On Tuesday evening, February 8, the Navigating the Medical System Lecture Series, hosted by Congregation Etz Chaim, presented an informative virtual lecture on liver disease. Dr. Mel Breite, Founder and Director of the Navigating the Medical System Lecture Series, shared that screening for colon cancer is now recommended for those 45 and over and it’s a 100% avoidable disease. He noted that everyone receives blood tests when they have a check-up, and in the metabolic profile there is a liver test. A lot of people receive abnormal results on that test. He then introduced the featured speaker, Dr. Constantine Fisher, MD, attending gastroenterologist at NewYork-Presbyterian Queens Hospital.

Dr. Fisher shared a detailed, user-friendly lecture on liver disease. He included slides with clear illustrations, as well. First, he showed a slide with a picture of a healthy liver that gradually deteriorated. It showed how, first, fat had infiltrated the liver, and this then led to inflammation, which led to a hardening called fibrosis, and then the next bad step was cirrhosis or scarring. After that, cancer occurs. We need to prevent these bad steps from happening. The liver is a spongy organ on the right side of the abdomen, and it contains a pint of blood flowing through it at any time. Its job is to remove toxins and to convert them to non-toxins. It converts ammonia to urea. It also makes bile. It stores energy and iron and it is responsible for blood clotting; it helps to remove bacteria, and it also clears drugs from the body.

Dr. Fisher then shared the common causes of liver disease. They include alcohol, viral hepatitis, autoimmune diseases, and genetic diseases. He explained that cancer of the liver is caused by the invasion of fat into the liver. Non-alcoholic fatty liver disease is generally benign, and there is fat infiltration but no inflammation and no symptoms.

He taught that “Liver disease has become a global problem and it mimics the rates of obesity, which are 20-30%.” African countries have less, and they also have less obesity. Cirrhosis is scarring that stops the liver from functioning. Symptoms of cirrhosis include fatigue or confusion, yellowing of skin and eyes, swelling of abdomen and legs, life-threatening bleeding, blood clots, liver cancer, and then death. Fat kills liver cells. Dr. Fisher showed a slide of a normal liver and contrasted it with a slide of a liver with cirrhosis.

He then enumerated risk factors for fatty liver, which include obesity, too much fat in the abdomen, diabetes, high cholesterol, older age, sleep apnea, and underactive thyroid. The first three listed above are the most common causes. There is a small subset of people with a genetic predisposition for fat to creep into the liver. However, most liver disease is caused by the factors listed above.

Liver disease is often detected through abnormal bloodwork. There are no symptoms until there is significant liver damage. Doctors will detect liver disease through blood tests that show liver enzymes and ultrasound. Rarely, they will do a liver biopsy.

He shared that there is no wonder drug to treat it. However, he did share that treatment involves weight-loss, which is gradual, one to two pounds per week. He also recommended exercise of 200 minutes a week, which is a half hour, six days a week. The next component of treatment is a healthful diet that is high in fiber and vegetables and minimizes bread and pasta. The Mediterranean Diet is recommended. Also, he said to avoid drinking alcohol. In addition, it is important to keep tight control over diabetes and to reduce your cholesterol level.

The program concluded with a Q&A session.

The community thanks Dr. Breite and Congregation Etz Chaim for this enlightening lecture series.

 By Susie Garber