Your liver is the largest organ in your body. It is also one of the most important because it plays an essential role in turning food into energy, and removing poisons from the blood. But did you know that instances of some liver diseases are on the rise?
The Centers for Disease Control and Prevention (CDC) estimates that the number of deaths from end-stage liver disease in the United States is currently between 30,000 and 40,000 annually.
The most common cause of liver cirrhosis, chronic alcoholism accounts for approximately 40% of the 26,000 people who die from the disease. Cirrhosis is characterized by the replacement of healthy tissue with fibrous tissue, regenerative nodules, and liver scarring.
The resulting hardening of the liver interferes with blood circulation, eventually leading to irreversible liver damage and a complete loss of liver function.
Here’s a list of common liver diseases and problems includes:
- Acetaminophen toxicity
- Alcoholic liver disease
- Fatty liver disease (NAFLD)
- Hepatitis (viral, autoimmune, iron overload)
- Primary sclerosing cholangitis (PSC)
1. Acetaminophen Toxicity
The Journal of the American Medical Association (JAMA) reports that when given the maximum approved daily dosage of acetaminophen – a substance present in a range of common over the counter medications, test subjects developed early signs of possible liver damage.
Signs and Symptoms of Acetaminophen Toxicity
- Itchy skin
- Yellowing of your skin or the whites of your eyes
- Dark urine
- Upper right-sided abdominal tenderness
- Nausea and vomiting
- Unexplained flu-like symptoms
- Confusion or disorientation
Read the in-depth guide to Acetaminophen Toxicity and Liver Damage.
2. Alcoholic Liver Disease
In 2015, cirrhosis was one of the leading causes of death in the United States. Alcoholic liver disease usually develops after years of excessive alcohol intake.
The longer the period during which alcohol is excessively consumed and the greater the amount ingested, the higher the likelihood of developing alcoholic liver disease.
Signs and Symptoms of Alcoholic Liver Disease
Symptoms are usually worse after an episode of heavy drinking (acute alcoholic hepatitis), and tend to vary with the severity and progression of the disease.
Sometimes symptoms do not present themselves until the disease is relatively advanced.
- Abdominal pain and tenderness
- Ascites (fluid in the abdomen)
- Dry mouth / excessive thirst
- Loss of appetite
- Weight gain
- Altered level of consciousness
- Bloody or dark, black, or tar-like bowel movements
- Breast development in males
- Difficulty concentrating
- Fluctuating moods
- Impaired judgment
- Impaired short- or long-term memory
- Redness on feet or hands (palms and soles)
- Slow, sluggish, lethargic movement
- Vomiting blood or coffee ground material
Check out the in-depth guide to Alcoholic Liver Disease.
3. Primary Liver Cancer
Primary liver cancer is a growing problem, and generally remains undetected until it has reached the advanced stages because most people do not exhibit symptoms early on.
By protecting yourself from cirrhosis and chronic hepatitis – the two leading causes of the disease – you can greatly reduce your risk of developing liver cancer.
People with cirrhosis should undergo regular screening for liver cancer with ultrasounds and blood testing.
Signs and Symptoms of Primary Liver Cancer
- A yellow discoloration of the skin and whites of the eyes (jaundice)
- Abdominal pain, especially in the upper right part of the abdomen
- Abdominal swelling (ascites)
- An enlarged liver
- General weakness and fatigue
- Loss of appetite
- Nausea and vomiting
- Weight loss
- Fevers or night sweats
Learn more in this in-depth Primary Liver Cancer Guide.
4. Non-Alcoholic Fatty Liver Disease – NAFLD
Fatty liver disease (or steatosis) can be a progressive condition, but not always.
The exact cause of NAFLD is unclear. Many researchers, however, believe that metabolic syndrome — a cluster of disorders including diabetes, hypertension, hyperlipidemia, obesity, heart disease, and stroke — plays a crucial role in the development of NAFLD.
NAFLD Levels of Severity
- Simple fatty liver (steatosis) – There are no symptoms, fat is present in the liver, but no inflammation
- NASH (Non-alcoholic steatohepatitis) – Inflammation begins to appear and eventually, scar tissue forms as more cell injury occurs.
- Cirrhosis – Liver scarring results in a hard liver that is unable to function properly and this can be fatal.
