Liver Disease
Liver disease refers to any condition that affects the structure or function of the liver, an essential organ responsible for detoxification, metabolism, bile production, and nutrient storage.
Liver diseases can be acute or chronic and arise from various causes, including infections (e.g., hepatitis), excessive alcohol consumption, fatty liver disease, autoimmune conditions, or genetic factors.
Common symptoms may include fatigue, jaundice (yellowing of the skin and eyes), abdominal pain, and swelling. Early diagnosis and treatment are crucial to prevent complications such as cirrhosis, liver failure, or liver cancer.
What is Liver disease?
The liver is a big, strong organ that does hundreds of vital tasks for your body, and one of its most crucial jobs is to filter toxins out of your blood. Although your liver is well-suited for this task, it is also susceptible to the toxins it processes; too many toxins can overwhelm its capacity to do its job, either momentarily or over a somewhat prolonged duration.
When medical professionals talk about liver disease, they often mean long-term disorders that gradually destroy your liver. Toxic poisoning, viral infections, and several metabolic disorders are common causes of chronic liver disease. Despite having a tremendous capacity for regeneration, your liver is always under stress as it attempts to repair itself. It eventually loses its ability to keep up.
What are the stages of chronic liver disease?
There are about four phases in the progression of chronic liver disease:
- Hepatitis.
- Fibrosis.
- Cirrhosis.
- Liver failure.
Stage 1: Hepatitis
Hepatitis is indicated by inflammation of the liver tissues. Your liver’s reaction to toxins or damage is inflammation. It seeks to start the healing process and get rid of infections. Acute hepatitis, an immediate and temporary reaction, is often responsible for this. However, the inflammation also persists after the injury or poisoning occurs. Fibrosis, or scarring, is the end result of hyperactive healing brought on by chronic hepatitis.
Stage 2: Fibrosis
Fibrosis makes your liver gradually stiffen as thin bands of scar tissue build up over time. When there is scar tissue blocking blood flow through your liver, it has reduced access to oxygen and nutrients. This is how the vitality of your liver starts to steadily decline. Reversing some fibrosis is surprisingly possible. Scarring may lessen and your liver’s cells may regenerate if the damage is slowed down enough.
Stage 3: Cirrhosis
If you have cirrhosis, your liver will be badly and permanently scarred. The fibrosis cannot be reversed at this stage. Your liver can’t rebuild its tissues if there aren’t enough healthy cells left for it to use. It is still possible to delay or even stop the harm at this stage, though. You might not initially notice the decline in liver function brought on by cirrhosis since your body will attempt to compensate for it.
Stage 4: Liver failure
Liver failure occurs when your liver can no longer function well enough to meet your body’s needs. “Decompensated cirrhosis” is another name for this ailment because your body cannot compensate for the losses. You’ll start to see the affects all over your body when liver functions start to deteriorate. Without a liver transplant, chronic liver failure worsens gradually but finally leads in death. You need a liver to survive.
How common is liver disease?
Liver disease affects about 4.5 million adults in the United States, or 1.8% of the total population. It kills over 57,000 Americans annually. It accounts for 4% of all deaths worldwide, or almost 2 million deaths annually.
Acute liver failure accounts for a tiny percentage of deaths, with cirrhosis complications accounting for the majority. Men and those assigned male at birth (AMAB) are twice as likely to have liver disease as women and those assigned female at birth (AFAB).
Symptoms and Causes:
What are liver disease’s initial symptoms and indicators?
Chronic liver disease often has no symptoms in its early stages. Acute hepatitis episodes, however, can occasionally be the first sign. For instance, there is an acute phase before the chronic phase of a viral hepatitis infection. For a short while, you may have nausea, a stomachache, or a fever as your immune system fights the infection. It turns into a chronic infection if it is not eradicated.
Acute symptoms may also occasionally flare up or start with more severe symptoms in some other forms of liver disease. Liver disease symptoms are often ambiguous in the early stages. They could consist of:
- Upper abdominal pain.
- Nausea or loss of appetite.
- Fatigue and malaise (feeling tired).
What symptoms may one expect from advanced liver disease?
As your liver function starts to deteriorate, you may start to experience additional symptoms. Later stages of liver disease are when this occurs. Bile flow in your biliary system stalling is one of the initial symptoms of deteriorating liver function.
Bile is no longer efficiently produced by your liver or transported to your small intestine. Bile instead starts to seep into your blood. This results in particular symptoms, such as:
- Jaundice is a yellowing of the skin and eye whites.
