Liver Disease In The Elderly: Causes And Treatments

Liver function decreases with age as its size and blood flow decrease.The prevalence of chronic liver disease is increasing in the elderly population.  Investigating the older person with abnormal liver function is important; even with mild abnormalities. For example, metabolism decreases and some drugs are not inactivated as quickly in older people as they are in younger people. As a result, a drug dose that would have no side effects in younger people may have dose-related side effects in the elderly.  Seniors are also less able to handle stress. In addition, low bile production can lead to gallstones.

 

 

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Liver:  Its Functions

The liver’s many functions include:

  • Production of bile that is required in the digestion of food, in particular fats
  • Storing of the extra glucose or sugar as glycogen, and then converting it back into glucose when the body needs it for energy
  • Production of blood clotting factors
  • Production of amino acids (the building blocks for making proteins), including those used to help fight infection
  • Processing and storage of iron necessary for red blood cell production
  • Manufacture of cholesterol and other chemicals required for fat transport
  • Conversion of waste products of body metabolism into urea that is excreted in the urine
  • Metabolizing medications into their active ingredient in the body

Cirrhosis is a term that describes permanent scarring of the liver. In cirrhosis, the normal liver cells are replaced by scar tissue that cannot perform any liver function.

 

Liver: Treatments

Treatment for liver disease in the elderly can be the same as for younger people but with age appropriate modifications. Each liver disease will have its own specific treatment regimen. For example, hepatitis A requires supportive care to maintain hydration while the body’s immune system fights and resolves the infection. The elderly are more susceptible to dehydration and gallstones.

In patients with cirrhosis and end-stage liver disease, medications may be required to control the amount of protein absorbed in the diet. The liver affected by cirrhosis may not be able to metabolize the waste products, resulting in elevated blood ammonia levels leading to lethargy, confusion, and coma. Low sodium diet and water pills (diuretics) may be required to minimize water retention.

In those patients with large amounts of fluid accumulated in the abdominal cavity, the excess fluid may have to be occasionally removed with needle and syringe. Using local anesthetic, a needle is inserted through the abdominal wall and the fluid is withdrawn.

 

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