Website of the week
This excellent summary is the place to go for an update on your knowledge of chronic viral hepatitis.
Hepatitis B and C are the main focus of this article, which is accompanied by helpful diagrams and illustrations. It discusses the assessment of liver function in the presence of these diseases, the natural progression and available treatments. GPs come across these conditions more frequently now and are increasingly involved in management. We need to be able to inform our patients authoritatively about what the future holds for them. In only four pages of this PDF you should be able to obtain most of the information you are likely to need.
Why go there: succinct, clear presentation.
Downside: dates from 2001
Information from: BMJ
This address takes you straight to the start of a series of gross and microscopy images of cirrhosis from a variety of causes.
Macronodular and micronodular appearances are shown plus a variety of histology slides, each with a brief description of what you are seeing.
Some of the macroscopic images have a linked CT scan of the organ illustrated.
It is worth seeing the underlying processes going on inside the patient with jaundice or ascites.
I wonder whether showing a patient one of these pictures of a cirrhotic liver might serve as a helpful boost to a heavy drinker’s good intentions of reducing their intake.
Why go there: excellent pathology images.
Downside: little clinical information.
Information from: Florida State University College of Medicine.
Liver disease in pregnancy
This caught my eye because it is not a situation I have thought much about.
Severe liver disease associated with pregnancy is an unusual situation for the GP to face, but there are some common and important situations such as cholestatic pruritus of pregnancy and the hepatic consequences of pre-eclampsia.
It only take a few minutes to read and will raise your awareness.
Why go there: a quick reminder.
Downside: a messy web page.
Information from: The Merck Manual.
This UK charity website has been around since 1988 and is concerned with adult liver disease.
Under the ‘Liver Diseases’ tab are explanations of everything patients are likely to come across from the common forms of hepatitis to rarer conditions such as Budd-Chiari syndrome and Wilson’s disease.
Particularly useful is the section on Gilbert’s syndrome, a benign condition that can generate a great deal of anxiety.
There is much more to this neat, well-laid out website that can be unreservedly recommended to patients.
Why go there: does the job efficiently.
Information from: The British Liver Trust.
Sad to say, there are 1.2 million web pages offering alternative treatments for hepatitis C. Sad, because only a tiny proportion of these are likely to offer anything useful.
You will not want to bother with reading the screensful of guff on this website, in fact you probably will not want to go much beyond the first paragraph, which says: ‘The medical profession does a poor job of dealing with hepatitis. Anti viral drugs have a lot of unwanted side-effects and have proven to be rather ineffective at dealing with hepatitis.
‘Fortunately, there is plenty you can do to knock out hepatitis B and C using safe and natural health supplements. Some are highly effective and powerful virus killers… most natural supplements that have anti viral properties have absolutely no side-effects.’
Eventually you are led to a link where you are encouraged to buy ‘Medicine Man Tea’ and ‘Immune System Tea’ at about £90 a packet.
Why go there: to remind yourself what patients may believe.
Downside: desperate people may go for this.
Information from: Health-Reports.com
Dr Barnard is a former GP in Fareham, Hampshire