Liver Disease

Liver Disease

Liver Disease

by Swedish Staff and Contributors

Symptoms of Liver Disease
Liver Disease Defined
What Causes Liver Disease
Diagnosis
Treatment
Risk Factors
Prevention

Symptoms of Liver Disease

Symptoms of liver disease can include:

  • Jaundice – yellowing of your skin and the whites of your eyes
  • Abdominal pain and swelling
  • Chronic itchy skin
  • Urine that’s dark in color
  • Stool color that’s pale or tar-colored, bloody
  • Chronic fatigue
  • Nausea
  • Lack of appetite

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Liver Disease Defined

Your liver is the largest organ in your body.  It’s located in the upper right part of your abdomen and is a vital organ that has many jobs. The liver filters harmful substances from your blood and changes food into energy by making proteins, regulating sugar in your blood, and storing vitamins and minerals. The liver also works with your stomach and intestines to help you digest food.

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What Causes Liver Disease

Acute Liver Disease

Acute liver disease (“hepatitis”) can be caused by many things.  Viruses such as hepatitis A, hepatitis B, and hepatitis C are the most common cause of acute liver disease.  Other causes include alcohol use, certain drugs, poisons, autoimmune disease, or rare metabolic disease.  Most patients will recover completely; however, some can develop chronic disease.

Chronic Liver Disease

There are many kinds of chronic liver diseases that progress over months to years, sometimes causing the liver to fail. Viruses cause some of them such as hepatitis B and hepatitis C. Chronic liver disease can also be the result of drugs, malnutrition, poisons, autoimmune disease, metabolic disease, or long-term alcohol consumption. You may also develop liver disease through an inherited disorder that causes your body to absorb and store too much iron called hemochromatosis. If your liver forms scar tissue because of an illness, it's called cirrhosis. Cancer can affect the liver. 

Acute Liver Failure

Acute liver failure, when the liver fails rapidly, can be caused by an overdose of acetaminophen (Tylenol); hepatitis A, hepatitis B; reactions to certain herbal and prescription medications; and eating poisonous wild mushrooms.

 

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Diagnosis

A physical exam is needed to diagnose liver disease. Your doctor will ask about your medical history and any symptoms you may be experiencing. The following tests or procedures may be done to diagnose liver problems:

  • Blood tests. Liver problems can be diagnosed using a group of blood tests called liver function tests. Other blood tests may be done to look for specific liver problems or inherited conditions that affect the liver.
  • Liver Biopsy. A liver biopsy, a procedure to remove tissue from your liver, may help in diagnosing liver problems. A biopsy is most often done using a needle inserted through your skin to extract a tissue sample (needle biopsy). The tissue sample is sent to a laboratory where it can be examined and studied under a microscope.
  • Imaging tests. Non-invasive procedures such as computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasound can be used to create pictures of your liver and detect problems.

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Treatment

Procedures to Monitor the Liver

Below are procedures that may be done to monitor the condition or function of your liver or related organs such as your gallbladder or bile ducts.

  • Liver biopsy. A procedure that’s done by inserting a needle through your skin to extract a tissue sample (needle biopsy). The sample is sent to a laboratory for testing to help determine how your liver is functioning. 
  • CT scan (computed tomography).  This is a procedure using X-ray technology to take multiple views of the inside of your body.
  • ERCP (endoscopic retrograde cholangiopancreatography). This procedure can reveal blockage or narrowing in the bile ducts. An endoscope (small, flexible tube) is inserted into your mouth and guided through your esophagus and stomach to the top of your small intestine, where the bile ducts meet the intestine. Dye is inserted through the scope to make the bile ducts show up on an X-ray. Tissue samples or fluid may be taken by inserting instruments into the scope. The samples are sent to a lab to be studied.
  • HIDA scan. This procedure checks the function of your gallbladder or liver using a radioactive fluid (marker) that’s put into your body. As the marker travels through your liver to the gallbladder and into the intestine, it can be seen on a scan. The marker can show whether bile ducts are missing or blocked, as well as other problems.
  • MRCP (magnetic resonance cholangiopancreatography). This is an imaging test that creates pictures of your bile ducts, pancreas and gallbladder. The test can reveal abnormal or narrowed bile ducts, or gallstones.
  • Sonogram. This test uses sound waves to create a picture of your liver and can reveal collections of bile leaking out of the liver and gallstones.

