- Neeraj Bhala, specialist registrar in gastroenterology and liver medicine1,
- Guruprasad Aithal, professor of hepatology2,
- James Ferguson, consultant hepatologist1
- 1Liver Unit, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UK
- 2NIHR Biomedical Research Unit in Gastrointestinal and Liver Disease, Nottingham University Hospitals NHS Trust, Nottingham, UK
The new chief medical officer for England’s first annual report in November 2012 highlighted that liver disease is a growing clinical burden and public health priority in the United Kingdom.1 Although death from liver disease is decreasing in other European populations, deaths from chronic liver disease and cirrhosis in the under 65s in England increased by around 20% from 2000 to 2009, making it the fifth leading cause of death (fig 1⇓). Because the major drivers of increasing liver disease are all potentially preventable (particularly high alcohol consumption, but also obesity and chronic hepatitis B and C infection), comprehensive action is clearly needed to deal with the problem.
What can healthcare practitioners do to help stem the rising tide of liver disease? The best way to promote optimum liver health is to facilitate behavioural change in those at risk. Every clinical encounter can be used—for example, to screen for alcohol use disorders or to look proactively for early signs of liver disease (rather than assuming that this is another stakeholder’s responsibility).
The current recommended upper …