Liver disease is chronically overlooked and underfunded due to a lack of awareness of its seriousness and prevalence, together with the stigma that often surrounds it. Help cultivate change for your patients and beyond by improving early detection and prevention courtesy of The British Liver Trust’s advice.

Liver disease is a major public health crisis and is currently the biggest cause of death of those aged between 35 to 49 years old in the UK. Since 1970, liver disease mortality rates have increased by 400 per cent. This is in stark contrast to other major killer diseases, such as heart disease and cancer, in which the number of deaths have either remained stable or decreased.

In many cases, liver disease is linked to social deprivation. People who live in more deprived areas are up to six-times more likely to die of liver disease than those who live in wealthier areas. There is much to be done.

The British Liver Trust want to make liver disease prevention, detection and treatment a central part of routine healthcare in primary care.

Three-quarters of people are diagnosed with liver disease at a late stage, by which time the opportunity for treatment and intervention is often limited and sometimes too late. This is because there are very few symptoms in the early stages, and if there are, they are vague and often go unnoticed. When symptoms do start to appear, such as jaundice, damage to the liver has reached an advanced stage.

Prevention is Better than Cure

More than 90 per cent of liver disease is preventable. The three major causes of liver disease in adults are alcohol-related liver disease, obesity, and viral hepatitis.

The British Liver Trust’s Love Your Liver campaign focuses on three simple steps to improve liver health:

• Drink within recommended limits and have three consecutive days off alcohol every week

• Cut down on sugar, carbohydrates and fat, and get more exercise

• Know the risk factors for viral hepatitis and get tested or vaccinated if at risk

Health professionals are well-placed to reduce the public’s risk of developing liver disease by screening them for the risk factors and signposting them to the relevant support services.

Resources for Healthcare Professionals

The British Liver Trust are supporting GPs and primary care professionals to deliver care to patients with a range of resources, materials and best practice guidelines.

Interpreting Liver Blood Tests

Most people learn that they have a liver problem from their GP, often as a result of routine blood tests.

Guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG with input from a wide number of groups, including the Royal College of General  Practitioners and The British Liver Trust.

They deal specifically with the management of abnormal liver blood tests in adults in both primary and secondary care under the following sub-headings:

• What constitutes an abnormal liver blood test?

• What constitutes a standard liver blood test panel?

• When should liver blood tests be checked?

• Does the extent and duration of abnormal liver blood tests determine subsequent investigation?

The Royal College of General Practitioners Toolkit

The Royal College of General Practitioners made liver disease a clinical priority area in April 2016 for three years. The liver champion’s mandate was to support primary care to work towards better identification of patients at risk of, or in the early stages of, liver disease.

The goal of the programme was for GPs to intervene before liver disease becomes established. This included the development of a toolkit with a range of resources for all primary care professionals.

NHS Health Check

The new NHS Health Check, Best Practice Guidance 2019, published in October 2019, now includes liver disease for the first time, which will contribute to earlier diagnosis of liver disease in a variety of settings, including general practices, pharmacies, and community settings.

The check will focus on finding ways to lower this risk and to ensure that people with the early stages of liver disease are diagnosed earlier. They can then make lifestyle changes to improve their liver function and prevent it from becoming a serious health problem.

The British Liver Trust continue to campaign for change, working tirelessly to raise awareness, improve early diagnosis and detection, and support clinicians to give the best possible care.

For more information and resources, visit www.britishlivertrust.org.uk/gpresources.