Blood Tests to Monitor the Liver

A small amount of blood may be taken and tested for one or more of the following:

  • Albumin is a protein made by the liver. When you have liver disease, the level of albumin in your blood (serum albumin) may be low.
  • Alpha fetoprotein (AFP) is a protein made by the liver. In an adult, a high level of AFP in the blood can be a sign of liver cancer.
  • Alkaline phosphatase (alk phos) is an enzyme produced in the liver and bone. A high level of alk phos may suggest a problem with the bile ducts in your liver.
  • Alanine aminotransferase (ALT) is an enzyme produced by the liver. When the liver is damaged, ALT leaks into the blood. A high level of ALT in your blood can be a sign of liver problems such as inflammation, scarring or a tumor.
  • Ammonia is a harmful substance left behind in your blood after digestion. Normally, the liver removes ammonia from your blood and turns it into urea, leaving your body with urine. If the ammonia level in your blood is too high, your liver isn’t functioning properly.
  • Aspartate aminotransferase (AST) is an enzyme made by the liver. High levels of AST suggest liver injury, especially if the ALT level is also high.
  • Bilirubin is a yellow substance made when your body breaks down red blood cells. It’s collected by the liver to be sent out of your body with a bowel movement. When something is wrong with your liver or bile ducts, bilirubin may build up in your body causing jaundice. Blood tests may be done to measure your total bilirubin and your direct bilirubin. A high total bilirubin level means your liver isn’t breaking down bilirubin. A high direct bilirubin level suggests a blockage in the bile ducts.
  • A complete blood count (CBC) is a test that measures your red blood cells, white blood cells and platelets in your blood. Problems with these counts can mean infection or illness. They can also be a sign of a problem with your spleen, an organ close to the liver that can be affected by liver disease.
  • Essential fatty acids (EFAs) are nutrients in the body. EFA levels may be lower when liver disease is present because your liver can’t absorb and transport EFAs as it’s supposed to.
  • Gamma-glutamyl transpeptidase (GGT) is an enzyme that’s often measured using a blood test along with other enzymes to gauge liver problems. If alk phos and GGT are both elevated, this is a sign that the bile ducts in your liver may be diseased or blocked.
  • Glucose, or the level of sugar in your blood, is maintained by your liver. If your glucose level is low, this may mean the liver is not working properly.
  • Prothrombin time (PT) tests the ability of your blood to clot. Your liver makes a protein that helps with clotting. Problems with clotting can be a sign of liver disease. Part of this blood test, the international normalized ratio (INR), measures vitamin A levels.
  • Serum bile acid (SBA) is the amount of bile acid in your blood. A high level may mean that bile ducts are blocked.
  • Vitamins A, D, E, and K are fat-soluble vitamins absorbed by your liver with help from bile. If a blood test shows that levels of these vitamins are low, this could mean your liver is not absorbing them properly.
  • Zinc is a nutrient that is absorbed by the liver. A low zinc level could mean your liver isn’t absorbing zinc properly.

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Risk Factors

Some liver diseases are potentially preventable and associated with lifestyle choices.

  • Alcohol-related liver disease is due to excessive consumption and is the most common cause of liver disease that’s preventable.
  • Hepatitis B and C are viral infections that are most often spread by exchanging bodily fluids through unprotected sex, sharing unsterilized needles and syringes for drug injection, and using unsterilized equipment for tattoos or body piercing.
  • Acetaminophen (Tylenol) overdose is a common cause of liver failure. It is important to review dosing guidelines with your doctor or pharmacist.
  • Some medications may irritate your blood vessels causing narrowing or formation blood clots (thrombosis). Birth control pills may cause hepatic vein thrombosis, especially in smokers.
  • Chemical exposure may damage your liver by irritating liver cells resulting in inflammation (hepatitis), reducing bile flow through the liver (cholestasis) and accumulation of triglycerides (steatosis). Chemicals such as anabolic steroids, vinyl chloride, and carbon tetrachloride can cause liver cancers.
  • Hereditary liver disease can be passed genetically from generation to generation. Examples include Wilson's disease (copper metabolism abnormalities) and hemochromatosis (iron overload).

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Prevention

The best way to prevent liver failure is to reduce your risk of developing cirrhosis or hepatitis. Here are some tips to help prevent those conditions:

  • Get a hepatitis vaccine or an immunoglobulin shot to prevent hepatitis A or B.
  • Eat healthy.
  • Drink alcohol in moderation and avoid alcohol when taking acetaminophen (Tylenol).
  • Practice good hygiene. Wash your hands thoroughly after you use the bathroom and before you touch any food.
  • Don't handle any blood or blood products.
  • Don't share personal toiletry items such as toothbrushes and razors.
  • If you get a tattoo or a body piercing, make sure the conditions are sanitary and all equipment has been sterilized properly.
  • When having sex, be sure to use protection (condoms).
  • If you use illegal intravenous drugs, don't share needles with others.

This content was created using EBSCO’s Health Library. Edits to original content made by Swedish.

Diagnosis and Treatment

For more information:

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