Liver Disease: Symptoms, Causes, Treatment

The liver can not be undervalued. It is essential in digesting food and filtering toxic substances out of your body. 

Unfortunately, untreated liver disease can lead to organ failure, which can affect many organs and cause complications such as bleeding and infection.

Keep reading to find out everything you need to know about liver disease.

What is liver disease?

Liver disease is also known as hepatic disease. It is often used as a general term that refers to any condition affecting the liver. 

Liver disease can be inherited or genetic. However, certain environmental factors that cause liver disease can occur through the DNA damage caused by viruses such as hepatitis B virus or hepatitis C virus and heavy alcohol consumption. These affect the liver’s inherent ability to regenerate and repair its DNA contributing to liver disease. 

Liver disease may develop for these reasons, but these conditions can damage the liver and affect its function. Also, when the course of the problem lasts long, it becomes chronic. However, both acute or chronic damage and liver failure may eventually result in death.

How common is liver disease? 

In the United States, about 30 million people in total have liver disease. That is 1 in 10 Americans. Also, about 5.5 million people in the United States have chronic liver disease or cirrhosis. While in the United Kingdom, liver disease is the third leading cause of premature death.

Worldwide, liver disease accounts for approximately 2 million deaths per year. One million deaths are due to complications of cirrhosis, while the other million are due to viral hepatitis and hepatocellular carcinoma.

Types of liver disease

Interestingly, there are more than a hundred different kinds of liver disease. The most common are hepatitis, autoimmune conditions, fatty liver disease, cirrhosis, liver cancer, and liver failure. We discuss these conditions below.

Hepatitis

Hepatitis is inflammation of the liver. It is often caused by viruses that damage the liver, making it difficult to function normally. 

There are different types of hepatitis viruses are as follows: 

  • Hepatitis A often infects people through contact with contaminated food or water. Recovery can take a few weeks, even when symptoms resolve.
  • Hepatitis B is typically spread through bodily fluids, such as blood and semen, leading to acute or chronic conditions. Unfortunately, there is no cure for hepatitis B. However, it is treatable, so early treatment is vital to prevent complications. You can achieve prevention through regular screenings tests if you’re at risk.
  • Hepatitis C is similar to hepatitis B since it can also result in acute or chronic conditions. Also, it is typically spread through contact with blood from an infected person with hepatitis C. It often doesn’t show symptoms early, but it can lead to severe liver damage later.
  • Hepatitis D is a type of hepatitis that people can not contract independently. It can only occur in people with hepatitis B, and this is severe hepatitis can also be acute or chronic.
  • Hepatitis E is typically spread through consuming contaminated water and food. Usually, it can resolve without any lasting complications within a few weeks.

Although most types of viral hepatitis are contagious, vaccination can help prevent it. You can reduce your risk by getting vaccinated for types A and B. Other preventive steps include using condoms during sex and not sharing needles.

Fatty liver disease

There are two major types of fatty liver disease leading to fat buildup in the liver and other effects. These types are:

Alcoholic fatty liver disease

As the name suggests, it is caused by heavy alcohol consumption. In the early stages of alcoholic liver disease, the fat build-up in the liver cells increases due to more fatty substances being produced versus the amount breakdown by bile. 

Progression of the disease can lead to inflammation and subsequent scarring and can even lead to a form of liver cancer known as hepatocellular carcinoma.

Nonalcoholic fatty liver disease 

This results in a similar condition to alcoholic liver disease, however, other factors besides alcohol intake cause it. Such as: 

If there is no management, both types of fatty liver disease lead to liver damage, cirrhosis or scarring, and liver failure. 

Autoimmune conditions

Without treatment of these autoimmune conditions, cirrhosis and liver failure can occur. Therefore it is crucial to understand them. Some of these autoimmune conditions that cause liver disease include the following: 

  • Autoimmune hepatitis: In this condition, the immune system mistakenly attacks the liver’s healthy cells, resulting in inflammation. 
  • Primary biliary cirrhosis (PBC): In this condition, the immune system damages the bile ducts in the liver, causing a buildup of bile.
  • Primary sclerosing cholangitis: In this condition, the immune system causes inflammation that gradually damages the bile ducts in the liver, leaving them blocked and causing a buildup of bile. 

Genetic conditions

Several genetic conditions, which can be inherited from one parent, can also affect your liver and cause damage due to the lack of some enzymes or genes needed for the liver’s normal function. These include: 

  • Hemochromatosis: It is a condition that causes your body to store more iron than needed. This abnormal condition causes the iron to remain in the liver and leaks into other organs leading to damage. 
  • Wilson’s disease: this condition is similar, but unlike hemochromatosis, it causes your liver to absorb copper rather than the normal function of offloading it into the bile ducts. Like any abnormal condition, this copper overload eventually damages the liver. It leaks through the bloodstream to other parts of your body, including your brain.

