Liver care

The top priority for healthy living with Hep C is to prevent, or at least reduce, further damage to the liver. Achieving this has two components. The first is to know what can damage the liver, and the second is to know what can help the liver.

Harmful

Alcohol

Cutting back, or stopping, alcohol consumption is the best choice people can make for the health of their liver. The exact amount of alcohol that is dangerous for people living with Hep C is not known, but the damage increases the more people drink. The best option is to cut back to zero drinking, but most healthcare providers would say that one drink at special occasions can be tolerated by the liver. This differs for everyone and people should keep in mind that “special occasion” doesn't mean every day. 

People may have difficulty limiting their alcohol use, especially if they are dealing with dependence issues. Small steps to reduce alcohol consumption, connecting with support groups, addiction treatment and counselling may be necessary to achieve limited alcohol consumption.

Cigarettes

Cigarette smoking is hard on the liver and the body. Most people are familiar with the standard smoking risks, like heart disease, lung cancer and breathing problems. Recent studies have shown that smoking cigarettes are also bad for the liver; if people smoke and drink, the damage is worse than either substance alone. Like alcohol, nicotine is highly addictive and can be hard to cut back. Most provinces and territories have a smoker's helpline. They are: 

Over-the-Counter Painkillers

Painkillers are generally divided into two categories. In the first is the analgesic (painkilling) and antipyretic (fever reducing) drug called acetaminophen, the active ingredient in Tylenol. The second category consists of non-steroidal anti-inflammatory drugs (NSAIDs), commonly known as ibuprofenor acetylsalicylic acid, the active ingredients in Advil and Aspirin. Each category of drug can provide pain and fever relief, and the NSAIDs also have anti-inflammatory properties. Some people say that NSAIDs are easier on the liver, but both categories of drugs have shown liver-toxic effects when more than the recommended dose is taken. People with Hep C often use painkillers to manage side effects and symptoms, but they should never exceed the allowable or recommended dose. Doctors can provide additional information on how to manage pain and can recommend the best choice for patients with Hep C.

Helpful

Nutrition

Good nutrition helps people with overall health, especially because liver disease affects digestion and the metabolism, absorption and storage of nutrients. Eating well gives people the energy and nutrients they need to feel well, have functioning immune systems, help their liver regenerate or maintain itself and manage Hep C symptoms.

Eating well for people with Hep C means:

• choosing a variety of foods each day, including protein to help fight infection and aid in liver regeneration 
• taking in an adequate amount of calories without being excessive
• eating vegetables and fruit rich in vitamins A and C
• avoiding alcohol to allow the liver to regenerate
• limiting foods high in fat and sugar
• consulting a doctor before starting a multivitamin
• avoiding iron supplements

Exercise

Exercise is part of staying healthy. Obesity and steatosis (fat build-up around the liver) can interfere with the effectiveness of Hep C treatment and also make liver problems worse. Light to moderate exercise can boost energy, reduce stress and prevent weight gain. For people with hepatitis C who are feeling unwell or who are experiencing side effects from treatment, it may be difficult to think of exercising. Exercise does not have to be strenuous or complicated; people can build gradually to exercising 15–30 minutes, three times per week. Finding physical activities that people enjoy and that are simple to do will make exercising easier. Ten minutes of activity here and there adds up!

Physical activity is recommended for all people with HCV, except those with decompensated liver disease or other metabolic complications.

Coffee

Although under debate, some studies have shown a relationship between drinking coffee and slower development of cirrhosis, hepatocellular carcinoma (HCC) and lower liver enzymes levels. More studies are needed to verify this and clarify the mechanism of action. Drinking too much coffee can cause other medical problems, but finding a balance by drinking two–three small cups of coffee per day may help a person with Hep C maintain a healthier liver. Making coffee can also be a social activity and an affordable option for people on a fixed income.