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Ask a SLU Liver Center Physician

Do you have a question about liver disease? We want to help you find an answer! Please submit your question below. All inquiries will be reviewed by a SLU Liver Center physician and our goal is to have your answer online within 48 hours - please check back. For your privacy, names are omitted from the online response.
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Answers to Your Questions

I understand some headache and pain relief medicines are harmful to the liver; could you let me know what you recommend in these situations?

“Acetaminophen in high doses can cause liver damage. In doses up to 2000 mg daily (i.e., no more than 6 regular tablets or 4 extra strength tablets daily), acetaminophen is considered safe for the liver. Acetaminophen is found in Tylenol and combination pain medications such as Percocet, Vicodin and Lortabs. It is sometimes abbreviated “APAP” on pill bottles.
The “NSAIDS” such as ibuprofen (Motrin) and naproxen (Aleve) can be a problem for some people with cirrhosis in that they can irritate the stomach lining and cause kidney problems. As with the use of any medication, a careful assessment of risks and benefits should be made in deciding what medication is best”  Dr. Brent A. Tetri

What is the most common liver disease in the adult population? In children?

“Nonalcoholic steatohepatitis (known as NASH) is probably the most common form of liver disease in adults and children now.  NASH is associated with obesity, diabetes and the metabolic syndrome, all of which have been increasingly common over the past two decades. A recent study found NASH in 12% of adults seeking routine health care. In some people, NASH causes fibrosis (scar tissue) to accumulate in the liver, even to the point of cirrhosis, and NASH cirrhosis now accounts for an increasing number of liver transplants. Eating a healthy diet and exercise can reverse the liver damage of NASH if these lifestyle changes are adopted before the disease has progressed to cirrhosis”  Dr. Brent A. Tetri

I have hepatitis C and am a four time non-responder to treatment.  The last time I tried therapy was 6 years ago.  Are there any new drugs that show a lot of promise for hard to treat patients like me?

“Advances continue to be made in the treatment of hepatitis C. Last year, two new drugs called protease inhibitors became available and either one is used with pegylated interferon and ribavirin. These drugs, boceprevir and telaprevir, have their own set of side effects but they substantially increase the chances of being cured of hepatitis C.
New medications are also being evaluated in clinical trials to see if they offer advantat, and if you are interested in discussing what might be available for you at the Saint Louis University Liver Center, you can call 314-977-9404 for more information”  Dr. Brent A. Tetri

What are some of the common symptoms of liver disease?

“Fatigue is the most common symptom of liver disease.  Other symptoms include joint pain, right upper abdominal pain, unexplained depression, malaise, increased liver enzymes, and many patients don’t have any symptoms at all”  Dr. Bruce R. Bacon

I have a friend who was recently diagnosed with hepatitis C.  Back when I was treated, the cure rate was rather low, 15-20%.  How successful are the current treatments and are side effects still difficult?

“With current medications for naive patients (those who have not been treated before) the cure rate is about 70%.  For prior non-responders, the cure rate is about 30-40%.  The side effects are the same since interferon and ribavirin are still part of the regimen”  Dr. Bruce R. Bacon

Are there medications available to treat hepatitis B?

“Yes – tenofovir (Gilead) and entecavir (BMS) are both very successful at suppressing hepatitis B”  Dr. Bruce R. Bacon