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The Hunger Project Bolen Report
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Liver and Gallbladder Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy The liver is derived embryologically from the gastrointestinal tract, budding off that part of the GI tract which will become the duodenum in the first trimester (first third) of pregnancy. The liver is located in the right upper quadrant (quarter) of the abdomen directly below the diaphragm. It is the largest internal organ in the human body.

Unlike any other organ, the liver has a dual blood supply, one arterial and the other venous. The arterial blood supply comes from the hepatic artery which is a branch off of the aorta (the great vessel coming from the heart) and brings fresh, oxygenated blood. The other blood supply comes through the hepatic portal system and brings nutrient rich "venous" (i.e., already having passed through a capillary bed and on its way back to the heart) blood from the small and large intestines, the pancreas and the spleen.

Blood coming directly from the digestive tract requires immediate attention and processing. Not only is it rich in nutrients, which need to be stored in the liver, it also is rich in toxic material derived from the digestive process. It may also have a load of toxins usually present in the colon of a person eating a typical Western diet rich in cooked foods.

Blood leaving the liver is collected in the hepatic vein, and from there it goes to the inferior vena cava thence to the right side of the heart for a trip through the lungs and a bath in oxygen.

The liver is divided into hundreds of thousands of lobules, each one a storage and detoxification plant. Each lobule receives a dual blood supply, just like the liver as a whole, from the digestive tract (the portal system) and the hepatic artery. Each one drains into the hepatic vein. Each cell in the liver makes direct contact via capillaries with all three of these systems: portal vein, hepatic artery and hepatic vein. The first two deliver nutrients and fresh blood respectively. The hepatic vein delivers deoxygenated blood, along with processed nutrients, back to the heart.

There is a second drainage system (besides the hepatic vein) to which each liver cell has direct access. This is called the "canalicular system." Each canaliculus drains into progressively larger ducts and culminates in the hepatic duct, which combines with the duct coming from the gallbladder to form the common bile duct. The common bile duct empties, in turn, into the duodenum. Most waste products formed by the liver exit the body through this system, and the rest is shunted via the blood stream to the kidneys, where it is excreted in the urine.

Notice on your diagram of the liver the position of the gallbladder and the bile duct. The gallbladder is a small sac, about the size of a golf ball, attached to the inferior surface of the liver. It stores the bile, a mixture of emulsifying agents, which are useful in the breakdown of fats for digestion by lipase from the pancreas. The gallbladder empties its contents through the common bile duct into the duodenum in response to the presence of fatty substances in that organ. There it emulsifies the fat into small globules, making it easier for lipase to make contact and do its job.

About 1.4 liters of blood pass through the liver every minute and, at any time, the liver contains ten percent of the blood volume of the entire body. The liver is capable of storing large quantities of glucose as glycogen, a starchy substance made of glucose molecules which allows the controlled release of glucose into the circulatory system on an as needed basis. The conversion of glycogen to glucose is controlled by the presence of insulin from the Islets of Langerhans in the pancreas.

It is this substance — glycogen — which endurance athletes try to build a large store of by eating lots of starchy foods the day before a contest. The liver also is responsible for storage of iron, copper, vitamins A, D and a large number of B vitamins. It also produces albumin, the major protein found in the blood, as well as prothrombin, fibrogen and heparin, all extremely important to the normal clotting and healing of wounds.

Amino acids are deaminated in the liver, and the nitrogen is made available for metabolism in the body as a whole. The liver also synthesizes cholesterol, which is necessary for construction and maintenance of cell walls and for the synthesis of many hormones. The liver can, to some degree, balance the proportion of carbohydrates, proteins and fats and make up for disproportionate intake in this way. This is achieved by the liver's ability to both break these substances down and reassemble them into different forms: fat to protein, protein to carbohydrate, carbohydrate to fat, carbohydrate to protein, etc.

Certain white blood cells (phagocytes), when they are in the liver, remove foreign substances and destroy bacteria. Drugs are detoxified in the liver, and cholesterol is excreted through the bile, which flows through the bile duct into the intestine. Also, hemoglobin breakdown — a natural outcome of aging of red blood cells — is accomplished in the liver and excreted as "bilirubin."

Naturally, all this metabolic activity produces a lot of heat, and together with the heart and skeletal muscles, the liver has a major role in maintaining normal body temperature.

This information is meant to assist you in placing the liver and its gallbladder in your awareness, so that you know you have them and so that you can live your life in a way that supports the health of these organs. It must be clear from the description above that the liver is "vital," i.e., necessary for life. You would die without your liver in a matter of days.

Because the liver has so much reserve capacity, it is possible to live with up to ninety percent of your liver function destroyed. However, when that line is crossed, deterioration of general health is rapid. Furthermore, you cannot enjoy all the vitality which is possible for you with less than 100% of your normal liver function.

The health of the liver is a reflection of the health of the rest of the body. There are do's and don'ts regarding the liver. Do enjoy a diet balanced in carbohydrates, proteins and fats; do practice weight control, achieve and maintain your ideal body weight; do not expose yourself to toxic chemicals such as alcohol. The most important thing you can do for the health and vitality of your liver is be aware that it exits; be aware of the jobs it does, and appreciate it. This will lead naturally to the desire to maintain excellent general health and therefore a very healthy liver.

The major diseases of the liver are cirrhosis and hepatitis. Cirrhosis is a scarring process combined with an attempt at regeneration. Liver cells can regenerate themselves but do a poor job of it, architecturally speaking. Regeneration of liver cells follows fatty degeneration caused by any prolonged toxic insult to the liver, the most common being ingestion of alcohol. Prevention lies in avoiding the ingestion of substances which damage the liver.

Hepatitis is caused by invasion of the liver tissues by an infective agent, sometimes a bacteria but most commonly a virus. Viral hepatitis is a serious, life-threatening disease. It is transmitted by fecal contamination of anything entering the body and through dirty needles. People who inject street drugs run a high risk of hepatitis and AIDS. While AIDS gets all the publicity, hepatitis kills many more people. Prevention lies in maintaining sanitary conditions and avoiding dirty needles.

The major diseases of the gallbladder are called "cholecystitis" (literally gallbladder inflammation) and cholelithiasis (literally gallbladder stones). These diseases are much more common in people who are overweight, in people over forty and especially in pregnant women. However, the most important factor in gallbladder disease often is overlooked — allergy. A gallbladder attack, with or without stones present, is often a manifestation of allergy. This should never be overlooked, and it should always be suspected. Many people have had unnecessary gallbladder surgery because the doctor was not informed, or simply forgot about this aspect of gallbladder problems.



The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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