What is a big van doing with its wheels camouflaged by photos of beer mugs in the exhibition area of the EASL, the largest European congress dedicated to liver disease? The answer is simple: the tireless volunteers of the British Liver Trust want to tell doctors around the world (around 7000) their story and their project. Get in the van, truck is perhaps more elegant, fill out a form and get in line. In the meantime, you examine the posters hanging on the wall of the truck and you discover that the glass of wine drunk the night before at dinner, but alas preceded by an aperitif, is far beyond what you could afford to not run the risk of damaging your liver.
And then the wait becomes tinged with a pinch of anxiety. Who knows what they will tell me about my liver and my extra pounds. When my name is called, I walk into one of the mini-mini-rooms where a burly British nurse is ready to give me a liver ultrasound. First she puts on the mask, intimidated by mine (yes, no one wears it, at the largest congress of hepatologists, like everywhere in London) and then she asks me what work I do: it will help her to adjust the level of information she will give me. “You know – he begins – here come superspecialists of the liver, I can’t say that the examination is not invasive and does not hurt, which instead all patients ask me when we go around with the truck”.
The minutes go by, Dorothy lingers, tries again, keeps twisting the probe, can’t get my liver right, keeps snorting and I begin to worry that something is wrong. I ask her with a hint of anxiety but she smiles: “It happens to one in ten – she says – the ribs are too tight between them and the liver is not visible. But I insist”. In the end she succeeds: “Her liver is fine, she has no fibrosis or cirrhosis. But please, eat well, don’t drink too much alcohol and exercise.” And perhaps it will also be appropriate to limit summer aperitifs, in fact.
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The London Fair is just one stage of the truck, not even the most useful from their point of view because statistically the hepatologists will be much more than well controlled. “Yes, but we travel a lot – explains one of the volunteers – especially in areas with less education and more alcohol consumed. We stop in front of shopping malls, in the main streets and do ultrasound scans. We explain that we do not diagnose, but when we find alarming situations – and they happen because liver diseases remain silent for many years – we recommend that you go to your doctor “.
Over two thousand ultrasound scans in 2021 and this semester of 2002, around England, Wales and Scotland. 19% of the people who got on that track already had liver damage and received a letter for the family doctor. The others an Ok by voice, like the one given to me.
The risk factors, these unknown
The most disconcerting thing? “It is the lack of awareness – admits another volunteer of the truck – most of the people we meet do not know what are the main risk factors for liver disease, namely alcohol, poor diet and obesity, and viral hepatitis. This is why it is important to go around and make sure that people know what they are doing, before the damage is evident: today three quarters of patients with cirrhosis are diagnosed late, when there is little room for treatment. “