The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen, beneath the diaphragm and above your stomach, but a small portion extends into the upper left quadrant.
Causes of Liver Disease
Liver disease has many causes.
Parasites and viruses can infect the liver, causing inflammation. Subsequently, this can lead to a reduction or disruption of liver function. The viruses that cause liver damage can be spread by blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of viral liver disease are secondary to the various hepatitis viruses. These include:
Immune system abnormalities
Diseases in which the human immune system attacks certain parts of the body (autoimmune) can affect the liver adversely. Examples of autoimmune liver diseases include:
An abnormal gene can cause various substances to build up in the liver and subsequently result in liver damage. Genetic liver diseases include:
Cancer and other growths
Bile duct cancer
Additional, types of liver disease include:
Signs and symptoms of liver disease include:
Skin and eyes that appear yellowish (jaundice)
Abdominal pain and swelling
Swelling in the legs and ankles
Dark urine color
Pale stool color, or bloody or tar-colored stool
Nausea or vomiting
Loss of appetite
Tendency to bruise easily
Risk Factors for Liver Damage
Factors that may increase your risk of liver disease include:
Heavy alcohol use
Injecting drugs and using sharing needles
Tattoos or body piercings
Blood transfusions received before 1992
Exposure to other people's blood and body fluids
Exposure to certain chemicals or toxins
High levels of triglycerides in your blood
Complications of Liver Disease
Complications of liver disease vary depending on the etiology of the liver problem. Untreated liver disease may progress to liver failure which can be a life-threatening condition.
Your Office Visit
What should you expect during your consultation
Your doctor is likely to ask you a number of questions. You may be asked:
When did you first begin experiencing symptoms? How severe are they?
Have your symptoms been continuous or occasional?
What, if anything, seems to improve or worsen your symptoms?
Have you had a fever?
Have you ever had your skin or eyes turn yellow?
What medications and supplements do you take?
How many days of the week do you drink alcohol?
Do you have any tattoos?
Does your job involve exposure to chemicals, blood or body fluids?
Have you ever had a blood transfusion?
Have you been told that you have had liver problems before?
Has anyone in your family ever been diagnosed with liver disease?
Testing and Diagnosis
Treatments and Medications
Treatment for liver disease depends on your diagnosis. Some liver problems can be treated with lifestyle modifications, such as stopping alcohol use or losing weight. Weight loss is best completed as part of a medical program that includes careful monitoring of liver function. Other liver problems may be treated with medications or may require surgery.Treatment for liver disease that causes liver failure may ultimately require a liver transplant.
Prevention of Liver Disease
Abstinence of alcohol: For healthy adults up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger has been considered acceptable. Heavy or high-risk drinking is defined as more than three drinks on any day or more than seven drinks a week for women and for men older than age 65, and more than four drinks on any day or more than 14 drinks a week for men age 65 and younger.
Avoid risky behavior: Get help if you use illicit intravenous drugs, and don't share needles used to inject drugs. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.
Get vaccinated: If you're at increased risk of contracting hepatitis or if you've already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.
Use medications wisely: Take prescription and nonprescription drugs only when needed and only in recommended doses. Don't mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.
Avoid contact with other people's blood and body fluids: The Hepatitis viruses are spread by accidental needle sticks or improper cleanup of blood and body fluids.
Maintain a healthy weight: Obesity can cause nonalcoholic fatty liver disease.
Herbal Medications and Liver Disease
Some herbal supplements used as alternative treatments can harm your liver.
More than a thousand medications and herbal products have been associated with liver damage, including:
Jin bu huan
To protect your liver, it's important to talk to your doctor about the potential risks before you take any complementary or alternative medicines.
The liver weighs about 3 pounds and is the largest solid organ in the body. It performs many important functions, such as:
Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.
According to the National Institutes of Health, cirrhosis is the 12th leading cause of death by disease.
Although less likely, other causes of cirrhosis include reactions to prescription drugs, prolonged exposure to environmental toxins, or parasitic infections.
