Liver disease is any illness of the liver which disturbs its function. It can refer to a broad spectrum of potential problems, including alcohol related illness. The liver has numerous functions for the body including producing bile for food digestion, storing glucose, fighting infection, processing iron, manufacturing cholesterol and converting waste products.
Cirrhosis is a term used to describe the permanant scarring of the liver, where normal cells are replaced by scar tissue that cannot serve a purpose. In some cases, acute liver damage may be reversible meaning that normal function can, on occasion, be restored.
There are a number of things which can happen to damage the liver, including the inflammation of the cells, the obstruction of bile flow, the accumulation of fat, the restriction of blood flow and damage which can occur to the liver tissue from certain chemicals.
Alcohol-related liver disease (or ARLD) occurs when the liver gets damaged through extended periods of alcohol abuse. Although symptoms may take some time to appear, when they do these can include nausea, weight loss, loss of appetite, a yellowing of the skin and the whites of the eyes and swelling around the stomach and ankles.
Each time the liver is forced to filter alcohol, some of the cells die. Although new cells can develop, prolonged alcohol misuse can often reduce the ability of the liver to regenerate itself, resulting in serious and permanent damage to the organ.
In binge drinkers, alcohol usually causes the liver to become fatty resulting in ARLD. In people who drink excessively over time, more serious types of ARLD such as hepatitis and cirrhosis can occur as the function of the liver begins to worsen and the organ starts to fail.
Through the exposure of the liver to certain medication or drugs, healthy cells can become temporarily inflamed or permanently damaged. This can vary widely between different drugs, with some only causing damage in large doses while others can cause gradual harm even when the correct dose is taken.
Medication prescribed to control high cholesterol can often cause the cells of the liver to become inflamed, a condition which is detected through blood tests designed to measure liver enzymes. Other types of medication linked to inflammation in the liver can include antibiotics (such as nitrofurantoin) and Methotrexate - the drug used to treat patients with autoimmune disorders. With most conditions, the problem will resolve itself when the medication is stopped.
A variety of viruses such as hepatitis can also lead to the liver becoming inflamed. Hepatitis A tends to cause acute inflammation which usually resolves itself over time. Hepatitis B and C can cause chronic hepatitis, with hepatitis C sometimes leading to cirrhosis or cancer of the liver in severe cases.
Although symptoms may vary depending on the type and cause of the liver disease, some common ones to watch out for include:
Jaundice (a yellowing of the skin caused by excess bilirubin in the bloodstream)
A feeling of fatigue and weakness
More specific symptoms can include:
Right upper abdonimal pain and vomiting after eating fatty foods (gallstones)
Easy bruising, impotence, itching, confusion, lethargy and muscle wasting (cirrhosis)
In order to diagnose liver disease, a physical examination will be carried out along with a study of the patient’s health history. Symptoms will be studied and risk factors will also be taken into account, and blood tests and imaging studies may also be used.
A liver biopsy may be needed to confirm the diagnosis. This involves a thin needle being passed through the chest wall and into the liver in order to take a small tissue sample for examination under a microscope.
Treatment options for liver disease can vary widely depending on the type of liver disease you have. Hepatitis A requires supportive care to maintain hydration while the body fights the infection, while gallstones may call for the gallbladder to be removed. In patients with severe liver disease or cirrhosis, medication may be needed to control the levels of protein the body absorbs. If the liver has failed completely, a liver transplant may be needed.