Dealing with a silent killer

THE party's over, the last balloon has been burst and you're still nursing a killer hangover with liver salts and headache tablets.

Most of us work on the theory that it'll quickly pass – a good fry up and some strong coffee and the excesses of the night before will be just a bad memory.

But it may be that the worst is yet to come. For the pounding we've just given our liver might well come back to haunt us in the future.

Mum-of-two Collette Thain didn't know much about liver problems until she found herself in a hospital in Ireland, aching from her neck to her pelvis, bleeding from every orifice and horribly jaundiced – "I felt like I'd swallowed glass," she recalls.

"The doctors weren't sure what was causing it. For eight days my urine was black, I was bleeding everywhere. They thought there was some kind of obstruction in the bile duct or gall bladder."

In fact, Collette, who lives in Blackford, was suffering from liver failure, and her life-threatening condition was nothing to do with alcohol or drug abuse.

Collette is among the one in every 1000 women in the UK to suffer from Primary Biliary Cirrhosis (PBC), an incurable auto-immune condition which slowly attacks the liver, destroying the bile ducts and leaving it scarred and unable to function properly.

What causes it is a mystery, as is the fact that it affects nine women to every man. Also baffling is why PBC is so common in Scotland, north-east England and Scandinavia.

For PBC sufferers, the damage to their liver is nothing to do with excessive behaviour but, warns Collette, the end result – scarring to the liver known as cirrhosis – is exactly the same.

"I often think of what people are doing to themselves at Christmas and New Year and I think if only they knew what could happen to their liver as a result, how it destroys itself silently and you know nothing about it," she explains.

At its worst, sufferers can expect oesophageal bleeds, projectile vomiting of blood and the realisation their life is in danger.

At its best, there are endless days of fatigue that make even the simplest chores unbearable.

"The tiredness is so bad sometimes that I can't lift my arms to do the washing and everything is a struggle," explains Collette, 51, who was awarded an MBE for her work with the PBC Foundation, bottom right, which she founded in 1996.

"Every day I wake up knowing it's getting progressively worse and there's nothing I can do."

A light drinker, Collette's liver troubles first surfaced in her teens with bouts of unexplained tiredness. It was only 20 years later when she suddenly fell dramatically ill on holiday in Ireland that the scale of her liver problems surfaced.

"The doctor was pretty brutal really," recalls Collette. "I said 'how long do I have' and he said some people can live just months. I was only 37 years old at the time.

"I later saw a doctor who said it's normal to survive five to seven years, but he wasn't giving out much hope. Well that was 14 year years ago, so I suppose I'm doing okay."

Her only hope for the future, however, is a liver transplant - but even if she gets one, it won't 'cure' her. "Because it's an auto-immune disease, the liver will just come under attack again," she explains. "It might be within a few years or it might take much longer, but it will happen."

Collette's condition was unavoidable, but for thousands of heavy drinkers and drug abusers, the damage to their liver is preventable.

The number of people clogging hospital wards with drink-related conditions is soaring: cirrhosis of the liver kills more than 1600 women a year, compared to 1200 seven years ago while last month it emerged that Scottish hospitals treated 41,651 people with alcohol-related conditions – up seven per cent on the previous year.

Hepatitis C, meanwhile, the result of a virus that can seriously damage the liver and affect its ability to function correctly affects around 50,000 people in Scotland.

But it's not only heavy drinkers, drug abusers and the unlucky few like Collette that are at risk from liver damage. For the rest of us, there are toxic substances almost everywhere – from the air we breathe to the water we drink and food we eat, all putting pressure on our liver's ability to filter them away.

The liver deteriorates quietly, warns Collette, with symptoms that can go unrecognised. "That's the trouble, you aren't really aware of anything until it's already quite bad."

She launched her charity in 1996, offering support to fellow PBC sufferers and raising money to support research into it.

"I just wish people would think a bit more of the consequences of what can happen to their body by overdoing it at this time of year," she warns.

&#149 For more information, visit


LIVER disease comes in several forms, but the end result is often the same. Whether it's self-inflicted or the result of pure bad luck in the form of an auto-immune disease, scarring to the liver, known as cirrhosis, can have devastating consequences.

Cutting down on alcohol and avoiding drug misuse is the obvious way to protect our liver. Being aware of the risks of Hepatitis C is another.

For the rest of us, PBC Foundation founder Collette Thain recommends following a healthy diet rich in largely organic fresh fruit, vegetables and meats, focussing on wholemeal products like brown breads and rice.

Alternative health practitioners and herbalists often recommend milk thistle. So popular is the remedy that many Edinburgh outlets were sold out in the weeks leading up to the festive period.

Liver disease can develop silently. Look for breakouts of psoriasis, acne, chronic headaches, fatigue and itching.

Yellow discolouration of the skin or eyes, abdominal swelling, dark urine or pale stools, nausea or loss of appetite may also be indications of liver problems.