Signs and Symptoms of Fatty Liver Disease
You may have NAFLD without any signs or symptoms. If there are symptoms, they are normally vague and non-specific. In the early stages, you may experience fatigue, malaise, or a dull ache in your upper right abdomen.
At a more advanced stage of NAFLD, you may experience:
- Bleeding from engorged veins in your esophagus or intestines
- Fluid in your abdominal cavity (ascites)
- Itching of your hands and feet, and eventually your entire body
- Lack of appetite
- Loss of interest in sex
- Mental confusion, such as forgetfulness or trouble concentrating
- Small, red spider veins under your skin, or easy bruising
- Swelling of your legs and feet from retained fluid
- Weight loss or weight gain
- Yellowing of your skin and eyes and dark, cola-colored urine
Read more about NAFLD and Treatment.
5. Viral Hepatitis
Hepatitis means inflammation of the liver. Hepatitis is not one, but many diseases – viral Hepatitis A through E are a result of viral infections which cause inflammation and damage to the liver.
Chronic hepatitis B infection increases a person’s chance of developing liver cancer by one hundred times. Chronic hepatitis C can also lead to scar tissue and chronic liver damage resulting in cirrhosis.
Typically, hepatitis A and E are acute infections.
Signs and Symptoms of Hepatitis
The symptoms of various hepatitis forms are similar, the most noticeable being jaundice. As the viral infection spreads throughout the liver, the organ becomes enlarged, often causing abdominal pain.
- Abdominal pain
- Dark urine
- Enlarged liver
- Joint aches
- Loss of appetite
- Mild fever
Learn more about the Different Types of Hepatitis.
6. Primary Sclerosing Cholangitis (PSC)
Cholangitis is inflammation of the bile ducts (drainage tubes) of the liver. Sclerosis is inflammation that leads to the extensive formation of fibrosis or scar tissue.
In primary sclerosing cholangitis (PSC), the bile ducts inside and outside the liver have become inflamed and scarred.
Signs and Symptoms of PSC
Because PSC progresses slowly, the disease can be present for many years before symptoms appear. The predominant symptoms are:
- Bile duct infection (can cause chills and fever)
- Intense itching
- Malabsorption (especially of fat) leading to decreased levels of the fat-soluble vitamins, A, D, E, and K.
- Severe jaundice (causing yellowing of the eyes and/or skin)
- Signs of cirrhosis
- Steatorrhea (a build-up of fat in stool, and loose, greasy, foul bowel movements)
Read more in this in-depth Guide to Primary Sclerosing Cholangitis.
Liver Disease Screening and Diagnosis
- Blood tests to measure liver function tests, blood counts, renal function, and coagulation (clotting) factors
- Computerized tomography (CT) scans take cross-sectional X-ray images of your internal organs and can look for abnormal morphology of the liver that suggests cirrhosis
- Magnetic resonance imaging (MRI) scans use magnetization and radio waves to produce images of the internal organs and can also look at liver morphology
- Ultrasound (ultrasonography) is a non-invasive test using high-frequency sound wave technology to create an image of your liver
- Liver biopsy can evaluate for fibrosis or scar tissue in the liver and it can also assess the degree of inflammation; in some cases, a cause of cirrhosis may be identifiable on a liver biopsy
Treatment of End Stage Liver Disease:
A liver transplant surgery provides the only chance of survival for someone whose liver has been destroyed by injury or illness. Transplant surgery provides the organ recipient with a healthy liver so that the body can return to relatively normal functioning.
While transplant rejection and the life-long need for immunosuppressive drugs are serious considerations, liver transplant prognosis is very good. Nationally, the overall patient survival rate one year post-surgery is over 86% and almost 78% after three years.
Prior to needing a transplant, complications of cirrhosis can be managed with medications. Fluid pills, or diuretics, can be used to help manage fluid buildup in the abdomen (ascites) and legs. If confusion / disorientation, or hepatic encephalopathy develops, medications can be used to help manage this.
Endoscopy is also needed to screen for esophageal and gastric varices (enlarged veins in the esophagus and stomach). If these are present, medications may be started to help reduce the risk of bleeding, or variceal band ligation can be performed during the endoscopy to help destroy/scar down the veins.
Cancer screening with ultrasound and blood testing is also important due to the higher risk of developing liver cancer.