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OPINION

Sally Davies: ‘Preventing liver disease must be seen as a priority’

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England is one of the few countries in the EU where a major cause of preventable death is on the increase. We need to take action to tackle this issue, says Sally Davies

My recent report highlights that comprehensive action is needed to stop the rising tide of liver disease.

The report, which is the first of two volumes, provides a comprehensive picture of England’s health by bringing together a number of data sources in one place for the first time. I know that health professionals respond to data, and where possible I have shown the data by local area. For me the data highlighted that England is one of the few countries in the EU where a major cause of preventable death is on the increase.

Between 2001 and 2009, deaths from chronic liver disease and cirrhosis in the under 65s increased by around 20% while the average rate of deaths fell by the same amount in our most comparable EU countries, the EU15.

And all three major causes of liver disease – obesity, undiagnosed infection, and, increasingly, harmful drinking – are preventable.

I am supporting the government taking comprehensive action to tackle the issue. The NHS Commissioning Board is working on a new liver disease strategy working with the NHS, Public Health England and local authorities to go further in tackling liver disease. The aim is to see the mortality gap between England and the best in Europe halved over the next 10 years.

‘All three major causes of liver disease – obesity, undiagnosed infection, and, increasingly, harmful drinking – are preventable’

The treatment options for alcoholic liver disease largely depend on whether you stop drinking alcohol and make changes to your lifestyle – preferably for the rest of your life. Treatment includes brief interventions aimed at stopping drinking alcohol, medication and – in the most serious of cases – a liver transplant.

But in the early stage of alcoholic liver disease (fatty liver and hepatitis), people who stop drinking and are not obese have a good chance of their liver repairing itself.

The figures are stark: it is estimated that 90-100% of heavy drinkers have alcoholic fatty liver disease, one in four drinkers with fatty liver disease will develop alcoholic hepatitis and one in five drinkers with fatty liver disease will develop cirrhosis

I welcome the new nursing vision and strategies for action to maximise nurses’ skills to improve the public’s health. Preventing liver disease is a priority and sticking to the recommended daily limit of alcohol units is the best way of preventing alcoholic liver disease. 

It’s vital that nurses have up-to-date advice on alcohol guidelines and the skills to have conversations about alcohol consumption. From health visitors and school nurses working with families and young people, to nurses, practice nurses and district nurses working with adults and also those working with patients already affected by liver disease – all nurses play a significant role in stopping the rising tide. 

Sally Davies is chief medical officer at the Department of Health

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