Liver Disease

What is Liver Disease?

Liver disease is any disorder of the liver that impairs its normal function and can range from minor infection or scarring to serious conditions such as liver cancer. More than 100 types of liver disease have been identified.

The liver is one of the largest organs of the human body and is situated in the upper right portion of your abdomen. It performs some of the body’s vital functions including:

  • Production of bile juice
  • Storing sugars in the form of glycogen
  • Purifying blood from harmful substances
  • Making proteins that help in blood clotting

Risk Factors

The common risk factors that can cause liver disease include:

  • Diabetes
  • Obesity
  • Autoimmune diseases
  • Excessive alcohol consumption
  • Exposure to chemicals or toxins
  • Exposure to infected blood (hepatitis infected person) by the sharing of contaminated needles, razors or blood transfusions
  • Genetic diseases such as Wilson’s disease, Hemochromatosis, and Alpha-1 antitrypsin deficiency

Common Liver Diseases

Some of the common liver diseases include:

Jaundice

Jaundice is a condition that occurs when bilirubin, a yellow pigment produced by the breakdown of red blood cells in the liver, accumulates in the liver. It is characterized by yellowing of the skin and the white regions of the eyes and is caused by a viral infection, blocked bile ducts, liver diseases or certain medications.

Hepatitis

Hepatitis is an inflammation of the liver tissue. Exposure to alcohol, toxins or drugs over a long period of time may result in hepatitis. It may also occur due to an autoimmune response in which antibodies (proteins) produced by your immune system damage your liver tissue, but most often, it is caused by a viral infection.

Autoimmune Liver Disease

The immune system protects the body by attacking and destroying foreign and harmful substances. However, in autoimmune liver diseases, the body’s immune system attacks its own liver (liver cells and bile duct cells), causing inflammation and liver damage. For example, autoimmune hepatitis.
Untreated autoimmune liver disease can progress into cirrhosis, liver failure, and cancer.

Fatty Liver Disease

Fatty liver disease is a condition caused by excess fat buildup in the liver cells. It is most common in middle-aged people. Fatty liver disease is also called hepatic steatosis. Fatty liver is of two types:

  • Non-alcoholic Fatty Liver: Buildup of fat in the liver is not associated with the consumption of alcohol.
  • Alcoholic Fatty Liver: Buildup of fat in the liver is associated with excess alcohol consumption.

Simple fatty liver is an early stage of fatty liver disease and often not serious. Nonalcoholic Steatohepatitis (NASH) is an advanced stage that causes inflammation of the liver and damage to liver cells causing liver cirrhosis, liver cancer, ascites, and ultimately, liver failure.

Liver Cirrhosis

Cirrhosis is severe scarring of the liver and poor liver function due to excessive exposure to alcohol or due to a viral infection. According to the National Institute of Health (NIH), people who regularly consume alcohol for more than 10 years can develop cirrhosis. Excess scar tissue is formed when your liver is exposed to the damaging factors for a long period of time, making it difficult to repair itself. A cirrhotic liver appears hard and shrunken.

Wilson’s Disease

Wilson’s disease is a rare genetic disorder that causes copper poisoning in your body.
Copper is an essential micronutrient present in your food and is required for healthy nerves and bones. Normally, the liver eliminates excess copper in bile juice, but, in people with Wilson’s disease, copper elimination is impaired causing its accumulation in the liver, brain, and eyes.
Untreated Wilson’s disease causes secondary complications such as kidney disorders, neurological problems, liver cirrhosis, and liver failure.

Alpha-1 Antitrypsin Deficiency (A1AD)

A1AD is a genetic disorder that causes lung disease due to insufficient production of the enzyme Alpha-1 antitrypsin (AAT). Normally, AAT is produced by your liver and protects your lungs from infections and harmful chemicals. People with A1AD can develop diseases such as asthma, wheezing and Chronic obstructive pulmonary disease (COPD).

Hemochromatosis

Hemochromatosis or ‘Iron-overload’ is a genetic disorder that causes more than normal iron absorption by your body. Excess iron is stored in the pancreas, heart, and liver. Untreated hemochromatosis may cause liver cirrhosis, arthritis or certain heart diseases.

Liver Cancer

Cancer is the uncontrolled division of abnormal cells. Liver cancer may begin as a mass of abnormal cells called a tumor. Benign tumors remain localized and do not spread to neighboring tissues. Malignant tumors begin to spread into nearby tissues, lymph nodes or organs, disrupting their function. Most liver cancers are malignant and may lead to liver failure.

Liver Failure

Liver failure occurs when a significant portion of your liver is non-functional and cannot be repaired. Various untreated liver diseases may lead to liver failure and cause secondary complications such as cerebral edema, problems related to blood clotting and kidney failure. Most often, a liver transplant is the only option and is usually successful.

Symptoms

The symptoms vary depending on the type of liver disease. Common symptoms include:

  • Yellow skin and eyes
  • Dark urine
  • Abdominal pain
  • Nausea and vomiting
  • Loss of appetite
  • Swelling of abdomen and legs
  • Fatigue
  • Itchy skin
  • Blood clotting problems

Diagnosis

Your doctor will assess your symptoms and may order:

  • Liver function tests
  • Certain blood tests
  • Imaging tests such as X-ray, MRI or CT-Scan
  • Liver Biopsy

Treatment

Treatment depends on the underlying cause. The treatment may include:

  • Quitting alcohol consumption
  • Diet modification usually involves a decrease in salt intake
  • Weight loss program (obese people)
  • Medications to treat viral infection and other symptoms
  • Medications to control autoimmunity
  • Management of diabetes
  • Liver transplant in severe cases

Prevention

Liver disease can be prevented by:

  • Vaccination
  • Controlling diabetes
  • Eating healthy
  • Drinking alcohol in moderation
  • Maintaining a healthy weight
  • Avoiding contact with an infected person
  • Preventing exposure to toxic chemicals
  • Royal College of Surgeons of Edinburgh
  • International Liver Transplantation Society
  • International Hepato-Pancreato Biliary Association
  • Mediclinic City Hospital
  • American College of Surgeons