- Dark-colored pee (urine).
- Light-colored poop (stool).
- Digestive difficulties, especially with fats.
- Weight loss and muscle loss.
- Musty-smelling breath.
- Mild brain impairment (hepatic encephalopathy).
- Pruritus is characterized by itching skin without a rash.
Your blood flow, hormones, and nutritional condition may all be impacted when liver disease worsens. This could show up in a variety of ways. Your skin and nails may exhibit the following symptoms and indicators:
- Spoon nails.
- Terry’s nails.
- Nail clubbing.
- Spider angiomas.
- Tiny red dots on your skin (petechiae).
- Little yellow pimples caused by fat accumulation on your eyelids or skin.
- Easy bleeding and bruising.
- Red palms of your hands.
When fluids accumulate in your body after leaking from your blood vessels, you may have symptoms such as:
- Swollen abdomen (ascites).
- Swollen ankles, feet, hands and face (edema).
When a person is assigned female at birth, indications of liver disease may include:
- Irregular periods (menstruation).
- Female infertility.
When a person is assigned male at birth, indications of liver disease may include:
- Shrunken testicles.
- Enlarged male breast tissue.
What are the complications of end-stage liver disease?
When your liver can no longer regenerate and is gradually deteriorating, it is referred to as end-stage liver disease. This includes decompensated cirrhosis and liver failure. Portal hypertension and primary liver cancer (hepatocellular carcinoma) are the two most important adverse outcomes of end-stage liver disease. In patients with cirrhosis and liver failure, complications from these two diseases are the main reasons for hospitalization and death.
Portal hypertension:
When the portal vein that passes through your liver is compressed by fibrosis, portal hypertension results. When the portal vein experiences high blood pressure, your body redirects blood flow to other veins that are related to it, causing them to expand and become thin. The veins may burst, leak, or bleed. These varices can cause abrupt, severe, and perhaps fatal internal bleeding.
Additional complications, though rare, include:
- Enlarged and overactive spleen (hypersplenism).
- Respiratory failure (hepatopulmonary syndrome).
- Kidney failure (hepatorenal syndrome).
Liver Cancer:
The majority of persons who develop liver cancer have chronic liver disease, even though not everyone with chronic liver disease develops primary liver cancer (hepatocellular carcinoma). Your liver cells are altered by the cycle of inflammation, repair, and scarring, which increases the likelihood that they may develop into cancer. Additionally, medical professionals think that certain chronic hepatitis viruses could disrupt the DNA in your liver cells.
What are the causes of liver disease?
Liver disease comes in more than 100 forms, however it can be divided into a few subcategories. Among the causes are:
Viral infections: Chronic viral hepatitis infections, such as hepatitis B and hepatitis C, can result in chronic hepatitis.
Alcohol-induced hepatitis: Acute or chronic hepatitis can result from heavy alcohol consumption. Liver failure and cirrhosis may result if it persists over an extended period of time.
Toxic hepatitis: Acute or chronic hepatitis can result from long-term overexposure to contaminants, such as industrial chemicals or medications.
Non-alcohol related fatty liver disease: Excess fat can be stored in the liver due to metabolic disorders linked to obesity, high blood sugar, and high blood lipids. This can lead to inflammation (non-alcohol related steatohepatitis).
Biliary stasis: Bile can accumulate and damage your liver due to congenital (existing at birth) diseases including biliary atresia and cystic fibrosis that block or slow the flow of bile via your bile ducts. Gallstones and biliary stricture are examples of non-congenital causes.
Autoimmune diseases: Primary biliary cholangitis, primary sclerosing cholangitis, and autoimmune hepatitis are among the autoimmune diseases that can result in persistent inflammation and scarring in the liver or bile ducts.
Inherited metabolic disorders: Chronic liver damage can result from conditions like hemochromatosis, Wilson disease, Gaucher disease, and glycogen storage disorder (GSD) that cause toxic compounds to accumulate in your blood.
Cardiovascular diseases: Chronic liver damage can result from conditions that impact the flow of blood to and from the liver, such as right-sided heart failure, ischemia, vascular disorders, and Budd-Chiari syndrome.
Which variables increase the chance of developing liver disease?
Liver disease may be more likely to strike you if you:
- Drink alcohol heavily.
- Use intravenous drugs.
- Use pain relievers like aspirin or acetaminophen
- Have metabolic syndrome.
- Are regularly exposed to toxic chemicals.
- Are frequently in contact with bodily fluids, such as blood.
Diagnosis and Tests:
How do you test for liver disease?
