Well, it's your liver that does it. A mere 1000-1200 gms of it, in a triangular shape, your liver sits pretty in the abdomen. Made up of hepatocytes, it produces a bile which helps digest all that your tongue decides to taste, says Dr Virendra Singh, MD, DM (Gastroenterology), assistant professor, Department of Hepatology, PGI, Chandigarh. Besides, it also performs the function of metabolising drugs.

So quite understandably, if our liver were to give up, it would be worse than bad news for the rest of the body. Some of the most common diseases of the liver include viral hepatitis, amoebiasis, hydatid, Witson's disease and auto-immune disease are found but very rare. Hepatitis, the most common these days, is the inflammation of the liver. It is caused by A,B,C,D and E viruses. Hepatitis A and E viruses spread through contaminated water and food and do not cause chronic liver disease. In India, HAV is mainly found in children below ten years and is caused due to poor hygiene. Hepatitis B, C and D viruses are caused by parental mode (through infections and blood transfusions). The general symptoms include loss of appetite, jaundice and itching. The patient may also develop encephlopathy brain disease which could be fatal. Hepatitis B, C and D viruses (HBV, HCV, HDV) cause chronic liver diseases. It has been found that HBV and HCV cause cancer.

Cirrhosis, typical trait of an alcoholic's liver, is caused by chronic liver disease. This is because of fibrosis i.e., scarring of the liver due to which pressure develops in the GII (Gastro Intestinal Iract) around oesophagus and if the veins burst, haematemasis or bleeding through the mouth happens. Cirrhosis can trigger off a series of other complications like collection of fluid in the abdomen, encephlopathy and kidney problems. ``To check collection of fluid in the abdomen, we recommend a low salt diet besides administering diuretics which help the fluid pass out as urine,'' he adds. Then there is also being used a technique called TIPS which involves connecting the portal vein to the hepatic vein through a metallic stent. ``But this is done only on patients likely to undergo a hepatic transplant because it's temporary and very costly. Moreover, expertise in this is available only at a few centres in India.''

Hepatic transplant seems to be the only in fulminant cirrhosis cases. ``Yes, but it is very costly and still in its infancy in India. It costs Rs 60-70 lakh,'' says the doctor. Chronic HBV and HCV are treated with interferons. But the treatment is again very expensive by Indian standards. Immunisation for HAV, HBV and HDV is available but unfortunately not so for HCV. ``We don't have a technology and expertise for hepatic transplant ,'' says Dr Singh.

That more than says how very important it is to keep the liver running. It's not all that difficult a deal, provided you keep away from alcohol and contaminated food and drinks. Vaccination for HAV and HBV is also a big must in high risk areas.