The symptoms of cirrhosis of the liver vary with the stage of the illness. In the beginning stages, there may not be any symptoms. As the disease worsens, symptoms may include:
Hepatitis A, B & C
The liver, the body's largest organ weighing about three pounds, is located on the right side of the abdomen, protected by the lower rib cage. It is responsible for over 5,000 life-sustaining functions, produces most of the building blocks used by the rest of the body and removes harmful chemicals. The liver produces bile that is transported to the small intestine to aid in the digestive process. The liver also produces proteins, hormones and enzymes that keep the body functioning normally, as well as materials that help in normal clotting of the blood, and to cleanse the body of substances that would otherwise be poisonous. It has a role in the processing of cholesterol, maintenance of blood sugars levels, and the processing of drugs.
When the liver becomes diseased, it may have many serious consequences. Viral infections are the most common diseases to affect the liver. When a virus damages a liver cell, the cell can no longer function. With fewer healthy cells to carry on their important work, many body functions can be affected.
Hepatitis means inflammation of the liver. There are many reasons for the liver to be inflamed, and not all of them are due to viruses. Certain toxic drugs and immune disorders may cause liver inflammation. The most common cause for liver inflammation is viral hepatitis. When liver inflammation is present for more than 6 months, the condition is referred to as chronic hepatitis. In the United States: There will be 500,000 new cases of viral hepatitis this year. More than 4.5 million Americans have chronic viral hepatitis. That is nearly 2 percent of the United States population. Chronic viral hepatitis, well tolerated in many, may result in premature death from cirrhosis or liver cell cancer and is a leading indication for liver transplantation.
Symptoms produced by viral hepatitis are varied and differ depending upon whether the hepatitis is acute or chronic. Many cases of acute hepatitis are so mild that there may be no symptoms or only non-specific "flu-like"symptoms for a few days or weeks. Symptoms of Viral Hepatitis Acute hepatitis refers to inflammation of the liver and symptoms which are more short-term and sporadic. Acute hepatitis is less likely than chronic hepatitis to result in permanent damage to liver function.
Acute Hepatitis Chronic Hepatitis Severe Fatigue Fatigue
Yellow Eyes Yellow Skin Joint Aches Skin Rashes
Dark Urine Loss of Memory Low Grade Fevers GI Upset
Note: many patients with either acute or chronic hepatitis have NO SYMPTOMS, and symptoms are not a reliable means of knowing if progressive liver damage is occurring.
There are currently seven viruses known which cause liver inflammation. They are called hepatitis A, B, C, D, E, F and G. Because of this terminology, they are commonly referred to as an "alphabet soup" of names.
Hepatocellular Carcinoma (HCC) - Liver Cancer
Hepatocellular carcinoma is a cancer that arises in the liver. It is also known as hepatoma or primary liver cancer.
HCC is the fifth most common cancer in the world. Recent data shows that HCC is becoming more common in the US. This rise is thought to be because of chronic hepatitis C, an infection that can cause HCC.
Abdominal pain is the most common symptom of HCC and usually is present when the tumor is very large or has spread. Unexplained weight loss or unexplained fevers are warning signs in patients with cirrhosis. Sudden appearance of abdominal swelling (ascites), yellow discoloration of the eyes and skin (jaundice), or muscle wasting suggests the possibility of HCC.
This may include injection of anti-cancer chemicals into the body through a vein or through chemoembolization.
The technique of chemoembolization is a procedure where chemotherapeutic drugs are given directly into the blood vessels that supply the tumor and small blood vessels are blocked so that the drug stays within the area of the tumor. Chemotherapy can provide some relief of symptoms and possibly decrease tumor size (in 50% of patients) but it is not curative.
Ablation (tissue destruction) therapy in the form of using radiofrequency waves, alcohol injection into the tumor or proton beam radiation to the tumor site are other options for treatment. There is no data to indicate that any one of these treatment is better than another.
Surgery is only available to patients with excellent liver function who have tumors less than 3-5 cm that are confined to the liver. If the patient is able to undergo surgery successfully, the five year survival is 30-40%. Many patients may have recurrence of HCC in another part of the liver.
Liver transplantation is a treatment option for patients with end-stage liver disease and small HCC. There is however a severe shortage of donors in the USA.