What is liver disease?
Liver disease, or hepatic disease, is a general term that includes any disease, disorder or condition that affects the liver. The liver is a vital organ located in the right upper area of your abdomen under the ribs. Normal functioning of the liver is crucial to your overall health and life. Liver disease causes liver damage and reduces the liver's ability to perform its vital functions including:
Assisting in digestion of food
Clearing the blood of toxins
Fighting infection
Making blood-clotting proteins
Metabolizing or processing medications and other substances
Producing proteins, enzymes, and healthy blood
Removing waste
Storing vitamins, minerals and energy
Common forms of liver disease include the following:
Autoimmune liver disease is a disorder in which the immune system attacks the body. Examples include autoimmune hepatitis (a form of hepatitis in which the immune system attacks the liver) and primary biliary cirrhosis (swelling and blockage of the bile ducts).
Bile duct obstruction is caused by gallstones, tumors, or other factors.
Budd-Chiari syndrome is caused by blood clots that block veins in the liver.
Cirrhosis of the liver is scarring of liver tissue, which reduces liver function. Cirrhosis of the liver is most commonly caused by chronic alcohol abuse and chronic hepatitis B or C.
Congenital abnormalities of the bile ducts block the normal flow of bile.
Genetic diseases, such as hemochromatosis (excessive levels of iron in the body that cause liver damage) and Wilson’s disease (an inherited disease that causes excessive retention of copper in the liver).
Hepatitis is a viral infection.
Liver cancer and benign liver tumors impair the ability of the liver to function normally.
Liver failure is deterioration and failure of liver function and a life-threatening complication of serious or end-stage liver disease and damage.
Symptoms of early liver disease can be vague and similar to many other less serious diseases, such as chronic fatigue syndrome or viral gastroenteritis. A hallmark symptom of advancing liver disease is jaundice, a yellowing of the skin and whites of the eyes.
In some cases of liver disease, rapid diagnosis and treatment may reverse liver disease. However, once permanent liver damage has occurred, it cannot be reversed or cured. Patient compliance with an effective treatment plan may be able to slow or stop progression of liver damage and minimize or delay complications, such as liver failure.
Liver disease is a serious and potentially life-threatening condition. Seek prompt medical care if you have unexplained symptoms, such as nausea, fatigue, diarrhea or weakness. In addition, if you have any form of liver disease, do not take any supplements, over-the-counter medications, or prescription drugs without consulting your health care provider. This is because the liver may not be able to clear the drugs from the body, resulting in dangerous, toxic levels of chemicals or substances in the body.
Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of acute or advanced chronic liver disease, such as shakiness, jaundice, confusion, severe shortness of breath, abdominal swelling, or a change in consciousness or alertness. Seek immediate medical care (call 911) if you, or someone you are with, have overdosed on a drug or ingested a toxic substance.
What are the symptoms of liver disease?
Symptoms of liver disease can vary depending on the type of liver disease and individual factors. Early symptoms of liver disease are often not specific and may be confused with symptoms of many other conditions, such as indigestion, viral gastroenteritis, or chronic fatigue syndrome. Early symptoms may include:
Fatigue
Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
Itchy skin
- Jaundice (yellowing of the skin and eyeballs)
Serious symptoms that might indicate a life-threatening condition
Symptoms of advanced liver disease can indicate the development of serious complications, such as liver failure, portal hypertension, or esophageal varices. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious or life-threatening symptoms:
Ascites (a buildup of fluid and swelling in the abdomen)
Bleeding, such as vomiting blood or heavy rectal bleeding
Change in level of consciousness or alertness, such as passing out or unresponsiveness
Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations or delusions
Edema (swelling) in the legs
Jaundice (yellowing of the skin and whites of the eyes)
Muscle tremors or shakiness
Poor cognitive functioning, due to the liver’s inability to filter toxins and a buildup of waste products in the blood and brain
Severe shortness of breath or difficulty breathing
What causes liver disease?
Liver disease is due to a variety of diseases, disorders and conditions that damage the liver. Liver disease usually begins with inflammation and enlargement of the liver, which may be reversible in some cases with prompt treatment. Left untreated, liver inflammation leads to fibrosis (scarring) of the liver tissue that eventually replaces healthy tissue. Scarred liver tissue cannot function normally, but prompt treatment may still reverse damage in some cases.
