes his story will make others aware of the potential hidden damage they may be doing to themselves through drink.

Although overall alcohol consumption in the UK has fallen in recent years, it has doubled since 1950.

Public Health England said the UK was one of the few European countries where drinking levels and alcohol-related harms are increasing.

Among its recommendations the report calls on the government to introduce a minimum unit price for alcohol of 50 pence, as recommended by dozens of health organisations.

It says the UK should introduce universal hepatitis B vaccination and set a 'clear goal' for eliminating hepatitis C within the next 15 years.
More testing
Prof Graham Foster, consultant hepatologist at Barts Health NHS Trust said GPs needed to be far more aware of liver disease.

He said blood tests and ultrasound scans could pick up liver disease years before permanent damage was done, but far too few were carried out.

Prof Foster said: "We need a network of specialist liver centres with firm targets. Part of the problem is that liver disease is lumped together with GI (gastrointestinal). Consultants have targets for the number of endoscopies they do and this takes resources and the focus away from liver disease."

Last year NHS England announced it was not planning to publish a long-awaited national liver strategy.

Dr Michael Glynn, National Clinical Director for GI and Liver Disease at NHS England, said: "There's no doubt that more needs to be done across the system to address the large areas of liver disease that are preventable and to improve survival rates. To do this, early detection and prevention is vital."

NHS England said it would consider the recommendations of the MPs report.

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