Drug-induced liver disease

Certain drugs and supplements can lead to liver damage if your body becomes exposed to them. In addition, if you don’t stop the medication in time, it can become chronic.

Cancer

Primary liver cancer has its origin in the liver, whereas secondary liver cancer is spread from cancer that began somewhere else in the body. 

The most common type of primary liver cancer is hepatocellular carcinoma which is usually caused by the complications of untreated liver diseases. It starts as tiny as spots within the liver before expanding.

Cirrhosis

Cirrhosis is defined as scarring within the liver tissue due to other liver diseases and causes of liver damage such as syphilis and cystic fibrosis, although less common. 

Even though the liver can regenerate in response to injury, this regeneration process results in the development of scar tissue which affects its ability to function correctly. 

The underlying causes can be resolved and treated if managed in the early stages. However, without treatment, it can lead to complications that can even be life-threatening.

Liver failure

Chronic liver failure is often the result of any type of liver failure. It occurs when a significant part of your liver is damaged, so it can’t function properly. 

Acute liver failure can happen suddenly, usually due to overdosing or poisoning. Generally, though, progress to chronic liver failure is a slow process with many telltale signs and symptoms. 

fatty liver disease

Signs and symptoms of liver disease

Liver disease might not always cause noticeable symptoms. Also, since there are a variety of liver diseases, the symptoms tend to be specific for that illness and depend on the underlying cause until late-stage liver disease and liver failure occur. 

At the early stage of liver disease, one can experience the following symptoms:

  • Nausea
  • Loss of appetite
  • Fatigue
  • Diarrhea

However, the classic symptoms of liver disease are nausea, vomiting, pain in the upper right side of the abdomen, and jaundice. Jaundice is a sign which shows yellow discoloration of the skin and sometimes the eyes due to elevated bilirubin concentrations in the bloodstream.

 There can also be the following symptoms as liver disease progress:

  • Pale, bloody, or black stools.
  • Enlarged stomach due to ascites.
  • Bleeding disorders know as thrombocytopenia and coagulopathy.
  • Encephalopathy is a brain issue affecting cognitive function.
  • Risk of bleeding symptoms taking place in the gastrointestinal tract.

When to see a doctor

It’s essential to tell your doctor all the symptoms that affect you. If you have liver disease, you should see your doctor whenever you have new or worsening symptoms. 

The following symptoms show that liver failure has progressed and requires immediate medical attention:

  • Jaundice
  • Easy bleeding
  • Coma
  • Confusion or mental disorientation
  • Pain in the upper right abdomen
  • Fluid buildup in legs
  • Fluid buildup in the abdomen
  • Generalized body swelling
  • Swollen abdomen

doctor

What causes liver disease?

Every type of liver disease has its cause, as we discussed earlier. These include: 

Infection

Infections by parasites and viruses cause inflammation that reduces liver function. The most common liver infections are hepatitis viruses, including Hepatitis A, Hepatitis B, and Hepatitis C.

Immune system abnormality

Autoimmune diseases occur when the immune system attacks certain parts of your body and the liver. Common autoimmune liver diseases include:

  • Autoimmune hepatitis
  • Primary biliary cholangitis
  • Primary sclerosing cholangitis

Genetics

Abnormal genes inherited from one or both parents can cause liver damage due to improper function that causes various substances to build up in your liver. Genetic liver diseases include:

  • Hemochromatosis
  • Wilson’s disease

Other causes 

Additionally, other causes of liver diseases include: 

  • Liver cancer
  • Bile duct cancer
  • Liver adenoma
  • Air pollutants
  • Chronic alcohol abuse
  • Fat accumulation in the liver (nonalcoholic fatty liver disease)
  • Particular prescription or over-the-counter medications
  • Certain herbal compounds

Risk factors

Factors that may increase your risk of liver disease include:

  • Heavy alcohol use
  • Obesity
  • Blood transfusion before 1992
  • Exposure to other people’s blood and body fluids
  • Unprotected sex
  • Exposure to certain chemicals or toxins
  • Family history of liver disease
  • Type 2 diabetes
  • Tattoos or body piercings
  • Injecting drugs using shared needles

blood test

Diagnosis

Your healthcare provider or doctor may recommend one or more of these diagnostic tests and procedures as part of evaluating liver disease: 

Liver function tests

A blood test to detect the liver’s health. These include: 

  • Alanine transaminase (ALT) test
  • Alkaline phosphatase (ALP) test
  • Albumin and total protein test
  • Aspartate transaminase (AST) test
  • Bilirubin test

Liver biopsy

Doctors take a small tissue of the liver to detect the underlying cause of the liver disease.