Scarred liver tissue that is not treated or reversed progresses to cirrhosis, a condition in which the liver is permanently damaged. If advancement of cirrhosis is not slowed or stopped, large areas of the liver will no longer function, leading to liver failure.
Underlying diseases, disorders of the liver and conditions that can lead to liver disease include:
Alcohol dependence or alcoholism, which can lead to fatty liver and cirrhosis
Autoimmune conditions, such as autoimmune hepatitis (a form of hepatitis in which the immune system attacks the liver) and primary biliary cirrhosis (swelling and blockage of the bile ducts)
Bile duct obstruction due to gallstones, tumor, or other causes
Budd-Chiari syndrome (blood clots that block veins in the liver)
Certain genetic or congenital conditions and disorders, such as hemochromatosis (excessive levels of iron in the body that cause liver damage),
Wilson’s disease (an inherited disease that causes excessive retention of copper in the liver), and cystic fibrosis (an inherited disease that causes a buildup of mucus in the liver, lungs and other organs)
Congestive heart failure (inability of the heart to effectively pump blood)
Glycogen storage diseases
Infections, such as hepatitis A, B, and C
Liver cancer and benign liver tumors
Overdose of certain medications, such as acetaminophen (Tylenol) or exposure to some toxins
Trauma or injury to the liver
What are the risk factors for liver disease?
A number of factors increase the risk of developing liver disease. Risk factors include:
Alcoholism
Coronary artery disease (due to atherosclerosis, also called hardening of the arteries, or other causes)
Diabetes (chronic disease that affects the body’s ability to use sugar for energy)
Exposure to certain toxins, such as arsenic and vinyl chloride
Exposure to hepatitis
High triglyceride blood levels
Immunodeficiency of any type
Infestation by parasites
Intestinal bypass surgery
Intravenous drug use
Long-term treatment with corticosteroids
Reducing your risk of liver disease
Not all people who are at risk of liver disease will develop the condition. However, you can lower your risk of developing liver disease by:
Avoiding risk factors for hepatitis, such as having unprotected sex with more than one partner or sharing needles for tattooing or drug use
- Eliminating exposure to environmental and occupational toxins
Not drinking alcohol or limiting alcohol intake to one drink per day for women and two drinks per day for men
Seeking regular medical care and following your treatment plan for chronic diseases and conditions, such as alcoholism, diabetes, obesity, high cholesterol, and coronary artery disease
How is liver disease treated?
Scar tissue formed in the liver due to advanced liver disease is permanent. The goals of treatment are to cure the disease, if possible; prevent, stop or slow the progression of damage to the liver; and minimize and quickly treat any other complications and coexisting conditions, such as portal hypertension and hemorrhage. Treatment plans include a multifaceted, individualized approach that varies depending on the type of liver disease and underlying cause; your age and medical history; and other individual factors. For example:
Alcoholism treatment includes abstaining from alcohol, which often requires participation in an alcohol treatment program.
Bile duct obstruction is treated by surgical removal or bypass of the blockage and possibly widening of the affected duct.
Hepatitis treatment may include corticosteroid drugs for autoimmune hepatitis or the medication, interferon, to treat a hepatitis infection.
Liver failure and liver cancer may be treated with a liver transplant in some cases. This major surgical procedure involves using a healthy donor liver to replace a severely diseased liver.
What are the possible complications of liver disease?
Complications of liver disease are serious and life threatening if the condition advances to liver failure. In some cases, you may be able to reduce your risk of serious complications of liver disease by following the treatment plan your health care professional designs specifically for you.
Complications and common coexisting conditions of liver disease include:
Adverse effects of liver disease treatment
Ascites, which is a buildup of fluid and swelling in the abdomen
Cirrhosis (permanent scarring)
Esophageal varices, which are swollen veins in the esophagus due to portal hypertension. These bulging veins can burst, leading to life-threatening hemorrhage.
Hepatic encephalopathy, which involves changes in the brain due to an inability of the liver to filter toxins, such as ammonia. Hepatic encephalopathy can lead to coma and death.
Hepatocellular carcinoma (liver cancer)
Portal hypertension, which is high blood pressure in a large abdominal vein that can lead to esophageal varices and other problems
