Liver disease is nowadays very common and is on the rise mainly due to the lifestyle n ill habits of the general population. alcohol is one of the main causes. It is important to understand that alcohol in mild to moderate quantites will not cause disease but drinking heavily for more than 5 years will lead to problems.

There are certain signs which can warn us off impending liver disease or those which help us catch the diase early so that much of the liver can be saved.

The clinical features of liver disease are thus:

1. Hands : clubbing, dupuyten’s contracture,flapping tremors, leuconychia
2. Face : jaundice, spider naevi, parotid swelling, rhinophyma
3. Chest: loss of body hair, gynaecomastia
4. Abdomen : distension, testicular atrophy, dilated abdominal veins, hepatosplenomegaly, ascites. On auscultation hepatic bruit are heard.
5. Legs: oedema
6. The patient appears unkempt, smells of alcohol of fetor hepaticus, and may also have encephalopathy.