Ultrasound

An ultrasound can help visualize and determine the cause of liver failure.

C.T. scan

A CT scan can be used to detect any abnormalities.

Magnetic resonance imaging (MRI)

MRI of the liver is performed to identify the cause and severity of the condition.

Treatment

Liver diseases are often progressive, meaning they tend to get worse over time. Therefore, the doctor needs to know your illness and its stage since this will affect treatment. 

However, possible treatments include:

  • Medications: Medicine for viral infections like hepatitis or inherited conditions like Wilson disease. Also, steroid-based drugs are an option for treating autoimmune hepatitis.
  • Lifestyle changes: These changes can help manage certain types of liver disease, such as fatty liver disease. The steps to take include avoiding alcohol, limiting calories, and eating more fiber.
  • Liver resection: If it helps recovery, doctors can remove the affected part of the liver. The liver can grow back to normal.
  • Liver transplant: Severe liver failure requires a transplant, so your body can run on a healthy liver.  

Complications

Some liver diseases can raise your risk of developing liver cancer. For instance, chronic infection with hepatitis viruses such as HBV or HCV can increase this risk. 

Other factors that increase the risk of primary liver cancer include excessive alcohol consumption, nonalcoholic fatty liver disease, and certain inherited liver diseases.

If you don’t receive treatment for these conditions, they will continue to damage your liver, leading to cirrhosis, which scars the liver. Subsequently, this affected and damaged liver will lose its ability to function since there is not enough healthy tissue. Liver disease that progresses can eventually lead to liver failure and these other complications:

  • Infection of the blood, urinary tract, or respiratory organs.
  • Bleeding and bleeding disorders.
  • Kidney failure
  • Cerebral edema is the formation of excessive fluid in the brain.

Outlook 

If found early, many liver diseases should be manageable through regular screenings and checkups. Also, with early treatment and beneficial lifestyle changes, many people can avoid severe liver damage and prevent liver failure.

However, permanent damage can occur without treatment, leading to complications. Therefore, once cirrhosis and severe scarring have started and cannot be reversed, a liver transplant is the only viable option.

Ways to reduce your risk of liver disease 

Generally, focusing on a nutritious diet and having regular physical exercise is beneficial and prevents liver disease. Other health-conscious steps include: 

  • Use medications wisely: Make sure to take prescription medicines as needed. Avoid mixing illicit drugs and mixing medication with alcohol. 
  • Maintain good hygiene: Avoid contact with other people’s blood and body fluids, and always wash your hands thoroughly before eating. 
  • Keep your food safe: Make sure you heat your food before eating and have clean hands before eating or preparing food.
  • Vaccination: Hepatitis A and hepatitis B vaccines are readily available to obtain. However, consult with your doctor before getting it. 
  • Protect your skin: Ensure that you remain protected when in contact with insecticides and other toxic chemicals. You can wear protective gear such as gloves, long sleeves,  and a mask.
  • Drink alcohol in moderation: Limiting alcohol means one drink a day for women and two drinks a day for men.
  • Practicing safe sex: Use a condom during sex. Get tattoos and body piercings at secure locations and don’t share needles to inject drugs.  

Conclusion

The liver is vital to many bodily functions, including digesting food, processing, and distributing nutrients. However, many kinds of liver diseases and conditions can affect it, such as hepatitis, caused by viruses and others resulting from particular medicines or drinking too much alcohol. However, long-lasting injury to the liver can cause scar tissue to form and lead to cirrhosis. 

If liver disease is found early, it has a better prognosis. Although, many causes of liver disease can be prevented by people taking the proper steps.

One can prevent liver disease by restricting alcohol intake, getting the hepatitis B vaccination, and maintaining a healthy lifestyle through eating well and exercising regularly.

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Sources

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  2. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Clinical Course and Diagnosis of Drug-Induced Liver Disease. [Updated 2019 May 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548733/ 
  3. Tripodi, Armando; Mannucci, Pier Mannuccio (2011-07-14). “The Coagulopathy of Chronic Liver Disease.” New England Journal of Medicine. Massachusetts Medical Society. 365 (2): 147–156. https://pubmed.ncbi.nlm.nih.gov/21751907/ 
  4. Kim JW, Park S, Lim CW, Lee K, Kim B (June 2014). “The role of air pollutants in initiating liver disease.” Toxicological Research. 30 (2): 65–70. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112066/
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