The first step in a medical professional’s liver disease screening is a physical examination. In addition to asking about your symptoms, they will search for obvious indicators. They might also inquire about your lifestyle, food, and medical background. Lastly, they will examine for liver disease using imaging scans and laboratory tests. These could consist of:
Blood tests: Signs of liver illness, the severity of liver disease, and liver failure can all be seen on a panel of liver function tests. These gauge your blood’s levels of bilirubin, proteins, and liver products such liver enzymes. Additionally, blood tests can reveal negative effects such decreased blood clotting, inflammation, or certain infections.
Imaging tests: It is possible to determine the size, shape, and texture of your liver with an abdominal ultrasound, CT scan, or MRI. This may show growths, fibrosis, and edema and inflammation.
Elastography: Elastography is a unique kind of imaging examination that measures the degree of fibrosis or stiffness in your liver using MRI or ultrasonic technology.
Endoscopy: A form of endoscopic imaging may be required if your healthcare practitioner needs to see into your biliary tract. During an endoscopy, a tiny camera called an endoscope is sent through your upper gastrointestinal tract. They can view your bile ducts using EUS or ERCP from the endoscope.
Nuclear medicine imaging: During a nuclear liver and spleen scan, a (harmless) radioactive tracer material is injected into your body and detected by a gamma camera. The parts that aren’t working properly will be highlighted by how your liver absorbs the tracer.
Liver biopsy: A liver biopsy is a simple technique that involves taking a tiny sample of liver tissue for laboratory testing. Usually, a hollow needle can be used by a medical professional to collect the sample. To check for malignancy or to confirm cirrhosis and help identify the cause, you may require a liver biopsy.
Management and Treatment:
How do you treat liver disease?
Certain liver illnesses require certain medicinal interventions. For example, antivirals cure viral hepatitis, while corticosteroids and immunosuppressants treat autoimmune disorders. The main treatment for liver disease, however, is frequently a change in lifestyle. For any kind of liver disease, but especially for those brought on by excessive fat storage, alcohol, or other pollutants, lowering the toxic load on your liver is crucial.
However, successful treatment of liver disease before irreversible harm is done depends on early detection. Regretfully, not everyone is able to identify liver illness in time to stop its progression. You may require further treatments for problems such as portal hypertension or liver cancer if you already have cirrhosis or liver failure. You may eventually require a liver transplant if your liver is unable to recover.
Prevention:
How can I reduce my chance of developing liver disease?
Liver disease can be avoided by:
Getting vaccinated: Viral hepatitis A and B can be avoided with vaccines.
Practicing good hygiene: careful food handling, careful needle usage, and handwashing after using the restroom can all help stop the spread of illnesses.
Using drugs as prescribed and consuming alcohol in moderation: Treatment for substance use disorders (SUDs) can help avoid toxic hepatitis.
Managing metabolic factors: like your blood sugar and blood lipids. A medical professional can assist with this.
Summary:
Any disorder that destroys your liver is referred to as liver disease. The liver is an essential organ that produces bile, stores energy, and filters blood, among other things. Damage to the liver impairs its ability to operate, which can result in a number of health issues.
FAQ:
Is it possible to treat liver disease?
Changes in lifestyle can help treat some liver issues. These can include decreasing weight or not drinking alcohol. These alterations frequently occur as part of a treatment regimen that involves monitoring liver function. Surgery or medication may be used to treat further liver issues.
How is the liver treated?
Your doctor could suggest lifestyle modifications including quitting alcohol, avoiding over-the-counter pain relievers like acetaminophen, cutting back on fatty foods, and losing weight. In certain cases, doctors may give medications to treat symptoms and enhance liver function.
Can liver disease be recovered from?
A liver transplant is frequently the sole option for treating a failing liver. However, the illness can occasionally be reversed by treating an acute or inherited cause. For example, medications might lessen liver damage when excessive use of the over-the-counter pain drug acetaminophen causes liver disease.
In seven days, how can I cleanse my liver?
Healthy Diet: Eat a diet high in nutrients that help cleanse the liver, such as fruits, vegetables, whole grains, lean meats, and healthy fats. Avoid processed foods and sugary snacks. Keep Yourself Hydrated: To boost liver function and aid in the body’s detoxification, drink lots of water throughout the day.
References:
- Liver Disease. (2024, December 27). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17179-liver-disease
- National Library of Medicine. (n.d.). Liver diseases. MedlinePlus. https://medlineplus.gov/liverdiseases.html
- Liver problems – Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502