Liver is the largest metabolically active visceral organ handling storage of glycogen; breaking down toxins, drugs;, hormone and clotting factor production; Immunological barrier and conditioning and excretion of waste.

All the food and substances ingested by mouth have to go through the liver and are modified/ metabolised in the liver. Due to this constant contact with items/antigens coming through the gut, it acts as an modulator and activator of our immune system - builds a mature immune system and is instrumental in reducing allergies in childhood.

Liver has a large functional reserve and is able to function adequately even when 70-80% of it is removed. Because of the diverse functions and a large reserve, initial symptoms of unhealthy liver are nonspecific and may not be easily apparent.

On the other hand advanced liver disease is easy to identify.

Some of the signs and symptoms which may point to an unhealthy liver are:

1) Poor appetite – Not feeling hungry, aversion to food

2) Fatigue /tiredness – Commonest but very nonspecific

3) Myalgia (Muscle pains), loss of muscle mass – Skeletal muscle acts as a liver sparer but in Liver disease muscle protein is converted to glucose

4) Pruritis / Itching -can be a presenting symptom and is confused for allergy

5) Jaundice, fluid in abdomen (ascites), bleeding gums – blood in stools/vomitus, and altered sensorium are seen in advanced liver disease. Jaundice is also seen in acute liver disease Early Consultation helps.

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