Can you tell us more about "parasites in the liver" and how this could lead to cirrhosis? My friend's mother was told that she has this, and that it "usually" comes from eating undercooked meat over the years. She is Japanese and does eat sushi (raw fish). She does not drink alcohol.

Lesa

There are many kinds of parasites that can invade the liver, causing acute and/or chronic liver damage depending on the type of parasite involved. Some clues to the type of parasite affecting your friend's mother may lie in her eating habits, as well as her ethnicity.

One parasitic disease, trichinosis, arises from eating undercooked meat. In this disease, parasites can affect the bile ducts draining the liver, leading to right-sided abdominal pain, fever, jaundice and an enlarged liver. While the patient may be acutely ill, anti-parasitic drug therapy will usually lead to resolution. Trichinosis does not typically lead to cirrhosis.

Another parasitic infestation, clonorchiasis, is linked to eating raw fish. This infection is most common in Asia. It is a more chronic disease than trichinosis, and patients usually do not experience symptoms until long after the initial parasitic infection. Symptoms include right-sided abdominal pain and jaundice. Imaging studies of the abdomen and liver may reveal evidence of the obstruction of the bile ducts draining the liver -- a situation that may be mistaken for cancer of the bile ducts. Ironically, by causing chronic inflammation in the bile ducts, long-standing clonorchiasis sometimes actually leads to bile-duct cancer. Although the disease is usually diagnosed when bile-duct obstruction occurs, if it is not detected soon enough, scarring of the liver (cirrhosis) may have already occurred.

Finally, cirrhosis of the liver can be a direct result of parasitic disease. In a condition called schistosomiasis, parasites travel to the liver and settle in the liver's small veins. After some time, scarring (cirrhosis) occurs as a result of the inflammation and the body's attempt to fight the infestation. This parasite is acquired via skin exposure, usually from wading barefoot in fresh water in Asian countries.

If your friend's mother thinks she has been exposed to a parasite, she should seek medical attention as soon as possible so she can receive a diagnosis and start appropriate therapy, if she has not already done so.